Monday, March 10, 2014

Using Emotion Focused Therapy with Couples

     Couples coming for counseling are often in a state of crisis.  The issues can be many: careers, communication, money, parenting, sex, infidelity, substance abuse, trust.  Some couples have never attempted therapy, choosing to work on their own or with the support of family and friends.  Others have tried therapy a number of times but have not found satisfaction.  Many couples see counseling as a last try at saving the relationship having already considered separating.  Some, however, use therapy to determine whether the pairing will take off or how to improve a stalled relationship.

     One intervention that works well and quickly is Emotion Focused Therapy based on the book by Dr. Sue Johnson, Hold Me Tight: Seven Conversations for a Lifetime of Love (Johnson, 2012).  It is an easy and engaging read, great for any couple, and a good starting point for counseling.  It dovetails beautifully with attachment based therapy which focuses on relationship instead of behavior and the lasting effects of childhood experiences, particularly early trauma.  Combined with Attachment Communication Training outlined by Michael Orlans and Terry Levy in Healing Parents: Helping Wounded Children Learn to Trust and Love (CWLA, 2006) it provides practical skills and tools.

     For one, EFT gives people permission not to be perfect.  It actually assumes that each of us has a few leftover wounds from childhood that sometimes haunt us in the present.  Second, Emotion Focused Therapy gives people permission to ask for help from their partner in healing these old wounds.  No man, or woman, is an island, and the expectation of a relationship is that the pair can develop a "Dance of Attunement" that meets the needs of each individual (Parenting from the Inside Out by Daniel Siegel, M.D. and Mary Hartzell, M.Ed. [Penguin, 2003]). Third, EFT respects the sovereignty of the individual in the give and take of a relationship but also holds each accountable.

     Johnson identifies attachment needs or rights as: love, respect, safety, attention, value, and validation and alternately attachment wounds as feeling: hurt, abandoned, afraid, unnoticed, devalued, and demeaned.    EFT focuses on accessibility, responsiveness, and engagement.  The seven conversations or steps are: recognizing the pattern, uncovering attachment wounds, revisiting past disconnections, engaging and connecting, apologizing and forgiving, bonding through sex and touch, and keeping love alive.  Effective communication steps including sharing, listening, restating, and feedback go a long way in helping couples reconnect.  Humor and humility really help, too.

     For example, Mark and Jane came complaining of constant arguments over his work schedule and her shopping.  Mark grew up with an overbearing mother who believed he married "beneath him".  Jane was raised by socialites who kept up appearances.  As Mark spent more time at work, Jane developed a serious drinking problem and eating disorder.  Her parents blamed Mark.  His mother encouraged him to dump her.  Underneath this attack-attack pattern was real love and commitment.  Mark and Jane learned to carve out space for their relationship and protect it from outside attack.  They started routinely communicating much deeper feelings and intimacy and teamwork returned.

     Karen and Tim had lived together for more than a year.  They enjoyed each other's company immensely.  Karen loved Tim's friends and his unique career.  Tim loved Karen's daughter and her sense of humor.  It was a really comfortable relationship, but Karen wanted more.  The relationship with her daughter's father never took off, and she wanted to settle down.  Tim had suffered a painful divorce and was still bruised.  Their pattern was attack-withdrawal.  Karen picked at Tim over chores and bills but what she really wanted was marriage.  Tim had said "someday" to marriage several times but then tried to avoid any further conversations.  When Karen was able to ask for what she really needed, and Tim felt safe enough to say no, they were able to stay friends but not partners.

     Emotion Focused Therapy helps couples move toward deeper more meaningful conversations.  One thing that couples like the best is the ability to give themselves a break, to be human, to make mistakes with each other, to catch them, to correct them, and to keep working on relationship.