Israeli Association for Couple and Marital Therapy Association 2018-for sendin… · EFT –...
Transcript of Israeli Association for Couple and Marital Therapy Association 2018-for sendin… · EFT –...
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Israeli Association for Couple and Marital Therapy
Presented by:
George Faller, LMFT
Developed with Dr. Sue Johnson
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If you don’t know where you are
going – you will wind up
somewhere else. Yogi Berra
Can’t find what you are not looking for!
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EFT – Couples Therapy For the first time we have a theory of love!
The couples therapist is in territory of the:
• Understandable
• Predictable
• Explainable
• Changeable
• These organize attachment behaviors in relationships
We Know:
The Territory – The Problem
The Destination – Goal
The Map – Key Moves/Moments
This new science is based on observation of distress, satisfaction, bonding in action, change in therapy. 3
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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, and
c) the responsiveness of the partner.
ARE you there for me? Accessible, Responsive and Emotionally Engaged…..
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EFT Assumptions
2) In trying to connect, distressed couples get caught in negative repetitive sequences of interaction where partners express secondary emotions rather than primary emotions.
3) Insecure attachment leads to negative interaction cycles and, in return, negative interaction cycles lead to insecure attachment (it is circular).
4) Rigid interactions reflect and create negative absorbing emotional states. Negative absorbing emotional states reflect and create rigid interactions (it is circular).
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EFT Assumptions
5) Partners are not sick or developmentally delayed. They are stuck. Most needs and desires are adaptive.
6) Attachment needs are universal, although their expression is culturally defined. The way we seek and obtain support is defined differently in various cultures and even in different families and must be understood and respected.
7) Change involves new experiences and new relationship events. Therapy is about creating these new relational experiences.
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Research on EFT – Outcomes
EFT is one of only a few empirically supported treatments for couples therapy. (Snyder, Castellani & Whisman, 2005).
EFT studies demonstrate a 70 – 73% rate of shifting from distress to recovery for the four outcome studies composing the EFT meta-analysis (Johnson, 2003).
90% showed significant improvement
Two-year follow– results stable – 60% maintain gains or continue to improve.
Excellent Outcome (35), Process Research (15), Reviews (18) , Meta-Analysis (3)
Relationship between therapist and client vital for success
APA Gold Standard
Check website for studies – www.iceeft.com
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“All of us, from cradle to grave, are happiest when life is organized
as a series of excursions, long or
short, from the secure base provided
by our attachment figure(s).”
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Attachment Theory
John Bowlby A secure base (1988, p. 62)
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The first and
foremost
instinct of
humans is
neither sex nor
aggression -
it is to seek
contact and
comforting
connection 9
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Our ability to
reach for
others, to
seek
calming and
comfort, is
our strength
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MARY AINSWORTH
· Developed the Strange Situation Procedure
· Four Attachment Categories: A,B,C,D
Type A -- Avoidant
Type B -- Secure
Type C -- Ambivalent/ Anxious
Type D -- Disorganized
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The Paradox of Dependency
To be
emotionally
connected is to
be
STRONGER –
more resilient,
more
autonomous
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“ I have seen a lot of irrational cognitions but not a lot
of irrational emotions” ~ Sue Johnson
Attachment Theory is a map for Positive, Loving,
Stable Relationships which explains:
• The logic of our emotions
• The longings and needs guiding interactions
• A path for repair and renewal
• A language of love
• A guide to the pivotal moments in love relationships
•More than just survival, its how we thrive
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The New Science of Love A loving relationship is the best antidote to stress
Emotional connection with a loved one is a potent
source of resilience and strength
Emotional isolation is dangerous
“Suffering is a given; suffering alone is intolerable”
The worst part isn’t the pain but the lack of response. It’s
the baby crying without being picked up.
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Having a loved one hold your hand
really does take the hurt away =
Power of Attachment
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THE TRUSTING BRAIN: HOW YOU RESPOND TO
AMBIGUITY…… THE BENEFIT OF THE DOUBT
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IN A TRUSTING RELATIONSHIP, AN AMBIGUOUS
FACIAL EXPRESSION OR TONE OF VOICE IS NOT
“READ” IMMEDIATELY AS NEGATIVE. THE TRUSTING
BRAIN GIVES THE TRUSTED OTHER THE “BENEFIT
OF THE DOUBT” AND AUTOMATICALLY ASSUMES
MORE POSITIVE THAN NEGATIVE INTENT
VENTRO-
MEDIAL
PFC SHOWS
GREATER
ACTIVATION
THAN THE
AMYGDALA
MISTRUSTING
BRAIN: AMYGDALA
RESPONDS MORE
STRONGLY THAN
THE VMPFC TO
AMBIGUOUS
FACES AND VOICES
mistrust trust
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How Big is the Hill?
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Cellular Level- Telomeres Dr. Elizabeth Blackburn
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From Atoms to Galaxies
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:Growth Index
Body
Keeps
Score
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The people we love are the "hidden regulators" of
our bodily processes and our emotional lives.
