1. Attachment theory & Emotionally Focused Therapy

2. Founder & Key Concepts Susan Johnson Leslie Greenberg
EFT is a combination of Attachment theory, and Experimental and Rogerian techniques and Structural theory (i.e. patterns)

4. What is Attachment?
…the capacity to form and maintain healthy emotional relationships which generally begin to develop in early childhood – Enduring bond with “special” person – Security & safety within context of this relationship – Includes soothing, comfort, & pleasure – Loss or threat of loss of special person results in distress

5. Attachment is important
Having close connections is vital to every aspect of our health – mental, emotional, and physical.
80% of all men and women was gradually growing apart and losing a sense of closeness, and not feeling loved and appreciated.
Severe and intense fighting were endorsed by only 40% of the couples.

6. 10 Central Tenets of EFT and Attachment theory
Attachment is an innate motivating force
Secure dependency complements autonomy
Attachment offers a safe haven
Attachment offers a secure base
Accessibility and Responsiveness builds bonds
Fear and uncertainty activate attachment needs
The process of separation distress is predictable
Finite number of insecure forms of engagement can be identified
Attachment involves working models of self and others
Isolation and loss are inherently traumatizing

7. What creates close connections?
No Connection
Lack of emotion
Unresponsive
Emotionally unavailable
Connection
Emotion is key
Are responsive to one another
Are emotionally available to one another

8. Accessibility: Can I reach you?
This means staying open to your partner even when you have doubts and feel insecure.
It often means being willing to struggle to make sense of your emotions so these emotions are not so overwhelming
You can then step back from disconnection and can tune into your lover’s attachment cues.

9. Responsiveness: Can I rely on you to respond to me emotionally?
This means tuning into your partner and showing that his or her emotions have an impact on you.
It means accepting and placing a priority on the emotional signals your partner conveys and sending clear signals of comfort and caring when your partner needs them.
Sensitive responsiveness always touches us emotionally and calms us on a physical level.

10. Engagement: Do I know you will value me and stay close?
The dictionary defines engaged as being absorbed, attracted, pulled, captivated, pledged, involved.
Emotional engagement means the very special kinds of attention that we give only to a loved one.
We gaze at them longer, touch them more.
Often we talk of this as being “emotionally present.”

11. Main assumptions
EFT is based on clear, explicit conceptualizations of relationship distress and adult love.
These conceptualizations are supported by empirical research on the nature of marital distress and adult attachment.
Key moves and moments in the change process have been mapped into nine steps and three change events.

12. Goals of EFT To foster the creation of a secure bond between partners
To expand and re-organize key emotional responses
To create a shift in partners' interactional positions and develop new cycles of interaction

13. View of distress in EFT
Relationship distress is maintained by absorbing negative affect
Affect reflects and primes rigid, constricted patterns of interaction
Patterns make safe emotional engagement difficult and create insecure bonding

14. View of Distress Rigid repetitive interactional patterns:
No exits – no detours/ repair impossible
Rigid narrow positions – fight/flight/freeze
Most common patterns
Criticize, complain, express contempt
Defend, distance, stonewall
Results: self reinforcing cycles or reactivity/self protective strategies

15. Negative emotion cycle
Partners cannot attune to one another because they are so absorbed in their own negative affect
Cannot communicate because of their own state

16. Research 70 – 73% recovery rate in 10-12 sessions.
Two-year follow- up on relationship distress, depression, and parental stress – results stable – 60% continue to improve.
Depression significantly reduced.
Best predictor of success – female faith in partner’s caring (Not initial distress level).

17. Principles & Concepts
Looks within at how partners construct their emotional experience of relatedness
Looks between at how partners engage each other.

18. Focus of EFT: The 4 P’s Experiential Systemic
Present
Primary Affect
Systemic
Process (time)
Positions / Patterns
The counselor is a process consultant

19. 4 P’s Present experience
Deal with the past when it comes into the present to validate client’s responses as it relates to how they coped/survived
When emotion is re-experienced it is now in the present
Focus is on current positions/patterns
Don’t ask “why”, focus on what is.

