Emotionally Focused Therapy (EFT) is a form of therapy that focuses on adult relationships and attachment/bonding. EFT Therapy aims to help partners and individuals understand and transform their emotional responses, particularly those contributing to relationship distress. Dr. Sue Johnson is one of the primary developers of this approach, a relatively new Humanistic method. This post goes over some key points about EFT Couples Therapy.
EFT Therapy Overview 
The following is an overview of the basic tenets of EFT Therapy. Of course, you can always contact me or schedule a consultation if you want more information about emotionally focused therapy and how it might work for you and your partner.
Theoretical Basis for EFT Therapy
Emotionally Focused Therapy (EFT) is grounded in several theoretical foundations that inform its approach and techniques. These theories are primarily rooted in attachment theory, humanistic psychology, and systems theory.
Attachment Theory
Key Proponent: John Bowlby
Core Concepts:
- Attachment Bonds: Attachment theory posits that humans are wired to seek out and maintain close relationships to ensure survival and emotional security.
- Attachment Styles: Based on their early experiences with caregivers, individuals develop different attachment styles (secure, anxious, avoidant, disorganized), influencing adult relationships.
- Emotional Regulation: Secure attachment helps individuals regulate their emotions effectively. Insecure attachment can lead to difficulties in managing emotions and relationships.
EFT Application:
- EFT aims to create secure attachment bonds between partners by helping them recognize and express their attachment needs and fears.
- The treatment focuses on identifying and modifying negative interaction patterns from insecure attachment styles.
Humanistic Psychology
Key Proponents: Carl Rogers, Abraham Maslow
Core Concepts:
- Person-Centered Approach: Emphasizes the importance of empathy, unconditional positive regard, and genuine therapist-client relationships.
- Self-Actualization: When provided with a supportive environment, people have an innate tendency to grow and achieve their full potential.
- Emotional Experience: Emotions are central to human experience and personal growth.
EFT Application:
- I create a safe, empathetic, and non-judgmental environment that encourages clients to explore and express their emotions.
- The therapy emphasizes experiencing and understanding emotions to facilitate change and healing.
Family Systems Theory
Key Proponents: Ludwig von Bertalanffy, Gregory Bateson
Core Concepts:
- Interconnectedness: Systems theory views relationships as interconnected systems where each part affects the whole.
- Circular Causality: Relationship problems result from circular patterns of interaction rather than linear cause-and-effect relationships.
- Homeostasis: Systems seek stability, and changes in one part can lead to changes in the entire system.
EFT Application:
- EFT focuses on partner interaction patterns, viewing their behaviors and emotions as interrelated and mutually influencing.
- The therapy aims to disrupt negative cycles of interaction and establish new, healthier patterns that promote emotional connection and stability.
Integrative Therapy Approach
EFT integrates these theoretical foundations into a cohesive approach emphasizing the importance of emotional experiences and attachment needs within relational systems. Combining these theories, EFT couples therapy provides a structured yet flexible framework for helping individuals and couples develop secure, emotionally fulfilling relationships.
Mechanisms of Change
There are three main mechanisms by which emotionally focused therapy produces change.
- Attachment Theory: EFT is based on attachment theory, which posits that humans are wired for connection and that secure emotional bonds are essential for mental health and well-being.
- Emotional Accessibility: EFT helps couples create secure attachment bonds by increasing emotional accessibility and responsiveness between partners.
- De-escalation of Negative Cycles: EFT helps couples identify and de-escalate negative interaction cycles, allowing them to engage in more positive and supportive behaviors.
Goals of Emotionally Focused Therapy
The main goals of EFT Couples Therapy are to:
- Strengthen the emotional bond between partners.
- Create a secure attachment.
- Foster better communication and emotional responsiveness.
EFT Couples Therapy Process
EFT Couples Therapy typically involves 8-20 sessions, depending on the complexity of the issues being addressed. There are three primary stages:
- Assessment: During this phase, I collect background information, including your history, and talk to you about current relationship dynamics. The goal is to identify negative patterns and see your strengths as a couple.
- Identifying Emotions: The next step is helping partners identify their underlying emotions and needs.
- Restructuring Interactions: The primary phase involves facilitating new, more positive patterns of interaction, promoting secure attachment.
EFT Therapy Restructuring Phases
The restructuring phase of emotionally focused therapy listed above has three phases for most couples.
- De-escalation: Identifying and understanding negative interaction patterns is the first part of restructuring.
