Being a couples therapist in Boulder, CO, is a very interesting experience. Boulder is famous for having an incredibly large population of relationship counselors. It means that there is a general openness to couples counseling, since it is such a "normal" thing to do. At the same time, it might be extremely difficult for a couple to choose a therapist, which is sometimes referred to as the paradox of choice.
One way to make sure that your next couple therapist will be qualified to help you, is to make sure that they are trained in at least one specific evidence-based modality that is aimed towards helping couples. This is important since couples therapy is not individual therapy with two clients in the room instead of one. The dynamics in the therapist office are different, and the goals are different. The client is not one person, it is the relationship.
As someone who does not believe in one cookie-cutter approach that fits all couples, I have been trained in and am practicing my own combination of what I find to be the most helpful of couple counseling modalities including Emotionally Focused Couple Therapy (EFT), Gottman Couples Therapy, Solution Focused Therapy, Strategic Therapy, Structural Therapy, and others.
Today I'd like to tell you about one of my favorite approaches, and arguably the most researched of all couples therapies out there: Emotionally Focused Couple Therapy (EFT). The following text is a part of one of my papers for my Doctoral program. As such, it contains a lot of references to existing research, to help you expand your knowledge, if you are so inclined.
The History of the Development of EFT
The Origins of EFT
The roots of Emotionally Focused Couple Therapy (EFT) can be tracked to early eighties (Johnson & Greenberg, 1985) when Sue Johnson and Lee Greenberg formulated a new approach to couple therapy that they felt was very much needed. They seeked to create an approach that would fill the void of clear and validated couple therapy interventions, that are more human centered, and less behavioral in their approach. The first manual was published in 1988 (Johnson & Greenberg, 1988). The name EFT (Johnson, 2017) emphasizes the importance of emotion as the main organizational force in constructing and maintaining patterns of interaction. Emotion in EFT is the primary focus and not a non-important byproduct of behavioral interactions as it was popular to think in the field back then.
EFT as an Empirically Based Couple Therapy
Twenty years of research support the efficacy of EFT (Johnson, 2017). Following the first manual that incorporated theory and findings from the first study on EFT, eight other researches followed, that showed the following results:
Couples showed 73 percent recovery from marital distress in only 10 to 12 sessions. In comparison, the recovery rate for couples who were receiving behavioral interventions was just 35 percent (Jacobson et al., 1984).
Generally, there are no issues with relapse after the completion of EFT, which has been a significant problem with behavioral approaches (Jacobson & Addis, 1993).
EFT showed success with highly distressed couples (Johnson, 2017) and with men who were emotionally withdrawn (Johnson & Talitman, 1997).
EFT researchers were able to identify specific highly effective interventions that promote change (Bradley & Furrow, 2004; Johnson, 2003). EFT established important tasks and effective processes to deal with attachment wounds, and forgiveness (Johnson, Makinen & Millikin, 2001).
EFT and Attachment Theory
The theoretical base for EFT is attachment theory (Johnson, 2017). Attachment is the search and the development of close and meanigful relationships with other humans from birth to death (Bowlby, 1988). Attachment is the deep and innate need in each person that underlies many of our actions, thaughts, and feelings (Mikulincer & Shaver, 2007). It starts with the bond children successfully or unsuccessfully develop with their cargeviers and carries on into other social interactions in older age, romantic relationships included. When romantic partners can consistently be mututally repsonsive the emotional needs of each other, they can form secure bonds, according to atachment theory (Wiebe et al., 2017).
Johnson (2017) describes the ten central tenents of attachment theory:
Attachment is a primary motivating force.
Autonomy is healthy only when coupled with secure and effective dependance on others.
Attchment is an essential psycho-phisiological mechanism of safety and resilience.
Attachment provides a secure base from which humans can explore the world.
Bonds between humans are built and shaped by mutual emotional responsiveness and emtional accessability.
Attachment needs are triggered whenever there is fear and uncertainty.
A lack of secure attachment can predict distress whenever there is seperation from caregivers or romantic partners.
