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Emotionally Focused Therapy: A Safe Adventure

Dr Sue Johnson is the leading innovator of Emotionally Focused Therapy, an attachment-based approach rooted in emotional process and originally used with couples. Her new book, Attachment Theory in Practice, took her over thirty years to write, and sees her apply her learning to the whole field of psychotherapy, sharing techniques for treating anxiety and depression as well as relationship problems. Here, she explains EFT’s value for contemporary practitioners, as a coherent cross-modality approach that’s all about the power of connection.

As an avid researcher and clinician mostly known for my work in couple and family interventions, for over three decades I have been immersed in observing, finding patterns in and changing the core interpersonal dramas that continually shape our personalities, our resilience and our most precious relationships. Learning how to make sense of and transform these dramas, where issues of how to share everyday chores run alongside existential realities such as whether it is possible to trust another with our vulnerabilities, has taught us so much. Particularly, it has taught us the power of actively using emotion to evoke new thoughts and behaviours and to shape new corrective emotional connections with others. We have learned the power of a certain kind of collaborative alliance. We have also learned the power of staying focused on present process as it unfolds in a session, in terms of regulating emotion in positive ways and helping clients move into positive dependency with others.

In my new book, Attachment Theory in Practice: EFT with Individuals, Couples and Families, I apply what we have learned to the whole field of psychotherapy. This field is in a state of chaos with over 1,000 different names for therapy interventions, over 400 manualized tested treatments which require many hours to master, a growing number of identified disorders and thousands of specific interventions offering immediate simple remedies to complex life problems. Dedicated empiricism, where we try to match treatment to client, a focus on common factors such as alliance, and even outlining the core shared features of different disorders, do not create integration per se. It takes a broad science-based, developmental theory of personality that melds self and relationship system, such as attachment theory, to do this. 

The humanistic experiential model, Emotionally Focused Therapy, best exemplifies the tenets of attachment science. It allows us to systematically craft potent corrective experiences that restructure client’s sense of self, model of other, emotion regulation strategies and habitual ways of engaging with others. And it does this across modalities.

Sarah, who is depressed and always self-depreciating, is able to access her desperation and sense of abandonment by her mother and her ex-husband. As she follows the flow of her emotion into an imagined encounter with this partner, she moves from numbing to an active assertion of her fears and needs in a way that shapes emotional balance and a sense of efficacy. The therapist knows how to assemble Sarah’s emotion with her using the map provided by attachment science.

As Mark and Jane outline the negative cycle of demand and shut down that has taken over their relationship, leaving them both alone, they begin to see their relational dance as the enemy and to tune into each other with new empathy. They can then gradually move into new levels of openness, emotional responsiveness and engagement – the very factors that structure secure bonding moments in any relationship. This offers them a new resource, as individuals, that helps Mark grow and deal with his traumatic stress and Jane address her anxiety at depending on others. New attachment dances shape new dancers.

The same kind of change occurs in a distressed family when a father is able to tell his very belligerent son, “I don’t know what to do right now, how to be a dad. So I shut down and shut you out. And then all there is between us is hurt and anger. I want to learn to be there for you.” His son weeps, and finally tells his father about his longing to be held and be “small” in a safe haven embrace where he can “belong”.

Attachment points to the power of vulnerability faced alone as the ultimate risk factor for psychological problems, and safe connection with others as the ultimate harbinger of health. It is a theory based on biology; on the fact that the unique vulnerability of our young has wired us for connection with others and this connection is as essential to us as the air we breathe. This perspective, with its thousands of research studies, goes to the heart of the matter. It renders therapy a safe adventure for both therapist and client. It offers us so much promise for crafting a coherent discipline of 21st century psychotherapy.

Attachment Theory in Practice: Emotionally Focused Therapy with Individuals, Couples and Families, by Dr Sue Johnson, is published by Guilford Press.

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Sue Johnson

Dr. Sue Johnson is a leading innovator in the fields of couple therapy and adult attachment. She is the primary developer of Emotionally Focused Couples and Family Therapy (EFT), which has demonstrated its effectiveness in over 30 years of peer-reviewed clinical research. Sue’s received numerous awards acknowledging her development of EFT, including the APA’s “Family Psychologist of the Year” in 2016 and the Order of Canada in 2017.  Her best-selling book Hold Me Tight (2008) has taught countless couples how to enhance and repair their love relationships. The book has since been developed into an interactive relationship enhancement program, Hold Me Tight Online. Her newest book for clinicians, Attachment Theory in Practice(2019), delineates the promise of attachment science for understanding and repairing relationships. As the founding director of the International Centre for Excellence in Emotionally Focused Therapy (ICEEFT), Sue trains counselors in EFT worldwide and provides guidance to 65 affiliated centers. She consults for the U.S. and Canadian military and the New York City Fire Department, and is a popular presenter and speaker for the general public. You can find out more about Sue and her work at drsuejohnson.com.