- Restructuring Interactions: Next, partners express deeper emotions and needs, leading to more supportive and understanding interactions.
- Consolidation and Integration: The final part is strengthening and maintaining new patterns outside therapy sessions.
EFT Therapy Techniques
EFT focuses on strengthening emotional bonds by addressing attachment needs and emotional responsiveness. Here are the key techniques I use in Emotionally Focused Therapy:
1. Reflecting and Validating Emotions in EFT Therapy
- Purpose: Helps clients feel understood and validated.
- Technique:
- Identify the underlying emotions expressed by the client (e.g., fear, sadness, or anger).
- Reflect these emotions back to the client using empathetic statements, such as:
“It sounds like you’re feeling really scared that your partner might not be there for you.”
- Validate their experience by normalizing their feelings:
“It makes sense you’d feel this way given what’s happened.”
2. Identifying Negative Interaction Patterns
- Purpose: Pinpoints unhelpful cycles of interaction that harm the relationship.
- Technique:
- Map out recurring conflicts (e.g., “pursue-withdraw” cycles where one partner seeks connection and the other pulls away).
- Name the cycle as the problem (not the individuals):
“This cycle of withdrawing and pursuing seems to be taking over your relationship.”
3. Reframing the Problem as Attachment Needs
- Purpose: Shift the focus from blame to unmet emotional needs.
- Technique:
- Explore the attachment needs underlying negative behaviors.
Example:- Partner A’s anger stems from a fear of abandonment.
- Partner B’s withdrawal stems from fear of conflict.
- Help clients express these needs in vulnerable terms, such as:
“When I get angry, it’s because I’m scared you don’t want to be close to me.”
- Explore the attachment needs underlying negative behaviors.
4. Emotionally Focused Therapy Heightening Emotions
- Purpose: Deepens emotional engagement and brings core feelings to the surface.
- Technique:
- Use evocative questions to help clients access deeper emotions:
“When your partner pulls away, what’s the worst thing you fear?”
- Encourage clients to stay with the emotion instead of intellectualizing:
“Stay with that sadness—what’s it telling you about what you need?”
- Use evocative questions to help clients access deeper emotions:
5. Restructuring Emotional Bonds in EFT Therapy
- Purpose: Helps partners or family members develop new, secure attachment patterns.
- Technique:
- Guide clients in expressing vulnerable emotions and attachment needs to each other.
Example:“I need to feel like you’re here for me when I’m struggling.”
- Encourage the other partner to respond empathetically:
“I didn’t realize how scared you were. I want you to know I’m here.”
- Guide clients in expressing vulnerable emotions and attachment needs to each other.
6. EFT Couples Therapy Enactments
- Purpose: Create real-time emotional experiences to strengthen connections.
- Technique:
- Ask one partner to express a specific feeling or need directly to the other:
“Can you tell your partner how hurt you felt when they didn’t check in with you last week?”
- Coach the receiving partner to respond in a validating and empathetic way.
- Ask one partner to express a specific feeling or need directly to the other:
7. EFT Couples Therapy Softening
- Purpose: Helps defensive partners or family members access and express vulnerable emotions.
- Technique:
- Encourage individuals to drop defensive stances and reveal softer emotions (e.g., fear or sadness instead of anger).
Example:“I’m not just angry; I’m scared I’ll never feel close to you again.”
- Encourage individuals to drop defensive stances and reveal softer emotions (e.g., fear or sadness instead of anger).
8. Tracking Progress and Consolidating Changes
- Purpose: Reinforces new patterns and ensures lasting change.
- Technique:
- Highlight successful moments of connection and new behaviors:
“Notice how you stayed open to each other during that tough conversation.”
- Encourage clients to reflect on their growth:
“How does it feel to share your needs more openly now?”
- Highlight successful moments of connection and new behaviors:
EFT Therapy Stages
- De-escalation of Conflict: Identifying negative cycles and reframing issues as attachment needs.
- Changing Interaction Patterns: Facilitating vulnerable emotional expression and creating new bonds.
- Consolidation: Reinforcing new relational patterns and planning for the future.
EFT therapy is highly effective for improving emotional connection, fostering secure attachment, and resolving relational distress.
EFT Couples Therapy Research
I try to choose clinical techniques that have scientific research backing them. Here are some key findings and insights from research on EFT Couples Therapy:
- Research has consistently shown that EFT is effective for couples, with success rates of around 70-75% for distressed couples.
