How I Use EFT for Panic Attacks and Agoraphobia
Panic attacks can be frightening partly because of how quickly they can escalate. We notice our heart beating faster, feel dizzy or short of breath, or experience some other unfamiliar sensation, and our mind may immediately start wondering what’s happening. “What if I faint?”, “What if I lose control?”, “What if I can’t get out of here”? The fear of those sensations can then become part of what makes the experience even more overwhelming.
With agoraphobia, this fear can gradually become associated with particular situations. Driving through a long stretch of road, waiting at a red light, standing in line at a store, being somewhere far from home, or entering a place that feels difficult to leave can begin to trigger anxiety before anything has actually happened. Eventually, even imagining one of these situations may be enough to bring up fear.
When I use EFT with someone experiencing panic attacks or agoraphobia, I usually think in terms of gradually working with the different pieces that make up the problem. We don’t have to tackle everything at once, and we don’t necessarily need to begin with the most frightening experience. Instead, we can find a manageable place to start and follow the emotional charge from there.
Starting With Any Apprehension About the Process
Before working directly on the panic or agoraphobia, I like to pay attention to how the person feels about working on the issue in the first place.
Sometimes there’s fear that talking about a panic attack will trigger another one. Someone may worry that focusing on bodily sensations will make them worse, or that opening up certain memories will become overwhelming. There may also be understandable skepticism, particularly after trying many other things:
“I’ve struggled with this for so long that I don’t believe anything can help me”.
That apprehension can have the microphone first.
We might tap on:
“Part of me is afraid that focusing on this is gonna make it worse. I don’t know what will happen if I really go there, and this is just where I’m at right now”.
Or:
“I’ve tried so many things already, and part of me doesn’t believe this will be any different. I’m just tired of getting my hopes up. And this is where I’m at right now”.
We don’t necessarily need to wait until that concern has completely disappeared before moving forward. Even acknowledging it can be helpful. If part of us is saying, “I don’t want to do this”, I’d rather include that part in the process than ask it to sit quietly in the corner while we work on what we’ve decided is the real problem.
Giving Everyone a Chance to Speak
One analogy I sometimes use for this is a Town Hall Meeting.
Imagine that all the different thoughts, feelings, and parts of us are attending a town hall meeting. Some are scared. Some are angry. One might desperately want the panic to disappear. Another might be terrified that it never will. There may even be a part judging all the others for having this problem in the first place.
When certain voices repeatedly go without being acknowledged, they don’t usually disappear. They may keep trying to get our attention, sometimes even more loudly.
EFT gives us a way of letting these different reactions take turns at the microphone. We don’t have to agree with everything they say. We can simply allow them to express what is already there while we tap.
For someone struggling with agoraphobia, one of those voices might say:
“I feel like such a loser for having this problem. Other people can go anywhere they want without thinking about it, and I have to plan my whole life around whether I might panic”.
That self-judgment is worth giving the microphone to as well. Sometimes there are feelings about the problem layered on top of the original fear, including shame, frustration, anger, hopelessness, or embarrassment. If left unaddressed, they can make the original fear harder to shift. Instead, giving those reactions some tapping attention may make it easier to approach the fear itself with less internal pressure.
Making It More Bite-Sized With Specific Events
“Panic attacks” and “agoraphobia” are very broad targets. When possible, I prefer to make the tapping more focused by choosing a particular moment in time.
A recent experience can be a good place to start. Perhaps someone had a panic attack while waiting at a red light three days ago. Instead of trying to work on their entire fear of driving, we can go back to that particular moment:
“When I think about sitting at that red light on Tuesday and noticing that I couldn’t go anywhere, I can feel that fear coming up again. I remember thinking, ‘What if I panic and I can’t get out of here’? And this is where I’m at right now”.
We can also work with a specific future situation. If the person knows they’ll need to drive along the same road tomorrow, we might have them imagine approaching that particular traffic light and notice what happens:
“When I imagine driving toward that intersection tomorrow and seeing the light turn red, I feel scared that it’s going to happen again. Part of me already wants to avoid going that way, and this is where I’m at right now”.
Working this way gives us a smaller piece of the larger problem. It can also reveal other aspects that we hadn’t anticipated. Perhaps the fear of being stuck at the light decreases, but now the person notices that they’re worried about the drivers behind them seeing them panic. Or they suddenly realize that the strongest feeling is shame about needing someone else in the car with them.
Now we have another aspect that can have the microphone.
Keeping the Cup of Tea at a Manageable Temperature
Of course, even thinking about one specific experience may sometimes feel like too much.
