The ABCs of Emotionally Focused Couples Therapy

Rooted in attachment theory, EFT focuses on softer, primary emotions.

Key points

• Emotionally focused couples therapy targets emotions as a way to, ultimately, change behavior.
• Emotionally focused couples therapists help partners learn to express “softer” emotions (e.g., fear, sadness).
• These softer emotions underlie reactive “secondary emotions” (e.g., anger, hostility).

Emotionally focused couples therapy is a relationship intervention that has its roots in attachment theory. According to attachment theory, our interactions with caregivers (and, most notably, our primary caregiver) shape the way that we interact with others throughout our lives. Children are born with needs for objects necessary for survival, such as milk and water, as well as less tangible needs for emotional closeness, support, and protection. These needs must be met to ensure the survival of the infant, as we are born dependent on others for survival.

Development of an Attachment Style

The infant expresses these attachment needs through behaviors such as crying or smiling. Caregivers can be responsive, inconsistent, or unresponsive to the needs of a child. A caregiver’s degree of responsiveness has implications for the development of the infant’s attachment style (Bretherton, 1992), which may remain relatively stable throughout the course of an individual’s life. The main types of attachment styles are secure attachment, anxious-ambivalent attachment, and anxious-avoidant attachment (Bretherton, 1992).

Responsive caregivers nurture children to develop a secure attachment style. Those with a secure attachment style are able to form stable and satisfying bonds with others. In contrast, caregivers who are inconsistent with their responsiveness may foster an anxious-ambivalent attachment style in a child, characterized by separation anxiety and a failure to be soothed (Bretherton, 1992), which may result in preoccupation with relationship problems later in life. Caregivers who are unresponsive may have children who develop an anxious-avoidant attachment style, characterized by avoidance of close relationships. Thus, attachment theory posits that early caregiver-infant interactions result in persistent patterns of bonding later in life.

Repairing Attachment Bonds

The goal of emotionally focused couples therapy is to repair insecure attachment bonds to foster more secure attachment in couples. Emotionally focused couples therapy recognizes that all people have attachment needs, though these needs are expressed in different ways by different people (Johnson, 2000).

Behaviors are seen as enactments of our drive to connect to others and to ensure that our needs are met, given our attachment styles. Emotionally focused couples therapists guide couples to be responsive to each other’s attachment needs, as “accessibility and responsiveness are the two building blocks of secure attachment” (Johnson, 2000). All humans have a need for safe and supportive connections in their relationships. Couples’ negative behaviors are part of a struggle for secure attachment that involves attachment protest, clinging, and helplessness. These are all responses to separation distress, a result of threatened connection between partners (Johnson, 2000).

Soft and Hard Emotions

Central to emotionally focused couples therapy is the idea that secondary or “hard” emotions (such as anger, disgust, hostility, resentment, or withdrawal) are influenced by underlying primary or “soft” emotions (such as sadness, fear, or shame). Primary emotions are grounded in attachment fears or attachment injuries. There is a cycle between primary and secondary emotions and their expression, whereby secondary emotion expression causes further attachment insecurity and, thus, further negative primary emotions (Johnson, 2000). In other words, when secondary emotions are expressed in an unregulated way to the partner, negative interaction cycles ensue.

A very common example of this is the demand/withdraw pattern that is destructive to relationship stability and satisfaction (e.g. Eldridge, & Christensen, 2002). In contrast, expressing primary emotions enhances connection between partners. Thus, one goal of emotionally focused couples therapy is to have clients engage with primary emotions and learn to express them to their partners instead of expressing harmful secondary emotions.

Helping clients to have these kinds of primary emotion conversations and, thus, express their attachment needs, enhances each person’s responsiveness to their partner, healing attachment injuries. Thus, an emotionally focused therapist helps clients to get in touch with and express their softer emotions so that their partner is able to listen to and understand emotions without becoming flooded or defensive. This promotes attachment bonding in clients. Emotional responses are the target of intervention; communication patterns are the consequence of modified emotional responding (Johnson, 2000).

FAQs

Q: What is EFT and what does it focus on?

EFT is a structured, short-term, and evidence-based approach to couples therapy developed by Dr. Sue Johnson. It is grounded in attachment theory, which posits that humans are “hard-wired” for close emotional connection. The focus is on emotion, specifically, identifying and changing the negative interaction cycles that keep couples feeling disconnected, often by accessing the underlying, more vulnerable (or “soft”) emotions (like fear, sadness, or loneliness) that drive “hard” emotions (like anger or criticism). The goal is to create a secure, lasting emotional bond.

Q: What are “The ABCs” in EFT?

While the entire EFT process has three main stages (De-escalation, Restructuring, and Consolidation), “The ABCs of attachment” is a simple acronym sometimes used to describe the basic attachment needs that all partners seek to have met for a secure bond. A stands for Acceptance: Am I acceptable to you? Do you value and honor me as I am? B stands for Belonging: Am I important to you? Do I matter? Will you share with me and be my shelter? C stands for Comfort: Are you emotionally present? If I reach for you, will you be there for me and comfort me when I’m in distress?

Q: How long does EFT typically take and how effective is it?

EFT is generally considered a short-term therapy, typically involving 8 to 20 sessions, although the exact duration depends on the couple’s distress level and specific needs. It is one of the most highly validated approaches to couples therapy. Research shows that 70-80% of couples experience significant improvement and increased relationship satisfaction, and about 90% show lasting improvement after the therapy is complete.

Q: What are the negative interaction patterns that EFT tries to change?

In EFT, the problem is seen as the negative cycle itself, not the partner. The therapist helps the couple identify their specific “dance” that leads to distance and conflict. Common cycles include: The Pursue/Withdraw Pattern: One partner tends to pursue (criticize, demand, or seek connection intensely) while the other tends to withdraw (defend, become silent, or emotionally shut down). The Attack/Attack Pattern (High Conflict): Both partners pursue each other intensely, often with escalating criticism and defensiveness. The Withdraw/Withdraw Pattern (Emotional Distance): Both partners have retreated, leading to a “roommate” relationship with minimal emotional sharing or conflict.

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References

Bretherton, I. (1992). The origins of attachment theory: John Bowlby and Mary Ainsworth. Developmental Psychology, 28(5), 759.

Eldridge, K. A., & Christensen, A. (2002). Demand-withdraw communication during couple conflict: A review and analysis. In P. Noller & J.A. Feeney (Eds.), Understanding Marriage: Developments in the Study of Couple Interaction (pp 289-322). Cambridge, MA: Cambridge University Press.

Johnson, S. M. (2000). Emotionally focused couples therapy. In: L. Bevilacqua & F.M. Dattilio (Eds.), Comparative Treatments for Relationship Dysfunction. New York, N.Y.: Springer Publishing Company.