Stepping into Emotionally Focused Couple Therapy

Key Ingredients of Change

Lorrie L. Brubacher

• Publisher: Routledge
• Year: 2018
• ISBN:
  9780429919473
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This volume makes Emotionally Focused Couple Therapy (EFT) widely accessible to therapists of different orientations and to therapists in training. It provides clinicians with practical tools, an experiential tour through case examples, and simple guidance to step into EFT. An overview of the change events includes both client processes and therapist interventions moment-to-moment. 'In Stepping into Emotionally Focused Couple Therapy: Key Ingredients of Change, each step and stage of EFT is laid out in a practical and theoretically simple manner that extends beyond what therapists need to do, to helping therapists grasp what experiential therapy is, providing moment-by-moment examples of how to engage clients emotionally, and how to foster emotional engagement between partners.'- From the Foreword by S. Johnson and A. Lee

Part I
Emotionally Focused Couple Therapy: Stepping into Love as an Attachment Process

Chapter One
Introduction to emotionally focused therapy (EFT)

In this chapter, I introduce Emily, a therapist newly learning EFT. I give a brief history of the development of EFT, present the steps and stages of the EFT map for change, and outline the research validating EFT as an evidence-based approach. I conclude the chapter with scenarios of three different couples being seen by EFT therapist, Emily. Emily’s work with these couples will reappear, at times, as I walk you through the steps and stages of EFT.

Tuesday morning, autumn leaves swirling on the path between her steps, Emily walks towards her office, anticipating her first session of the day with Tara and Kyle. Emily enjoys working with this couple that is caught in a classic pursue–demand (Tara) withdraw–defend (Kyle) attachment dance. As much as she dislikes acknowledging it, Emily is also aware of feeling some dread about meeting with her second couple, Phil and Julie. Underneath their very calm exteriors and rather positive presentation of their relationship, Emily picks up hints of fragility in Julie, and an almost volatile protectiveness in Phil. Certainly this couple—two brave childhood trauma survivors—offer the biggest challenge for Emily in working collaboratively within the attachment frame of EFT. The back story of Julie’s discovery of Phil’s extensive use of pornography and each of their involvements in Twelve Step groups distracts Emily from the attachment frame at times. Her heart also skips a beat as she wonders, with the usual excitement and trepidation, how the new couple whom she has scheduled first thing after lunch will present. It is typical for her to feel nervous excitement before meeting new couples.

None of the couples presented is a real couple. They are composites of many couples with identifying characteristics altered. If any of the cases appear to represent someone you know, it is merely because of the universality of attachment themes.

Emily, a young couple therapist passionately devoted to her profession, frequently finds herself in the midst of intensely charged emotional turmoil between romantic partners. At times, the extreme emotions surrounding partners’ staunchly pronounced differences can pull her off balance emotionally. She feels a pressure to help them solve seemingly irreconcilable conflicts, and to dissolve the palpable tension that arises as they discuss issues that range from extended families, to childrearing, time spent at work, a lack of sexual intimacy, or a recently discovered affair. Secrets, rage, indifference, disgust, failed attempts to intervene, accusations, and counter-attacks can whirl around her like a swarm of bees disturbed by an intruder. Then, like a cool refreshing wind wafting through an open window, Emily draws a reframe from attachment theory of this emotionally distressing drama playing out before her. As she looks through the attachment lens, Emily tunes in to hear that the tones in the room are playing a song of longing for secure connection and acceptance. Beneath the couple’s battle over the recent family vacation gone wrong, she hears one partner’s plea for respite from complaints and demands, and the other partner’s protest for engagement and closeness.

Recently, Emily has been stepping into emotionally focused couple therapy (EFT), and she feels some degree of relief with the depathologising framework which attachment theory provides for the various dramas of romantic love in distress. She has known that the communication techniques and problem solving skills she taught her couples, while effective in her office, have routinely gone out of the window when emotions ran high at home. Now, as she is slowly integrating the theory and science of attachment, and beginning to see emotion as a perception/appraisal—motivational process, she feels as if she is getting a new lease on life and on her work. “My job is no longer to fix and teach and change the partners or solve their problems” Emily repeats to herself. “I no longer have to find the solution to their problem or help them fight more politely. All I need to do is attune to them, and listen to their (emotional) music.” Emily has learnt that change will begin to happen as she helps her clients become aware of the longing that each one has to feel precious and to be honoured by the other. She has seen that change begins when she helps each partner to participate in identifying the predictable sequence of dance steps they take when one partner’s hurt or fear is conveyed as an angry protest or an abrupt disappearance. Emily calms down with the recognition that these predictable steps form the dance, the cycle, the fight that is unfolding before her eyes. “I need to trust myself to be fully present to the music and the dance—that is my most important offering.”

Emily knows that after a couple has disentangled their cycle of repetitive interactions, they will explore together the softer, more vulnerable emotions and fears and good intentions that have gone underground and been buried under reactive emotions and behaviours. The reactive (or protective) emotions and behaviours have become so automatic they are almost imperceptible, she realises. It will be a while before the couple moves to the next part of the work, but Emily reminds herself that when they do, these more vulnerable feelings and longings will be uncovered and explored like newly discovered treasures. These previously unacknowledged, unexpressed emotions will be alchemist’s gold for the couple, as they transform previously negative cycles of distancing and blaming into positive cycles of increasing safety, connection, and joy.

