Emotion Focussed Therapy

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Emotionally Focused Couple Therapy

S.Varadharajan

Clinical Psychologist

Department of Clinical Psychology

Sri Ramachandra University


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Outline

Introduction

Foundation

Theoreticalbackground

Basic overviews

Assumptions

Interventions

Treatment Process

Strengths

Research findings


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Introduction Emotionally focused couple therapy is a short

term, systematic and tested intervention toreduce distress in adult love relationship

Emotion pulls for and organizes key responses

in close relationships To create a safe, egalitarian relationship with

partners

Exploring how emotions direct the couplesdance and how the dance then shapes key

emotions


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Constriction and rigidity is replaced byexpensiveness and flexibility

Focuses on key factors in relationship distress,significant role of emotional communication inthe development of relationship distress

To make safe emotional engagement so thatpartners can soothe, comfort and reassure eachother

Therapist to learning from clients what ismeaningful for them and how they view intimaterelations.


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Founders..

1980s

Leslie Greenberg

Susan Johnson

Science of love &attachment theory

Systemic & experiential


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Theoretical Background

Humanistic/Experiential Systemic

AttachmentTheory


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The Attachment Perspective

Attachment is an innate and primarymotivating force.

Secure dependence is a sign of health andcomplements autonomy.

Attachment offers a safe haven.

Attachment offers a secure base


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Accessibility and responsiveness build secure healthybonds

Fear and uncertainty activate attachment needs

Anxious attachment, manifests as extreme distress onseparation, clinging and aggressive attempts to obtain

a response from loved one.

Avoidant attachment- lack of safe emotionalengagement is to deactivate the attachment systemand suppress attachment needs.

Fearful avoidantseeking closeness with fearfulavoidance of closeness when it is offered.


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These ways of engaging significant others are

self maintaining patterns of social interaction

and emotion regulation strategies.

Attachment involves inner cognitive workingmodels of self and other.

Isolation and loss are inherently traumatizing

Attachment is an integrative theory.


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Basic elements of experiential model

Alliance is a key

An optimistic non-pathological stance is essential

Openness & engagement is healthy

Session focus on moment to moment process

There is a privileging of emotions

Significant change requires a new corrective

emotional atmosphere


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Basic elements of systemic model

Causality is circular

Consider behavior in the context

Elements of a system have a predictable and

patterned relationship with each other

All behaviors has a communicative aspect

Task of the therapist is to interrupt negative

cycles of interaction, so that new, more adaptive

patterns can emerge.


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Experiential & Systemic synthesis in EFT

Both focus on present experience

View people as the process not as the product

Focus the circular cycles of interaction between

people & the emotional experience of each

person at each steps of the cycle.


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Basic Overview of EFT

EFT views couple distress as being maintained by

absorbing negative affect.

Absorbing negative affect both reflects and primesrigid, constricted patterns of interaction.

These patterns make the safe emotional engagementnecessary for secure bonding impossible.


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The goals of EFT are to:

Access, expand and re-organize key emotional

responses.

Create a shift in partnersinteractional positions.

Foster the creation of a secure bond between partners

through the creation of new interactional events thatredefine the relationship.


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EFT Assumptions

1) Accessibility and responsiveness are the building

blocks of a secure attachment bond. Consequently,

Couples therapy is about

a) the security of the attachment bond,b) accessibility,

c) the responsiveness of the partner.


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A.R.E you there for me?

Access

ible Can I

reach you?

Will youopen up tome?

Respons

ive

Can I

depend onyou?

Will youcome whenI call?

Engaged

Are you

emotionallypresent?

Do youshare?

Will you

keep meclose?


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2) Emotion is a target and agent of change.

Emotion:

a) Source of information

b) Communicates - organizes social interactionsc) Orients & primes responses

d) Vital element in meaning - colors events

e) Has control precedence


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3) Emotion frequently leads to adaptive actions

Asserting, defendingAnger often leads to:

Seeking support, withdrawingSadness

Attending, exploringSurprise/Excitement

Hiding, expelling, avoidingDisgust/Shame

Fleeing, freezing, giving upFear

Connecting, engagingJoy


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4) Negative emotions occur at two levels:

Primary and Secondary.

a) Primary Emotions are the deeper, more vulnerable

emotions such as sadness, hurt, fear, shame, and

loneliness.

b) Secondary Emotions are the more reactive emotions

such as anger, jealousy, resentment, and frustration.

They occur as a reaction to the primary emotions.

c) Primary emotions generally draw partners closer.

Secondary emotions tend to push partners away.


