Emotionally Focused Therapy

Dr. Sue Johnson developed Emotionally Focused Therapy in the mid-1980s as an alternative method of traditional couple’s therapy after receiving her doctorate in counseling psychology. She noticed that negative emotions, particularly anger and conflict, were often disregarded from interventions. Johnson disagreed with this approach as she believed that all emotions, including anger and conflict, are an integral aspect of understanding attachment bonding. Thus, she developed a therapy model that focused on the client’s emotional experience while helping them communicate their emotional experiences in healthier ways. 

Johnson began developing EFT by studying videos of couples therapy sessions. Johnson observed that the majority of couples were overwhelmed with emotion, often resulting in either shutting down or lashing out while the root of the conflict remained unresolved. For example, it may seem as if an escalating argument is about dirty dishes piling up in the sink. Still, after some analysis, she discovered that the underlying tension is often displaced from a deeper unresolved issue such as feeling unloved or unappreciated. Discussing the emotions behind the argument is what brings about lasting change. Johnson then launched the first EFT outcome study. It was highly successful, but she had not understood why it had worked so well just yet. Why would a partner lash out instead of communicating those emotions?

Johnson attended a talk given by Dr. Neil Jacobson, the pioneer of cognitive-behavioral marital therapy. He spoke about how relationships were a bargain, and negotiating that bargain is the key to successful relationships. A “you do the dishes and I do the laundry” contract was the basis of couples therapy at the time. Johnson left the conference feeling something wasn’t correct about that approach. She concluded that you could not bargain for safety, love, and responsiveness. 

Johnson began to develop this insight further, adapting it to John Bowlby’s attachment theory. According to attachment theory, human infants are biologically hardwired to need a secure attachment to at least one caregiver. Therefore, a healthy relationship with a caregiver in infancy and early childhood should lead to a secure attachment style. However, when an infant’s relationship with their caregiver is disrupted in some way, various types of insecure attachment styles may develop. As people grow older, this attachment style can transfer to romantic relationships. For example, if emotional distance is perceived within a close relationship, someone with an insecure attachment style may become triggered if a situation is interpreted as a threat. When a person experiences a threat or even a perceived threat, the part of the brain called the amygdala is activated, resulting in various instinctive emotional reactions and defense mechanisms, such as flight, flight, or freeze responses. Johnson identified that at the root of many arguments is an intense human need for safe and secure bonding. She posited that underlying fears of abandonment and insecurity pave the way for negative cycles of interaction and unfulfilled emotional needs. Johnson refers to this cycle as a “dance” and the emotions as the “music”; thus, if you can change the music, you can change the dance.  

EFT is described as an intersection of:

• Carl Roger’s humanistic approach, which recognizes the importance of acceptance, genuineness, and empathy.  
•  Salvador Minuchin’s structural family therapy, which maps relationships and interactions between different members of a family.
•  John Bowlby’s attachment theory, as previously described.

The American Psychological Association (APA) recognizes EFT as a gold standard approach to couples therapy, and ample clinical research supports its efficacy.