Emotionally Focused Therapy for Couples and Attachment …

1 ANZJFTV olume 26 Number 22005 pp. 82 8982 Emotionally Focused Therapy for Couples (EFTC) is animportant framework for Couples Therapy . It providesan integrative model, drawing upon experiential,systems and Attachment theory to understand thedynamics of the couple relationship and to describethe therapeutic process. The aim of this paper is toask how EFTC uses Attachment theory, and whether itdraws as fully as it can upon the richness of thattheory to inform the process of Therapy . This is set inthe context of the evolving importance of attachmenttheory for therapeutic Therapy represents something of a paradox: ithas a long history stretching back 80 or more years,yet it is only in the last 20 years or so that it has begunto emerge as a modality of Therapy in its own right(Shmueli & Clulow, 1997).

2 Prior to that, couplestherapy seems often to have been largely in theshadow of either individual psychotherapy or of familytherapy, with the therapeutic techniques of those ther-apies being applied to work with Couples . Emotionallyfocused Therapy for Couples (EFTC) is an example of asignificant development within Couples Therapy in thatit provides a model that has at its core an understand-ing of the dynamics of the couple relationship. Due inpart to its clearly articulated therapeutic model andprocess, EFTC has lent itself to empirical investiga-tion, and has been shown in a number of studies to behighly effective (Johnson, Hunsley, Greenberg &Schindler, 1999). Emotionally Focused Therapy has roots in a long tra-dition of research into the experiential process ofpsychotherapy (Greenberg, Rice & Elliott, 1993;Gendlin, 1996; Webster, 2003), but also draws uponsystems theory and Attachment theory.

3 In fact, attach-ment theory is described in the literature of EFTC asproviding the core underpinning theory for the model(Greenberg & Johnson, 1988; Johnson, 1996, 2002).We believe it is, however, open to argument as towhether EFTC draws upon the full potential of attach-ment theory. Attachment theory is used by EFTC toprovide an understanding of some of the underlyingdynamics of conflict in the couple relationship, butattachment theory also has the potential to shape thetherapeutic process in EFTC with greater article provides a brief overview of the thera-peutic process of EFTC, followed by a review of howattachment theory is now being used to inform psy-chotherapy. That review provides a framework tosuggest some ways in which the therapeutic implica-tions of an Attachment theory perspective could beused to greater effect in Focused Therapy for CouplesAttachment, Cycles of Interaction, and AffectThe biologically based process of Attachment behav-iour is aimed at maintaining closeness and contactwith key Attachment figures.

4 According to EFTC,when an individual experiences disappointment,hurt, or a threat in their couple relationship, theywill have an emotional response; its purpose is elic-iting from the other partner behaviour necessary forrestoring a sense of security in the relationship. Theform that the emotional response takes will dependupon the individual Attachment style; this style isacquired in infancy and modified by subsequentexperiences with Attachment figures, including theircurrent partner. Often there will be a primaryEmotionally Focused Therapy forCouples and Attachment TheoryJim Crawley and Jan GrantJim Crawley is a psychotherapist in privatepractice. Address for correspondence: JimCrawley, 15 Colin Street, West Perth, WA6005. E-mail: Grantis Associate Professor and CourseCoordinator, Master of Psychology(Counselling) programme at Curtin : ( fear or hurt), which is pushed out ofawareness and replaced by a defensive secondaryemotion ( anger) that is expressed to thepartner.

5 The partner may well respond in a similarmanner expressing not their primary emotionalresponse to the individual s distress, but a defensivesecondary does a vicious verbal attack signal a needfor compassion, or emotional withdrawal signifylove? An attacking partner perhaps feels hurt orscared by the behaviour, and fears rejection or aban-donment. It is the attacker s fear of beingabandoned that leads him or her to lash out likesomeone in imminent danger of also sees couple relationships as inherentlysystemic and interactional. In particular, it focuses onunderstanding the cyclical, destructive pattern ofinteraction that is at the centre of the difficulties part-ners experience. This pattern is described as beingorganised around the regulation of the two centraldimensions of closeness/distance (or pursue/distance)and dominance/submission (Johnson, 1996).