– Sue Johnson "Hold Me Tight"
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Theory of Love: Attachment Theory
Bowlby, 1969-1988
Common Attachment Needs & Longings
To be & feel loved
To trust spouse/family member is going to be
there in time of need and/or desperation
To have (among others):
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A Safe Haven
Acceptance
Understanding
Empathy
Recognition
Validation
Protection
Comfort
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We are created to need feedback
from others
Attachment needs are from cradle to grave. Not just for
babies! Dependency shouldn’t be a bad word.
We are focusing on intimate relationships but these
needs are met in many different kinds of relationships.
God, Kids, Friends, Co-workers, Pets, Self, Clients…
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Let’s Keep It Simple
Its all about responding to
each other!
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Good Enough Responding - %? 1. Attunement = Feels Good/ Marked by Positive Affect
2. Disruption = Feels Bad/ Marked by Negative Affect - Leads to Disconnection
3. Repair = Bridge Back to Feeling Good/ Opportunity to Repeat Bad or Emerge into New Good
Open Systems Theory
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What is a Healthy, Loving Marriage? Is it a friendship, a negotiation, a deal to make, a skill, or an
impossibility?
First and Foremost:
It’s a Special Kind of Emotional Bond
The answer to our basic, built-in need for a safe haven and secure base
Accessibility and responsiveness are key
Why do we not ask for it explicitly?
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John Gottman’s Research: Love
Lab
Master- Happy & stable couples can:
1. Turn toward
2. Rebound from conflict
3. Make successful repair attempts
4. Soothe self and other
5. Stay emotionally engaged despite negativity
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John Gottman’s Research Disaster- Distressed Couples are unable to:
1. Create sufficient positive interaction
2. De-escalate and repair
3. Soothe self and other
4. Stay emotionally engaged
5. Get out of intense all-consuming negative affect and rigid, repetitive interactional patterns
Simple solution switch complaint/ compliment 5:1 ratio
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Results of Disconnection = Poor health
Insecurity linked:
Increased risk of depression, anxiety, PTSD,
substance abuse, domestic violence, divorce, lower
education/ income, troubled children, and suicide
Mental, Emotional, Spiritual, Physical
Consequences
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What happens when we lose our
connection?
Wired in response: Still Face Experiment
1) Protest- fight
2) Hold On- wait
3) Depression- Loss- Give Up
4) Detachment
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What happens when we lose our
connection?
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Isolation and
loss are
inherently
traumatizing –
it is a danger
signal of
life or death
importance
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3 year Old Child Brain Scan-
Attachment Disorder
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What happens when we lose our
connection- Role Play 1
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• Start off responding and then go
still face when bell rings
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Creating Secure Attachment-Inter-Subjectivity
Two people are in synch
when they are affectively and cognitively present to each
other;
when the vitality of their affective states are matched;
their cognitive focus is on the same event or object;
and their intentions are congruent.
In essence they are co-regulating emotion and co-
creating meaning of the events they are attending to.
Attunement leads to connection/organization
Mis-attunement leads to disconnection/ confusion
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Words Tones (Prosody)
Tempo Volume Pause
Body language Gestures Breathing
Eye Contact Proximity
Touch
Attunement- Paying Attention
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When people don’t respond to our inner world then we
don’t develop words to speak about our experience.
Having no words, it is hard to describe feelings. The
inner world takes on a vague and nameless quality.
Subjective experiences continue to occur but they are
difficult to understand or communicate. They are not
trying to withhold or be difficult, it is a basic truth about
their life that they don’t know what to say about their
thoughts and feelings. They have a sense of self that
lacks coherence, continuity, clarity, and
comprehensiveness.
Dan Hughes
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Bowlby’s concept of developmental pathways
suggests that one can be brought back on to a
more secure pathway by adding the missing
component from life at a later date.
(Byng-Hall, 2000, p . 265)
We can provide this component through
1) therapist 2) partner 3) self-parts 4) higher power
5) friends, kids, pets, etc
Good News
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Embracing Emotions
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In order to connect and respond….
We need to understand our emotions.
Emotions are attachment language - right brain.
They are wired in - take precedence in our brains.
Hard to hide them -they seep out of every pore.
What % of a typical message is the actual word spoken?
Not illogical - perfectly reasonable if you get the context.
Our emotions are a compass - they communicate what matters, what we need, who we are.
Often multiple emotions simultaneously – soup.
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Primary and Secondary Emotion
Secondary Emotional Experience
Reactive, Defensive, Protective Emotion
Underlying Experience
Primary Emotion
Attachment Needs and Vulnerabilities
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Five Universal Emotions: 1. Joy- Surprise
2. Sadness
3. Shame
4. Fear
5. Anger- 2 kinds
1. Assertive Anger of Hope
2. Reactive Anger of Despair
Soft emotions pull others towards you. Hard emotions push others away.
