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, EFT marriage counselling (couples relationship therapy) assists distressed couples in creating new, more positive interactions and attachments. It does this by helping couples to access and express the deeper feelings and dependency needs that underlie their conflict.
Following a description of the effectiveness of Emotionally Focused Therapy (EFT) and its theory of love, attachment theory, I illustrate my approach with the clinical case of a distressed couple.
To date, the effectiveness of Emotionally Focused Therapy 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. In the mid 1980s, I was a secondary therapist in the original outcome study 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 in 1987 for my doctoral dissertation. This study compared the effectiveness of twelve sessions of EFT couples counselling to eight sessions plus four sessions of a communication skills training component. The results showed that both treatments were effective in shifting couples from distressed to non-distressed compared to a wait-list control group.
Emotionally Focused Therapy Vancouver’s Theory of Love: Attachment Theory
The theory of EFT Vancouver 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 attachment 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.
Emotionally Focused Therapy rejects the view that relationship conflict is a reflection of character deficits or flaws of the individuals. Instead, this attachment style counselling 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.
My approach to Emotionally Focused Therapy is also informed by Dr. Geoffrey Carr’s Making Happiness. Dr. Carr advances the innovative theory that it is intrusive feelings that underlie insecure attachments and distressed relationships (for an introduction to his notion of intrusive feelings, see the article, Intrusive Feelings).
Finally, couples attachment therapy maintains that the negative fight cycle is partner’s misguided but well-intentioned attempt to establish a secure attachment. In EFT attachment counselling, the negative fight cycle is seen as a stress reaction to partners’ fears of lost intimacy and security. The goal is to help distressed couples change their negative cycle and to establish a secure attachment in which their dependency needs for contact/comfort and acceptance/safety are met.