6 Morerecently Greenberg talks also of the cycle ofblame/withdraw and of a sequence of rage shame(Greenberg, 2002).The Change ProcessCentral to EFTC s understanding of change is thepremise that change follows from the attainment of anew experience of emotional bonding between the part-ners in the Therapy process. This occurs when primaryemotions can be expressed and responded to in the rela-tionship. Change in EFTC is achieved through thefacilitation of three sequential movements . De-escalation of the conflictbetween the partnersinvolves the progressive unfolding of the experiencethat each partner has in the relationship, and theclarification of the interactive cycle between them. Re-engagement of the withdrawing or submissivepartnerin the relationship, which involves thatpartner identifying and owning, in the presence ofthe other, their primary emotional experience in therelationship.

7 Softeninginvolves dominant or pursuing partnersowning and expressing their primary vulnerability:for example, the experience of unloveableness andshame that lies beneath their controlling behaviouror critical spells out a sequence of nine recursive activitiesthat the therapist facilitates in order to enable these83 Emotionally Focused Therapy for Couples and Attachment TheoryANZJFTJune 2005three movements to occur (Greenberg & Johnson,1988; Johnson, 1996; Webster, 2003). Attachment Theory in PsychotherapyThe Attachment framework was developed by JohnBowlby (1958; 1973) to account for the way that indi-viduals form emotional bonds with significant others,and how psychological disturbances such as depressionand anxiety are linked with disruption to those showed how Attachment provides for the safetyand protection of the growing child, and how separationor loss disturb this secure base or safe haven , generatingpowerful and primitive emotions in an attempt to restorethe theory is currently attracting renewedinterest and is being applied to individual psychother-apy, Couples , family , and short-term dynamic Therapy (Clulow, 2001; Coren, 2001; Erdman & Caffery, 2003;Fosha, 2000.)

8 Holmes, 2001; Johnson, 2002; Whiffen,2003; Sable, 2000); indeed, an expanded edition of thejournal family Processwas recently devoted in entiretyto Attachment and family systems. Attachment theory,however, is not so much a method of treatment as a wayof thinking about relationships, including the therapeu-tic relationship. It enables us to think about the client sexperience within a developmental framework and toformulate explanations about his/her Strategies in RelationshipsAttachment theory offers a way of conceptualisinghow the effects of early events have influenced the working models (Bowlby, 1973) of relationship thatthe individual employs (Fosha, 2000; Sable, 2000).Whereas secure Attachment experiences lead tounconscious beliefs that others are available, under-standing, and responsive (Fonagy, 2001b), insecureattachment experiences lead to unconscious beliefsthat significant others are unavailable and unrespon-sive, or rejecting, abandoning, and abusive.

9 Central to EFTC s understandingof change is the premise that changefollows from the attainment of anew experience of emotionalbonding between the partnersin the Therapy process. Jim Crawley and Jan Grant84 ANZJFTJune 2005 Individuals search unconsciously for a partner whocan somehow fit or tolerate their internal workingmodel, with the hope that old patterns can be mas-tered. Understanding these experiences and therelational strategies they produce assists therapists toformulate therapeutic goals helping clients to cometo a more balanced position not too distant andnot dependently close to the therapist and Competence and Reflective FunctionTherapy assists clients to recapture memories andexpress feelings that have been disallowed in previ-ous relationships (Fosha, 2000).

10 This, in turn, helpsclients to create a more coherent narrative orunified vision of themselves a story about theself (Holmes, 2001; Sable, 2000). This capacity toconstruct a coherent narrative about oneself andone s difficulties is directly linked to secure attach-ment (Main, 1995) and the capacity for mutualityin also encourages exploration of the rela-tionship between client and therapist. This allowsfor connections to be made between previous emo-tional experiences and emotion experienced incurrent relationships, expanding what Fonagy(2001a; 2001b) refers to as the capacity for mentali-sationor reflective function is thecapacity to reflect on one s own and other s mentalstates; it is highly correlated with secure attachmentand psychological couple relationships, it is often this need to havea place in the mind of the otherthat lies behind manyconflicts, such as how much time is spent and Kirsten have reached a mutuallyacceptable compromise, where Kirsten spendstime alone at parties and large social gatherings occasions Gavin does not enjoy.