Basic Handout

26 Pages·2017·29.92 MB·English

Emotionally Focused Therapy for Couples
Dr. Sue Johnson
www.iceeft.com

Copyright: Dr. Susan Johnson 2017
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Couples Therapy: New Era

NEW KNOWLEDGE:

•  Power of relationships on mental & physical health (eg. Heart disease, immune functioning, depression),
on resilience. Lovers are regulators of each other’s physiology, emotional functioning.
•  Nature of relationships (positive/negative – the problem in CT-John Gottman and Ted Huston).
•  Powerful proven interventions such as EFT –Empirical validation.
•  In session change process (in EFT heightened emotion & alliance crucial).
•  New science of love (offers a focus/goal for CT-adult attachment).
•  New targets for CT-people in context of key relationships. CT used for individual problems (depression,
anxiety).

For the first time there is convergence. A potent integration of theory/research/practice is possible.
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LOVE

Most used word / Rated most important goal
It is:
•  A mysterious mixture of sex and sentiment ?
(If so: cannot understand it, make or keep it).
•  A science of love is impossible.

Or is it:
•  An exquisitely logic survival system ?
•  Our foremost and most basic need – from the cradle to the grave ?
•  Our only defense against “emotional starvation”.
•  A haven of safety and strength. Effective Dependency.
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Love: A Huge Diversity of Ideas
All agree romantic love involves a ‘hurricane of emotion”

After that:

•  Sexual desire dressed up – infatuation – a “fever”

•  Immature idealization – “perceptual anesthesia”

•  Evolutionary reproduction strategy - 4 years
•  Brief infatuation - Then a friendship

•  An addiction (dopamine)
•  Illusion - Invention of medieval troubadours
•  A rational deal – negotiated exchange
•  A moral – mystical force
A Mystery - Disastrous idea!
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EFT – Couples Therapy
For The First Time:
The couple therapist is in territory of the:
• 
Understandable
• 
Predictable
• 
Explainable
• 
Changeable
We 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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Empathic Responsiveness is the Essence
of Emotionally Focused Therapy

The empathic responsiveness of the therapist creates safety. The goal is to guide
partners into this responsiveness with each other.

“Resolve to be tender with the young, compassionate with the aged, sympathetic with the
striving and tolerant with the weak and the wrong.
Sometime in your life you will have been all of these.” (Lloyd Shearer)

Most Basic EFT Intervention: Empathic Reflection
•  Creates safety
•  Focuses and slows processing
•  Better organizes & distills experience – creates coherence
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The Problem:
W: Do you love me? (accusing tone)
H: Of course I do. How many times have I told you?
W: Well it doesn’t feel like it (tears, looks down, turns away)
H: (Sighs-exasperated) Well, maybe you have a problem then. I can’t help it if you don’t feel
loved. (Set mouth, lecturing tone.)
W: Right. So it’s my problem is it? Nothing to do with you, right? Nothing to do with your ten
feet thick walls. You’re an emotional cripple. You’ve never felt a real emotion in your life.
H: I refuse to talk to you when you get like this. So irrational. There is no point.
W: Right. This is what always happens. You put up your wall. You go icy. Till I get tired and give
up. Then, after a while, when you want sex you decide that I am not quite so bad after all.
H: There is no point in talking to you. This is a shooting gallery. You’re so aggressive.
Rigid pattern- blame/withdraw.
No safe emotional connection-escalating danger and isolation.
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Shut DOWN Shut IN Shut OUT
Protection / Prison
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Emotionally Focused Couples Therapy

Looks within at how partners construct their emotional experience of relatedness.
•  (Using Rogerian Interventions)
Looks between at how partners engage each other
•  (using Systemic Interventions and tasks)
In Order To:
•  Reprocess / expand emotional responses
•  Create new kinds of interactions / change the dance
•  Foster secure bonding between partners

website: WWW.ICEEFT.COM
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5 Basic
THE
1.
Moves of EFT Reflect &
Distill
Present
Process
(within
between)
Repeat these
5 moves 2.
again and 5. Affect
again, as you Integrate/ assembly &
Validate
move deepening/
through the “look dwihd”a t you new
emotions
steps and
stages of EFT.

