Riddhima Pathak

2339441

3MPCL
 Introduction

Although problems to establish satisfying intimate relationships with partners is one of

the most common issues brought up by clients in therapy settings (Horowitz, 1979), the

approaches to tackle them can still be categorized as a fairly young discipline. As a part of this

discipline, new techniques and methods are being devised relentlessly. Currently, four treatments

are widely used while seeing couples as clients, these treatments are Cognitive Behavioural

Couples Therapy, Integrative Behavioral couple therapy, Gottman’s Approach and Emotional

Focused Therapy for couples. Out of these, one of the most widely applied is EFT. It was first

described in literature in 1985 (Johnson & Greenberg, 1985).

Emotionally Focused Therapy (EFT) is a structured, short-term therapeutic approach

designed to assist couples in enhancing their emotional connection and resolving relational

conflicts. Developed by Dr. Susan M. Johnson in the 1980s, EFT is rooted in attachment theory,

which posits that human beings have an innate drive for emotional bonding and connection. By

focusing on the emotional needs that underpin relationship dynamics, EFT provides couples with

tools to better understand their interactions, navigate conflicts, and ultimately foster a secure

emotional bond.

The therapeutic framework of EFT is particularly significant in a world where

relationship dissatisfaction and distress are increasingly common. Many couples experience

cycles of negative interactions, where misunderstandings and unmet emotional needs lead to a

breakdown in communication and connection. EFT addresses these patterns by helping partners

identify and articulate their underlying emotional vulnerabilities, allowing them to replace

reactive behaviors with empathetic understanding. This process not only improves emotional

responsiveness but also enhances relationship satisfaction, making EFT a valuable intervention
for couples facing various challenges, including those related to communication, intimacy, and

trust.

At the heart of EFT is the recognition that emotional connection is fundamental to a

successful and fulfilling relationship. John Bowlby’s attachment theory serves as a foundational

principle in EFT, suggesting that secure attachments promote emotional regulation and

resilience. In contrast, insecure attachments can lead to distress, anxiety, and emotional

dysregulation, creating a cycle of negativity in relationships. EFT operates on the premise that

when couples can express their emotional needs and vulnerabilities in a safe and supportive

environment, they can break free from negative interaction patterns. This shift enables partners

to respond to each other’s emotional bids with empathy and understanding, fostering a deeper

emotional bond.

EFT has garnered considerable empirical support, making it one of the most researched

and validated therapeutic approaches for couples. Studies demonstrate that EFT is effective in

improving relationship satisfaction and emotional connection across diverse populations and

presenting issues, including trauma, infidelity, and chronic illness. Its adaptability and focus on

emotional processes make it a suitable intervention for a wide range of couples, regardless of

their specific challenges.

The principles of EFT extend beyond the therapy room, influencing how couples

approach their relationships in everyday life. By learning to recognize and articulate their

emotional needs, partners become more adept at navigating conflicts and fostering intimacy. This

empowerment not only enhances relationship satisfaction but also contributes to individual

well-being, as partners cultivate healthier emotional regulation strategies.

 This article throws light upon the development of EFT over the years. Developed by Dr.

Susan M. Johnson and Leslie S. Greenberg. EFT focuses on helping couples form secure

emotional bonds by addressing the attachment needs that underlie relationship conflicts. It

addresses persistent negative emotions or affect that are slow to fade. The therapeutic approach

aims to foster emotional responsiveness between partners, leading to improved relationship

satisfaction and emotional security.

History

EFT emerged in the 1980s, rooted in attachment theory, a developmental perspective

advanced by John Bowlby (Bowlby, 1988). It was created in the early 1980s to address the lack

of standardized and validated non behavioral approaches to treating couple distress. At that time,

the focus in the field was mainly on behavioral and cognitive changes, with little attention given

to the role of emotions in both theory and practice. Bowlby’s theory emphasizes the human need

for connection, particularly in times of stress or threat, and the role that secure attachments play

in shaping emotional regulation and personal resilience. When an attachment bond is threatened,

partners tend to engage in predictable patterns of behavior, starting with protest and anger, then

progressing to seeking or clinging behaviors, and ultimately leading to feelings of depression and

despair. If the partner fails to respond or re-establish connection, the relationship may end in

detachment and separation (Bowlby, 1969). EFT adapts this theory into a humanistic and

experiential therapeutic model ,as described by Rogers (1951) and Perls (1973), focusing on the

interaction patterns between couples that shape emotional engagement and bonding. It uses

Systems Theory to explore how each partner's behavior influences the other's reaction, creating a

back-and-forth interaction that can lead to a typical problematic "dance" fueled by uncontrolled,
instinctive emotions. Johnson's work has profoundly influenced couples therapy by integrating

empirical research on emotional and behavioral responses within intimate relationships. Over

time, EFT has become one of the most widely researched and applied models in couples therapy,

particularly due to its effectiveness in addressing relationship distress and emotional

disconnection.