“I don’t know how to do all this yet,” Emily realises, but she sits more calmly and hopefully with each couple, recognising that the tension before her is the normal attachment distress of two people who are important to one another. She is learning to trust that her empathically attuned presence and validating understanding of each unique attachment drama is the first and hugely important step out of oppressive darkness. She takes comfort in Bowlby’s essential message to carers of infants: that they do not need to be perfect; they just need to be present.

After a brief overview of the origins of EFT and the fundamental ingredients of change in the process of EFT, I introduce three couples in the early stages of treatment. I anticipate that at least one scenario, if not all three, will be similar to the challenges you face with your own couples. Following this, I discuss how this book can enhance your couple therapy practice and give an overview of how information is organised within the book.

The origins of EFT: drawing from three worlds

EFT began with Johnson and Greenberg (1985, 1988) observing their couples in therapy to identify the effective therapeutic moves and the client processes that lead couples from distress to relationship satisfaction and trust. While observing their recorded therapy sessions, they were admittedly biased towards an experiential approach of empathic reflections of emotional experience, non-pathologising acceptance and the power of therapist congruence and moment-to-moment engagement in the relationship (Perls, 1969; Rogers, 1961, 1980). Given that they were tracking interactions between partners, and observing the context of partners’ impact on one another, they realised that it was necessary to add a systemic orientation to the general experiential perspective. Systems theory (Bertalanffy, 1968) is epitomised in family therapy by Minuchin and other structural family therapists (Minuchin & Fishman, 1981). In both systems theory and experiential approaches, problems are seen in terms of process, rather than as being inherent in the person.

It was not long before Johnson noticed recurrent themes in the couples’ stories: fears of loss and abandonment, loneliness, loss of connection, broken trust, fears of rejection, and a sense of failure. She recognised that these themes pointed couple therapy in a new direction. No longer did intimate relationships appear to be rational bargains and businesses, or cohabiting arrangements to be negotiated. She recognised that, in fact, they were emotional bonds, replete with the same intense longings, needs, and thrills as the bonds between parents and infants. What a remarkable and revolutionary discovery this was. In fact, Johnson’s creative and compassionate genius was one of the initial steps of “cracking the code for love” in the field of couple and family therapy (Burgess Moser et al., 2015; Johnson, 2013).

The therapeutic model of emotionally focused therapy for couples was developed and first tested in the early 1980s (Johnson & Green berg, 1985, 1988). Unique to this model was a clearly delineated theoretical integration of experiential (Perls, 1969; Rogers, 1961) and systemic traditions (Minuchin & Fishman, 1981), focusing simultaneously on intrapsychic and interpersonal experience. No other psychotherapeutic approach had previously synthesised these two traditions. Emotion was featured as both target and agent of change in creating corrective emotional experiences that repaired distressed couple relationships. Johnson’s later addition of the attachment orientation (Bowlby, 1973, 1979, 1980, 1982) resulted in EFT becoming the only couple therapy based on an empirically validated theory of adult love. Adding the attachment base to EFT also strengthened and streamlined the tasks of transforming distressed couple relationships into safe and secure emotional bonds (Johnson, 2004; Johnson et al., 2013). Emily smiles, recalling the metaphor of integration she has heard: Rogers, Minuchin, and Bowlby, sitting together over a cup of tea, and then whispering into Sue Johnson and Les Greenberg’s ears messages about the essential problem in couple distress and the path towards safe and secure bonds.

EFT integrates (1) attachment theory with (2) systemic and (3) humanistic, experiential approaches in a pragmatic manner that respects clients’ ability to change and grow. The attachment perspective keeps a therapist on track, tuned into the attachment channel and focused on the goal of shaping bonding moments that respond to partners’ wired-in needs for secure emotional connection. Tuning in to the attachment channel, an EFT therapist notices triggers, actions, impulses, and emotional expressions as signals of connection and of separation distress. An EFT therapist looks through an attachment lens and sees that everything happening between partners is essentially about how important they are to one another. However ineffective their attempts might be, partners are both acting to secure the tattered connection between them. Attachment theory defines the essential problem of romantic relationship distress as mis-attempts to meet the universal longings for a securely bonded attachment relationship. Attachment theory also provides guidance for a couple therapist as to what is necessary and sufficient to restructure ineffective relationship patterns into safe emotional connection and lasting secure bonds.

Berscheid (1999) noted that developing a science of interpersonal relationships “requires transcendence of psychologists’ traditional individualistic orientation, as well as more research on the impact of affect on cognition and research on the impact of relationships’ exterior environments on their interior dynamics” (p. 260). This quotation pays attention to all three elements integrated in EFT: (1) attachment theory relinquishes an individualistic orientation claiming that we cannot survive without others; (2) experiential therapy holds that emotion shapes meaning and has precedence in driving behaviours (Tronick, 1989); (3) systemic therapies focus upon the intertwined impact which internal and external environments have on one another.