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5) In trying to connect, distressed couples get caught in

negative repetitive sequences of interaction where

partners express secondary emotions rather thanprimary emotions.

6) Insecure attachment leads to negative interactioncycles and, in return, negative interaction cycles lead to

insecure attachment (it is circular).


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7) Rigid interactions reflect and create negative

absorbing emotional states. Negative absorbing

emotional states reflect and create rigid interactions (it

is circular).

8) Partners are not sick or developmentally delayed.They are stuck. Most needs and desires are adaptive.


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9) Attachment needs are universal, although their

expression is culturally defined. The way we seekand obtain support is defined different in various

cultures and even in different families and must be

understood and respected.

10) Change involves new experiences and new

relationships events. Therapy is about creating these

new relational experiences.


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Interventions

3 tasks

1. Create and maintaining a therapeutic alliance.

2. Accessing and reformulating emotion.

3. Restructuring key interactions.


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1. Create and maintaining a therapeutic alliance.

Empathic Attunement

Acceptance

Genuineness

Continuous active alliance monitoring


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2.Accessing/Exploring and reformulating

emotion

Fostering an emotion focus

R-I-S-S-S-C(Repeat-Imagesuse-Simple words-

Slow pace-Soft voice-Clients words)

Validation

Evocative Responding

Empathic Conjecture or Interpretation


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3.Restructuring Interactions

Tracking, reflecting, replaying interactions

Reframing in the context of the cycle andattachment processes

Restructuring and shaping interactions


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Treatment Process

Stage 1:De-

escalatio

n

1. Assessment

2. Identify negative cycle / Attachment issues

3. Access underlying attachment emotions

4. Frame problem cycle, attachment needs/fears

Stage 2:Restructuring the

Bond

5. Access implicit needs, fears, models of self

6. Promote acceptance by other expand dance

7. Structure emotional engagement express attachmentneeds.

Stage 3:Consolida

tion

8. New positions / cycles enact new stories of problemsand repair

9. New Solutions to pragmatic issues


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1. Alliance & assessment: Creating an alliance and

delineating conflict issues in the core attachment

struggle.

What are they fighting about and how are they

related to core attachment issues.


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2. Identify the negative interaction cycle, and eachpartners position in that cycle.

Goal is to see the cycle in action and then identify

and describe it to the couple and work to stop it.


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3. Access unacknowledged emotions underlying

interactional positions.

Goal is to help each partner to access and accept

their unacknowledged feelings that are influencingtheir behavior.

Both partners are to reprocess and crystallize their

own experience in the relationship so that they

can become emotionally open to the other

person.


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4. Reframe the problem in terms of underlying feelings,

attachment needs, and negative cycle.

The cycle is framed as the common enemy(externalizing the problem) and the source of the

partners emotional deprivation and distress.


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5. Promote identification with disowned attachment

emotions, needs, and aspects of self, and integrate

these into relationship interactions.

Goal is to help the couple redefine their experiencesin terms of their unacknowledged emotional needs.


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6. Promote acceptance of the other partners

experiences and new interactional responses.

Goal is to work to get each partner to accept,

believe, and trust that what the other partner isdescribing in terms of underlying emotional needs is

accurate.


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7. Facilitate the expression of needs and wants and

create emotional engagement and bonding events

that redefine the attachment between the partners.

Goal is to help couple learn to express theiremotional needs and wants directly and create

emotional engagement


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8. Facilitating the emergence of new solutions to old

relationship problems.

Without the old negative interaction style and with

the new emotional connection and attachment, it iseasier to develop new solutions to old problems.


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9. Consolidating new positions and new cycles of

attachment behaviors.

Help couple clearly see and articulate the old andnew ways of interacting to help the couple avoid

falling back into the old interactional cycle.


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Strengths..

EFT is based on clear, explicit conceptualizations ofmarital distress and adult love. Theseconceptualizations are supported by empiricalresearch on the nature of marital distress and adult

attachment.

EFT provides a clear map that therapists can followto help couples and families become emotionallyconnected and responsive to one another.

EFT is collaborative and respectful of clients,combining experiential Rogerian techniques withstructural systemic interventions.


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Strengths..

Change strategies and interventions are specified.

Key moves and moments in the change process have

been mapped into nine steps and three change events.

EFT is an empirically validated model for couple therapy.There is also research on the change processes and

predictors of success.

EFT has been successfully applied to many different kinds

of problems and populations


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Research findings

A recent meta analysis of the best studies found 70-73%

of couples to be recovered from marital distress and 90%

of couples to have significantly improved.

Relapse is not a significant issue with EFT


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Thank You

Emotion Focussed Therapy

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