There are many different ways to approach couples therapy - Emotionally Focused Couples Therapy is one of them. If you are considering whether Emotionally Focused Couples Therapy can help you and your partner with your difficulties, then this article is for you. I want to share with you facts, studies and case studies to explain more about Emotionally Focused Couples Therapy. This way you can consider if the method fits you.
What is Emotionally Focused Couples Therapy?
Emotionally Focused Couples Therapy (EFT) is an evidence-based couples therapy that focuses on the interaction patterns of couples in conflict and the emotions that accompany them. It was developed by Sue Johnson and is practiced by couples therapists worldwide.
Goals of EFT
Emotionally Focused Couples Therapy focuses on repairing the attachment relationship between both partners and facilitating new, safe attachment experiences in sessions. This helps the partners perceive the relationship as secure. Another goal is to get out of the vicious cycle of reactive responding and learn to stop the vicious cycle. One of the ways EFT accomplishes this is by bringing emotions into focus and reorganizing the emotional experience of both partners.
Attachment Theory for Adults
Central to EFT is the attachment theory of John Bowlby, a child psychiatrist who focused on the bond between mother and child. He defines attachment as a close emotional connection to specific people who, when possible, provide both protection and support . Experiences from interactions with these people, called attachment figures, continue to shape our understanding of relationships later in life. While for children these attachment figures are usually the parents, for adults it is the partner. If problems arise in a relationship, they can be seen as attachment problems.
Emotionally Focused Couples Therapy assumes that people in conflicts often react as pursuers or withdrawers. While the pursuer over-activates the attachment system and tries with all his might to rebuild and control the attachment, the withdrawer usually deactivates the attachment system, i.e. withdraws completely and reacts indifferently. Both are effects of our body's natural stress response, the so-called "fight, flight or freeze" response - one either freezes or prepares to fight or flee. You can also find out more about attachment and relationships here.
Why do couples have problems? EFT's Answer
In EFT, it is believed that the main problem couples face when seeking therapy is a lack of emotional security in the relationship. The secure bond between the partners is "damaged" and too few interactions take place that could rebuild emotional security. This is because, in general, the partner is seen as a safe haven as an attachment figure and helps to deal with difficult feelings and thoughts, among other things. If problems now occur in the relationship, this secure attachment is interrupted. This interruption can be described as trauma-triggering and inevitably leads to an automated stress reaction: fight, flight or freeze. The aforementioned "pursuer-withdrawer dynamic" develops.
How is Emotionally Focused Couples Therapy structured?
EFT is divided into 3 phases which help to escape this vicious circle.
The first phase focuses on de-escalating the conflict. An important first step here is to jointly identify the vicious circle the couple is in and explain the behavior of both parties. Initially, sessions are held to work through the couple's shared history, and as needed, one individual session for each partner is possible to understand the individual history.
The second phase is about rebuilding the bond. Here the bonding needs of both partners are openly communicated and encouraged. This open communication about feelings and needs is accompanied by a certain emotional vulnerability. In order for both partners to be able to open up to the other again in this way, both pursuers and withdrawers must be worked with individually. The couple thus experiences more and more moments in which they respond empathically to each other and welcome the other's vulnerability.
In the third phase, the consolidation phase, conflicts can already be worked on more easily because the couple has developed new techniques and a new understanding of each other. These changes now need to be consolidated.
What does Emotionally Focused Couples Therapy actually look like? Example of a couple
Max and Laura come to couples counseling because they are arguing more and more frequently. Laura is frustrated because she wants more initiative and suggestions for joint plans from Max, and Max is annoyed by the fact that Laura doesn´t prioritizes time together, but always wants to do something with others. The conflicts between the two become more frequent, and both persist in the belief that the other is to blame for their problems. In couples therapy, we take a closer look at what happens when Max does not fulfill Laura's wishes. Laura then feels rejected, declares that she is too demanding for Max, she becomes sad and withdraws. Max then becomes angry because he feels that Laura's wishes restrict his freedom. He then declares to himself "I am powerless and must meet Laura's expectations," and he sees Laura as demanding. He reacts to this with what is typically an pursuer behavior: He gets loud and desperately tries to convince Laura of his point of view and excessive demands. In couples therapy, we work out the vicious circle and how they can get out of it. This helps both of them share their emotions and what they interpret about themselves and each other. Furthermore, they learn to repair their bond and understand each other better. Since then, conflict occurs less frequently and both are more satisfied with their relationship and feel better understood.
EFT Study Results
While this all sounds logical, some may wonder if EFT is actually effective. A number of researchers have already addressed this question and shown in various studies and meta-analyses that
- EFT as couples therapy has the same effect as behavioral couples therapy (for many the "gold standard") .
- EFT also improves marital satisfaction over time .
- EFT was shown to be effective for couples with low or moderate levels of distress  However, this does not mean that EFT is the only true therapy for couples; other therapies also performed well in this meta-analysis. Nevertheless, it is always important to make sure that the form of therapy is right for you.
Which couples is EFT appropriate for?
There are some situations and couples for which the emotionally focused couples therapy is particularly suitable. These are:
- Couples who are ready to get to know their own and their partner's emotions better
- Couples who are willing to be vulnerable and dare new behaviors in sessions
- Couples who are constantly arguing, have communication problems, and feel emotionally distant from each other
- Couples who have been through a significant life event together (e.g. affair, or other breach of trust)
- Couples who want to strengthen their relationship
For which couples is EFT not appropriate?
There are also situations and couples for whom EFT is not the right form of therapy. For example:
- Couples who want quick fixes and short-term support
- Couples who focus on the content of their difficulties
- When there is physical violence in the relationship
- When there are secret affairs that the partners do not want to end
- Couples with severe mental health problems (e.g., schizophrenia, major depression, or addiction) if they are not also being treated independently of couples therapy
- Couples who want to break up and are looking for a solution-focused approach
Summary of Emotionally Focused Couples Therapy
As you have learned, EFT is a method for couples to overcome their difficulties. Would you like to learn more about Emotionally Focused Couples Therapy? Here is a link to EFT Community Germany. If you want to learn even more about EFT. You can also find more information on the website of the founder of EFT, Sue Johnson. EFT is also used for individuals and families and more information can be found at the ICEFT International Institute for Emotionally Focused Therapy.
Do you have difficulties as a couple and would like to get to know Emotionally Focused Couples Therapy? Then feel free to contact me!
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 Beasley, C. C., & Ager, R. (2019). Emotionally Focused Couples Therapy: A Systematic Review of Its Effectiveness over the past 19 Years. Journal of Evidence-Based Social Work (2019), 1–16.
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This article was written in collaboration with Anna-Maria Hebestreit.