Mental Health
What You Need To Know About Emotionally-Focused Therapy (EFT)

What You Need To Know About Emotionally-Focused Therapy (EFT)

10 min read


Landis Bejar

How would you describe Emotionally Focused Therapy (EFT)?

Emotionally Focused Therapy is an evidenced-based therapy approach that focuses on the ways in which our interpersonal interactions get organized into patterns and cycles. Though the approach is traditionally used for couples therapy, the concepts can be used with families and individuals who want to explore important interpersonal relationships and relationship patterns.

The goal of EFT is to work toward what’s called “secure attachment.” That is, the idea that each partner can provide a sense of security, protection, and comfort for the other, and can be available to support their partner in creating a positive sense of self and the ability to effectively regulate their own emotions.

This is different than other types of couples therapy where you might be teaching skills, tools, and scripts to a couple to use to improve their communication. EFT folks are kind of under the impression that when our emotions are heightened during an argument, it’s too hard to remember those tools and they get tossed out the window. It’s really about restructuring and finding an understanding about why and how we get into those patterns in the first place so that we can interrupt them.

The ultimate outcome of treatment involves a new sense of self and a new way of relating to your partner, which in turn, evokes new responses from that partner.

When Would You Suggest EFT?

Couples who struggle with conflicts and communication problems are likely to benefit from Emotionally Focused Therapy. Although couples mainly use EFT, it is important to note that individuals and families could benefit from this type of therapy, as well.

EFT for Couples

EFT would be an excellent choice for couples who fight often, and either or both of them wrestle with:

  • Addiction
  • Depression
  • Chronic health issues like cancer and cardiovascular illness
  • Post Traumatic Stress Disorder (PTSD)

EFT can also be helpful to couples dealing with unfaithfulness and other traumatic occurrences like sexual abuse in the past and present. Having a child or children with a serious health condition may also contribute to conflicts that couples can solve through EFT.

EFT for Individuals

Individuals who need to work on issues linked to their emotions can also benefit from Emotion-Focused Therapy.  A teenager who has Conduct Disorder, for example, can get this kind of treatment from a therapist to help them work on their conduct and general interactions with others.

EFT for Families

Emotion-Focused Therapy is also suitable for family members who desire a secure bond among themselves. Individuals with depression or childhood trauma can get help to reconnect with their families and improve bonding, as well.

What Techniques Are Used In EFT?

Therapists employ a range of therapy techniques in Emotion-Focused Therapy to attain specific goals depending on where the individual or couple is at. These strategies were identified through task analysis of psychotherapy session transcripts and are known as "therapeutic tasks."

Empathy-based Techniques

Therapists use empathic exploration for problem-relevant experiences and empathic affirmation to move unpleasant feelings to a position of self-affirmation. Identification of vulnerability leads to self-affirmation, in which the client feels understood, hopeful, and strong.

Relational Methods

Relational techniques include building a productive working atmosphere, exploring goals, and investing in counseling to improve self-awareness.

Therapists use these approaches in the early phases of therapy, but they can also use them in later stages when clients encounter friction or withdraw. In these situations, the individuals need to heal their relationships and increase self-awareness while creating a stronger link, and their therapist is there to help them through it

Practicing Methods

This method involves clearing space, focusing on feelings, and encouraging the client to feel and express their emotion. Clients are taught to express appropriate emotions through systematic evocative unfolding and chair work techniques.

Action Tasks

Action tasks are action-oriented. To handle self-evaluative splits, they use chair work such as two-chair dialogue and enactment (blocked feelings and resignation). Individuals can address unfinished business through empty chair work, such as resentment and unforgiveness.

Finally, compassionate self-soothing can help with stuck, uncontrollable pain.

Task Reprocessing

Situational and perceptual reprocessing tasks can support people through things like dealing with difficult or traumatic experiences by retelling those experiences in the presence of a trained professional, or rewiring or reworking those narratives to be more in line with what feels empowering and true for the individual. 

What is EFT Tapping?

Often referred to as EFT Tapping or just Tapping, EFT (Emotional Freedom Techniques) is a non-invasive energetic modality which helps to release blockages and ‘reprogram’ information that’s been locked away, often since early childhood.