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Speed of Emotional Processing
James Gross
1. 100 millisecond brain to react/respond & show on face
2. 600 millisecond for the frontal cortex to register
response and shut down the facial expression
3. 500 millisecond lag time which is written on the face
so when partner says “nothing is wrong” the face
says otherwise
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Speed of Emotions
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Benefits/ Costs of Each Emotion
1. Anger – makes people scared and pushes away
+ increases focus, confidence, performance, creativity, optimism, assertiveness and sense of control
2. Fear – makes us hide, feel small & not be in moment
+ helps us focus (air traffic controllers) , stay in control,
and opens the doorway to vulnerability
3. Sadness – it hurts and overwhelms others
+ tears relieve our distress hormones and pulls others closer
4. Shame – cuts us off from others & we turn on self
+ provides energy and sense of hope to fix problem
5. Surprise/ Joy – less resilient to discomfort & stress
+ open, curious, playful- eustress
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Many Therapists have an Energy
Problem
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2. Demonstrate Role Play Attuning Emotions
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EFT Steps and Stages Overview
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Throughout the EFT Stages the focus is (The 4
P’s) : Integration= Linking different elements
into well functioning whole SYSTEMIC - Dance - Cognitive - Details - Elevator Up -Top
down - Left Brain - Verbal - Explicit Self
PROCESS (time) instead of content Rigidity
POSITIONS / PATTERNS (structure) – circular vs. linear causality
EXPERIENTIAL - Music - Emotions - Big picture - Elevator Down - Bottom up - Right Brain - Non Verbal - Implicit Self
PRESENT MOMENT (Emotion brings past alive. Past is used to validate present blocks, styles, fears).
PRIMARY AFFECT – Focus on / Validate Chaos
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Between the chairs
Between the ears
New Conversations
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Implicit – Explicit
E.F.T. is “bottom-up” activating the implicit domain,
making the hidden regulation system visible as an
experiential approach; “felt-sense” of cycle.
Uses the explicit domain/top down to delineate cycle,
develop the attachment narrative as couples’ comes in
and out of emotional experience in the room.
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Experiential-Emotions
Systemic-
Zoom In/ Zoom Out, Background/ Foreground
Attachment
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Neuroscience
Much of our experience runs on automaticity
The higher brain takes a tremendous amount of energy to run
so it is efficient to have much that runs outside of our
awareness
The downside is that much of our emotional lives function on
automatic pilot and we get into trouble
With automaticity emotions easily overrun our thoughts
left brain can be hijacked by more primitive responses
Doing the same old same old makes the cycle more
entrenched and doesn’t allow for new experiences and new
emotions to emerge NO CHOICE
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Change in EFT
Therapy creates the opportunity for choice
vs. automaticity
Change in EFT includes a left brain
understanding and a right brain
experience (Co-Co) even as we, the
therapists, remain emotionally attuned
throughout
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Connection
Keep Your Focus
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9 Steps of EFT - 3 Stages Stage One- De-escalation
1) Assessment
2) Identify negative cycle/attachment issues
3) Access underlying attachment emotions
4) Frame problem – cycle, attachment needs
Stage Two- Restructuring - Withdrawer Re-engagement/ Pursuer Softening
5) Assess implicit needs, fears, model of self
6) Promote acceptance by other
7) Structure emotional engagement
Stage Three- Consolidation
8) New positions/cycles -- enact new stories
9) New solutions to pragmatic issues
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Pursuer Withdrawer
Criticizes-Attacks
He Doesn’t Care- shift
from self to other
Anger
Fear Abandonment-Sadness
To Be Loved-Important
Shut Down-Avoid
She’s Too Demanding –shift
from self to other
Numbness-Frustration
Fear Failing-Not Good Enough
To Be Loved- Important
The cycle circles from Action Tendency in one partner to triggering unmet attachment needs in the
other partner, then up and around.
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1.Permission for Survival
2.Explore Vulnerability
3.Allow to exit if too difficult
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Keeping It Simple
Replacing Reactive
Conversations with Deeper,
Vulnerable Conversations
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3. Role Play Exercise - Dyads
Imagine saying to your partner or family member:
When you _________ (specific concrete cue, action tendency – criticize, blame, shut down), I do not feel safely connected to you, I tend to then ______________ (action tendency). I do this with the hope that ______________________________ (protection of relationship).
When it does not work, I decide that ____________________________________(name catastrophic conclusion, attachment fear). I realize that the more I ____________________ (action tendency), the more you seem to __________________________ (action tendency). Then we are more cut off from each other.
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“When you understand the implicit positive, connection- seeking intent in the destructive behaviors of the negative cycle, you will be able to see the couples’ distress more clearly through the attachment lens. The EFT cycle is rigidly maintained by each partner’s way of managing the disconnection between them, while searching for closeness.”
Sue Johnson
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When relationships are unsafe..
If temporary & specific - it can be repaired
If it’s chronic, general, automatic, habitual:
Breaks connection
Increases isolation/ distance
Can be disastrous to relationship
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When relationships are unsafe…
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Route One-
Turn up the
emotional heat
•Push, Pull
•Poke, Demand
•Worry, Fret
•Fight
•Catastrophize
•Mobilize
Route Two-
Turn off the
emotional heat
•Turn off needs
•Deny
•Suck it up
•Shut down
•Hide
•Withdraw
Only Two Routes to cope with lack of safety:
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Going Deeper- Helping
Withdrawers & Pursuers
Reach Out to Each Other
Through Enactments
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Two Different Realities of Being on a Island
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Different Goals:
Get Closer Less Fighting
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Sometimes we need to fix it!
