ThePathtoaSecureBond: EmotionallyFocusedCoupleTherapy

1 The Path to a Secure Bond: emotionally Focused Couple therapy !Susan M. JohnsonUniversity of Ottawa!Paul S. GreenmanUniversity of Quebec in OutaouaisEmotionally focused therapy (EFT) for couples combines experiential andsystemic techniques to expand emotional responses and cycles of inter-action. This approach has also been used to treat depression, chronicillness, and anxiety disorders. EFT appears to translate well across cultureand class, focusing on universal key emotions and attachment the EF T perspective, adult love is a hardwired, adaptive attachmentresponse. The therapist s in-session focus is on the processing of emo-tions and key interactional patterns as they occur in the present, becauseemotional experiences are the primary instruments of change in thisapproach.

2 The therapist is a relationship consultant who offers a safeplatform whereby each partner can distill, expand, and transform experi-ence and find new ways to connect with the other. The case presentedhere illustrates the three stages of EFT: deescalation, restructuring inter-actions, and consolidation. 2006 Wiley Periodicals, Inc. J Clin Psychol:In Session 62: 597 609, : emotionally focused therapy ; emotion; couple therapy ;attachmentAn observer watching an emotionally focused therapy (EFT) session with a couple wouldsee the therapist continually engaged in three tasks: actively monitoring and creating asafe alliance with both partners, focusing on and expanding emotional responses, andlinking these responses recursively to the interactional patterns that lead the couple intoCorrespondence concerning this article should be addressed to: Paul S.

3 Greenman, , Department of Psy-choeducation and Psychology, 283 Alexandre Tach Blvd., Box 1250, Hull Station, Gatineau, QC J8X3X7, Canada; e-mail: OF CLINICAL PSYCHOLOGY: IN SESSION, Vol. 62(5), 597 609 (2006) 2006 Wiley Periodicals, online in Wiley InterScience ( ). DOI: The therapist explicates and expands these patterns to include safe, emotionallyengaged interactions (Johnson, 2004).So, in a beginning session, the EFT therapist might note that a husband speaks ofneeding to tell or push his wife and that she seems to give up or move away. Thetherapist would encourage the couple to consider this negative dance and its conse-quences for the connection between them.

4 The therapist would then support one partnerto expand on an emotional response, perhaps by accessing the husband s irritation andhelping him link it to an underlying desperation about not being able to connect withhis wife. The therapist would help the husband express his reactionary irritation directlyrather than simply blaming his spouse and would also support the husband as he connectswith his underlying desperation and shares it with his wife. Next, the therapist wouldwork with the wife to discover how she hears and responds to this communication. Theexpression of deep, attachment-oriented emotions, such as the desperation noted previ-ously, has the potential to change both interactional patterns and each partner s construc-tion of the emotional reality of the relationship.

5 EFT therapists thus move between afocus on people s construction of their inner emotional experience and a focus on eachpartner s creation of key attachment interactions for better or for specifically, EFT therapists work with emotion by reflecting emotional responsesand key moves in the interactional dance, validating and normalizing responses, askingevocative questions, and replaying key moments. They often heighten the process withimages or interpretations. The therapist works with interactions by reflecting patterns andreframing them in terms of attachment and stuck cycles that are the enemy in thecouple s relationship. EFT therapists create enactments in which couples make their pat-terns explicit and slowly try out new ways of connecting and : Theoretical theoretical basis for treatment in this couple therapy is experiential and systemic(Minuchin & Fishman, 1981; Rogers, 1951).

6 The theoretical basis for understandingadult love is adult attachment theory (Bowlby, 1969; Hazan & Shaver, 1987).Theories of TreatmentAs in other humanistic therapies, in EFT the therapist collaborates with clients in theongoing reprocessing and reconstruction of each partner s experience and helps to gen-erate new meaning in their experience that can then empower them and facilitate is a systemic therapy in that problems are seen as the result of constricted or rigidways of responding to context cues and interacting with others. From a systemic view-point, emotion is a leading or defining element that organizes the pattern of interactionsthat constitute a relational system.

7 The therapist s empathic response is to the client as the translator is to the text (Elliot, Watson, Goldman, & Greenberg, 2004, p. 113).From this perspective, the distilling of new meanings offers new choices and opens upimplicit automatic responses for therapist s stance is that the client s responses are valid and understand-able given a particular context and that the client can grow given a safe validatingenvironment. This depathologizing focus is on ways people become stuck in patternsof emotional processing and engaging with others and then cannot adapt to new contexts(Bowlby, 1969).598 Journal of Clinical Psychology: In Session, May 2006 Journal of Clinical Psychology: In SessionDOI on emotion is, as the name suggests, a key feature of EFT.

8 The EFT ther-apist focuses on the core emotions identified as universal: anger, fear, surprise, shame,joy, sadness, hurt/anguish, and surprise (Tomkins, 1991). Each emotion has a cue, ageneral instantaneous appraisal (negative/positive, safe/unsafe), physiological arousal inthe body, reappraisal in which meaning is assigned, and a compelling action tendencythat moves a person into a particular response. In this way, emotions are the principalorganizers of behavior, especially in close relationships in which emotional signals arethe music of the dance between of Love RelationshipsThe theory of relationships that informs EFT is attachment theory. This theory is sys-temic (Johnson & Best, 2003) and postulates that intra- and interpersonal realities createeach other in a circular feedback fashion.

9 Patterns of interaction with loved ones are thearenas in which individuals experience and define themselves. The couple therapist of adult love that reflects current research on distress and satisfaction in marriage(Gottman, 1994; Huston, Caughlin, Houts, Smith, & George, 2001). This research sug-gests that emotional engagement and emotional responsiveness (the two determinants ofasecurebondputforwardbyattachmenttheor y)arethemainpredictorsofsatisfactioninma rriage, and that soothing responses are generally crucial elements of this cycles of criticism and complaints infused with anger, followed by distancingand defensiveness, are the death knell of love relationships precisely because they makesafe emotional engagement basic tenet of attachment theory is that a safe emotional connection to a fewloved ones is a fundamental survival need wired in by millions of years of evolution.

10 Can I count on you to be there for me? Will you come when I call? and Are youwithin reach? are the crucial questions that all spouses ask. From the attachment per-spective, the fear of isolation and the helplessness that accompanies it are in every humanheart. Effective or secure dependence exists when there is confidence in a positive, lov-ing answer to these questions. This theory contradicts the popular idea of self-sufficiencyand the focus on differentiation from partners experience disconnection, a predictable process of separation anxietyunfolds. People begin with protest, which usually takes the form of coercive anger, fol-lowed by clinging and seeking.