Emotionally Focused Couples Therapy

In Emotionally Focused Couples Therapy (EFT), Susan Johnson and Leslie Greenberg integrate psychoanalytic theory, specifically attachment theory, with

Couples Therapy recent research on negative behavioral interactions to formulate an intervention for distressed relationships. According to EFT, couples' adjustment involves both the intrapsychic emotional experiences of each partner and the couples' interpersonal interaction patterns. These processes are mutually determined and both are targeted for intervention in BFT.

Intrapsychic emotional experiences are rooted in partners' internal models of attachment, learned from past attachment experiences, particularly the infant's attachment to the mother. These working models affect how partners respond emotionally to negative interpersonal experiences and are in turn affected by these experiences as well. Distressed relationships are insecure bonds in which the attachment needs of one or both partners are not met because of rigid interaction patterns that block emotional engagement. The core problem in these relationships is partners' inaccessibility and inability to respond to or engage the partner. Therapists target both the underlying emotions and the rigid, negative interaction patterns in order to restore accessibility and form a new, secure bond between partners where each can have his or her innate needs for protection, security, and connectedness met.

The core of EFT is the accessing and reprocessing of the emotions underlying negative interaction patterns and the enactment of new patterns in which partners are affiliative and engaged. Distress is alleviated, not through new skills or new insights, but through the experience of new aspects of the self and new interaction patterns that take place in the therapy sessions. Thus, when Diane begins to nag Joe in therapy, the therapist helps Diane to focus on the underlying sadness she feels at not being close to Joe. Joe is better able to respond to her feeling of sadness than to her nagging, and the two experience a moment of closeness and understanding. The EFT therapist uses several general techniques to create this experience for the couples. First, a strong positive alliance is established with both partners. This alliance is critical if the couple is to feel safe enough to express and process their underlying emotions. Second, the therapist focuses on the moment-by-moment experience of the clients to help them reshape interactions and emotional experiences as they occur. Third, as interactions are tracked and emotions restructured, the therapist encourages the clients to replay their interactions to create new, more positive relationship events.

Initial studies have indicated that EFT is more effective than a waiting period of no therapy and at least as effective as CBCT and BCT. In comparing EFT, CBCT, and BCT, EFT was found to be more effective than BCT on marital adjustment, intimacy, and target complaint level.

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