Emotions are centrally important in the experience of self, in both adaptive and maladaptive functioning, and in therapeutic change. Change occurs by means of awareness, regulation, reflection, and transformation of emotion taking place within the context of an empathetically attuned relationship. EFT works on the basic principle that you must first arrive at a place before you can leave it. Therefore, in EFT an important goal is to arrive at the live experience of a maladaptive emotion (e.g., fear and shame) in order to transform it. The transformation comes from the client accessing a new primary adaptive emotional state in the session.

Core emotions of attachment and fears of loss of attachment arise deep in the brain. The deeper into the brain one goes the less it is available to the fast pace of everyday awareness. Emotions are physiological neuroendocrine responses to which we react, when they come into awareness, with thoughts and feelings about those feelings. In EFT the aim is to create a new relationship event to act as a kind of transformer and thereby change reactive emotion with positive emotions of attachment.