Emotional Focused Therapy (EFT)

Emotional Focused Therapy (EFT) is an integrative style of therapy drawing its theoretical framework from ideas on attachment, existentialism, systemic approaches and Gestalt perspectives (Elliott & Greenberg, 2007). EFT has a specific focus on the couple’s experience of emotions and the concept of wholeness as it relates to interpersonal relationships.

The theory underlying this approach suggests that emotion is the fundamental construction of the self and a key determinant of self organization whereby our emotions are considered to be connected to our most essential needs and therefore can alert us of situations that are essential to our wellbeing (Greenberg, 2006). In serving as a prompt to important situations, emotions are also seen to guide us in to actions that try to meet our needs within relevant situations. Therefore, it is thought to be the prevalent emotions within the individual that will guide them towards what changes need to occur. So once the underlying emotions in a conflict are identified, the negative views and behavioural reactions that result from those emotions can be changed for the better.

A quote from Johnson (2007) from the International Centre for Excellence in Emotion Focused Therapy (ICEEFT) clarifies the philosophy of this approach.

“We adhere to the philosophy that relationships are at the core of human experience. Research indicates that emotionally fulfilling relationships are integral components of mental and physical health, and that emotionally focused interventions have the power to establish and re-create supportive bonds among individuals. We are therefore dedicated to the understanding and enhancement of couple and family relationships through an emphasis on emotions and their interpersonal impact. We believe that all people can maximize their potential given a nurturing social environment, which we endeavour to foster in our work with clients”.

The essence of EFT is helping distressed couples reprocess their emotional responses in order to adopt a healthier interaction. The therapeutic environment plays a vital role in this style of therapy. The focus of the therapist using this model is to help clients identify their experience more effectively and then to encourage them to explore and make sense of their emotions prompted by the experience. The therapist must be fully engaged, unconditionally accepting, empathetic and genuine, to enhance interpersonal safety and freedom for the couple so they can explore their emotions. The therapist also functions as a coach, guiding the couple as they explore their emotions. Some have suggested that this type of therapy is more suited to couples who are moderately distressed (Vatcher & Bogo, 2001).

EFT adopts a perspective that change occurs by means of:

• Emotional awareness,
• Emotional regulation,
• Emotional transformation and
• Emotional reflection (Pos & Greenberg, 2007; Greenberg, 2006).

Emotional awareness involves clients being aware of their primary emotions. This involves the actual feeling of the emotions and being aware of it. Greenberg (2006) suggested that it is only after one feels the emotion that they can express it, thus increasing their awareness and acceptance of the emotion.  Acceptance of emotion is viewed as the first step to change.

Emotional regulation refers to the ability to contain and regulate emotional experiences in order to learn distress tolerance skills. This is achieved by the therapist providing a safe, supportive and empathetic environment in which clients can learn emotional regulation skills. Emotional regulating skills include identifying and labelling emotions, allowing and tolerating emotions, increasing positive emotions and reducing vulnerability to negative emotions (Greenberg, 2006) Negative emotions often express an attempt or intention to exclude the other. Negative emotions are often fueled by an underlying fear of the unknown, a fear of the actions of others, and a need to control them or stop them to avoid being harmed.

For example: apathy, grief, fear, hatred, shame, blame, regret, resentment, anger, hostility.

Positive emotions express an attempt or an intention to include the other. This is characterised by working on learning more viewpoints, interacting more with others, enjoying making things better. Positive emotions are fueled by an underlying desire for enjoyment and unity.

For example: interest, enthusiasm, laughter, empathy, action, curiosity.

Emotional transformation The term ‘transformation’ of emotional states refers to a thorough and rapid progression through an emotional state that is likely to change that emotion into a healthier, more functional and productive state. For example, hopelessness often transforms into empowerment, sadness into love, fear into confidence, anger into peace, etc. The strategy involves the person briefly facing the challenging emotion in such a way that it facilitates a reduction of the emotion and then a new emotional state emerges.

Emotional reflection refers to making meaning of the emotion experienced. Reflection on experience (verbally or writing) can help couples express their experience and gain understanding of their emotions (Greenberg, 2006). Emotional reflection promotes emotional awareness, which is the focal point for change to occur, according to this style of therapy.

Goals of Therapy

• Create a more secure and resilient bond between the couple by getting them to express their emotions.
• Normalising attachment needs of each partner
• Maintain a neutral, collaborative therapeutic relationship with the couple to promote emotional acceptance
• Create a shift in each partners interactional positions and initiate new cycles of interaction

Source: (Long & Young, 2007)

Strengths of EFT

• Based on clear, explicit conceptualisations of marital distress and adult love. These conceptualisations are supported by empirical research on the nature of marital distress and adult attachment.
• EFT is collaborative and respectful of clients and emphasises therapeutic relationship that is necessary for growth.
• Applicable to many different kinds of problems and populations.

Weaknesses of EFT

• May not be suitable for clients who experience more profound problems
• Focus is on emotions and neglects other behaviours that may contribute to the problem
• May be dismissed by those clients that seek psychotherapeutic depth in their therapy

Source: www.mentalhealthacademy.com.au