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Important to Understand
Survival Benefits of Withdrawal
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Emotionally Shutting Down:
• Adaptive for dangerous / competitive environments that demand
cognitive focus on tasks
•Valued by peers, get feedback you fit in and are appreciated
•Values such as toughness, assertiveness, task orientation, logic,
fearlessness, confidence, and perseverance become the measures for
success
•.Easier to be independent
•Discipline works well, excellent performance
•Honor the avoidance
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Important to Keep Your Cool
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Disadvantages of Emotional
Avoidance
Success at work comes at a huge price at home
Being self-reliant leaves little room for healthy dependency
Emotional inhibition becomes a habit applied automatically across all settings
Distancing from feelings guarantees large gap in experience of self
The armor used to carry out the mission/fight the battle makes it difficult to feel alive when off duty
Price to not feel bad is less good!
Increased risk of depression, anxiety, PTSD, substance abuse, domestic violence, divorce, suicide
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Common Underlying
Emotions
Withdrawers often feel:
Pressure
Inadequate
Afraid of failure
Overwhelmed
Numb – frozen
Tension – on egg shells
Confused
Judged, criticized
Defensive
Empty
(Information obtained from the EFT Workbook, p. 148) 70
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De-Activating Strategy: flight reactions characterize avoidant attachment- distance and control in
close relationships
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Meet them in their Head
What is it like to not know, not be able to fix, not understand?
Help them put words to the racing thoughts and confusion- there you find the anxiety/ helplessness
What does helplessness feel like?
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Good at Compartmentalizing
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Key is withdrawers being loved regardless of performance
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Trained not to want emotional conversations and instead trying to
keep it positive
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Placating avoids Escalation
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Upwards Path Towards Nowhere
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Pressure to Perform
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Key is withdrawers being loved regardless of performance
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Relationships = Minefield
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Understanding Withdrawer’s World
For the withdrawer, emotional engagement is a minefield in which staying present and engaged can result in unintended and possibly disastrous consequences to himself, his partner, or his relationship.
Staying present means walking-on-eggshells and being uncomfortable; rather be at work than home.
Try always to be two steps ahead- anticipating- future focus, not in the present moment. It’s exhausting, reading a book a break from pressure.
Unfair- taught to shut down emotions and then blamed for not being able to express them and they come to believe there is something wrong with them.
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Great on Defense leaves little room for Offense
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Choosing Between Two Bad Options
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Only Safe When Getting It Right
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Trying to Outrun Failure/ Escalation
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Worst Feeling is often Helplessness
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If you can get away or block the negative messages, would you do it?
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Real Play 5- Honoring the Function of
Defenses- If you could get away from the
negative messages, would you?
Withdrawal- Imagine
Driving Alaska- initials someone critical with you (feel trapped-
can’t escape)
What do you feel (in your body), what do you tell yourself, want to
do want to do?
Turn and share/ honor function of the withdrawal
Anger- Imagine moment when most angry
Honor Function
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Classic Withdrawer Moves I don’t know
Anger to push away message
Humor to relieve stress
Focusing on positive
Intellectualization
Deflection
Minimizing
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Capture the moment right before they retreat
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And when you Fail……………….
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Scaffolding Deeper Withdrawer Misunderstood, Can’t Fix
Not Knowing, Confusion
Pressure to Perform, Egg Shells
Frustrated
Stuck
Helpless
Failing, Deflated, Disappointed
Rejected, Sad
Unloved, Shame, Pain
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Down
&
Over
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Key To Withdrawer
Re-engagement is:
1st - Confront Avoidance in Self- Shadow Boxing- shift from other focus to self focus
2nd - Withdrawer stands up for his/her needs and comes forward to assert himself, not to placate the pursuer
Key is withdrawers being loved without performance
3rd - Appreciate the risk- standing up with insecurities when best attempts to show self already have failed
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Spock Video- Protect self by
choosing not to feel
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The only reason they try so hard is they care so much
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Choice Not to Feel because Feelings
usually don’t end so well
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To survive withdrawers learn to hide the vulnerable
parts of themselves and fail to respond just like
their caregivers who caused the initial problem
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Withdrawers must experience success around
vulnerability otherwise they shouldn’t engage
If partner can’t therapist needs to stand in the gap
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Learning to run from pain creates a template that
cause 1) aloneness in their pain & 2) not being
able to be there in partner’s pain
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Your Courage Today will Change how
Future Generations do Vulnerability
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Withdrawer’s Needs Being Met
Feeling Successful
Confident
Decisive
Engaged
Calm
Relaxed
Energized
Joy opens up curiosity
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6. Role Play
Withdrawer Reengagement- Step 5 & 7, Pursuer not reactive
Honor protection
Using interventions- conjectures
Get Primary- Helpless, Failure
Set up Enactment
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Common Underlying
Emotions Pursuers often feel:
Hurt
Alone
Not wanted
Invisible
Isolated
Not important
Abandoned
Desperate
Disconnected
Deprived
(Information obtained from the EFT Workbook, p. 148)
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Important to Understand
Survival Benefits of Pursuing
102
Protesting / Pursuing:
• Spend more time talking = more practice at communicating and
expressing feelings
•Confronting problems is reaching for connection; often more sensitive to
relationship issues
•Easier to be dependent, part of team
•Power / control in going forward
•Better focus, drive, need to fix
•Honor the anxiety
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Costs of Pursuing
103
Protesting / Pursuing:
• Too Much
•Mean, Resentful
•Desperate, Isolating
•Crazy Making
•Shame
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Hyperactivating
Strategy: fight responses characterize
anxious attachment; heightened desire for
closeness & security
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Understanding the World of Pursuers
Lost in crowd in foreign country!