One might liken it to a combination of acupuncture, without the needles, and brief talk therapy. The client taps on their own body on specific points while being guided with suggested words specific to their issue or situation. The process creates shifts in awareness of past events and current beliefs and allows for the information to be experienced in a new way, letting go of the emotional weight.

Created by Gary Craig, based upon older research and experiences with Thought Field Therapy (Dr. Roger Callahan), tapping can be used for almost any ailment or issue, from cravings and habits to physical pain and chronic conditions, anxiety and depression to PTSD and trauma responses. It’s based upon the idea that everything is energy, including emotions, and that energy can be stored in the body with the emotions in an unhelpful way, creating blockages in the system and an inability to access what we want. Tapping helps the body and energy system release these blocks and return to balance

Practitioners are able to guide clients through reprogramming of troubling or even traumatic events without triggering a trauma response, without the client needing to relive the trauma. The process can create shifts in a very short period of time…a handful of sessions rather than years of talk therapy. It can even be used when clients aren’t aware of the origin of their issues.

Tapping is versatile, non-invasive, easy to learn and practice and creates lasting effects in short time periods. If you’re dealing with trauma responses or significant events or emotions, it’s a good idea to work with a certified practitioner to help guide you through the session while minimizing emotional discomfort and avoiding re-traumatizing situations.

The Process of EFT Treatment

Nine steps in three stages define the EFT change process. The first four steps form the first stage, which aims to de-escalate the issues. The middle stage of the treatment comprises the following three steps, which involve strengthening the bonds. In the last stage, the wrapping up of treatment comprises steps seven through nine.

These steps are there to guide therapists and track their clients' progress. The three stages include:

De-escalation of the Cycle

The main focus of this stage is:

  • Step 1: To identify the most pressing issues.
  • Step 2: To determine how challenging interaction habits contribute to conflict when significant concerns arise.
  • Step 3: To identify, with the help of the therapist, unspoken concerns and negative emotions associated with an attachment that are at the root of negative interaction patterns.
  • Step 4: Reframe the couple's concerns regarding negative interaction patterns, underlying emotions and fears, and each person's attachment requirements.

Through this process, couples gain an understanding of the ways that fears and insecurities could be affecting their relationship. They start seeing responses like anger outbursts and shutting down as a call for connection or disconnection. Couples can adapt skills of empathy, emotional availability, and engagement with each other. These skills help them have a stronger connection and a feeling of safety between them.

Restructuring Patterns of Interaction

Partners get to be more responsive to each other's needs during this process. At this stage, the couple learns to express their emotions through words and be compassionate and understanding towards their partner.

The therapist helps the individuals to:

  • Step 5: express their attachment requirements as well as their deep feelings.
  • Step 6: learn acceptance and compassion for their partner's attachment requirements and deep feelings.
  • Step 7: learn how to express attachment needs and feelings and negotiate situations that likely produce conflict.

This process minimizes the couple's conflicts while enhancing a secure emotional bond. The individuals learn to share deep, hidden emotions by allowing themselves to be vulnerable and request their partner to meet their needs.

Consolidation and Integration

During this last step, the therapist assists the partners in working on advanced communication skills, which they should practice when they interact with each other. The couple can acknowledge their changes and how the new patterns prevent conflict.

The final steps entail the following:

  • Step 8: The therapist instructs the couple on using new communication techniques to discuss old issues and develop new solutions.
  • Step 9: The couple develops a plan to make new interaction patterns a permanent part of their lives following therapy.

The couples replace the previous habits that often lead to conflict with the current trends of bonding interactions. These positive patterns become constructive and natural, creating a permanent change.

They both get to realize peace and healing within the relationship.

How did EFT come to be? What types of philosophies inform EFT?

Dr. Sue Johnson and Dr. Les Greenberg founded EFT in the early 1980s as a response to the lack of clearly defined and validated couples interventions. Dr. Johnson describes Emotionally Focused Therapy as being influenced by the Attachment Theory of John Bowlby, the Humanistic/Experiential Theory of Carl Rogers, and Structural Theories of Salvador Minuchin. In her book, Creating Connection, Johnson imagines, “EFT is a reflection of the kind of conversation that experiential therapist Carl Rogers and structural systems therapists, such as Minuchin or others, might have had if they had discussed a case of relationship distress over tea.”