Principles and Structure

EFT is structured around three main stages (Johnson, 2004). The first stage is

de-escalation, where the therapist works with the couple to identify and understand their negative

interaction cycles. This stage involves recognizing how these patterns are triggered by unmet

attachment needs and emotional vulnerabilities. The second stage, restructuring interactions,

focuses on creating new interaction patterns. Couples often come to therapy after an incident

where one partner felt abandoned, betrayed, or experienced a breach of trust. In EFT, these

incidents are referred to as attachment injuries and often become obstacles to important changes

during stage 2 of the therapy (Makinen & Johnson, 2006). The therapist helps each partner

express their underlying emotional needs and vulnerabilities in ways that promote connection

rather than conflict. The third and final stage, consolidation, reinforces these new patterns,

helping couples maintain emotional responsiveness and avoid falling back into old habits.

Couples ultimately gain the ability to recognize when the negative cycle starts,

understand both their own and their partner's deeper issues driving the cycle, and express their

needs more effectively. This enables them to be less reactive and more capable of managing

negative emotions, as well as addressing underlying fears and needs. Rather than expressing
negative or critical emotions, they learn to share vulnerabilities, making it easier for both

partners to listen, understand, and support each other.

EFT employs various techniques that emphasize emotional engagement, including

evocative responding, where the therapist mirrors and amplifies clients’ emotions, encouraging

deeper emotional processing. Another key technique is reframing, where interaction patterns are

viewed through an attachment lens, helping partners understand that their conflicts stem from

attachment needs rather than mere behavioral issues. Enactments allow partners to express

emotions to one another in a safe and structured setting, facilitating emotional closeness and

understanding.

There are four key assumptions of EFT that arise out of these theoretical perspectives.

First, emotional re- sponses and interactional patterns are reciprocally deter- mining and both

must be addressed in therapy. Second, partners are stuck in negative patterns that preclude the

responsiveness necessary for secure bonding. They are not viewed as immature or unskilled but,

rather, as needing support to formulate their attachment needs and fears in a manner that
promotes secure bonding. Third, emotion is seen as a key element in the definition and the

redefinition of close relationships. New emotional experience and new interactions are necessary

for change to occur. Fourth, adult intimacy is best viewed as an attachment process. This process

gives couples interventions a specific focus, target, and set of goals (Johnson, 1999).

Critique: Strengths and Weaknesses

EFT has gained recognition for its significant strengths. First, it is deeply rooted in

empirical research, particularly the attachment theory which provides a scientifically validated

framework for understanding relational dynamics. Its focus on emotions, often overlooked in

other models, enables partners to address the core issues driving relational distress rather than

simply focusing on surface behaviors. In a study, Johnson and Greenberg (1985b) evaluated

couples who underwent EFT and compared their post-therapy results with their own pretreatment

control scores from 8 weeks before starting EFT. They discovered that the couples showed

significantly higher relationship satisfaction after therapy compared to their pretreatment control

scores. Additionally, the structured approach of EFT provides therapists with a clear and

accessible framework, making it easier for clinicians to apply, especially for those new to

couples therapy.

Dandeneau and Johnson (1994) found that couples who received EFT (n = 12)

demonstrated greater empathy and self-disclosure after therapy, along with higher observed

intimacy and more stable relationships during follow-up. In contrast, the cognitive couple

therapy group (n = 12) showed improvements that diminished after therapy concluded. Research

demonstrates that EFT is highly effective across different types of couples, including those
dealing with trauma, infidelity, and chronic illness, highlighting its adaptability and effectiveness

in various contexts.

Emotionally Focused Therapy for Couples seems to be an effective approach for couples

in distress who are dealing with the impact of illness in their lives (Wiebe & Johnson, 2016).

Dessaulles, Johnson, and Denton (2003) examined the effectiveness of EFT for couples dealing

with depression and whether it could improve a depressed partner's mood. Dessaulles, Johnson,

and Denton (2003) conducted a pilot study with couples where the female partner was depressed.

