Emotionally Focused Therapy for Couples

Emotionally focused therapy (EFT) is a type of short-term therapy that is used to improve attachment and bonding in adult relationships. This approach to couples therapy was developed by doctors Sue Johnson and Les Greenberg in the 1980s and is rooted in research on love as an attachment bond. This treatment can help couples form a more secure emotional bond, which can result in a stronger relationship and improved communication.

EFT Is Based on Attachment Theory

Attachment between people typically provides a safe haven: a retreat from the world and a way to obtain comfort, security, and a buffer against stress. Attachment also offers a secure base, allowing you to feel safe while you explore the world and learn new information. Its formation begins in childhood with a primary caretaker, such as a parent.

Those early, established patterns carry through to adulthood. An unavailable caretaker creates distress in a baby akin to an unavailable partner creating distress in an adult. Attachment theory provides the emotionally-focused therapist with a road map to the drama of distress, emotions, and needs between partners. 

How Insecure Attachment Weakens a Couple's Bond

Any perceived distance or separation in our close relationships is interpreted as danger. Losing the connection to a loved one threatens our sense of security. "Primal fear" ensues and sets off an alarm in part of our brain called the amygdala, also known as the fear center.

Once the amygdala is activated, it triggers our fight-or-flight response. When incoming information is familiar, the amygdala is calm. However, as soon as the amygdala encounters threatening or unfamiliar information, it increases the brain’s anxiety level and focuses the mind’s attention on the immediate situation.

People go into a self-preservation mode, often doing what they did to "survive" or cope in childhood. This is the reason we are triggered as adults in our romantic relationships, in the same repeating (and unhealthy) patterns from our formative years. EFT can help to unwind these automatic, counter-productive reactions.

Emotionally Focused Therapy Creates Healthy Patterns

EFT provides a language for healthy dependency between partners and looks at key moves and moments that define an adult love relationship. The primary goal of the model is to expand and re-organize the emotional responses of the couple.

The change process has been mapped into a clearly defined system consisting of nine steps across three stages that help guide the therapist and track progress. The three stages of EFT are:

De-escalation

This step is focused on identifying negative interaction patterns that contribute to conflict, identifying negative emotions related to attachment issues, and reframing these issues. This helps couples better see how insecurities and fears are hurting their relationship.

Partners begin to view undesirable behaviors (i.e., shutting down or angry escalations) as “protests of disconnection.” Couples learn to be emotionally available, empathetic, and engaged with each other, strengthening the attachment bond and safe haven between them. 

Restructuring

During this stage, each partner learns to share their emotions and show acceptance and compassion for their partner. This helps each partner become more responsive to their partner's needs.

The process reduces couples’ conflict while creating a more secure emotional bond. Couples learn to express deep, underlying emotions from a place of vulnerability and ask for their needs to be met.

Consolidation

During the final step, a therapist helps the couple work on new communication strategies and practicing skills when interacting with each other. This can help couples see how they have been able to change and how new interaction patterns prevent conflict.

New sequences of bonding interactions occur and replace old, negative patterns such as “pursue-withdraw” or “criticize-defend.” These new, positive cycles then become self-reinforcing and create permanent change. The relationship becomes a haven and a healing environment for both partners.

Who Can Benefit from EFT

Emotionally focused therapy can benefit couples who are struggling with conflict, distress, and poor communication. While often used in couples therapy, EFT can also be helpful in individual therapy and family therapy. With individuals, this approach can help people improve emotion-related problems. It can also help family members form more secure bonds with one another. 

The distressed couples who may benefit from EFT include those where one or both partners have:

• Depression
• Addiction
• Post-traumatic stress disorder
• Chronic illness

EFT has proven to be a powerful approach for couples dealing with infidelity or other more traumatic incidents, both current and past. Neuroscience also intersects attachment theory and EFT. More recently produced MRI studies demonstrate the significance of secure attachment. Our attachments are potent, and our brains code them as “safety.”

EFT is being used with many different kinds of couples in private practice, university training centers, and hospital clinics. It is also quite useful with various cultural groups throughout the world.

Effectiveness

EFT has many strengths as a therapeutic model. First, it is supported by extensive research. Second, it is collaborative and respectful of clients. It shifts blame for the couples' problems to the negative patterns between them, instead of the couples themselves (or individual partners).

There is a substantial body of research outlining the effectiveness of this treatment. It is now considered one of the most (if not the most) empirically validated forms of couples therapy.

What to Expect From Emotionally Focused Therapy

During an EFT session, a therapist observes the dynamics between a couple and then acts as a collaborator to coach and direct new ways of interacting. Unlike some other forms of therapy where the therapist is more of a passive listener, EFT therapists take an active role in guiding the conversation. It also focuses on addressing emotions and interactions within the session rather than focusing on things like worksheets and homework.

Therapists are empathetic and help couples realize that their emotions are valid. They help couples and individuals recognize behaviors and patterns that they may not even be aware of and see how these actions contribute to conflict in a relationship.

A Word From Verywell

Emotionally focused therapy can be an effective way for couples to form stronger bonds and build a better relationship. Research has found that EFT can improve interactions between partners and reduce the amount of stress that people experience in their relationship.