Emotionally Focused Couple Therapy (EFT) has greatly influenced the world of marital therapy. It was developed by Susan Johnson and Leslie Greenberg in the early 1980s. While Johnson and Greenberg were working with couples, they noticed the lack of delineated techniques in couple interventions and recognized how emotions shape the relationship (Johnson& Greenberg, 1987). With this motivation and the influences of many approaches, they created this new therapy modality. EFT is one of the most acknowledged, researched, empirically validated, and effective therapies for improving distressed couple relationships (Johnson et al., 1999).
Attachment theory guides EFT in understanding partners’ needs, such as comfort, security, and intimacy (Burgess-Moser, Johnson, Dalgleish, Lafontaine, Wiebe & Tasca, 2015). Based on this theory, relationship distress is related to separation distress and an insecure bond between partners (Johnson, Hunsley, Greenberg, & Schindler, 1999).While partners who have secure bonds are capable of recognizing and responding to the partner’s needs, couples who have insecure bonds might not be responsive to each other’s protests (Johnson& Greenman, 2006). Insecure couples might demonstrate more avoidance, less openness, less respect, and more negative emotions (Seedall &Wampler, 2013). Based on attachment theory and its crucial role in adults’ romantic relationships (Johnson, 2004), EFT emphasizes that present sensitivities might represent family of origin issues. In other words, “here and now interaction” might have origins in early attachment bonds with a caregiver (Johnson, 2004). EFT therapists believe that people's attachment injuries have a dramatic impact on how people perceive themselves, others, and the world at large (Johnson, Makinen& Millikin, 2001). Those who felt threatened or felt distressed in the past and did not obtain comfort and response from attachment figures might struggle with attachment issues (Seedall & Wampler, 2013). They might become highly anxious if they do not receive a response from the attachment figure (Johnson & Greenman, 2006). Those who were consistently rejected by attachment figures might avoid emotions and deny their attachment needs, struggle to open up emotionally (Seedall & Wampler, 2013).
These traumatic experiences can cause extreme vulnerability, feelings of isolation, abandonment and separation, and they can play a pivotal part in a relationship (Johnson, Makinen& Millikin, 2001). These attachment injuries can violate a partner’s trust and they can emerge whenever a partner does not obtain a positive response to their attachment needs, in particular during times of loss, transition, danger and uncertainty (Johnson, Makinen& Millikin, 2001). These negative experiences prevent them from relying on their attachment figures and maintaining a secure bond. Hence, past attachment injuries might not allow partners to experience secure relationships (Johnson & Greenman, 2006). Johnson (2001) states that dealing with specific types of betrayals or past or present relationship traumas interfere with treatment. Johnson (2001) emphasized that attachment injuries can be treated by EFT, and secure attachment can develop as a result of resolving attachment injuries. For this reason these events need to be addressed and resolved in couple’s therapy. Otherwise, they will keep influencing the negative interactional cycles, and prevent the experience of safe emotional engagement (Johnson, Makinen& Millikin, 2001).
According to Emotionally Focused Couple Therapy, accessing, expressing, and reprocessing the emotions behind couples’ negative interactions create a change (Dalgleish, Johnson, Moser, Wiebe, &Tasca, 2015). In the pursuer- withdrawer cycle, the most common negative interaction between couples, one partner pursues and blames the other to receive a response while the other partner withdraws and dismisses. This negative interaction does not meet attachment needs of either partner and also creates insecurity in the relationship (Dalgleish et al., 2015). Johnson (1999) reported that the change in couple’s interaction appears in three events: negative cycle de-escalation, withdrawer engagement, and blamer softening (Johnson et al., 1999).
Cycle de-escalation helps partners identify problematic interaction patterns as the root cause of difficult in their relationship. In this event, couples begin to be aware of their negative interaction pattern and see this pattern as their enemy (Johnson, 2004). When the couple becomes aware of their automatic responses they are able to respond to each other’s distress more consciously (Johnson& Greenberg, 1987).
The blamer-softening event causes a decrease in attachment anxiety, and attachment avoidance, and helps build secure attachment in the relationship (Dalgleish et al., 2015). This event requires critical partners to be vulnerable and share their needs. By sharing their attachment needs, blamer partners ask their significant others for reassurance and comfort, which leads to the withdrawn partner to be more engaged and responsive (Dalgleish et al., 2015). Withdrawer re-engagement helps the withdrawer partner learn to signal and to express their fears, vulnerabilities, and attachment needs (Greenman &Johnson, 2013).
Emotionally Focused Couple Therapy suggests that change comes through new emotional experiences. From the perspective of EFT, “Change occurs by helping people make sense of their emotions through awareness, expression, regulation, reflection, transformation and corrective experience of emotion.”(Greenberg, 2010). Restructuring and reinforcing the emotional bond between partners facilitate them to feel secure and allows for greater closeness (Johnson, 2004).
Emotionally Focused Couple Therapy considers emotional responses as the main target of change. The theory indicates that emotions guide our perception and they also activate attachment behaviors. They motivate us to communicate our needs and longings to others, and respond to them. Based on this idea, emotions are primary sources and emotional experience has the power to change how partners see themselves and others in the relationship (Johnson, 2004).
The theory divides emotions into two categories: primary emotions and secondary emotions. While primary emotions are considered as a key agent in the relationship, secondary emotions usually appear as defensive coping strategies (Johnson, 2004). EFT focuses on reaching out to primary emotions and expressing them. Insecure couples might struggle feeling emotionally safe with one another and this prevents them from being vulnerable in front of each other. For this reason, many times insecure couples might not be aware of partner’s primary emotions.
Johnson (2004) states that validation of primary emotions and attachment needs are key factors to initiate emotion regulation. In sessions, couple therapists focus on emotional processing by exploring individuals’ emotional experiences, reflecting, and validating them. As emotional processing continues, EFT therapists reframe the partner’s emotional experience and address vulnerable emotions. This helps the couple to see each other’s from different perspective and helps their connection. EFT therapists, then, create enactment and facilitate partners to express their feelings to each other.
The theory emphasizes that the process of change involves generating emotionally corrective experiences (Johnson, 2004). A corrective emotional experience is characterized by ventilation of emotions and creating new responses to them in the session.
This article involves emphasizing the formulation of Emotionally Focused Couple Therapy theory and application to a case example of a couple with infidelity. First, this paper will review the development of EFT and the influences of attachment theory. Next, it will illustrate how emotional interventions can influence the couple’s interactions and how key events create a change in couple’s interactions. In order to obtain a better understanding regarding EFT, theory of change, major clinical interventions, and structure of the therapy will be presented. Finally, this paper will present a clinical example, applying Emotionally Focused Couple Therapy to a couple who struggle with infidelity and discuss the outcomes.