Becoming an Emotionally Focused Therapist

The Workbook

James L. Furrow, Susan M. Johnson, Brent Bradley, Lorrie Brubacher, T. Leanne Campbell, Veronica Kallos-Lilly, Gail Palmer, Kathryn Rheem, Scott Woolley

• Publisher: Routledge
• Year: 2022
• Print ISBN: 9780367483425
• eBook ISBN: 9781000537918
• Edition: 2
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

This second edition of Becoming an Emotionally Focused Therapist: The Workbook has been fully revised by expert therapists with advances in attachment science and emotionally focused therapy (EFT) practice, the integration of the "EFT Tango"—a guide to the EFT process—and new chapters on working with both individuals and families.

Suitable as a companion volume to The Practice of Emotionally Focused Couple Therapy or as a standalone learning tool, it provides an easy road-map toward mastering the ins and outs of EFT with practice exercises, review questions, and compelling clinical examples.

Invaluable for clinicians and students, this workbook takes the reader on an adventure: the quest to become a competent, confident, and passionate emotionally focused therapist.

SECTION III EFT APPLICATIONS

9 EMOTIONALLY FOCUSED INDIVIDUAL THERAPY (EFIT)

DOI: 10.4324/9781003039457-12

This chapter reviews the application of the emotionally focused therapy (EFT) model, well known as a couple intervention, for individuals dealing with depression, anxiety, and the aftereffects of traumatic experience. As outlined in Attachment Theory in Practice: Emotionally Focused Therapy with Individuals, Couples and Families (Johnson, 2019) and in Brubacher (2017, 2018), emotionally focused individual therapy (EFIT) is a model of intervention based on the perspective on health, dysfunction, and growth offered by attachment science and on an integration of experiential (Rogers, 1961) and systemic (Minuchin & Fishman, 1981) interventions. The great strength of attachment theory is that it seamlessly integrates inner experience and relational pattern (Bowlby, 1969, 1988) and shows how each defines the other through the process of affect assembly, regulation, and expression. EFIT is inherently relational, always seeing the individual evolving in the drama of one’s intimate connections. Individual therapy as a modality has often taken individual functioning out of this context, which from the EFIT perspective is like taking a fish out of water—its evolutionary context—and expecting to really understand how a fish actually functions.

EFT TASKS AND GOALS WITH INDIVIDUAL CLIENTS

In this section we explore the EFT tasks and goals as they apply to EFIT. As with any modality of EFT, the tasks follow a similar function. The tasks orient the therapist to the core elements necessary in the EFT process of change.

Task 1. Creating and Maintaining a Therapeutic Alliance

The EFT therapist stance is best defined by the acronym ARE. The therapist is accessible, responsive, and engaged, entering into attuned connection in the manner of a good parent who is intent on creating a secure bond with the individual client while at the same time attuning to the client’s experiences with key figures that populate their world. Therapist attunement is essential to alliance maintenance and repair, which is necessary in the EFT therapist’s effort to sustain an ongoing emotional balance and focused genuine presence. Repairing ruptures and realigning misattunement strengthens the therapist’s alliance and promotes client’s exploration and felt confidence in this unique therapeutic bond.

Task 2. Accessing, Assembling, Expanding, Distilling and Deepening Emotion

Accessing, assembling, expanding, distilling, and deepening emotion occur particularly in Move 2 of the EFT Tango; however, the therapist is constantly tuned to emotional cues and almost invariably follows the emotional charge in session. The therapist helps an individual to discover how their emotion is constructed, often distilling reactive emotional experiences down to a core threat or perceived danger that underlies the more surface coping responses such as rage, numbing, or despair. In this process, the therapist helps clients experience and process emotions embedded in anxiety and depression in new ways, opening pathways for more effective emotion regulation and expression. The therapist follows the map of the unfolding process of emotion and basic attachment needs and fears, provided by attachment science and the accumulated clinical wisdom of EFT.

Task 3. Restructuring Key Interactions and Key Ways of Engaging

In Task 3, the EFT therapist restructures key interactions and key ways of engaging with emotion, both when intense unwanted emotion is triggered intrapsychically and by significant others. It is as necessary to shape interpersonal change events with individuals as it is with couples and families. The shaping of these interpersonal encounters crystallizes stuck places, core vulnerabilities, and automatic ways of coping and responding, and it structures new corrective emotional experiences that change individuals’ key inner dramas. It is in reshaping these inner dramas that an individual’s sense of competence and worth can be discovered and consolidated.

The Goals of EFIT

EFIT is oriented to helping clients create emotional fitness, which is the capacity to recognize and use one’s emotions as a reliable guide and to function with flexibility, connectedness, resilience, and efficacy. The EFT therapist always attunes to individuals in their attachment, relational contexts, viewing individuals as essentially co-regulating beings—functioning optimally when they have one or two others on whom they can depend. Depending on others is what Bowlby (1988) called effective dependency, an ingredient essential to health and well-being. The state of optimal dependency involves having positive views of some others as trustworthy and dependable and a view of self as lovable and competent. The specific goals of EFIT include:

• To offer corrective emotional experiences that positively impact models of self and other and shape new responses to self and other.
• To offer transformative moments where vulnerable emotions that are frightening, alien, and unacceptable are encountered with balance.
• To facilitate clients to move into the accessibility/openness, responsiveness, and full engagement that characterize secure attachment with others.
• To help clients to shape a coherent sense of a worthy, competent self who can deal with existential dilemmas and become a fully alive human being.

