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



Today we hear from talented NYC Therapist and entrepreneur, Landis Bejar, about the ins and outs of Emotionally Focused Therapy (EFT), which can be an empowering and relationship-changing technique for couples and individuals alike.

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.

How would you describe Emotionally Focused Therapy (EFT)?

EFT 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.

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 EFT 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 EFT 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.

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?”

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?”

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, EFT 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 connect@mywellbeing.com.

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