4. 3.
Explore how Turn new
each experience
experiences into new
the new steps steps/signals
to partner/
“how does it feel to
hear …” enact
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The Key Challenges of Couple Therapy

1.  To make sense of the drama, the emotional circus, the dilemmas in a
love relationship. To have a map and a way home.
2.  To create a secure base for inner and inter exploration - openness and
engagement in therapy - with both partners - in every session.
3.  To make potent emotion the agent of change - the therapists friend. To
change how emotion is regulated and expressed in the couple’s dance.
4.  To de-escalated demon dialogues that shape disconnection and help the
couple find BALANCE.
5.  To shape in the moment positive bonding interactions, removing blocks
and dealing with injuries, risks, fears.
6.  To help the couple make the in session changes LAST.
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EFT is Experiential EFT is Systematic
•  Focus is whole person not the problem •  Focus on context/process – Different
per se contexts evoke different aspects of self,
strategies.
•  Focus is process – how problem is
constructed in the moment •  Find the LEADING, ORGANIZING
ELEMENT and shift this to
•  Focus is generating new corrective REORGANIZE system. The SECOND
experience (not explanations) ORDER CHANGE – not simply
symptom
modification.
•  Focus on Pattern/Circularity –
feedback loops – two way interactions
that self-perpetuate. Construction is
problematic – open flexibility is health.

How one communicates limits the response options of others – emotional signals organize interactions.

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The Strengths of EFT as a
Model of Couple Intervention
On target for couples goals/on target for core issue in distress.
•  The only couple therapy based on a clearly articulated and densely researched
theory of adult love and bonding and related neuroscience. Fits with research
on relationship distress and satisfaction. What we understand we can shape
and repair.
The gold standard for research in CT
•  Outcome studies (over 25 years - 16 studies) show consistent positive results –
as does follow-up.
•  Process of change studies (9) offer a map for in session change.
•  Studies of the impact of EFT training have begun.

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The Strengths of EFT as a
Model of Couple Intervention
Generalizability
•  Different populations showing anxiety and depression respond - co-
morbidities. EFT used with many different kinds of clients.

Effective training resources and procedures
•  EFT is outlined in terms of steps of therapy and specific interventions with
many training resources available. Certification available.

Breath of impact
•  EFT integrates a focus on attachment - self and system - in a collaborative and
respectful manner – few drop outs. Core changes in love relationships foster
personal and family growth / resilience.

Other applications
•  EFT is used with families, with couples seeking education and enhancement
(the Hold Me Tight Program), with post-deployment war vets. The perspective
and interventions also generalize to individual therapy.
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EFT Research
Meets the gold standard set out by bodies such as APA for psychotherapy
research. EFT epitomizes the very highest level set out by this standard.

The meta-analysis (Johnson et al, 1999) of the four most rigorous outcome
studies conducted before the year 2000, showed a larger effect size (1.3) than
any other couple intervention has achieved to date – 70-75% recovered on
DAS with significant improvement – 86-90%

Studies consistently show excellent follow-up results – some studies show that
significant progress continues after therapy. Nine studies on the process of
change validate EFT interventions.

The generalizability of EFT across different kinds of clients and couples e.g.
depression and PTSD – results are consistently positive.

A recent study on EFT effects on attachment security with an FMRI
component shows that EFT changes attachment security and the way contact
with a partner mediates the effect of threat on the brain.

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Changing Responsiveness to
Threat with EFT
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The Focus of EFT (The 4 P’s)
EXPERIENTIAL
•  PRESENT MOMENT (Emotion brings past alive. Past used to validate present blocks,
styles, fears).
•  PRIMARY AFFECT – Focus on / Validate
SYSTEMIC
•  PROCESS (across time) – PIVITOL MOMENTS
•  POSITIONS / PATTERNS of interaction – self sustaining feedback loops
THE THERAPIST IS A PROCESS CONSULTANT !
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EMOTION
Cue- Rapid appraisal of environment – Body arousal
Meaning/Reappraisal – Action Tendency (Arnold)
•  Source of information – fit between environment cues and needs / goals
•  Vital element in meaning
•  Primes action response
•  Communicates – organizes social interactions
Six core emotions (facial expressions) and adaptive actions.
ANGER Assert, defend self

SADNESS Seek support, withdraw

SURPRISE/EXCITEMENT Attend, explore

DISGUST / SHAME Hide, expel, avoid 
FEAR Flee, freeze, give up goal 
JOY Contact, engaging
Panksepp’s attachment “panic”
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EFT Core Assumptions
1.  Rigid interactions reflect / create emotional states and absorbing
emotional states reflect/create rigid interactions (loop).
2.  Partners are not sick / developmentally delayed/unskilled … they are
stuck in habitual ways of dealing with emotions/engaging with others at
key moments.
3.  Emotion is seen as target and agent of change.
4.  Change involves new experience and new relationship events.
5.  Effective couple therapy addresses the security of the bond,
mutual accessibility and responsiveness.

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