Emotional constriction presents as rigid reactivity, panic, and desperation
Being alone, feeling unimportant and vulnerable are pursuers’ worst nightmares - much safer/more control to be angry
No response is worse case scenario
Good at message “I’m right, you’re wrong”
Go for pain under fear -- don’t stop short 105
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Understanding the World of Pursuers
When people we love stop paying attention, stop
investing, stop fighting for the relationship, trust
begins to slip away and hurt slowly seeps in.
Disengagement triggers shame and fears of
abandonment.
Its insidious slowness is often worse than a
traumatic event like an affair because there is no
event to point to the separation / brokenness. It
can feel crazy making.
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UNFAIR!
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Just Stop Talking
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I thought you weren’t coming home so I
panicked & I don’t believe you!
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Racing Mind- Crazy Making
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Rejection on so many Levels
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Scaffolding Deeper Pursuer Angry, Misunderstood, Shut Out
Unfair, Righteous, Tricked
Frustrated, Bad Hair
Stuck, Unsure
Anxiety, Helpless, Unheard
Powerless, Exhausted
Rejected, Abandoned
Sad, Alone
Unloved, Broken, Shame, Pain
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How many times will you risk?
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Set up to Mistrust and then blamed for being negative
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Help make meaning out of Anger
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Appreciate the Risk What we are asking pursuers to do is crazy:
To go to their scary, shameful, hiding place where they feel ugly/small and share it with someone who is unreliable and has already rejected the best presentations of themselves
If the worst fear is abandonment then what is the most likely outcome of revealing their warts?
Ultimate Confirmation!
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So painful to be so physically close
but emotionally miles away
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The external criticism of Pursuer often
reflects the internal critic
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The Key for Pursuers is Asking from a
Softer Place:
Pursuer comes forward in vulnerable way to
seek comfort not assign blame!
Shift focus from the other to the self. Learn to
plug into and listen to softer emotions.
Unfair- Left alone with no responses- normal to
be anxious-survive by fighting for response- then
blamed for being too combative/ anxious.
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Unpack the moment right before they get angry or when their partner leaves
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The cure for rejection is love and
acceptance in broken places
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Pursuer’s Needs Being Met
Feeling Connected, Grounded
Understood
Seen, Heard
Wanted
Calm, Warm
Relaxed
Energized
Hopeful 122
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5 Hold Me Tight Exercise
Part 1
What am I most afraid of? What are the fears that leap out at
moments of disconnection and pull me into our Demon Dialogue?
Take the elevator down. Own and order your fears.
Focus inside and find a felt sense. Name it using simple image,
adjective or emotion such as “shattered”, or “helpless.”
I would describe this felt sense as:
___________________________________________
____________________________________________________
____________________
Explore and share the “Terrible Ifs” embedded in the fear. Start
with these words, “When I am afraid I think about…”
The listener just attends (listens intently) and tunes in.
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Part 2: Making Needs Explicit- Speaking Aloud
What do I need from you? How can you help me
to feel a secure connection?
Listen to and own the longing in you fear—the
Hold Me Tight message.
Shear this “I need” with your partner (keep it
simple, no more than two sentences) When,
deep inside, I feel _________, I need you to ( you
do have to ask!)
Listener just attends, tunes in. Offers a response
to this stated need.
Share what it was like to have this conversation.
What have you learned about each other? What
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Secure Connection:
Key Learning
In love, you don’t have to be rich or
smart or talented or funny.
You just have to be there.
Robert Karen
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Deep and lasting love is
within the reach of all of us.
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WORKING WITH FAMILIES
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What if …. As a family therapist you were in the territory of the… Understandable, Predictable, Explainable, Changeable We Now Know: • The Territory – The Problem • The Destination – Goal • The Map – Key Moves/Moments
New Science- based on observation of distress, satisfaction, bonding in action, change in therapy.
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Thomas Video
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Aligning the Parents’ Caregiving with Child’s Attachment
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Autonomy Connection
Attachment Needs
Often 2way Block Parent Responding to Needs Or Child Expressing
Parents Care Giving System
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We Change and Explore Together
Being a family requires a life long process of change.
A parent’s role and influence may change but a parent’s importance remains.
Growth requires exploration and exploration is more likely from relationships of safety and security
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Emotionally Focused Family Therapy
EFFT is a brief process experiential approach that is designed to transform negative interaction patterns by restructuring attachment bonds and increasing parental accessibility and responsiveness to children .
