Dr Sue Johnson PhotoEmotionally Focused Therapy is a therapeutic approach developed by Dr. Sue Johnson in the 1980s in response to the distress she saw in many of her patients. It has continued growing since then. This is an approach mostly used in couples therapy to improve relationships by working with emotions, however, it has been used with individuals and families too.

Emotionally Focused Therapy is a structured approach and is usually short-term, having around 8-20 sessions

It was based on theories of adult attachment. EFT has been practiced and studied for over 20 years, and there are studies to support its effectiveness, suggesting that 90% of couples show improvement and around 70% reduce their distress and recover. Emotionally Focused Therapy is recommended for a variety of couple’s issues, however, it is not indicated for situations where there is on-going abuse in the couple, but it can be used for many other difficulties a couple may face.

EFT borrows elements from person-centered therapy and from other approaches. It involves humanistic techniques and a respectful attitude towards patients, but also has more structured elements and interventions from systemic approaches that view the couple or family as a system rather than two individuals. Emotionally Focused Therapy seeks to work with emotional responses, expanding the range of these responses, and to change the interactions partners have with each other. EFT is focused on building a secure bond between partners.

A key aspect of EFT is emotional bonding. Emotional bonding is seen as a central aspect of human existence, as people have a need for attachment that is a basis for survival and that continues from childhood to adulthood. People not only want safe emotional connections, but actually need them. Adults will seek attachments too, often in romantic relationships, and the idea of adult attachments is one of the central ones in Emotionally Focused Therapy.

Attachment has a neurological basis. The threats to attachment activate a primal fear in the fear center of the brain, the amygdala. People do not always react in a rational manner when attachment is involved, because it means a lot to them, so threats or unfamiliar situations related to attachment trigger a self-preservation instinct. People have a profound need for a safe attachment that also is important for adults.

Emotionally Focused Therapy recognizes the negative communication patterns that a couple might engage in

The negative or provocative behaviors are seen as behaviors that try to fulfill the need for connection, even if they do not work. A negative pattern of communication can be seen as a way to reach an emotional bond. EFT helps partners communicate in a way that favors the development of a safe bond and a secure emotional attachment.

When there are difficulties in a relationship, EFT links to them to issues with attachment. The partners struggle to understand whether the other person is committed to them and can be relied upon, if their attachment figure is available for them. However, the way to test this bond can be problematic and be done with signals that are unclear, confused, or misinterpreted. Miscommunication leads to certain reactions from the other partner that do not address the underlying need and lead to an escalation of the conflict. Partners may react with anger, trying to provoke a response from their partner, or withdrawal, in which they do not respond to the partner’s provocations or behavior, neither of which is constructive and lead to escalations. Often, one partner reacts with anger, while the other withdraws.  Through the therapist’s intervention, it is possible to change this communication and create a positive environment where the partners can communicate their needs and receive the security they are seeking. Emotionally Focused Therapy changes the emotional responsiveness in a couple’s communication which leads to a deeper transformation of the couple’s dynamics.

EFT focuses on the strengths. It helps the couple discover strengths that are present and they didn’t know they had to take advantage of these strengths to resolve the problem. The approach takes a humanistic view of the individual as knowing what they want and need and being able to change their way of seeking to fulfill these needs.

An important aspect of EFT is that it is a highly structured approach. It has three phases and nine steps total. Phase 1 is the “Assess and Deescalate Phase”, including four steps: identifying the conflict, identifying the cycle in which the conflict occurs, accessing emotions that have not been acknowledged, and reframing the cycle to help the couple rally against it. Phase 2 is the “Change Events Phase”, and it includes three steps: promote identification of unresolved or disowned needs, promote acceptance between partners, and facilitate the expression of these needs. Phase 3 is the “Consolidation of Change” and involves two two steps: new solutions and consolidation. Essentially, Emotionally Focused Therapy involves a process in which the conflict and the context of the conflict is identified. Then, the partner’s hidden and deeper needs are identified and express. The partners work on supporting each other’s needs and finding new ways to express them. The final stage involves developing new solutions to the issues and consolidating the solutions to ensure that the couple’s new patterns stick. The structure offers a comfortable way of working that guides the process along The structure shows where the work is now and where it is headed, helping create a more organized process that moves forward and creates a stable process that leads to stable results.

Overall, Emotionally Focused Therapy has empirical support and is based on the theories of attachment, for which there is neurobiological support. It focuses on understanding the needs of each partner and helping them express these needs with their partner’s support. The therapeutic process seeks to change the communication the couple has and the ways of expressing their needs to create a secure attachment. EFT has the advantage of being structured and short-term, which makes it more accessible.

References:

Jones, L.K. (2009). Emotionally Focused Therapy With Couples — The Social Work Connection. DSW Social Work Today, 9 (3).

ICEEFT. What is EFT? Retrieved from https://iceeft.com/what-is-eft/