Sunday, April 26, 2015

Emotional Focused Couples Therapy

A) Assumptions• Partner’s needs, desires, and primary emotional responses are seen as healthy and adaptive.
• It is how these needs are enacted in a context of perceived danger that creates problems
• Therapist validates experiences and responses rather than teaching them to be different.
• People are seen as being stuck in absorbing emotional states and in self reinforcing interaction cycles rather than as being deficient.
• They are simply stuck in set ways of relating to each other.

B) Motivation Normal Couple Functioning
• Adult love is a bond, an emotional tie with an irreplaceable other who provides a secure base from which to confront the world and a safe haven- a source of comfort, care, and protection.
• A Bond consists of behavioral, cognitive, and attachment elements.
• It involves a set of attachment behaviors, a set of emotional responses, and strategies to regulate such responses, and an inner representation of prototypical interacts, which constitute working models of self and other in this context.

C) Dysfunction Development of Behavior Disorder
• Emotional detachment of one or both partners.
• Unacknowledged feelings that underlie interactional positions.
• Attachment needs that continue to go unmet.
• Primary emotions that are excluded from individual awareness and not explicit in the partner’s interactions

D) Intervention Goals of EFT
• Reorganize emotional responses
• New corrective emotional experience of engagement.
• Create shift in interactional pattern
• Initiate new cycles of interaction
• Secure bonding
• Focus on attachment concerns
• Safety, Trust, Contact
• Grasp hidden rationale behind “irrational” responses

E) TechniquesStage 1: The De-escalation of Negative Cycles of Interaction
Step 1. Creating an alliance
Step 2. Identifying the negative interactional cycle
Step 3. Accessing the unacknowledged emotions
Step 4. Reframing

Skills used:• Empathy – a necessary prerequisite for and an integral part of all EFT interventions.
• Focus on accessing and expanding primary emotional responses, which are often presented as secondary, reactive responses.
• Reflection
• Validation
• Implicit emotions explicit
• Placing secondary emotions in context
• Empathic conjecture/interpretation
• Evocative responding (reflections/questions)

Stage 2. Changing Interactional PositionsStep 5. Promoting identification with disowned attachment emotions, needs
Step 6. Promoting acceptance of partner’s experiences
Step 7. Facilitating expression of needs and wants and creating emotional engagement

Skills used:• Safe working distance
• Heightening
• Focus on primary attachment emotions
• Deepen each client’s engagement with primary, underlying emotion
• Seeding attachment softening Disquisition

Stage 3. Consolidation and Integration
Step 8. Facilitating the emergence of new solutions to old relationship problems
Step 9. Consolidating new positions and new cycles of attachment behaviors

Skills used:• Tracking and reflecting
• Enactment
• Externalization
• Reframing
• Restructuring interactions
• Heightening new responses

Techniques Specific to Difficult Therapeutic Impasses• Diagnostic picture or narratives
• Specific “picture” painted by therapist of couple’s positions
• Presents limited choices of future
• Individual sessions
• Address specific emotional responses that block engagement
• Useful when crisis occurs

The “How” of InterventionsRISSSC
Repeat
key words and phrases
Image to capture and hold emotion
Simple words and phrases
Slow pace
Soft voice
Client’s Words in a collaborative, validating way


F) Limitations• It can be used with many different types of couples:
• GLBTQ, older, with chronic illness, PTSD, or depression.
• It can be used across many, different cultures.
• However, it is not useful with:
• Couples who are clearly separating, no commitment.
• Couples who are in a clearly abusive relationship, unsafe to be vulnerable.