Understanding Anxiety Through an Emotion-Focused Therapy Lens

“In therapy, the goal is not simply to help clients worry less. It is to help them understand what their anxiety may be protecting, signalling, or communicating.”

Anxiety is one of the most common reasons people seek therapy. Yet despite access to evidence-based treatments, many people continue to struggle with chronic worry, self-criticism, emotional overwhelm, and a persistent sense of unease.

Emotion-Focused Therapy (EFT) offers a different perspective on anxiety. Rather than viewing anxiety solely as a problem to be managed or reduced, EFT seeks to understand the emotional processes that contribute to anxiety and help clients transform the underlying emotional experiences that maintain it.

Looking Beyond Symptoms

Traditional approaches to anxiety often focus on reducing symptoms such as excessive worry, avoidance, or physiological arousal. While these interventions can be effective, EFT asks a further question: What emotions might anxiety be protecting us from?

From an EFT perspective, anxiety is often not the core problem itself. Instead, it can emerge as a response to unresolved emotional pain, unmet emotional needs, difficult life experiences, or problematic ways of relating to ourselves.

Research examining Generalised Anxiety Disorder (GAD) through an EFT framework found that clients frequently presented with patterns including worry, self-criticism, emotional avoidance, shame, loneliness, fear, and unmet needs for care, protection, acknowledgement, and connection. These experiences often existed beneath the surface of anxiety symptoms. (O’Brien et al., 2017)

Anxiety as a Signal

EFT views emotions as fundamentally adaptive. Emotions provide information about our needs, relationships, values, and experiences. When emotional experiences become blocked, avoided, or overwhelmed by secondary reactions, difficulties can arise.

For many people experiencing anxiety, worry can function as a way of staying occupied with thoughts while avoiding deeper emotional experiences such as sadness, shame, grief, fear, or vulnerability. Although this strategy may provide temporary relief, it can also prevent meaningful emotional processing and long-term change.

In therapy, the goal is not simply to help clients worry less. It is to help them understand what their anxiety may be protecting, signalling, or communicating.

What Does the Research Say?

Over the past decade, researchers have been investigating EFT as a treatment for anxiety disorders, particularly Generalised Anxiety Disorder (GAD) and Social Anxiety Disorder (SAD).

A 2017 exploratory study examining EFT for GAD found promising outcomes, suggesting that EFT may be an effective approach for helping clients experiencing chronic anxiety. The study highlighted the potential value of working directly with emotional processes rather than focusing solely on symptom reduction. (Timulak et al., 2017)

Building on this work, a 2022 feasibility randomised controlled trial compared EFT and Cognitive Behavioural Therapy (CBT) for the treatment of GAD. Researchers found that EFT was a viable treatment option, producing encouraging results and supporting the case for further large-scale investigation of EFT for anxiety disorders. (Timulak et al., 2022).

Robert Elliott and Colleagues have adapted EFT for the treatment of social anxiety and SAD (Elliot, 2013; Elliot & Shahar, 2017; Shahar, 2020) A 2017 study published by Shahar, Bar-Kalifa, & Alon found that EFT significantly reduced the symptoms of social anxiety and self-criticism for 11 participants seeking treatment for SAD.

While research in this area continues to develop, these findings add to a growing body of evidence supporting emotion-focused approaches for anxiety treatment.

Emotional Change Creates Lasting Change

A central principle of EFT is that emotions are best transformed through new emotional experiences.

Rather than helping clients simply think differently about their anxiety, EFT helps clients access, understand, process, and transform the emotional experiences that contribute to their distress. This may involve working with fear, shame, loneliness, grief, unmet attachment needs, or longstanding patterns of self-criticism.

As clients develop a deeper understanding of their emotional world, anxiety often begins to make more sense. Rather than being viewed as an enemy to defeat, it becomes a pathway toward understanding underlying emotional needs and experiences.

A Different Way of Understanding Anxiety

Anxiety can feel overwhelming, confusing, and exhausting. Yet from an EFT perspective, anxiety is not simply something to eliminate.

It may be a signal that important emotions are seeking attention, understanding, and processing.

By helping clients safely engage with these emotional experiences, EFT offers a pathway toward greater self-understanding, emotional resilience, and lasting change.

The Application

Understanding anxiety through an EFT lens can help therapists move beyond symptom management and work more effectively with the emotional processes that maintain distress.

For therapists interested in expanding their skills in this area, AIEFT’s upcoming EFT in Action: Working with Anxiety workshop with Barry Strmelj will explore how anxiety develops, what it may be signalling, and practical EFT interventions for working with anxiety in the therapy room.

Learn more and register here.

___________________________________________________________________________________________________________

References

Elliot, R. (2013). Person-centered/experiential psychotherapy for anxiety difficulties: Theory, research and practice. Person-Centered & Experiential Psychotherapies, 12 (1) 16-32.

Elliott, R. & Shahar, B. (2017) Emotion-focused therapy for social anxiety (EFT-SA). Person-Centered and Experiential Psychotherapies, advance online publication.

O’Brien, K., O’Keeffe, N., Cullen, H., Durcan, A., Timulak, L., & McElvaney, J. (2017). Emotion-focused perspective on generalized anxiety disorder: A qualitative analysis of clients’ in-session presentations. Psychotherapy Research, 29(4), 524–540.

Shahar, B. (2020). New Developments in Emotion-Focused Therapies for Social Anxiety Disorder. Journal of Clinical Medicine, 9, 2918.

Shahar, B., Bar-Kalifa, E., & Alon, E. (2017). Emotion Focused Therapy for Social Anxiety Disorder: Results from a Multiple-Baseline Study. Journal of Consulting and Clinical Psychology, 85(3), 238-249.

Timulak, L., McElvaney, J., Keogh, D., Martin, E., Clare, P., Chepukova, E., & Greenberg, L. S. (2017). Emotion-focused therapy for generalized anxiety disorder: An exploratory study. Psychotherapy, 54(4), 361–366.

Timulak, L., Keogh, D., Chigwedere, C., Wilson, C., Ward, F., Hevey, D., et al. (2022). A comparison of emotion-focused therapy and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: Results of a feasibility randomized controlled trial. Psychotherapy, 59(1), 84–95.