Another analogy I use frequently is that doing EFT is like drinking a Cup of Tea. We want enough emotional activation so that the tapping can help us process and release the emotional charge (in other words, we want the cup of tea to be warm enough), while being careful about letting the tea become boiling hot.
If remembering stopping at the red light immediately brings up a huge wave of fear, we can gently zoom out from any triggering details:
“Just thinking about it, I feel really scared, and this is where I’m at right now”.
We don’t need to replay every detail of the experience. We can stay at that greater distance while tapping and see what happens.
If the emotional intensity suddenly becomes overwhelming, we can create even more protective distance. We might simply tap silently through the points for a while. We can also look around the room and place some of our attention on something that feels pleasant or neutral enough: a plant, a picture on the wall, the view through the window, or the feeling of our feet against the floor.
Once things feel more manageable, we can decide whether we want to gently bring some attention back to what we were working on.
What About EFT During a Panic Attack?
This same back-and-forth can be useful as a resource between sessions if a panic attack occurs.
During a strong wave of panic, I wouldn’t recommend trying to analyze where the fear came from or deliberately increase the intensity. There is already plenty happening as it is. We can simply tap and orient some of our attention toward anything that feels neutral or pleasant about the present environment.
For example, we might notice the chair underneath us, look around and name a few things we can see, or focus on something that feels neutral, pleasant or even boring enough while continuing to tap (anything that can help us feel a bit safer in the present moment).
As the intensity becomes more manageable, we may be able to give the current experience a little more of the microphone:
“My heart is pounding”.
“I’m scared I’m going to faint”.
“I really want to get out of here”.
“I’m afraid this is going to get worse”.
We can tap with whatever is already there without trying to make it go away as quickly as possible or change it into something positive.
If another big wave arrives, we can widen our attention again and return to silent tapping or tap through the points while orienting to our surroundings, or while thinking about anything or anyone that feels like a positive, calming resource to us. If things settle somewhat, we can gently notice the sensations and thoughts again.
In other words, we can move back and forth depending on how hot the “cup of tea” is at that particular moment.
There is also an important longer-term consideration here. With panic and agoraphobia, we don’t want tapping to gradually become something we believe we must do in order to survive a feared situation. Part of longer-term work with panic often involves becoming less afraid of the sensations themselves (by gradually expanding our “window of tolerance”) and gradually becoming more able to experience situations we’ve been avoiding. For that reason, I think of tapping during a panic attack as one possible resource within a larger process rather than something that always needs to make the sensations disappear.
Gradually Approaching the Situations We’ve Been Avoiding
With agoraphobia, another important part of the work involves gradually approaching situations that we’ve started avoiding because of the fear of panicking.
With EFT, we can initially do some of this work through imagined or mental exposure. Rather than immediately putting ourselves in a situation that feels overwhelming, we can imagine a specific future situation while tapping and notice what comes up.
For example, if someone has become afraid of driving on long stretches of road, we might begin by having them imagine an upcoming drive. We can make the scene specific: picture getting into the car, pulling away from home, approaching the particular stretch of road that feels frightening, and notice at what point the emotional intensity starts to increase. You don’t need to go straight to the worst part.
Perhaps the emotional intensity appears when they imagine reaching a section where there isn’t an easy place to pull over:
“When I imagine reaching that part of the road and realizing there’s nowhere to pull over, I feel trapped. I’m afraid I’ll start panicking and won’t be able to get out, and this is where I’m at right now”.
We can tap on that particular moment and see what happens. As the emotional charge changes, we might continue a little further into the imagined journey. Maybe another aspect appears: “What if I get dizzy?”, “What if I lose control of the car?”, “What if I’m too far from home?”. Each one gives us another piece to work with.
The same approach can be used with other situations someone has been avoiding. We might imagine standing in line at a store, sitting at a red light, taking public transportation, walking through an open space, or being somewhere without a familiar person nearby. Rather than trying to mentally rehearse the entire experience at once, we can slow it down and notice which particular moments carry the most emotional charge.
Over time, we can gradually build toward real-life exposure, approaching some of these situations outside of the tapping session in manageable steps. The exact progression will depend on the person and the situation. Someone who has been avoiding a particular store, for example, might eventually practice going there for a short period before gradually staying longer or going farther inside.
EFT can also help us explore whatever comes up around taking those steps. Someone might feel relatively calm imagining the store during a session but become much more anxious when thinking, “Tomorrow I’m actually going to do it”. That apprehension can have the microphone too.