EFFT is a natural extension of EFT .
The key difference is that there are multiple relationships that are horizontal and vertical and change over time.
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EFFT Treatment Goals
“The goal of EFFT is modify relationships in the direction of increased accessibility and responsiveness, thus helping the family to create a secure base for children to grow and leave from.” (Johnson, 2004, p. 245) • Change problematic interactional patterns that sustain attachment
insecurity among family members. (ID Negative Cycle)
• Create new patterns of accessibility and responsiveness that promote felt security for children and secure connections between caregivers.
• (Replace with Positive Cycle)
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EFFT Key Assumptions
• Fixed Patterns: Rigid patterns of negative interaction create states of fear, grief and anger. Working together these emotions and patterns limit communication and increase insecurity.
• Felt Security: The enactment of typical attachment needs for security, protections and contact are adaptive – yet in a context of insecurity the enactment of these needs may prompt restraint or rejections.
• Reorganizing: Accessing a reorganizing key emotional experiences is the most powerful route to new interactional sequences and intra and interpersonal change.
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Fixed Patterns of Family Distress
Escalating emotional tensions result from secondary emotional responses - Over and under responding to attachment signals.
• Lack of caregiver availability
• Disruption in caregiving alliance
• Increased insecurity in partner’s relationship
• Increased defensiveness/ acting-out behaviors in children with unmet attachment needs
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“The attachment perspective views a secure emotional connection to significant others as an adaptive, wired-in survival mechanism that fosters optimal development and mastery of the environment (Bowlby, 1969) … families ability to balance needs for individual growth and connectedness while providing nurturance…” (Johnson, et al. 1998, p. 244(
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Dependency Paradox Accepting Dependence Independence (Feeney 2007)
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Building Blocks of Felt Security Safe Haven – Going to another for comfort, help, and reassurance in time of need .
Secure Base - Three characteristics are necessary )Feeney & Thrush, 2010 (
• Being available in case security is needed
• Not necessarily interfering with exploration
• Encouraging and accepting exploration
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Care Seeking - Caregiving
Complimentary system: Attachment figure’s response to the goals and needs of another’s attachment behaviors / signals of discomfort and distress. Stronger – Wiser Other .
• Attunement: Involves evaluation of signals and threat appraisal.
• Representational flexibility and balance - relationship specific.
• Caregiving Support – resource for repair. Change in families more likely when a “caregiver establishes greater confidence in the availability of
another adult.” (Kobak & Mandelbaum, 2004 p. 158 (
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Tapping Into the Care Giving System
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An availability and supportive attachment figure in a times of need:
Reduces a person’s distress
Engenders positive feelings:
• Being loved
• Being grateful
• Being at peace
For adults accessing these positive feelings can be done by thinking about a responsive and supportive attachment figure.
Shaver & Mikulincer, 2016
ATTACHMENT SECURITY
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Exercise
Think of a time when you experienced ”felt security” from an attachment
figure – a “stronger wiser other”.
• What words would you use to describe that experience?
• What thoughts did you have about that person?
• What thoughts did you have about yourself?
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Inter-Subjectivity
In essence they are co-regulating emotions (experiential) and co-creating meaning (systemic) of the events they are attending to.
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Importance of Emotional Engagement 3 year Old Child Brain Scan- Attachment Disorder
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When people don’t respond to our inner world then we don’t develop words to speak about our experience. Having no words, it is hard to describe feelings. The inner world takes on a vague and nameless quality. Subjective experiences continue to occur but they are difficult to understand or communicate. They are not trying to withhold or be difficult; it is a basic truth about their life that they don’t know what to say about their thoughts and feelings. They have a sense of self that lacks coherence, continuity, clarity, and comprehensiveness.
Dan Hughes
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Bowlby’s concept of developmental pathways suggests that one can be brought back on to a more secure pathway by adding the missing component from life at a later date. (Byng-Hall, 2000, p . 265) We can provide this component through: 1) therapist 2) family member 3) self-parts 4)higher power 5)friends, kids, pets, etc
GOOD NEWS: ATTUNEMENT= HEALING
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PLACE
Playfulness: A light, hopeful, open and spontaneous
Loving: Delight, Enjoyment
Acceptance: Unconditionally directed at all of the experience of the other
Curiosity: Nonjudgmental, not-knowing, active interest in the other’s experience
Empathy: Felt sense of the other; actively experienced and communicated.
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EFT Stages and Markers of Change
• Process experiential: Present focus
• Emotion focus = Language of attachment
• Systemic: First-order and second order change
• Re-engaging attachment and caregiving systems
Stage 2 Restructuring
Stage 1 De-escalation
New meaning Child Reaching Parent Responding
De-escalation Openness
Stage 3 Consolidation
Identify Blocks & Negative Cycles
Create Positive Cycle
Repir Without Therapist
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Key Differences in EFT with Families
Family Process – Developmental System – Changing Needs - Attunement
– Hierarchy – Needs reciprocal not mutual
– Generational Influences – Parental attachment histories
Complexity – Role of the therapist – Flexible, Leading
– Treatment modes – Moving between dyad, triads, family
– Intensity of EFFT – Moves quickly, enactments
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EFFT Steps and Stages
.