20. 4 P’s
Primary emotions
Validating and moving from secondary to primary emotions
Stay with emotions, create safe haven
Organize the emotion of a past experience so that client can engage in the here & now

21. Stages & Steps Stage 1: De-escalation Stage 2: Restructuring the Bond
Stage 3: Consolidation

22. 4 P’s Process patterns Positions
Look individually how each person is processing in the moment
“What happens…then what…then what”
Positions
The position each partner is taking in the relationship
Work to create new position & new patterns

23. Nine Steps of EFT
Steps 1 – 4 Assessment & Cycle De-escalation
Alliance & assessment: Creating an alliance and delineating conflict issues in the core attachment struggle.
What are they fighting about and how are they related to core attachment issues.

24. Nine Steps of EFT
Steps 1 – 4 Assessment & Cycle De-escalation
2. Identify the negative interaction cycle, and each partner’s position in that cycle.
Goal is to see the cycle in action and then identify and describe it to the couple and work to stop it.

25. Nine Steps of EFT
Steps 1 – 4 Assessment & Cycle De-escalation
3. Access unacknowledged emotions underlying interactional positions.
Goal is to help each partner to access and accept their unacknowledged feelings that are influencing their behavior.
Both partners are to reprocess and crystallize their own experience in the relationship so that they can become emotionally open to the other person.

26. Nine Steps of EFT
Steps 1 – 4 Assessment & Cycle De-escalation
4. Reframe the problem in terms of underlying feelings, attachment needs, and negative cycle.
The cycle is framed as the common enemy (externalizing the problem) and the source of the partner’s emotional deprivation and distress.

27. Nine Steps of EFT
Steps 5 – 7 Changing Interactional Positions and creating new bonding events
5. Promote identification with disowned attachment emotions, needs, and aspects of self, and integrate these into relationship interactions.
Goal is to help the couple redefine their experiences in terms of their unacknowledged emotional needs.

28. Nine Steps of EFT
Steps 5 – 7 Changing Interactional Positions and creating new bonding events
6. Promote acceptance of the other partner’s experiences and new interactional responses.
Goal is to work to get each partner to accept, believe, and trust that what the other partner is describing in terms of underlying emotional needs is accurate.

29. Nine Steps of EFT
Steps 5 – 7 Changing Interactional Positions and creating new bonding events
7. Facilitate the expression of needs and wants and create emotional engagement and bonding events that redefine the attachment between the partners.
Goal is to help couple learn to express their emotional needs and wants directly and create emotional engagement.

30. Nine Steps of EFT
Steps 8 – 9 Consolidation/Integration
8. Facilitating the emergence of new solutions to old relationship problems.
Without the old negative interaction style and with the new emotional connection and attachment, it is easier to develop new solutions to old problems.

31. Nine Steps of EFT
Steps 8 – 9 Consolidation/Integration
9. Consolidating new positions and new cycles of attachment behaviors.
Help couple clearly see and articulate the old and new ways of interacting to help the couple avoid falling back into the old interactional cycle.

32. Case example
-yuM

33. Overview of Process
Develop an alliance, identify cycle, identify and access underlying emotions, and work to deescalate
Engage the withdrawer
Soften the pursuer/blamer
Create new emotional bonding events and new cycles of interaction
Consolidate new cycles of trust, connection and safety, and apply them to old problems that may still be relevant

34. Contraindications of EFT
Different Agendas
Separating Couples
Abusive Relationships
Substance Abuse
Depression and Other Psychiatric Illness

35. Johnson, S.M. (2008). Hold Me Tight: Seven Conversations for a Lifetime of Love. New York: Little Brown.
Johnson, S.M. (2004). The Practice of Emotionally Focused Marital Therapy: Creating Connection. New York: Bruner / Routledge.
Johnson, S.M., Bradley, B., Furrow, J., Lee, A., Palmer, G., Tilley, D., & Woolley, S. (2005) Becoming an Emotionally Focused Couples Therapist : A Work Book. N.Y. Brunner Routledge.
Johnson, S.M. & Whiffen, V. (2003). Attachment Processes in Couples and Families. Guilford Press.
Johnson, S.M. (2002). Emotionally Focused Couple Therapy with Trauma Survivors: Strengthening Attachment Bonds. Guilford Press.