There are mainly two ways of dealing with and responding to unsecure attachemnt: with anxiety and avoidance, which create the two main unsuccesful attachement styles.
We see the world according to our attachemnt styles.
Isolation and loss lead to trauma.
The Pursuer-Withdrawer Cycle
At the center of EFT work lies the metaphor of a dance that couples dance (Johnson, 2017). Emotion is the music that organizes that dance. One partner in the dance is the pursuer, and the other one is the withdrawer. According to EFT, the partners will take these roles upon themselves and play a part in cycle that will reinforce negative patterns of communication. When the pursuer will ask for emotional connection, the withdrawer will withdraw, which will make the pursuer pursue even harder, which will push the withdrawer even further away. This self-reinforcing cycle prevents couples from having the relationship that they genuinely want.
EFT’s Theory of Change
EFT’s theory of change is the synthesis (Johnson, 2017) of the ideas of the experiential therapist Carl Rogers (1951) and structural therapists, Salvador Minuchin among them (Minuchin, 1982). EFT combines experiential and systemic approaches and focuses on the system while not forgetting the individual. To create change, experientially EFT focuses on the following:
The clients’ processing and construction of experience in the present moment.
The fasciliation of change through the power the therapist’s empathy and acceptance.
Belief in the reselince and adaptivity of the clients.
Emotions elicit responses from others, which creates interactional patterns.
Creating new corrective emotional experiences with a couple in the therapy office.
To create change, systemically EFT also focuses on the following:
Exploration and explicit discussion of how interactions are maintained, including the degrees of closeness, withdrawal, and unresponsiveness.
Each action of the partner always happens within the context of the relationship.
Since EFT views the main problem in unhappy couples as the automatic emotional responses to each other, which keep on reinforcing themselves, the change can happen by making the cycle explicit and creating new interactions. In EFT it is being done experientially by changing the inner emotional experience of the partners, and systemically by altering the interactions between them (Johnson, 2017).
EFT is a highly structured process, with nine specific steps (Johnson, 2017; Johnson & Greenberg, 1985). The first two steps are assessment that is coupled with treatment: Identifying the issues that cause conflict and the cycle that keeps the couple in distress and prevents secure bonding. Steps three and four are about exploring the underlying feelings that drive the cycle, and reframing the interactional problems regarding as a cycle. Stage two of EFT includes the following steps and is more about the change itself than the exploration of the problem, though the separation is not clear cut. In step five the Eft therapist promotes identification of unmet attachment needs, and in step six the therapist facilitates acceptance of these needs between the partners. In step seven these needs are being expressed towards each other, which by itself changes the interactions within the couple. Step eight fosters the emergence of new solutions to old problems, and stage nine strengthens the new attitudes of safe base and the bond that the partners have experienced many times by now.
The Strengths and Limitations of EFT
EFT possesses many strengths as a therapeutic model. Both the theory and the practices of EFT are clearly formulated in nine steps, and documented, which makes it easy to use, to train and to research (Johnson, 2017). It is substantially supported by research, and shows substantial effects (Johnson, Hunsley, Greenberg & Schindler, 1999). The theory of EFT synthesizes experiential therapy, system theory and attachment theory, which all have a growing body of research to support them (Cassidy & Shaver, 1999). The combination of humanistic and systemic thinking allows to treat both the individual and the system in the couple. Even though EFT is mainly known as a couple therapy modality, it can be highly effective in working with families as well (Johnson, 2017). It is applicable to different populations: different cultures and social classes (Denton, Burleson, Clarke, Rodriguez & Hobbs. 2000), gay couples (Josephson, 2003), couples in old age (Bradley & Plamer, 2003), couples with chronic illness (Kowal, Johnson & Lee, 2003) and couples where partners who struggle with depression, anxiety and PTSD (Johnson, 2002). In a therapeutic setting, EFT is best suited to work with couples (Johnson, 2017). However, sub modalities like Emotionally Focused Family Therapy (EFFT) also exist, where a similar work is applied to families.