To save you a lot of reading, I’ll hit one major takeaway from each of those theories:

Humanistic/Experiential Theory of Carl Rogers

Emphasizes the great capacity that human beings have for growth as well as the positive adaptiveness of our emotional responses and needs, with less emphasis on deciding what’s “wrong” with a client (“pathologizing”).

Structural Theories of Salvador Minuchin

Basically, we do not live in a vacuum and we especially do not live in a vacuum when we’re in a partnership. Structural theory focuses on how our behaviors interact with, affect, and elicit various responses from those with whom we are in relationships. A classic EFT example: “I withdraw because you nag, and you nag because I withdraw.”

Attachment Theory of John Bowlby

Attachment theory is historically related to how infants attach to their mothers and then relate similarly to those around them. In EFT, we look at how attachment applies to adult relationships and forms the foundation for how we understand that great, big four-letter word, “LOVE.” Attachment theory informs our understanding of why it’s so painful and scary when we are betrayed or hurt by a partner - it basically feels as scary as if an infant had been abandoned by its mother.

How hands-on is the therapist in a EFT-style therapy?

The emotionally focused therapist is definitely more hands-on and is characterized as active, engaged, and flexible. The role of the EFT therapist is to serve as a “process consultant,” a “choreographer,” and most of all, an egalitarian collaborator who works with the couple to discover the possibilities of the couple’s relationship right alongside them.

The EFT therapist is definitely not a detached blank slate or passive observer; nor do they act as coaches or experts of the couple or their needs.

The EFT therapist style is intentional, validating, powerfully empathetic, which is exactly how it is possible for partners to feel accepted and safe to explore their emotions.

Please share three different real but anonymized examples of what EFT looks like in the room.

EFT Example 1: Therapist helps partner “Alex” to increase awareness of inner experience and the experience of a relational interaction that just took place:

  • “What happened there? I noticed you just flinched a little when ‘Kris’ touched your leg and then you were silent. What happened for you right then?”

EFT Example 2: Therapist reframes husband “Mike’s” tendency to shut down when his wife becomes angry with him as “Mike’s” feeling like a failure, rather than “Mike’s” being “cold” as his wife has named it. She also asks him whether she is understanding his experience correctly, because he is the expert of his own feelings.

  • “So when you hear your wife’s anger you move away - try to forget it - and she sees - what did she say?  - she sees ‘coldness.’ But in fact, you are trying to deal with a huge sense of defeat, a sense of failure, a fear that you can never please her -- so you shut down and shut her out. Am I getting it?”

EFT Example 3: Therapist helps Camila communicate (“enact”) her vulnerability (“attachment needs”) to her wife, Amy:

  • “Can you look at her and tell her please, ‘When you yell, I hear that I’m hopeless--I have already lost you, so I shut down to stop the pain’ -- can you tell her?”

Please share three or more issue areas EFT is particularly helpful in working through. Why do you think that is?

  1. Betrayal/mistrust
  2. Arguing
  3. Lack of intimacy/connectedness
  4. Family stress
  5. Stress brought on by life transition and/or family change

EFT is particularly helpful in these areas because helps get to the core issues underlying the conflict and the relationship distress and helps couples to understand why their emotions are heightened as a result of such stress, rather than shame them for “getting so emotional about it.”

How long does a EFT treatment generally last?

EFT is designed to be implemented in 8-20 sessions of couples therapy.  

Are there certain personality types that would work especially well with EFT?

EFT is designed to work with couples, and therefore inherently and intentionally works to meet many different personalities and is not a one-size-fits-all method. This is why much of the early stages of therapy focus on establishing a positive therapeutic alliance with both partners.

In general, EFT works best for couples who still have some emotional investment in their relationship and some willingness to learn about how they may have each contributed to the problems in the relationship.

Research has shown that EFT works best when the couple’s alliance with the therapist is high (hello, therapist matchmaking!).

Are there certain personality types that may not enjoy working with EFT?

EFT is not designed to be used with violent couples, with whom expressions of feelings are likely to be dysfunctional and could potentially place a vulnerable partner at higher risk. EFT is not generally used with couples who have already made the decision or started the process of separating.

How do you know if EFT is working for someone? How do you know if it’s not?

