What is Emotionally Focused Couple Therapy?

By Sarah McConnell

When couples come in for counselling, it always seems important to me to tell them what they are letting themselves in for. For one thing, most people don’t really know what couples therapists do – they just know that they need help because things aren’t going well in their relationship. Over the years, though, I’ve found that when people have a sense of the direction we’re taking in therapy, it makes it easier to understand what we’re doing and to pay attention to what is happening for them at home and to change things in increments so that the work we do in the therapy office has more chance of succeeding.

Emotionally Focused Couple therapy was formulated in the 1980s with the work of Les Greenberg and Sue Johnson, researchers in Canada. Les and Sue took strands of work invalessiobrito-two-love-whooping-crane-2-800px emotion research, experiential therapy, and attachment theory and wove them together to produce EFT. Les went on to continue his process research (looking in minute detail at the moment to moment interactions in therapy to discover what works and what doesn’t) and Sue went on to develop their research in the model we now call EFT. Sue’s most famous work is a book for couples called Hold Me Tight, which explains, in a very practical way, how EFT works and contains exercises for couples to do on their own at home. Sue’s later book for couples is called Love Sense.   There are many other great researchers in EFT, including my former mentor and colleague Brent Bradley, who, with Jim Furrow wrote another very practical guide for couples – Emotionally Focused Couple Therapy for Dummies.

So, what is EFT in practice, in the therapy room?   When couples arrive in therapy, they are often in conflict or experiencing distance from each other. This can be as a result of slow eroding of closeness over the years or because of specific “injuries” in the relationship (“when I really needed you, you weren’t there” “my husband/wife had an affair” “You didn’t stick up for me when your Mum was criticising me”). Whatever the cause, couples report that they are no longer able to communicate with their mate or if they try to they get a defensive or critical response or no response at all. What they often really mean is, “I don’t feel safe to be really vulnerable with my partner and I can’t be sure of a kind, compassionate response when I ask for what I need from them.”

For many couples, these issues – old or new, long standing or recent – often result in what we call a negative interaction cycle. More often than not, one partner is the more pursuing (blaming, critical or attacking) partner and the other is the more withdrawing (shut down, numb or defensive partner. The negative cycle results from these stances – the more the pursuing partner pursues, the more the withdrawing partner withdraws, which hurts the more pursuing partner, so the more the pursuing partner pursues – causing the withdrawing partner to withdraw – and so on.   This cycle or variations of it can start anywhere, with either partner. Each couple’s cycle is unique and composed of specific hurts and emotional reactions.

The interesting thing most couples don’t understand about each other when they argue or ignore each other at home is that underneath these surface reactions (anger, blame, defensiveness, coldness) there are softer emotions being triggered. These softer emotions are often about fear, shame or loneliness, which are experienced when the partner who is “supposed” to love and care for you is not available to you at that critical moment. We work to understand the couples whole emotional experience – what’s getting triggered (the softer emotions), what the reaction is (the reactive emotions) and how each person in the couple experiences these. Interestingly, what happens when partners start to feel and understand the softer emotions is that the negative cycle tends to slow down and become less frequent and less intense. Couples tend to start feeling closer, have more intimate moments and report fighting or distancing less. But that’s not the end of the story.

In order for more significant change to happen in the relationship, couples need to take the next step in therapy. It’s not enough to recognize the softer emotions. It’s important to learn how to let the partner know what’s going on and to reach out for the soothing and comfort that’s needed. This is what we do next in therapy. We start with the more withdrawing partner and work with them to help them understand clearly the fear, shame or loneliness that’s going on for them in the critical moments. We help those partners to reach out to their partner in the moment, in session to convey these fears and the corresponding needs to their partner so it’s clear what’s going on. Once the more withdrawing partner has found ways, with the help of the therapist, to communicate in this way, we help the more pursuing partner to respond lovingly.   This same process then happens again with the more pursuing partner – identifying what they are afraid or ashamed of, communicating this to their partner and receiving comfort and soothing. This part of therapy can be powerful and healing. We often work on those injuries I mentioned earlier here – these are often blocks to vulnerability and responsiveness and working through them changes the negative cycle radically.

As couples feel closer and safer with each other via this kind of work in therapy, it then becomes time to help the couple continue to open up with each other, to deal with any missteps as they happen (which they will) and to tackle problematic issues that the couple might have had trouble with when they were in their negative cycle as a team now that closeness and support feel easier to achieve.

This is often the time when couples feel they have transformed their relationship. Therapy often ends at this point or couples start to come less frequently, often only returning for maintenance or when they run into specific problems later on.