One thing I would be careful about is making the goal of each real-life experience, “I have to tap until I don’t feel anxious”. Part of recovering from panic and agoraphobia can involve gradually discovering that we can experience some anxiety and bodily sensations without needing to escape from them. Tapping can accompany that process, while we also give ourselves opportunities to learn from what actually happens when we stay with a manageable amount of discomfort.
And afterwards, we have another specific event to work with. We can look back at the experience and ask: Which moment was hardest? What did I predict would happen? What actually happened? Is there any part of the experience that still carries emotional charge?
In that way, the work can move back and forth between imagined situations, real-life experiences, and tapping on whatever we notice along the way.
Looking at Earlier Experiences
Once there is enough familiarity with the process, it may also be useful to explore earlier experiences that could be contributing to the current fear.
One obvious place to look is the first panic attack we remember. That experience itself can become emotionally charged. Someone who had their first panic attack in a crowded store, for example, may have really believed in that moment that something terrible was happening to them. Even years later, aspects of that experience may still carry a lot of emotional charge.
But earlier experiences don’t necessarily have to involve panic.
Perhaps someone was bullied and remembers feeling trapped while other children surrounded them. Maybe they grew up with a parent whose behavior could suddenly become unpredictable, or had an experience where they desperately wanted to leave somewhere but couldn’t. Experiences like these may or may not be connected to the current problem, so I prefer to remain curious rather than deciding beforehand what caused it.
If an earlier memory spontaneously comes to mind while we’re tapping on a current trigger, that’s often something we can become curious about. We can then work with that memory as its own specific event, again paying attention to keeping the emotional intensity manageable (so that the cup of tea doesn’t become boiling hot).
Could Part of Me Be Afraid of Getting Better?
Another area I often explore involves what are traditionally called secondary gains, although I often find it more useful to think of them as protective mechanisms.
We can become curious about a question such as:
“If I knew that this problem was completely gone tomorrow, is there any part of me that would feel uncomfortable about that?”
At first, the question can sound strange. Someone desperately wants to be able to drive again, travel freely, or go into stores without worrying about panic. Why would any part of them object?
But sometimes something does come up.
Perhaps being constantly vigilant feels protective because, “If I stop watching for the panic, it will catch me off guard”. Someone else might worry that if they get better, their family will expect too much from them. Another person may have become accustomed to having someone accompany them and feel frightened by the idea of suddenly being expected to do everything alone.
These concerns don’t mean that the person consciously wants to have panic attacks or agoraphobia. They give us additional information about what different parts of the person may be trying to protect them from.
And once again, those concerns can have “the tapping microphone”.
Following the Emotional Charge One Piece at a Time
Panic attacks and agoraphobia can involve many interconnected pieces: fear of bodily sensations, fear of another panic attack, memories of previous attacks, anticipatory anxiety, avoided situations, shame about having the problem, earlier experiences, and concerns about what might happen if things changed.
We don’t have to address all of these at once.
We can begin with whatever feels manageable today. That might mean tapping on the apprehension about doing EFT at all. It might mean choosing one recent panic attack, imagining one upcoming situation, or simply giving the microphone to the frustration of having dealt with the problem for so long.
And whenever the cup of tea becomes too hot, we can zoom out, tap silently, or orient some of our attention toward something neutral or pleasant until there’s enough room to decide where we’d like to go next.
Over time, we can continue following the emotional charge one manageable piece at a time, while paying attention to whatever thought, feeling, memory, or part of us is asking for the microphone next.
A brief note: Panic-like symptoms can sometimes have medical causes, particularly when they are new or unusual. If you’re experiencing symptoms that haven’t been medically evaluated, or you’re unsure whether what you’re experiencing is a panic attack, it’s important to speak with an appropriate healthcare professional. EFT can be used as a complementary tool, but it shouldn’t replace appropriate medical or mental health care.
That said, when working with panic attacks or agoraphobia, there can be many different aspects contributing to what we’re experiencing, and it isn’t always easy to know what to focus on when tapping by ourselves. It can also be helpful to have someone there to help us find a manageable distance from experiences that feel particularly intense. If you’d like some support exploring what’s coming up for you, you can learn more about my approach at brunosade.com.
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I’m Bruno Sade, a clinical psychologist and Accredited Certified Advanced EFT Practitioner. I work online with people around the world, helping them reduce the emotional charge behind difficult thoughts, memories, and triggers.
If you’re curious about experiencing EFT in a guided session, I occasionally offer a free EFT tapping session in exchange for a brief market research interview. You can sign up here.