Emotion-Focused Therapy (EFT) for couples is an evidence-based, humanistic, and experiential approach that emphasizes attachment and emotion to address destructive relationship patterns (Johnson, 2004). While EFT was not originally developed specifically for infidelity, research by Greenberg, Warwar, and Malcom (2010) demonstrated that it can be highly effective in helping couples recover from betrayal, rebuild trust, and move toward forgiveness.
EFT has strong empirical support, grounded in decades of attachment theory research, showing its effectiveness in strengthening emotional bonds not only between parent and child but also between romantic partners (Johnson, 2014).
EFT for couples provides the therapist a guideline for what is important, what works well for couples and what is needed to create a healthy relationship (Johnson, 2014). Change happens in the present moment with the therapist guiding the couple to go deeper into their emotional experience, understand how they make sense of these experiences and assist them in communicating these feelings to their partner (Johnson, 2014). With deep emotional work the focus must be creating safety during each session through validation and support from the therapist (Johnson, 2014).
Overall, the goal of EFT for couples is to guide the couple to change the way they argue, negotiate, increase satisfaction, and create a more secure emotional bond between the partners (Johnson, 2014).
EFT for couples can be broken down into five major steps the therapist must focus on throughout intervention. The first step is to maintain focus in the present moment, both on an individual level and between the partners, and the therapist must keep the focus on current emotions and patterns of engagement (Johnson, 2014).
Second, the therapist must deepen the emotions being experienced during interactions by asking the couple to turn inward, focus on their bodily sensations, slowing them down, and encouraging a deeper look into their primary core emotions (Johnson, 2014).
Third, the therapist must clarify the emotion and create a new interaction based on the primary core emotion that was experienced (Johnson, 2014).
Fourth, the therapist guides the couple through this new process of interaction by asking each partner what it was like to engage in a different way, creating a corrective emotional experience (Johnson, 2014).
Lastly, the therapist asks the couple to focus on the new process they created using the core emotions felt, thereby creating confidence for them in their ability to shape the way they interact (Johnson, 2014). The sequence of these steps will be repeated with different emotional intensity until each partner feels heard, understood and safe (Johnson, 2014).
EFT for couples highlights three basic stages of change during the therapeutic process. The first stage of change focuses on de-escalation of the couple’s negative cycle of interaction at the onset of therapy, targeting behaviours such as mutual withdrawal or critical demanding of resolution followed by withdrawal (Johnson, 2014). Using an attachment style framework, the therapist can explore this negative cycle with the couple and highlight how each partner can raise attachment fears and insecurity in the other (Johnson, 2014).
At the end of de-escalation, the couple can come together and help each other to recognize this cycle as problematic, rather than internalizing or blaming each other, therefore allowing the cycle to cease (Johnson, 2014). The initial de-escalation allows for a secure base to go deeper into the relationship during the second stage of change. Here, the therapist guides the couple to restructure their bond by creating powerful conversations during sessions (Johnson, 2014).
Guided by the therapist, both partners express their fears about the relationship, such as rejection or abandonment, in a manner that brings the couple closer together and allows them to respond to their partner’s fears in a more comforting way (Johnson, 2014). Once each partner can communicate their emotional needs, the bond can shift towards security allowing for open and responsive reactions (Johnson, 2014).
The third stage of change can be characterized as the consolidation of what has been discovered through therapy and focus on the future (Johnson, 2014). The therapist guides the couple to look at the changes made and create a story of how they became stuck in a negative cycle but were able to work together to solve the problem (Johnson, 2014).
EFT COMBINED WITH EMDR
Emotion Focused Therapy (EFT) for couples can also be combined with Eye Movement Desensitization and Reprocessing (EMDR) as intervention for couples working through the trauma of an affair (Negash, Carlson, & Linder, 2018). In the context of treating infidelity, both EFT and EMDR guide the couple to revisit the betrayal, explore and process deeper emotions, and modify the narrative and emotions still attached to the memory of the affair (Schade & Sandberg, 2012).
The therapist must use an EFT framework for couples and introduce EMDR only after the couple has identified strong secondary emotions and have demonstrated non-judgmental attunement and reassurance to each other (Negash, Carlson, & Linder, 2018). Couples who engage in criticism, defensiveness, contempt, and stonewalling will likely not respond positively to the introduction of EMDR as safety in the therapy room is necessary for effective processing (Negash, Carlson, & Linder, 2018).
The therapist’s decision to introduce EMDR is based on the identification of either one or both partners experiencing persistent trauma symptoms related to the infidelity (Negash, Carlson, & Linder, 2018). In the absence of trauma related symptoms (e.g., reliving or ruminating on the affair or intense emotional distress still tied to the affair), the therapist would usually continue therapy using an EFT framework without the addition of EMDR (Negash, Carlson, & Linder, 2018).
