Emotionally Focused Therapy – Flashcards

1 -attachment theory -Bowlby's ,2 - experiential theory (Carl Rogers -person centered theory) and 3 -systemic-structural therapies.

on the emotional system, which includes both interpersonal (i.e. the couple or family) and intrapsychic (i.e.the individual) systemic process

the therapist identifies the couples' behavioral interactional patterns (just like most systemic therapist) but also identifies the perceptions, emotions and underlying attachment needs (need for safe connection) that fuel the problematic behavioral interactions.

the therapist helps couples fundamentally restructure their interactions so that each partner is able to experience a sense of safety and connection with the other (i.e. gets their attachment needs met).

the therapist helps the couple solidify new patterns.

a brief therapy (approximately 8-12 sessions)

began to developed Emotionally Focused therapy in the 19082's, one of the most researched approaches in the field and is an empirically validated treatment for treating couples and family.

focuses on couples therapy that is based on a new paradigm for understanding adult love relationships.

humans have the need for secure attachment relationships across the life span not just in infancy and early childhood.

not only supports the claim that secure attachment affect physical health, but specific correlations have been identified; avoid ant attachment styles are correlated with pain-related complaints, and axioms attachment styles with cardio vascular conditions, yet secure attachment was not correlated with any specific health condition.

correlated with higher rates of psychopathology (internal-unhealthy patterns)

suggests that humans need secure relationships in order to emotionally self-regulate.

helps explain much of the puzzling behavior related to intimate couple and family relationships;

the problem is that humans are trapped in a paradox when tension arises in attachment relationships; the other person is both the primary source of comfort and safely and during conflict the most threatening danger.

1-Attachment is an innate motivating force; 2-Secure dependence complements autonomy (inter-dependence) 3- attachment offers an essential safe haven; 4-attachment offers a secure base;5 - emotional accessibility and responsiveness builds bonds; 6- fear and uncertainty activate attachment needs; 7 - the process of separation distress is predictable; 8- there are finite number of insecure attachment styles; (3 typical patterns (a) anxious and hyper activated- (such as anger, clinging, depression and despair: (b)avoidance - withdraws and distracted on unrelated tasks (c) combination of anxious and avoid ant (a person pursues closeness and then avoids it once offered) 9 - attachment involves working models on self and others (people use the quality of attachments to define themselves and others as lovable, worthy, and competent and develop internal models about what can be expected and how to engage in attachment relationships; 10- isolation and loss are inherently traumatizing (they can trigger a panicked survival responses - example solitary confinement is a universal form of torture.

couples therapy with trauma survivors; depression; couples with chronically ill children.

De-Escalation of Negative Cycles - Create an alliance and delineate conflict in the attachment struggle (map the cycle) Identify the negative interaction cycle Access unacknowledged emotions and underlying interactional positions Re frame the problem in terms of the negative cycle and attachment needs, with the cycle being the common enemy

Change Interactional Patterns and Creating Engagement Promote identification of disowned attachment needs and aspects of self, integrating these into relational interactions Promote acceptance of the partner's experience along with new interaction sequences Encourage direct expression of needs and wants while strengthening emotional engagement and attachment bonds (these steps are generally first done with the focus on the partner withdrawing and then the same process on the pursuing partner.

Consolidation and Integration Facilitate new solutions and old problems Consolidate new positions and new cycles at attachment

(a) establishing a strong therapeutic relationship needed for the exploration of difficult emotions and (b) developing a clear case conceptualization using attachment theory. In the final step of this phase, the therapist will help the couple reframe and externalize their negative interaction cycle in such a way that the couple or family conflict can be seen as failed attempts to connect (rather than the partner has become a horrible person), this is where the therapist can begin to start the conversation.

the therapist begins to work with the most withdrawn partner and helps this person identify, own, and directly express to the other partner his or her unmet attachment needs. (This is radical because the with-drawer is the one with the fewest complaints. She starts with the with-drawer to help them re-connect, it then becomes easier for the pursuer, who is pursing the connection to be more vulnerable to get their connection needs met. Then works with the pursuer in the same way.

this phase is more hopeful, as couples learn how to work through old issues using their new safely connected relational patterns (usually with far better results)

The therapists connection with each partner serves as a role model for the couple or family to relate to one another.

