Why One Therapist Loves Emotionally Focused Therapy

Recently, a newly graduated Master’s Level therapist asked what model people were using with couples and why.  This is the answer of one person, one therapist, from my heart.  In life as in therapy, there are many ways to understand a problem, to approach, to focus, etc. I invite any therapist reading this to first pause and ask yourself a few questions:

1)  What model or models do I work from the most?
2)  What in my life experience led me to one model, to several, to an eclectic blend or to developing my own model?
3)  What are the values and drivers inherent in this approach (or approaches) to therapy and how well do they reflect my values and drivers? 
4)  How well does the model I am using free me up to be authentically present in the room and where does it constrain me (every model constrains us – does my model constrain me in a way that feels right and relevant or in unnecessary, limiting ways):  

Why I Love Emotionally Focused Therapy, by Jim Thomas 

My couples really get absorbed by the Emotionally Focused Couples Therapy approach, EFT, developed by Sue Johnson. one of only two empirically validated therapy models for couples (the other is IBCT) that is recognized by the APA as an evidenced based model. Of great importance for me as a clinician is the robust results that come with successful EFT work (the results last over time).  EFT fits the research done by John Gottman about what leads to distress in close relationships. It is grounded in attachment theory and the new science of emotions. Having witnessed numerous bonding events and seen the immediate, long-lasting change, I could never go back to a more top-down, cognitive approach or solution-based approach alone (there are elements of cognitive work in EFT the difference is in how EFT leans in to emotions, in to emotional dysregulation and expanding emotional experience as the key source of direction, information, new interactions and change).

EFT addresses the key problem identified in John Gottman’s research – partners turning away from each other rather than towards each other – and does so with elegance, parsimony and grace that is accepting and validating.  EFT does not go after a partner’s defensive or reactive behavior.  Sue Johnson excels as embracing the process and moves couples make when distressed.  In a training tape from a live session at the Psychotherapy Networker conference, the female partner says, “He is trying to connect, but I always aware that I am a mess.”  Sue responds without hesitation, from a sincere place, “A mess, a mess, really?  you see yourself as a mess, I see you struggling with the fear that comes up inside you and between you.”  In that moment, she and her partner feel received and understood.

I like how Sue Johnson developed EFT. She learned it from her couples, by asking them what were the most meaningful sessions and parts of sessions with her.  For the couples, it came back to processing emotion in new ways and reaching to each other from that vulnerable, expanded emotional place including from fear, sadness and longing. In the room it is such powerful stuff. And the road map is clear…to foster alliance, to look for – track and reflect the couples negative dance (often the demand withdrawal pattern identified by John Gottman), to validate secondary emotional and behavioral processes while accessing deeper, more vulnerable primary emotions and place the behaviors and primary emotions in to an attachment frame.  

Then with the increasing safety in the room, couples begin to turn down their negative dance and naturally get more curious about their partner’s experience and their own. Then we choreograph the deep Stage 2 work of withdrawers engaging fully emotionally, sharing their own attachment fears, longings and needs. Then the previously often critical pursuer shares from a soft vulnerable place, their attachment fears, longings and needs.  In this way, with therapist gently guiding, couples learn to turn towards each other from a deep emotional place.  When their partner reaches back the bond between them strengthens. Soon, they have a heartfelt desire to fight for connection rather than fight about how they got disconnected.  It is transformative.

When they can turn to each other in this way, a key event occurs.  The bonding event happens when one partner reaches naked and vulnerable emotionally for their partner and their loved one reaches back softly to catch them.  We now have solid evidence that the partner’s brains change in those bonding moments!

A study lead by neuroscientist Jim Coan will be published on PLOS, November 30, that shows the brain changes as measured using an fMRI protocol before and after EFT with distressed couples.  Witnessing and sharing these moments with couples is magical.  The change in their faces, their countenance, they way they can look in each other’s eyes, the way they hold each other and more is palpable.  It is, quite honestly, addicting and motivates me to hang in there with couples early in therapy in conflict, distance or distress.

Though I borrow from many models and life experience, my couples and family therapy is firmly anchored in EFT. It is a bottom-up, limbic system approach with a clear cognitive frame – attachment theory – that both grounds my work, creates safety for the couple (or family) and provides me the freedom to show up authentically in the room in service of growth, healing and deeper connection. Attachment theory and the science of emotions also provides a cross-cultural bridge as the couple and I discover again and again that we may show up differently in the world, with different experiences and cultural histories, when it comes to the deep desire to connect and bond with our partners, our family, our friends and a community, we are much more similar than different. This alone is liberating and motivating leading to lovely cross cultural experiences for me that fuel my desire to reach a wide array of people in my office and beyond.

In the end, the key element of Emotionally Focused Therapy that resonates the most and keeps me delving deeper in to this work even with the most difficult or seemingly hopeless couple or family conflict, is the humanity inherent in the work.  Sue Johnson models this in her clinical work and how she talks about people.  She consistently looks for the positive intent in reactive behavior and the attachment significance of behaviors in a couples negative cycle (like the demand-withdrawal cycle identified in research by John Gottman). This pulls for me to see the vulnerability, fears and longings in my clients.  And to see those same things in myself and my own life.  As a result, EFT work opens my heart outside of the clinical session.

Thus, as an EFT Trainer, I can offer (along with co-trainers and helpers), a safe, supportive learning community for not only learning the stages, steps and interventions of the model, but also to learn about the parts of us inspired by or made anxious or doubtful in the work.
For these reasons and more than I can share here, my love affair continues to grow with this:

1)  Emotionally-focused model that uncovers our hidden relational dance.

2)  That honors our shared humanity.

3)  That fosters openness and showing our vulnerability to loved ones.

4)  That works with universal, cross-cultural primary emotions and needs for contact, comfort and connection (from cradle to grave).

5)  And that celebrates both connection and the individual expression that arises when we feel safe in this world.

Jim Thomas

My wish for every therapist is that they each find, develop, integrate or  create an approach to therapy that they can love, be authentic and enjoy  working within while borrowing from other approaches, from science,  from their spirituality, from their own life experience.

We put so much of ourselves in to our work and give freely from our  hearts.  My we each find a way to do this work that is true to our selves  and to the needs of our clients both.