Emotionally Focused Therapy
Updated: Jan 20
Emotionally Focused Therapy (EFT) is a form of short-term therapy that aims to improve couple relationships by rekindling the physical and emotional bond that can get sacrificed to disappointment in a partner and alienation from them, a common dynamic in distressed couples. If there is a motto for EFT, it is: “Hold me tight.”
Drawing on research supporting attachment theory, the therapy regards the security of partner connection as the best lever for change in a dysfunctional relationship and a necessary source of both couple and individual growth. Love, in short, is transformative. Restoration of the emotional ties enables partners to be physically and psychologically open and responsive to each other so that they can construct a mutually supportive and satisfying relationship in the moment and for the future.
EFT operates on the evidence that emotions are not accessories to human experience but organizing principles of our lives. The expression of longing and sadness over isolation is a powerful tool for eliciting the lost contact and responsiveness of a partner. Once that contact is restored, it becomes a renewable source of mutual comfort, a buffer against life’s many stresses. Couples can then go on to solve their own problems.
With the guidance of the therapist, couples are led to discover the unmet need for closeness that lies under their anger or alienation. Sharing that vulnerability not only opens the door to a new couple's dialogue but creates instant opportunities for expressions of tenderness. “Emotional responsiveness—tuning into and supporting the other—is the key defining element of love,” says Sue Johnson, Ph.D., who developed EFT along with Leslie Greenberg, Ph.D.
When Is It Used?
EFT is especially useful when couples arrive at counseling in emotional distress or feel so alienated they may believe that the relationship is irreparable. They may be displaying intense anger, fear, grief, loss of trust, or a sense of betrayal in their relationship. Such strong negative emotions are thought to be expressions of protest and despair over the loss of connection and the resulting feelings of physical and emotional abandonment. They are also believed to conceal feelings of fear, helplessness, and unlovability that result when bonds are ruptured.
It is also useful for couples and individuals who have difficulty expressing emotions or who believe that doing so is a sign of weakness. At the other extreme, EFT is of help to those who have trouble regulating emotions; their intense reactivity is believed to result from emotional alarms set off by fears of abandonment. In individual therapy, the therapist forms a secure alliance with the patient that becomes a safe haven for emotional exploration and expression.
EFT has many other applications because it directly targets the emotional isolation believed to be at the core of so many forms of mental distress. For example, the fears of loss and disconnection it addresses are thought to underlie many instances of depression and anxiety and experiences of trauma. The therapy is also used to repair family bonds in instances where parent-child relationships have become troubled.
What to Expect
Expect a course of treatment that typically consists of eight to 20 sessions held once a week. After taking a history from the couple, the therapist will observe their interaction patterns. Couples will be asked to identify their most pressing issues. Through observation, listening, and questioning, the therapist comes to understand the unspoken fears and insecurities that underlie negative interaction patterns.
The first several sessions are typically devoted to de-escalating the emotional reactivity and distress couples experience, especially if their life outside the therapy office. Couples learn to expand their emotional response patterns so that they can recognize and be responsive to their partner’s needs.
The second stage of therapy is devoted to restoring a deep emotional bond between partners. The goal is to create a sense of security that allows partners to share their vulnerabilities, provide comfort for each other, and serve as a secure base for exploration of the world and individual and partnership growth.
An EFT therapist is not just an observer but an active participant in the therapy. A very important part of the therapy is reframing such distancing behavior as anger or withdrawal not as pathology but as misguided bids for connection. That allows partners to express their deep feelings for each other and what they need from their partner.
The last few sessions consolidate the gains made in the previous sessions. For example, with their mutual support system now restored, couples are typically asked to discuss an old or ongoing problem so that they can develop new solutions. Patients get to practice comforting and connecting rather than disconnecting in the face of difficulty, as they understand the true emotional needs that formerly drove their negative patterns.
How It Works
Emotion-focused therapy puts emotional experiences and reactions front and center in therapy. It is based on attachment theory and the importance it places on connection to others as a source of feelings of comfort and safety and a vehicle for growth and development. Those others may be flesh-and-blood partners from whom one is currently experiencing a sense of alienation. Or they may lie within—the mental representations we all have of important figures in our lives, around which we often shape our relationships. Or they may be parts of ourselves.
Our need for others is built into the brain. Only connection provides the sense of safety we need to grow, risk, develop, and explore the world. In its absence, the nervous system is aroused; people are pitched into vigilance for danger, avoidance of risk, and a sense of helplessness, which, EFT holds, are key risk factors for all mental health problems.
Whether working with actual partners, in couples therapy, or mental representations of relationships in individual therapy, EFT explores the nature of our connections and the emotions they generate. It also helps people actively restructure those relationships so that they pave the way for new, more rewarding experiences.
For all its roots in attachment theory, EFT works very much with the reality of existing relationships and the emotions they generate. Patients come to understand how their negative interaction patterns are typically related to attachment-related fears of loss. Under the direction of the therapist, they learn to openly discuss their fears, identify the attachment needs that their fears mask, and instead of distancing themselves, use their vulnerabilities to seek closeness. From that position, they can readily solve life’s problems together.