STAGE 1 DE-ESCALATING FAMILY DISTRESS STEP 1 Building alliance and family assessment STEP 2 Identifying and processing negative interactional patterns. STEP 3 Accessing primary emotions underlying rigid positions associated with family patterns. STEP 4: Reframing negative interactional patterns in terms of the stuck patterns and in terms of attachment needs and responses.
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Step 1. Alliance and Assessment
Making room for all to be seen and heard Sub-system assessment (caregiving system and sibling system) Join and prioritizing parent initiative Assessing safety and decision
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Contraindications
• Domestic violence: Patterns of power and control making vulnerability unsafe among members.
• Substance abuse/addiction: Acting out parents and / or youth require treatment for these disorders prior to family treatment.
• Disengaged parents who refuse to actively participate in treatment or hostility at caregiver level
• Very young children: Play therapy and parent sessions are indicated.
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Decision Tree Flexibly tailor sessions to meet needs of each family.
• Some families may demand mostly family sessions while others call for
an emphasis on dyadic work.
Focus where major change events occur / needed.
• In best case scenario it occurs in family but some factors dictate the need
to break up into smaller units (e.g. Dyads, Triads)
Target is moving but same target- attachment is dyadic.
Invite Family into decision tree process, be clear about process
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Assessment: Parental Balancing Act- raising kids with a high degree of connection and
consistent, clear limits
Structure Care
Balance = Flexibility
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No Drama Discipline
• “Our children need repeated experiences that allow them to develop wiring in their brain that helps them delay gratification, contain urges to react aggressively toward others, and flexibly deal with not getting their way. The absence of limits and boundaries is actually quite stressful and stressed kids are more reactive. So when we say no and set limits for our children we help them discover predictability and safety to an otherwise chaotic world” xxiii
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Step 2. Identifying Negative Patterns
• Identifying the negative patterns that create and fuel attachment
insecurities-shifting focus from problem individual to problem between individuals
• Various overlapping and reactive cycles amongst all family members are made explicit and reframed as an attachment struggle that is shared by all family members
• Therapist gives clarity and attachment meaning to family distress
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Common Negative Patterns
Pattern 1. Over-functioning
• Critical / Intrusive Parent - Anxious
• Withdrawn/Depressed or Defiant Child – Avoidant
Pattern 2. Under-functioning
• Overwhelmed/Unavailable Parent - Avoidant
• Parentified or Symptomatic Child
Pattern 3. Mixed
• Indulgent/Ineffective parent-Hostile/demanding child
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Pursuer Withdrawer
Criticizes-Attacks
He Doesn’t Care
Anger
Fear Abandonment-Sadness
To Be Loved-Important
Shut Down-Avoid
He’s Too Demanding
Numbness-Frustration
Fear Failing-Not Good Enough
To Be Loved- Important
The cycle circles from Action Tendency in one partner to triggering unmet attachment needs in the other partner, then up and around.
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Mom Dad Dylan CJ
Rigid Patterns
Multiple Infinity Loops
Secondary
Universal Attachment Needs
Behavior
Trigger
other
self
Reverse direction from secondary
to secondary to primary to primary.
Behavior
Trigger Behavior
Trigger
Primary
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Step 3 Accessing Underlying Emotions
Working with parental blocks Accessing caregiving vulnerability Accessing child vulnerability
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Secure
Attuned
Flexible
Predictable
Preoccupied
Over Critical
Over Protective
Over Permissive
Dismissive
Indifferent
Absent
Rejecting
Fearful
Inconsistent
Chaotic
Disorganized
High
High
Low
Low Anxiety
Avo
idan
ce
Anxiety
Avo
idan
ce
Parental Blocks to Caregiving
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Degrees of Blocks
ID Block/ Resistance to Buy In
Negative View of Child
Negative View of Self
Help to See It
Make sense of It and Intentions Behind
Work through It/ Success in Vulnerability
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Care Seeking Intent • When you understand the implicit positive, “care- seeking intent” in the
destructive behaviors of the negative cycle, you will be able to see the family members distress more clearly through the attachment lens .
Problematic Attempts for Connection • The EFT cycle is rigidly maintained by each member’s way of managing
the disconnection, while searching for care, connection, and closeness.
Step 4: EFFT Reframe
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• Family system is less emotionally reactive.
• Patterns are acknowledged.
• Parent(s) is more accessible and responsiveness to child’s vulnerabilities.
• Parent(s) express intent to do thing differently- unlatched from blaming IP child.
• Parental goal alliance .
Markers of Family De-escalation
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STAGE 2 RESTRUCTURING FAMILY INTERACTIONS
STEP 5 Accessing and deepening child's primary emotion and attachment needs. STEP 6 Promoting caregiving responsiveness and acceptance of child’s pain and attachment needs. STEP 7 Restructuring family positions. STEP 8 Processing and expanding impact of change event to other family members.
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Accessing and deepening child’s attachment related affect / needs means getting specific about emotions and needs.
Accessing vulnerability with parents and children may have a similar relationship impact but key difference in focus.