EFT is a brief, integrative model, typically lasting for approximately twenty-five sessions and longer with trauma. The focus on emotion and interaction, which is an integration of experiential and systemic approaches, is integrated with an attachment perspective. Empiricism is integrated with the art of the therapist’s empathic creativity (Johnson & Brubacher, 2016c). EFT’s innovative contributions to the field of couple therapy are many. As the only couple therapy based on an empirically validated theory of adult love (attachment theory) it is making an impact on the conceptualisation of relationship distress and repair, and is expanding the empirical base for placing emotion in the forefront as the agent of change.

The EFT map: steps and stages of change

An EFT therapist follows the nine-step, three-stage EFT map (see Box 1.1) to help couples arrive at relationship satisfaction and secure connection. In Chapters Three to Eight, I detail the steps and stages, which are summarised in Box 1.1. An EFT therapist follows this map as a process consultant (Johnson, 2004), not as a coach, a teacher, a purveyor of wise insight, or a strategist solving problems, but as a consultant who focuses on present process to help couples make sense of their disconnection and to create new patterns of interaction that foster a secure bond.

Box 1.1. EFT steps and stages

Stage 1—De-escalation of negative cycle

Step 1. Alliance and assessment

Step 2. Identify negative cycle (triggers, actions, meanings) and attachment positions.

Step 2. Identify negative cycle (triggers, actions, meanings) and attachment positions

Step 3. Access underlying attachment emotions that are driving the cycle

Step 4. Frame the problem as negative cycle of attempts to meet needs.

Stage 2—Restructuring the bond: withdrawer re-engagement

Step 5. Withdrawer accesses underlying emotions, disowned needs, aspects of self. Deepens, distils, discloses.

Step 6. Promote acceptance in pursuer of new view of partner—expand the dance.

Step 7. Withdrawer steps close to partner, expressing needs and wants. Asking for needs to be met to feel safe to stay engaged in relationship. New interactions between partners: withdrawer risks stepping close, asserting needs and wants, pursuer responds, withdrawer receives the response. This marks the first antidote bonding event.

Stage 2—Restructuring the bond: blamer softening

Step 5. Pursuer accesses underlying emotions, disowned needs, aspects of self. Deepens, distils, discloses.

Step 6. Promote acceptance in now engaged withdrawer of new view of partner—further expand the dance.

Step 7. Pursuer, owning attachment fears and needs, risks reaching from a vulnerable place of engaged fear to ask for needs to be met to feel safely connected with partner. More new interactions between partners: pursuer risks reaching, engaged withdrawer responds, pursuer receives the response. This is the second antidote bonding event that redefines the security between partners.

Stage 3—Consolidation

Step 8. Integrate new bonding cycle with old problems. Support the emergence of new solutions to pragmatic issues. Partners can safely solve problems and cope with differences.

Step 9. Consolidate new responsive positions and cycles. Enact new stories of problems and repair. Create resilience story of “past distress and current bond”. Create future love story and rituals to keep love alive.

The focus of Stage 1 is to identify and become acquainted with the negative interactive cycle. This cycle is the problem that the couple describes upon arrival in the therapist’s office. The therapist tunes into the emotional music: the unexpressed, underlying story of disconnection, pain, fear of not mattering or not measuring up in a partner’s eyes that drives cyclic behaviours of protesting and shutting down. As the therapist listens to the partners’ stories of being let down, disregarded, not cared for, or even betrayed, she is able to validate the reactive emotion (such as anger) in the context of the clients’ experience. Reactive emotions are called secondary emotions, in that they are reactions to the core or primary emotions that typically remain unexpressed in the negative cycle (e.g., a partner becomes angry when she fears she is unimportant to her spouse).

Stage 1 includes:

Step 1. Building alliance and assessing for compatible agendas.

Step 2. Identifying positions of pursuit or withdrawal, and tracking the steps in the automatic reactive cycle.

Step 3. Accessing (discovering collaboratively) the underlying (preconscious) core attachment fears and unmet longings which are propelling the negative cycle.

Step 4. De-escalation—reframing the relationship problem as a specific negative interaction cycle. Delineating the cycle disempowers it from dominating the relationship.

Building and maintaining an alliance is the first and most important task. An EFT therapist carefully and empathically listens to understand the clients’ sto...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• ACKNOWLEDGEMENTS
• ABOUT THE AUTHOR
• Dedication
• FOREWORD
• INTRODUCTION
• PART I EMOTIONALLY FOCUSED COUPLE THERAPY: STEPPING INTO LOVE AS AN ATTACHMENT PROCESS
• PART II ATTACHMENT EMOTIONS AND ALARM BELLS RINGING: DE-ESCALATING NEGATIVE CYCLES IN STAGE 1 OF EFT
• PART III THE ROLE OF EMOTION IN CREATING LASTING CHANGE: RESHAPING ATTACHMENT BONDS IN STAGE 2 OF EFT
• PART IV INTEGRATION AND CONSOLIDATION
• PART V COMMONLY EXPERIENCED IMPASSES IN EFT THERAPY
• PART VI THE NEXT STEPS
• REFERENCES
• INDEX