Participants received either 16 weekly EFT sessions (n = 7) or pharmacotherapy (n = 5). Both

groups showed significant reductions in depressive symptoms, but only the EFT group

maintained these improvements through a 6-month follow-up.

However, EFT is not without limitations. One critique is its intense focus on emotions,

which may not resonate with couples from cultures or backgrounds where emotional expression

is discouraged.

Another limitation is that EFT assumes both partners are equally capable and willing to

engage emotionally. In cases where one partner is emotionally avoidant or unwilling to

participate fully, the therapy may not progress as intended, potentially exacerbating relational

tension.

Moreover, EFT can be slow and emotionally taxing, requiring substantial investment

from both the therapist and the couple. For couples seeking quicker, behavior-focused solutions,

EFT’s emotional intensity may feel overwhelming. Additionally, while EFT is effective for most,

it is less suited for couples where severe personality disorders or ongoing abuse exist, where

other therapeutic approaches might better address immediate safety concerns.

Recommendations for Improvement

To make EFT more effective across a wider range of couples, several modifications could

be implemented. One key improvement would be to integrate frameworks from

cognitive-behavioral therapy (CBT), which could help address specific behavioral changes in

addition to emotional regulation. This could make EFT more appealing to couples seeking both

emotional engagement and practical tools for behavior modification. Additionally, to

accommodate cultural variations, EFT could benefit from incorporating culturally sensitive

approaches that respect different norms around emotional expression.

Therapists also need to be trained in trauma-informed care to better support couples

dealing with deep emotional dysregulation or trauma histories. Integrating skills from

trauma-focused modalities. EFT could benefit from being more flexible in its structure, offering

adjustments for couples who may not be ready for intensive emotional engagement early in

therapy. Introducing psychoeducation on attachment and emotional regulation at an earlier stage

could help resistant partners ease into the process and better understand the value of emotional

engagement.

Sustenance should be another focus during and after the therapeutic process. While EFT

is effective in creating emotional bonds during therapy, there should be a stronger emphasis on

maintaining these changes over time. Implementing periodic follow-up sessions or booster

sessions could help couples sustain the progress they’ve made. This ongoing support would

reinforce new patterns of emotional engagement and prevent relapse into old behaviors,

promoting longer-term relationships.

Another possible intervention to increase the efficacy of EFT could be offering group

EFT sessions where multiple couples participate in the therapeutic process together could
provide additional support through shared experiences. Group settings allow couples to learn

from each other, gain different perspectives on relationship struggles, and feel less isolated in

their challenges. This collective experience could enhance the emotional engagement and

understanding between partners by seeing how others navigate similar issues.

Conclusion

Emotionally Focused Therapy is a valuable therapeutic model that has transformed

couples therapy by emphasizing the importance of emotional bonding and attachment. Its

strengths lie in its solid theoretical foundation and empirical support, making it a leading

approach in the field. However, its limitations, particularly its emotional intensity and cultural

specificity, suggest that adaptations are necessary to make it more universally applicable.

Integrating additional therapeutic frameworks and making cultural adjustments would help

expand its accessibility and relevance, ensuring that EFT continues to provide meaningful

therapeutic interventions for diverse populations.

From a personal standpoint, I strongly advocate for the strengths of Emotionally Focused

Therapy (EFT) in couples therapy. One of its most commendable aspects is its ability to address

the underlying emotional needs and vulnerabilities that often drive relational conflicts. Rather

than focusing solely on conflict resolution, EFT facilitates deeper emotional understanding

between partners, which I believe is essential for fostering long-term intimacy and trust in

relationships. This approach resonates with me because it emphasizes emotional depth, helping

couples reconnect on a fundamental level.

Additionally, the structured nature of EFT provides both therapists and couples with a

clear and systematic framework, which makes the therapeutic process more accessible and
organized. This is particularly valuable during emotionally charged sessions, where a

well-defined approach can offer stability and direction. Moreover, the empirical support backing

EFT—demonstrating its efficacy across a diverse range of couples, including those experiencing

trauma or infidelity—further solidifies its position as a reliable and effective therapeutic model.

For individuals like myself who prioritize emotional security and meaningful connection

in relationships, EFT’s focuses on creating a safe, emotionally responsive environment is one of

its most significant strengths. By facilitating emotional openness and repair, EFT enables couples

to rebuild and strengthen their bonds, making it a highly impactful therapeutic intervention.
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