Though EFT is heavily researched and is effective in wide variety of situations and populations, it is not without its limitations. While Gottman & Gottman (2018) are influenced by EFT, they show in their research that it is important not just to de-escalate the conflict which is a primary goal in EFT work, but also to increase friendship, as well as increase positivity in conflicts.
Since the EFT model proposes that in a couple one partner will be a pursuer and the other withdrawer, it might at first seem contradictory to the attachment theory that it builds upon. According to attachment theory (Bowlby, 1988), humans develop specific attachment styles. One can think at first that anxious-avoidant attachment style seems to fit the description of a withdrawer and anxious-ambivalent attachment fits the description of a pursuer. The question that might arise is, how can it be that only people with the opposite attachment styles find themselves in a romantic relationship? This seeming contradiction is resolved with the understanding the attachment styles might push us into specific behaviors in a relationship, but when coupled with another, one of the partners will take more of the pursuer role, and the other one that more of a withdrawer role (Johnson, 2017).
The are a few risks that are associated with the EFT model. Therapy would not be effective and can even cause harm when used when there is an ongoing affair or current domestic violence (Johnson, 2017; Gottman & Gottman 2017). When there is an ongoing affair, no emotional repair can happen since there is no full commitment to therapy. Moreover, the attachment wounds that need to be healed in therapy, are being inflicted in the present. When there is domestic violence within the couple, therapy might be used against the victim by the perpetrator back at home. In both cases, therapy would not be safe.
One of the biggest strengths of EFT can also, if not used carefully, become its biggest limitation. It is important to remember that the cycle of distress in EFT is just a map, it is not the territory. Models are helpful because they help us understand reality in simple ways. However, it comes at the expense of details. The EFT therapist should be careful of not falling so much in love with the model, that they forget the clients in front of them. Even if the therapist can quickly identify the cycle of pursuer and withdrawer, the people are always much more then the roles they play. The reality is always much richer and more complex then a model, and it will indeed be wise to consider the possibility of other factors that contribute to the negative interactions beyond unmet attachment needs.
Giving Balanced Attention to Cultural and Contextual Factors
As with any modality, the EFT therapist must be aware of cultural and contextual factors. Even though EFT training does not mention gathering information about the larger systems that the couple is a part of, I view that part as extremely important, and that is why in my sessions with each of the partners, I do individual assessment, mainly constructing a genogram (Browning & Hull, 2018). Details about the clients’ individual histories is important since they bring into the relationship the whole gamut of their family’s histories. Facts like family relationships, ethnicity, race, religion, substance abuse, and mental health issues, all play a part in a couple’s relationship. The EFT therapist must also be culturally sensitive and take into account power and privilege that might be affecting the interactions between the partners.
Sasha Raskin, MA, is an international #1 bestselling co-author , the founder and CEO of Go New , a transformational education program, a life, and business coach and a psychotherapist in Boulder, CO. He is working on a P.h.D in Counseling Education and Supervision and is an adjunct faculty at the Contemplative Counseling master’s program at Naropa University, from which he also graduated. Sasha has been in the mental health field for more than 10 years, worked with youth at risk, recovery, mental health hospitals, and coached individuals, couples, families, startups, and groups. He has created mindfulness stress reduction and music therapy programs within different organizations. Whether it’s in person or via phone/video calls, Sasha uses cutting-edge, research-based techniques to help his clients around the world to thrive.
As a coach Sasha Raskin provides individual and group coaching in Boulder, Colorado, and worldwide via video and phone calls. His services include: life coaching, business coaching, career coaching, ADD / ADHD coaching, leadership coaching, and executive coaching. Schedule your free 20-minute coaching phone consultation with Sasha Raskin
As a counselor in Boulder, CO, Sasha provides individual counseling in Boulder, CO , family therapy in Boulder, CO, and couples therapy in Boulder, CO, marriage counseling in Boulder, Colorado, and couples intensives / couples retreats, drawing from over ten years of clinical experience. Schedule your free 20-minute psychotherapy phone consultation with Sasha Raskin
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