There are some specific change points in EFT that the therapist works toward during the process:

  • The first change goal is trying to “de-escalate” the couple in conflict by helping them to identify and name the negative cycles and patterns and helping the couple to understand it from a different perspective.
  • The second major change point is trying to engage the partner who tends to withdraw during the couple conflict, and have that partner feel safe to assert themselves in session.
  • A final major change can be observed when the previously “hostile” or more vocal/active partner starts to risk expressing their own needs and vulnerabilities.
  • The ultimate change results in spouses/partners becoming more open with each other about their needs and fears which strengthens the bond (and their understanding and appreciation of that bond) between them.

How should a therapy-goer prepare for a EFT session? What type of work is entailed?

Because so much of successful treatment outcomes have to do with the therapeutic relationship, one concrete recommendation for preparing would be for a client to try to have a consultation call prior to the session and get a feel for their initial comfort level with the therapist. If the conversation feels safe, comfortable, and somewhat natural (given the inherent constraints of brief phone calls with strangers), that would be a great preparatory task.

After that, I would encourage EFT-bound therapy-goers to come with an open mind. Depending on your past experiences with individual or couple therapy, Emotionally Focused Therapy might look a little different than what you expected. There are going to be less worksheets, prompts, and homework, and more feeling, expressing, listening, and interacting throughout the session.

Of course, one might also prepare, like any other therapy session, by spending some time thinking about the issues you would like to work on, improve, or areas where you’re feeling stuck.

What is your favorite thing about EFT?

My favorite thing about EFT is the style of the therapist. When I was trained in the technique, the therapist presentation and style is a mix of being both incredibly warm, yet also very talented in using warmth and understanding for gentle confrontation that helps clients bring heightened awareness to strong, important feelings that inform recurring behaviors and interactions.

I also love how the attachment theory framework allows the therapist to reframe clients’ defensiveness, hurt, anger, shame, etc. as a natural reaction, rooted in how much they care for and need their partner for safety and security that is necessary to nearly all humans, and is hard-wired in us from infancy.

What advice might you give to a therapy-seeker wondering if EFT is right for them?

I would first encourage anyone who’s wondering to start by reaching out to a potential EFT therapist for a consultation call. This can really be a low-risk/low-investment way to get a feel for the therapist and ask any questions that are coming to mind. As mentioned above, so much of EFT has to do with the way in which the therapist relates to the client and how the therapist works to make the client feel comfortable in the therapy experience.

If the consultation feels good and you are able to get some initial questions answered in a way that feels comfortable for you, trying out a first session with the open mind we spoke about in Question 10.

What I wouldn’t do is let all this talk about “emotions” throw you off. Some might have a negative association with that word and can possible deter people who might feel that they aren’t an “emotional person.” The degree to which you see yourself as outwardly emotional or connected with your feelings before trying out EFT is really not important. It is the task of the therapist to spend the initial phases of the treatment focusing on relationship-building and creating a safe bond with the therapist for all individuals in the therapy room, which forms the foundation for safe exploration and understanding of emotion.

Thank you for sharing a glimpse of your perspective with us today, Landis. We’re grateful to work with you and know you are helping so many individuals and couples grow as individuals and partners.

If you’d like to learn more about Landis or work in more depth together, check out her website to book your first phone consultation and begin to explore your connection.

As always, if you have any questions or feedback, we’d love to hear from you. Reach our team any time at [email protected].

If you have any topics you’re eager to read about, or content you’d like to contribute, let us know! We’re all ears.

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About the author

Landis Bejar is a Licensed Mental Health Counselor in New York City. She uses Emotionally Focused Therapy (EFT) in her work with couples, individuals, and families to reshape ineffective relationship patterns and work through interpersonal strains and a variety of mental health concerns.

Landis is the founder of AisleTalk, a therapy and coaching practice dedicated to helping overwhelmed brides navigate the stress of wedding planning. Though weddings can often appear fabulous and euphoric from the outside, planning a wedding can also raise concerns related to partnership stress, family strain, financial burden, mood changes, body image insecurity, and much more. Landis helps brides deal with stress so that the planning does not take the excitement out of the process, nor the happiness from the wedding day.

Landis is a proud member of the My Wellbeing therapist network and happy to connect with clients who feel her style would be a good fit for their journey through life or down the aisle.

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