Therapists are humble and able to admit mistakes and misunderstandings. As a result, clients experience the relationship between them and the therapist as an authentic human encounter.

therapist maintain a nonjudgemental stance that is grounded in a positive view of human nature, an acceptance of human struggles and human recognition of how hard it can be to create secure relationships with those we love.

a process consultant who helps the couple reprocess their emotional experiences; a choreographer who helps the couple restructure their relationship dance; a collaborator who follows and leads the therapeutic alliance.

a coach teaching communication skills; a "wise creator of insight" into the past and or future; a strategist employing paradox or problem prescription.

How individuals process their experiences, particularly their key attachment-oriented emotional responses.

How partners organize their interactions into patterns and cycles.

the initial reactions to a given situation; these typically represent attachment fears and needs (usually softer, more vulnerable, such as feeling abandoned, alone, helpless, unloved, unwanted and inadequate.

emotions about the primary emotions, not the actual situation. Example: If the given situation is a critical remark, the primary emotion may be feeling inadequate, but the secondary emotion is likely to be anger about feeling inadequate. Secondary emotions often take the form of anger, frustration or withdrawal; these emotions allow the person to avoid the sense of vulnerability associated with primary emotions.

the salient secondary emotions because these are typically what couples initially present and are the only emotions of which many are conscious.

begins to raise each partner's awareness of the primary emotion underlying the secondary emotion, such as the hurt that is beneath the anger of having one's partner no longer expressing sexual interest.

the focus is primarily on the primary emotions.

identify the couples or families negative interaction cycle, which is typically conceptualized in EFT as a pursue/withdraw pattern

Pursue/Withdraw (most common cycle) - a readily identifiable partner who pursues connection and one who withdraws. Withdraw/Withdraw ( some couples present with what appears to be two with-drawers; however, in these cases there is typically a burned out pursuer, who has given up trying to connect. Attack/Attack; this pattern typically involves a with-drawer who sometimes turns, erupts into anger;and fights when provoked by his partner's pursuit (often in the form of criticism) Complex Cycles; Trauma survivor couples often present with a complex multimove cycle involves both high levels of anxiety and avoidance.

Accessible, Responsive and Engaged.

EFT therapist have a somewhat structured series of Initial sessions to determine if the couple is appropriate for EFT. Typically the assessment sessions are scheduled as following; 1- a joint couples session 2- followed by individual sessions with each partner; 3 - then the return to regular conjoint sessions.

Perceptions of problems and strengths Negative and positive interaction cycles Relationship history and key events Brief attachment history of each Observed Interactions in session Check for violence, abuse, or other contraindications Assess for prognostic indicators: degree of re activity, strength of attachment, and openness (response to therapist)

Commitment to the relationship Sense of physical and emotional safety Potential, current, and past affairs Trauma History Detailed attachment history

Different agendas for the relationship and therapy (ex; someone wanting to marry the other wants to remain single) Separating Couples (when it clear, one partner has left the relationship) Abusive Relationships (Couples in which there is physical, sexual and or emotional abuse are not appropriate for EFT. Untreated Addiction (Alcohol and SA do not preclude therapy, but they must be sober at session.

Creating secure attachment for both partners Developing new interaction patterns that nurture and support each partner Increasing direct expression of emotions, especially those related to attachment needs.

Validation - communicate to clients emotional experiences are understandable and understood."At first you felt sad when he does not want to spend time with you, then you became angry and tried to force him. Reflecting emotions - goal is to help clients more fully experience their emotions, both primary (attachment based) and secondary. Reflecting secondary emotions involves helping clients identify what they are feeling in the negative interaction cycle. Tracking the cycle - therapist tracks patterns and cycles of interactions and then reflect on these patterns to help couples better understand the nature of their relationship Evocative responding - evocative responses are based on conjecture, the therapist offers these tentatively, allowing the client to correct or rephrase. Emphatic conjecture - addressing defensive strategies, attachments longings and fears. Helping to generate new meanings to primary and secondary emotions.

Evocative responding Empathetic conjecture Heightening - involves using repetition, metaphors, images, and enactments of heighten, key emotions and interactions that pay a crucial role in maintaining the couples' negative cycle. Leaning in, say that again, did you hear that, used in right context these can be exactly what a person needs to explore complex and often painful feelings that arise in couples therapy. Re framing - systemic perspective, problems are to be re framed in the broader context of the relationship to emphasize to help the couple see the CYCLE as the common enemy and to help each see how THEY contribute to the NEGATIVE cycle. Restructuring Interactions (enactments)

Validation Evocative responding Re framing Restructuring interactions (enactments)