Emotionally focused therapy

This article is about emotionally focused therapy sometimes known as "EFT". For the unrelated alternative therapy also sometimes known as "EFT", see Emotional Freedom Technique.

Emotionally focused therapy (EFT) is a short term psychotherapy approach to working with couples and more recently with families. It is substantially based on the principles of emotion theory and attachment theory.

Emotionally focused therapy proposes that emotions themselves have an innately adaptive potential that, if activated, can help clients change problematic emotional states or unwanted self-experiences. Emotions are connected to our most essential needs. They rapidly alert us to situations important to our advancement. They also prepare and guide us in these important situations to take action towards meeting our needs. Clients undergoing EFT are helped to better identify, experience, explore, make sense of, transform and flexibly manage their emotional experiences.

Overview

Sue Johnson states in her book 'EFT with Trauma Survivors' that:

[A]ttachment theory...predicts that when attachment security is uncertain, a partner will pursue, fight, and even bully a spouse into responding to attachment cues, even if this has a negative general impact on the relationship (p. 179).

Emotionally Focused therapy (EFT), also known as Emotion-Focused Therapy for Couples (EFT-C) is an empirically supported humanistic treatment that arose out of emotion theory and attachment theory. It views emotions as centrally important in the experience of self, in both adaptive and maladaptive functioning, and in therapeutic change. From the EFT perspective 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 people must first arrive at a place before they 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 in to the brain one goes the less it is available to 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.

EFT-C is a short-term (8-20 sessions) structured approach that was originally developed in the 1980s by Leslie Greenberg and Sue Johnson. Now, Emotionally Focused Therapy is also used with families. There is significant research on this approach and it has been found that 70-75% of couples move from distress to recovery and that the gains are sustained for months to years following the end of treatment. As such, EFT-C is an evidence based treatment protocol.

Basic Principles

1. Relationships are attachment bonds

2. Change involves a new experience of the self

3. Rigid interaction patterns create and reflect absorbing emotional states. Its systemic.

4. Emotion is the target and agent of change

5. The therapist is a process consultant

6. Partners are viewed as coping as optimally as they can given their current circumstances i.e. non-pathologizing.

One premise of EFT-C is that emotions bring the past alive. The past validates present day fears, blocks and styles of relating, which then fuels conflict. If there is to be long-lasting change, emotions are engaged and activated in the creation of new relationship events.

Another premise is that attachment is maintained by perceived responsiveness and accessibility and by emotional engagement and contact. When those are uncertain, attachment becomes insecure and then follows protest, clinging, depression or despair and detachment. These become stuck in rigid patterns or negative interaction cycles until the underlying need for secure attachment is addressed.

The interactions of distressed couples are characterized by negative cycles where, for example, one partner pursues while the other withdraws. The therapist helps the couples go to the underlying emotions that keep them stuck in those rigid positions and negative interaction cycles.

Using the notion of transforming emotion with emotion, the EFT-C therapist guides each partner to expressing emotions that pull for compassion and connection. EFT-C promotes soothing and helps clients deal with unstated and therefore unmet attachment needs.

Emotion regulation is involved in three major motivational systems central to couples therapy – styles of attachment, identity or working models of self and other, and attraction. These are elaborated below.

Styles of attachment

Johnson & Sims describe four attachment styles.

1. People who are secure and trusting perceive themselves as loveable, able to trust others and themselves in relationship. They give clear emotional signals, and are engaged, resourceful and flexible in unclear relationships. Secure partners express feelings, articulate needs, and allow their own vulnerability to show.

2. People who have a diminished ability to articulate feelings, tend to not acknowledge their need for attachment, and struggle to name their needs in a relationship. They tend to adopt a safe position and solve problems dispassionately without understanding the effect that their safe distance has on their partners.

3. People who are psychologically reactive and who exhibit anxious attachment. They tend to demand reassurance in an aggressive way, demand their partner's attachment and tend to use blame strategies (including emotional blackmail) in order to engage their partner.

4. People who have been traumatized and who vacillate between attachment and hostility.

Emotion focused couples therapy for trauma survivors

See also: Complex post traumatic stress disorder

See also

• Attachment theory
• Attachment in adults
• Attachment in children
• Attachment measures
• Attachment-based psychotherapy

• Affectional bond
• Human bonding
• Jealousy
• Monogamy
• Object relations theory

• Interpersonal attraction
• Interpersonal communication
• Interpersonal compatibility
• Intimate relationship
• Terms of endearment
• Love

References

Greenberg, L.S. and Johnson, S. M. (1988). Emotionally Focused Therapy for Couples. Guilford Press: New York.

Further reading

• Greenberg, L. S., & Goldman, R. (2008). "Emotion-Focused Couples Therapy: The Dynamics of Emotion, Love and Power." Washington, DC: American

Psychological Association.

• Johnson, S.M. (2004). The practice of emotionally focused marital therapy: Creating Connection. New York: Bruner / Routledge. - Second Edition of 1996 book.

• S.M. Johnson, Brent Bradley, J Furrow, A Lee, G Palmer (2005) Becoming an Emotionally Focused Couples Therapist : A Work Book. N.Y. Brunner Routledge.

• Greenberg, LS and Watson, JC (2005) Emotion-Focused Therapy for Depression. Washington, DC: American Psychological Association Press.

• Johnson, S.M. and Valerie Whiffen(2003)(Eds). Attachment Processes in Couples and Families. Guilford Press.

• Johnson, S.M. (2002). Emotionally Focused Couple Therapy with Trauma Survivors: Strengthening Attachment Bonds. Guilford Press.

• Johnson, S.M., & Greenberg, L.S. (1994)(Eds). The heart of the matter: Perspectives on emotion in marital therapy. New York: Brunner Mazel.

• Greenberg, L.S., & Johnson, S.M. (1988). Emotionally Focused Therapy for Couples. New York: Guilford Press.
• Gurman, A., & Jacobson, N. (2002). Clinical Handbook of Couples Therapy. Emotionally Focused Couples Therapy: Creating Secure Connections, p. 221-250.

• Rice, L. & Greenberg, L. (Eds.) (1984). Patterns of change: An intensive analysis of psychotherapeutic process. New York: Guilford Press.

External links

• International Centre for Excellence in Emotionally Focused Therapy
• Ottawa Couple and Family Therapy
• Sue Johnson's EFT Web Site - Emotionally Focused Therapy for Couples
• Sue Johnson's book "Hold Me Tight: Seven Conversations for a Lifetime of Love" Web Site.
• Audio Interview with Sue Johnson about the book "Hold Me Tight"
• Attachment Questionnaire