• Similar Impact: Vulnerability is a door that opens both ways – primes a softer response.
• Key Difference:
• Allowing someone into my experience - (Parent and Child Focus)
• Making a bid for care, contact, and comfort - (Child Focus)
Step 5: Deepening Child Vulnerability
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Working with Child’s Blocks
Anxious • Aggressive/ Critical- negative view of parent • Unworthy/ Shame- negative view of self • Parentified child- need put self aside to take care of parent
Avoidant • Cold/ Shutdown- dismissive, minimalize, joke • Placate/ compliant
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Expand and organize a parent’s response to child
• Promoting parental confidence and making explicit parental accessibility
• Organizing parental responses to child’s needs
• Processing parental fears and blocks to engagement
• Engaging caregiving alliance as a caregiving resource
Step 6: Promoting Parental Responsiveness
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What is blocking the care-giving system?
• Caregiver relationship distress
• View of self; failure, shame, over-focus on self
• View of child; bad, spoiled
• Contextual issues: poverty, traumatic loss
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Blocks to Engagement
Parent Insecurity - Fear hijacks parent responsiveness
• Fears: Not sure how to respond (e.g. Distrust of emotion); Fear of Failure (e.g. Will I get it right?) and Possible Rejection (e.g. She won’t want what I have to give).
• Caregiving alliance – Resistance and distress between partners about responding to child’s vulnerability.
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Blocks to Engagement Parent Shame - Negative View of Self Making of past failures and perceived inadequacies through acceptance and ownership of what was avoided – (e.g. self compassion)
• Normalizing parent reactive responses – survival instincts.
• Acknowledging protective role of shame.
• Child feared that their behavior meant they were bad.
• When seen and accepted by another one can begin to accept self.
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Working with Blocks
Therapist uses primary emotion to prime motivational systems in the present moment.
• Caregiving Instinct: Parents looking to care for their children by providing contact, care, and comfort.
– Therapists honors “intent to care” – parent’s best intention.
• Attachment: Children are looking for care from their parents.
– Child’s behavior seen in attachment terms. (Therapist honors primary responses: Protest, Pain, Fear.)
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Responsiveness to Child’s Vulnerability
Keep Your Focus
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Therapists’ Relationship to Blocks
Try Talk Out of Block
Interferes with Therapist Focus- Exit Process
Permission leads to Greater Attunement & Reveals the Very Obstacle to Security
Slice Thinner
Block Becomes Bridge
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Ready for Parent’s Responses 1. Empathetic & Jumping In 2. Empathetic & Giving Space
3. Mixed-Mistrust & Jumping In 4. Mixed-Mistrust & Giving Space
5. Hostile & Jumping In 6. Hostile & Giving Space
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Keeping Focus with Interruptions • Parent jumps in and therapist not sure what to do. • Decision Tree for Transitioning
Green Light - If empathy for child, great - facilitate support Yellow Light - Often both mistrust/empathy, try validate mistrust and then go for empathy. Turn into green light if cannot then dealing with red light Red Light - If hostile response then we need to explore block- make sure tie bow/ tourniquets around child’s vulnerability before exploring/ decision tree
Therapist transitions w/o typing bow = abandonment Therapist getting permission with tying bow = help
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Restructuring family positions focused on parent responding and child receiving.
• Making caregiving intentions explicit.
• Structure parental enactment with attuned response to child or child’s
vulnerable reach to the parents.
• Promoting child receiving parental response.
• Processing impact of child response with parent.
Marker: Child receiving parental response.
Step 7: Restructuring
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Children must experience success around vulnerability otherwise they shouldn’t engage
If parent can’t therapist needs to stand in the gap
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• Exploring parental availability to other family members – systemic
assessment .
• Exploring impact of family vulnerability on other children / family
members .
• Refocusing on emerging blocks to caregiving responsiveness and
child vulnerability .
• Spring board to additional restructuring. (Steps 5 – 6 - 7.(
• Inviting members to explore vulnerable engagement in the family .
Step 8: Exploring Impact of Change Event
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Step 9: Strengthening new patterns of secure responding in the family and promoting new understanding of family as secure base .
• Creating new narratives of family connection
• Highlighting ways they are making repairs and confidence in new patterns .
Stage 3 Family Consolidation
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A secure emotional connection does not stop fights, differences, or hurt feelings in relationships…
A strong bond gives us the best place to rest, to heal, and to thrive with the challenges of life.
Building Strong Bonds Together
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Transformation- look for Physical Markers Proof of Clinical Success - Install Positive Emotions
• Feels Good, Joyful, Happy, Warm • Cheerful, Excited, Elated • Calm, Peaceful, Safe • Curious, Playful, Flirtatious, Confident • Loving, Affectionate, Touched • Connected, Attuned, Empathetic • Grateful, Thankful, Satisfied, Big Smile • Lighter, Easiness, Expansiveness
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Simple Rule: Connect before Fix
Add the missing component!
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Similarities
Sacred Stress
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George Faller, LMFT Certified EFT Supervisor and
Trainer President NYCEFT.ORG
914-434-0520 [email protected]
www.georgefaller.com
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