Emotionally Focused Therapy (EFT) Vancouver
Emotionally Focused Therapy (EFT) is an innovative approach
to couples therapy with strong empirical
backing. Developed originally in Vancouver, B.C., and now
recognized internationally, this approach assists distressed
couples in
creating a new, more positive attachment. It does this by
helping couples access and express the deeper feelings and
dependency needs
that underlie their conflict.
Following a description of the effectiveness of EFT and
its theory of love, attachment theory, I will illustrate
how EFT works with the
clinical
case of a distressed couple.
Effectiveness of EFT
To date, the effectiveness of EFT is validated by nine controlled
outcome studies over 15 years. This research shows that three
quarters
of couples are no longer distressed after 8-20 sessions of
EFT, with 95% experiencing improvement. In addition, two-year
follow-up
studies show that these changes are stable.
I was fortunate to participate in the early development
of EFT. In the mid 1980s, I was a secondary therapist in
the original outcome
study of EFT at UBC conducted by its originators, Dr. Leslie
Greenberg and Dr. Susan Johnson. Next, I was a primary therapist
in the
second research study demonstrating EFT's effectiveness,
conducted by Dr. Greenberg and Dr. Audrey Goldman. Finally,
I conducted a
constructive outcome study of EFT in 1987 for my doctoral
dissertation. This study compared the effectiveness of twelve
sessions of EFT
to eight sessions of EFT plus four sessions of a communication
skills training component. The results showed that both treatments
were
effective in shifting couples from distressed to nondistressed
compared to a wait-list control group.
EFT Theory of Love: Attachment Theory
The theory of EFT is predicated on a theory of relatedness
called attachment theory. Developed fifty years ago by John
Bowlby, who
studied the psychological adjustment of babies and children
who were orphaned during the Second World War, Bowlby concluded
that all
humans possess an innate yearning for trust and security,
or attachment. Children have needs for attachment with at
least one parent,
and adults have these needs with a romantic partner. According
to attachment theory, then, every individual has a legitimate
yearning
for a secure attachmnent to a significant partner. A secure
attachment is understood as a close, trusting relationship
in which each
person experiences fulfillment of legitimate dependency needs
for contact/comfort, and acceptance/safety. In a secure attachment,
both
people experience the relationship as a safe haven, a source
of security and nurture rather than distress.
EFT rejects the view that relationship conflict is a reflection
of character deficits or flaws of the individuals. Instead,
it
understands conflictual partners' negative behavior as an
understandable response to the frustration of the legitimate
need for a secure
attachment. When people can't get attachment figures to respond
to them and their needs, they do whatever they have to do
to get a
response. If a child feels unprotected by his parents, for
example, he might become defiant, clingy, or withdrawn. A
child who is
maladjusted, said Bowlby, is often driven by a broken or
insecure attachment with his parents.
It follows from attachment theory, that when partners are
in conflict, they no longer experience a secure attachment
to their partner. This might arise when
one partner is unsupportive or emotionally unavailable, causing
the other to experience insecurity.
In EFT any
breaches of attachment between partners are called "attachment
injuries", which over time unless resolved move the
couple toward a
distressed state characterized by a negative fight cycle.
In a distressed state, partners tend to see each other in
a negative light: as
selfish, mean-spirited, withholding, and the cause of their
distress.
Finally, EFT theory maintains that the negative fight cycle
is partners misguided but well-intentioned attempt to establish
a secure
attachment. The negative fight cycle is seen as a stress
reaction to partners' fears of lost intimacy and security.
The goal of EFT is
to help distressed couples reestablish a secure attachment,
in which their dependency needs for contact/comfort, and
acceptance/safety
are met.
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