EMDR as a stand-alone treatment is delivered in an eight-phase protocol that attends to past traumatic events, current situations causing disturbance, and creates templates for modification of problematic behaviour (Shapiro & Brown, 2019). Phase one and two focus on gathering information from the client, fostering a strong therapeutic alliance, and creating internal safety through introduction of resources for self-soothing (Shapiro & Brown, 2019).
Phase three through six is when the therapist and individual work together to identify a target (e.g., a memory or a trigger) and process this using the EMDR procedure (Shapiro & Brown, 2019). Creating a target involves the individual identifying vivid imagery of a trauma related memory, the associated negative self-referencing belief, and related emotions and bodily sensations (Shapiro & Brown, 2019).
During this time, the individual will also work with the therapist to create an alternative positive belief that will be used to replace the negative cognition (Shapiro & Brown, 2019). The individual is subsequently instructed to focus on all three aspects of the target while simultaneously engaging in bilateral stimulation (Shapiro & Brown, 2019).
Bilateral stimulation, or what EMDR also calls sets, can be achieved through back and forth eye movements, taps or tones (Shapiro & Brown, 2019). After each set, the individual is instructed to let their mind go blank and notice whatever thought, feeling or image of the memory comes to awareness (Shapiro & Brown, 2019).
Sets will be repeated until the individual reports no distress related to the target, at which point the focus is turned to the previously agreed upon positive belief (Shapiro & Brown, 2019). Phase seven and eight focus on closure and re-evaluation of the target to ensure no distress is lingering in the body related to the trauma target (Shapiro & Brown, 2019).
The combination of EFT and EMDR for couples consists of introducing EMDR during specific stages of change in the EFT framework (Negash, Carlson, & Linder, 2018). The couple must first identify and deconstruct their negative cycle, the partner who strayed must openly admit to the affair, and any long-standing power imbalances are addressed (Negash, Carlson, & Linder, 2018).
Each partner must feel they can trust themselves and their partner to refrain from engaging in the already identified negative cycle during the EMDR sessions (Negash, Carlson, & Linder, 2018). The therapist must remain attuned to the couple’s interaction and attachment-based trauma symptoms throughout EMDR as both partners are in the room during processing (Negash, Carlson, & Linder, 2018).
After attending to a couple’s concerns at the outset of each session, the EMDR protocol is utilized (Negash, Carlson, & Linder, 2018). One partner actively engages in EMDR while the other functions as a witness and source of support (Negash, Carlson, & Linder, 2018).
The witnessing partner must remain attuned and empathetic with what their partner is experiencing, allowing the witness to better understand the complexity of their partner’s reaction to the affair (Negash, Carlson, & Linder, 2018).
The witnessing partner is asked by the therapist to reflect on the impact their actions had on their partner and express their new understanding and compassion to their partner to promote safety and repair (Negash, Carlson, & Linder, 2018).
After engaging in EMDR the couple should have a deeper understanding about their own and their partner’s emotional process and increased emotional attunement.
Through this process the couple also creates a shared narrative of the affair that highlights the strength of the relationship (Negash, Carlson, & Linder, 2018). Couples who successfully complete EMDR may find it increasingly safer and more effective to engage in EFT and develop a deeper secure bond with one another (Negash, Carlson, & Linder, 2018).
If you would like to explore options for couples counselling and/or EMDR, contact us.
References:
Greenberg, L., Warwar, S., & Malcolm, W. (2010). Emotion-focused couples therapy and the facilitation of forgiveness. Journal of Marital and Family Therapy, 36(1), 28–42. doi: 10.1111/j.1752-0606.2009.00185.x
Johnson, S. M. (2014, February 19). What is emotionally focused therapy (or EFT)? [Video]. Youtube. https://www.youtube.com/watch?time_continue=15&v=xQCg-jC25fo&feature=emb_title
Negash, S., Carlson, S. H., & Linder, J. N. (2018). Emotionally focused therapy and eye movement desensitization and reprocessing: An integrated treatment to heal the trauma of infidelity. Couples and Family Psychology: Research and practice. Advance online publication. http://dx.doi.org/10.1037/cfp0000107
Schade, L. C., & Sandberg, J. G. (2012). Healing the attachment injury of marital infidelity using emotionally focused couple’s therapy: A case illustration. American Journal of Family Therapy, 40, 434– 444. http://dx.doi.org/10.1080/01926187 .2011.631374
Shapiro, R., & Brown, L. S. (2019). Eye movement desensitization and reprocessing therapy and related treatments for trauma: An innovative, integrative trauma treatment. Practice Innovations, 4(3), 139–155. https://doi.org/10.1037/pri0000092
This blog post was written By Jenn Struth, M.Psy