- Sustained Improvement: Studies have shown that EFT’s benefits are significant and long-lasting, with couples maintaining improvements for years after therapy.
- Meta-Analyses: Several meta-analyses have confirmed the effectiveness of EFT in treating relational distress, with significant effect sizes compared to control groups.
- Comparative Studies: EFT Couples Therapy is more effective than other forms of couples therapy, such as behavioral couples therapy, in improving relationship satisfaction and emotional connection.
- Neuroscientific Findings: Recent neuroimaging studies have shown that EFT can change the brain’s response to threats and increase feelings of safety and security between partners.
- Cultural Adaptability: EFT Therapy has successfully adapted for diverse cultural groups, demonstrating its versatility and broad applicability.
My Work with Emotionally Focused Therapy
Effective delivery of EFT requires specialized training and supervision, ensuring that therapists are well-equipped to handle the complexities of couples’ dynamics. EFT can be integrated with other therapeutic approaches, such as individual therapy, to address underlying issues like trauma or depression. – It is also used effectively for individuals and families, addressing issues like depression, anxiety, and trauma.
EFT Couples Therapy Example
Here’s a brief and fictitious example of how an Emotionally focused therapy session might unfold for a couple experiencing conflict:
John and Lisa have been married for ten years and have been arguing frequently about John’s long working hours and Lisa’s feelings of emotional neglect. This has intensified since the birth of their second child six months ago.
Establishing a Safe Environment
I work to create a non-judgmental and safe space for both partners to express their feelings. I might start by saying, “I want this to be a safe place for both of you to share your thoughts and feelings openly. My goal is to help you understand each other better and work towards strengthening your bond.” I’ll also ask if they have any questions about therapy or the approach we will use.
Exploring the Cycle
Next, I help the couple identify their negative interaction patterns and the emotions driving these patterns.
- Lisa: “John is always at work. When he comes home, he’s too tired to talk to me. I feel like I’m not important to him.”
- John: “I work hard to provide for our family. When I get home, I’m exhausted. I feel like nothing I do is ever enough for Lisa.”
- Me: “It sounds like a cycle in which John feels unappreciated and Lisa feels neglected. Let’s explore these feelings further. John, when Lisa expresses her frustration, how do you feel?”
- John: “I feel like a failure like I’m letting her down despite my efforts.”
- Me: “And Lisa, when John withdraws, what’s that like for you?”
- Lisa: “I feel lonely and unloved.”
Accessing Primary Emotions:
In the next step in EFT Couples Therapy, I guide the couple to access and express their deeper, more vulnerable emotions.
- Me: “Lisa, can you share with John how his long hours make you feel on a deeper level?”
- Lisa: “John, I feel abandoned when you’re not around. I’m scared that you don’t love me anymore.”
- John: “I didn’t realize you felt that way. I just thought you were angry with me.”
Restructuring Interactions:
The next step involves helping the couple express their needs and fears in a way that fosters connection and understanding.
- Me: “John, can you tell Lisa how you feel when she says she feels abandoned?”
- John: “I feel sad because I love you and don’t want you to feel that way. I need you to know that my work is important to me, but so are you.”
- Lisa: “I need to feel more connected to you, John. Can we find a way to spend more quality time together?”
Consolidating Gains:
Finally, I support the couple in solidifying their new patterns of interaction, “You both did a great job expressing your feelings and needs. Let’s work on a plan to ensure you have regular time together to strengthen your connection.”
I assign them homework to schedule regular date nights or daily check-ins to maintain their emotional bond. Future sessions will continue to address new issues and reinforce positive changes.
Over time, John and Lisa become more attuned to each other’s emotional needs, leading to a stronger, more secure relationship. This example illustrates how EFT Therapy helps couples move from a cycle of disconnection to one of emotional engagement and security.
Future Directions
I intend to continue studying the results of EFT Couples therapy as I do with all the techniques I use. As time passes, I hope to assess the sustained impact of emotionally focused therapy on couples’ relationships. I also plan to integrate technology, such as certain apps, to make EFT therapy more accessible and to enhance therapy outcomes. Emotionally focused therapy has been proven effective and is still evolving, which is a great combination and a core part of my combined humanistic treatment and relationship therapy approach. I also use this method in family treatment.
If you and your partner think EFT Therapy might be a good choice, or if you’d like more information to make a decision, please contact me anytime or schedule a consultation.