The therapist follows the five moves of the EFT Tango to reach each of these goals. The Tango moves organize a repetitive process with different levels of intensity that guide the entire process of change. Each move includes experiential and systemic interventions guided by a consistent focus on attachment themes and experiences.

Exploring the EFT Tango in EFIT

We now provide a snapshot of how a therapist helps an individual move through the EFT process of change using the five moves of the EFT Tango. In this brief example with Stephen, we observe how the EFT therapist reflects the present process in an early stage of EFIT to begin stabilizing stuck patterns, accessing underlying or unex-pressed core emotions, and moving slowly toward restructuring Stephen’s experience. The therapist focuses on using newly discovered and distilled emotional experience and engaging the present process to shape new ways of interacting and regulating emotion, concluding with consolidating, integrating, and celebrating change. Reading Stephen’s example, you can move through the EFT Tango and complete each exercise to explore the EFIT process.

Stephen: (speaking fast and directing his gaze at the carpet.) I know I am hard to deal with sometimes. I get very hyper. Wired. Have to be the best at what I do—and my sports things, and—well, everything. Have to be on the go. Busy. High energy. My wife says I am too much. Like—I want us to make love every night and then some. But she goes and sleeps on the couch. I get pretty angry, and then we really fight. She even mentioned divorce. She won’t talk to me for days. You know she was engaged to my best friend, and he dumped her, and then she agreed to go out with me. He is one of the richest men in the country now. Somehow, I persuaded her to marry me, but … My mum used to tell me “You’d better knock yourself out and find some magic or you’ll be a nothing like your father.” But I am fine. I just want some help with all this not being able to sleep and freaking out when I lose a case in court. Maybe I just need to try harder or get some sleeping pills—half my firm are on them. Some of them are really effective these days. … What was I saying? Oh yes (pauses) I get so angry. So, I go work out at the gym. If I stand still … well … no point, is there? Just emptiness there.

Exercise 9.1. Move 1—Mirror the Present Process

Which of the following therapist responses best illustrates a focus on the present process? Hint: The best answer will reflect in the present moment how Stephen copes and the emotional impact he is experiencing using this coping pattern. Choose 1 answer: _________

1. Therapist: You have this strong need to achieve, and it’s so hard for you when you lose a case in court—that you go home and put even more pressure on your wife to be affectionate and sexual with you. And I imagine that pressuring your wife to respond is making her frustrated with you. What do you think?
2. The therapist offers a mindfulness exercise to help Stephen calm down and sleep. After practicing the mindfulness exercise with him several times, the therapist assures him this will help him to sleep. Stephen is also given an exercise to use to help him go back to sleep, should he awake during the night.
3. You sound very wound up even now as you talk! So, caught up in this fear of losing—this sense of being a loser running, running at full speed, performing, pushing yourself continually to achieve—to avoid that emptiness of being no more than your dad? You push your wife to show desire for you, and she then moves away, and you end up feeling more unsure than ever that you matter to her, so you push again. The more you push, the more she turns away and the more frantic you become. In spite of your speed and your efforts, anger and emptiness lie in wait for you.

Exercise 9.2. Move 2—Affect Assembly and Deepening

Building on the present process that the therapist reflected, consider which of the following therapist responses best focuses on assembling Stephen’s emotional experience. Hint: The most useful intervention here might include reflecting key elements of his emotion (trigger—bodily arousal—meaning made—action tendency) into a coherent statement that highlights his core attachment panic. Choose 1 answer: _________

1. “What do you think it means that you cannot slow down and sleep? Did you receive messages, for example, that you have no right to slow down until you achieve more? It must be very difficult to feel continual pressure to push yourself to be bigger and better—fearing failure in your wife’s and mother’s eyes.”
2. The therapist focuses specifically on the trigger for his speed up, “You’ve said that you get especially wound up when you lose a case—you’ve said you feel like a loser, in fact. You talk about ‘freaking out’ when you lose a case.” Stephen introjects, “I’m dizzy—perhaps I am just not good enough—sexy enough—clever enough.” The therapist responds, “So your natural tendency is to run as fast as you can to avoid the danger of losing, of failing. This emotional music has taken over, and you are wired and angry all the time, dizzy, running from the fear of the ‘emptiness’—of not being good enough—that waits for you, yes?”
3. “You have a hyper speedy talking style! You are obviously trying to prove to your mother that you are not the failure she predicted. Your need to prove you are of more worth than your father is repeatedly getting in your way! Can you imagine how much easier life could be if you were to recognize that you have already achieved much more than your father ever did, even if your mother fails to recognize this obvious fact?”

Exercise 9.3. Move 3—Shaping an Encounter

Review the following three encounters that an EFT therapist could shape to help Stephen disclose his newly discovered emotional experience. The therapist could shape an encounter with the therapist, between two parts of Stephen, or with an image of his mother. Read each response and see if you can identify how the use of these encounters could expand Stephen’s exploration of his pattern of pressure (e.g., the treadmill of emptiness on which he is stuck). After reading each possible therapist response, jot down a new discovery Stephen might make from each encounter. The discoveries may be about how he constructs his world and how he engages with himself, with others, and with his own emotion...

Table of contents

• Cover
• Endorsements
• Half Title
• Title
• Copyright
• Dedication
• Contents
• Preface
• Section I: Theoretical Overview and Intervention Summary
• Section II: EFT and the Couple Treatment Process
• Section III: EFT Applications
• Appendix A: EFT Sexuality Assessment Questions
• Appendix B: Attachment History
• Appendix C: EFT Training Note Form
• References
• About the Authors
• Index