As a therapist, what keeps me going in this wonderful but sometimes challenging work is the transformation that I’ve seen in many couples. From painful, negative cycles to collaborative, supportive and compassionate positive cycles, where couples often recapture the kind of closeness and safety they had in the beginning of their relationship or create that safety and closeness for the first time. I love this work! I hope I’ve been able to convey some of the essence of it here. If you’d like to know more, check out some of the resources here. Welcome to the world of EFT!

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Couples, what is your attachment style?

Much of the work we do in Emotionally Focused Couples Therapy grew out of the psychoanalyst John Bowlby’s seminal work on attachmentIMG_5473.  Subsequent researchers and theorists have built on his work and analysed how different attachment styles affect relationships. In their book Attached, Amir Levine, MD, and Rachel S. F. Heller, MA, describe different styles of attachment and how they affect relationships.

Styles of attachment are:

Secure: People who feel securely attached are at ease with intimacy, don’t fear rejection, and are able to express love and warmth with relative ease.

Anxious: People who are anxiously attached fear that their partners may not be reliable sources of love and intimacy. Anxious partners need frequent confirmation and reassurance of value, support, and connection.

Avoidant: People with avoidant attachment styles fear attachment is a sign of dependence and seek to minimise closeness. They will try to establish that they can make it on their own with or without a partner.

Disorganised: A few people exhibit traits of both anxious and avoidant attachment styles.  They may fear becoming dependent because they fear no partner will reliably provide support and intimacy.

It is obvious that some pairings or attachment styles might create more problems than others. For example, an anxious person might do well with a secure partner, as reassurance and validation would likely be in steady supply. However, an anxious person in a relationship with an avoidant person might suffer seemingly interminable torment while simultaneously causing great distress for the avoidant partner.

However, understanding one another’s attachment style can improve empathy between partners regardless of their individual attachment styles and lead to better communication about each person’s needs and how to meet them.  With time and understanding, each partner can reassure the other that attachment does not necessarily mean dependence. The anxious partner may feel empowered to trust in the relationship without on-going demands for validation and recognition of intimacy, while maintaining healthy commitments and mutual validation.

The avoidant partner may also come to feel that shared intimacy is possible without losing independence or personal identity. In short, each partner can become securely attached to their partner. Of course, it is unlikely that both partners will suddenly become securely attached and forget all the past experiences that made them anxious or avoidant in the first place, but with greater understanding of the underlying emotions and relationship dynamics, each partner may view times of conflict through a different lens and be able to react with more patience and compassion for the other partner in addition to becoming more patient and compassionate to him or herself.

No couple can honestly claim to be perfectly matched and expect to never experience times of conflict, disappointment, or anxiety. Healthy couples can, however, expect to work through difficult emotions effectively, patiently, and sympathetically. Couples counselling can help couples identify their attachment styles and develop communication strategies to help work though difficulty constructively while offering mutual support. It won’t always be easy, of course, but a little effort and understanding go a long way to making a relationship mutually satisfying.

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FAQ: What to expect in couples counselling

Will I be blamed for our relationship problems?

The goal of counselling is to improve communication and connection in the relationship and to retrieve the emotional bond between you. Assigning blame is not part of the process. Most relationships have suffered injuries of one type or another. The injuries may be minor (miscommunication or misunderstanding) or they may be major (affairs, betrayal, severe disappointment). Couples responses to each other make sense in the context of hurt and pain and often negative cycles ensue. The role of the therapist is to find methods to help the couple understand and de-escalate the negative cycle and heal the injuries, not to punish either partner.

What if our relationship is beyond repair?

When couples fear they can no longer be together but want to be sure of their decision, they may go through a process of discernment, which entails an exploration of all facets of the relationship before making a final decision.

In some cases, couples know they are ending the relationship before seeking counselling. The role of therapy in such cases is to help the couple move forward in a constructive manner and avoid possible destruction of a hostile split.

Will I have to cry in therapy?

While clients do sometimes cry in therapy, it is not a goal of the therapy session. Crying is a natural human response to pain and is neither not judged. Your therapist will support you regardless of how you express your emotions.

Will anyone else know what we discuss in therapy?

Therapy is confidential, and anything said is kept between clients and their therapists. Exceptions occur when a therapist becomes aware that harm to the client or others is imminent, when there is some kind of abuse reported, or when the therapist’s records are subpoenaed by a court of law

How much does therapy cost?

I charge £60 per session.

How many sessions will be needed?

It varies by client of course, but 12 to 20 sessions is a good average.

If I can’t meet in person but need help, are there other options?

Sometimes, brief communication by email or phone is possible at no extra charge. Full sessions are also available online at the regular rate.

What if I feel unsafe in the relationship?

 Your therapist can help you take steps to protect yourself and find help and resources to protect you. Also, if a dangerous situation becomes obvious during a session, your therapist may be legally required to report it to appropriate authorities.

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