Emotionally focused therapy: Bridging the Gap Between the Brain and the Heart

Emotionally focused therapy (EFT) is a type of psychotherapy that recognizes the importance of emotions in personal development and interpersonal interactions. EFT aims to help clients understand their emotions, learn to manage them, and use them in a healthy and constructive way. This approach is particularly useful for those trying to overcome relationship problems, stress, anxiety or depression.

Emotionally focused therapy was developed in the 1980s by psychologists Leslie Greenberg and Sue Johnson as part of process-experiential psychotherapy for working with couples. This approach was inspired by attachment and human emotion theories, as well as the clinical work of Carl Rogers, the founder of client-centered therapy.

Although EFT was initially used primarily for couples, its methods have since been adapted for individual clients.

Since its development, many studies have confirmed the effectiveness of а Therapy. In particular, it has been effective in working with people suffering from various forms of anxiety, depression, post-traumatic stress disorder (PTSD), and relationship problems.

Today, EFT is used by many therapists around the world and continues to evolve and adapt to the needs of various client groups. This approach includes a variety of techniques, such as emotional saturation, reframing, and creating new images, which help people explore and change their emotional responses to various irritants.

Key Principles of Emotionally Focused Therapy

Emotionally Focused Therapy (EFT) is based on the principle of the central role of emotions in human personality development and relationship formation.

EFT recognizes that emotions are a fundamental part of the human experience and play a key role in behavior and interactions.

Emotions are seen as potentially healthy and useful sources of information about oneself and the world, which can be used for personal growth and development.

The primary method of working in EFT is the exploration and transformation of the client’s emotional states and reactions. During therapy sessions, clients learn to recognize, accept, and express their emotions, which helps them understand their feelings and manage them.

A crucial aspect of Emotionally Focused Therapy is creating a safe, supportive therapeutic environment where clients can calmly and without fear explore their feelings.

The Impact of Emotions on Behavior and Relationships

Emotions play a central role in our behavior and interactions with the world. They serve as a navigation system, indicating what is important to us, what brings pleasure, fear, or anger. Emotions motivate our actions and help us make decisions.

Experiencing positive emotions, such as joy or pleasure, we often act openly and actively, seek communication with others, and strive to achieve our goals. However, negative emotions, such as fear, anger, or sadness, can lead to withdrawal, conflict, or detachment.

Emotions are also an important element in relationships. They influence how we perceive others, how we react to them, and how they, in turn, react to us. Emotions can strengthen or weaken our connections with others. For example, shared laughter strengthens friendships, while anger or irritability can destroy them.

Therefore, understanding your emotions and being able to manage them is an essential skill that helps improve both individual behavior and interpersonal relationships.

The Role of a Safe Emotional Space

A safe emotional space in psychotherapy is a key element of healing and personal growth. Such a space creates conditions where clients feel protected, heard, and accepted, allowing them to open up, explore their feelings and experiences, and work on them in a calm environment.

In a safe emotional space, people can bravely face their fears, grief, shame, and other emotions they consider challenging or unacceptable. Confidence that their experiences will be accepted without judgment facilitates self-awareness and self-acceptance.

This is especially important in Emotionally Focused Therapy, which largely depends on the client’s ability to safely explore their emotional experiences and use this information for personal growth and change.

The Importance of Empathy and Emotion Validation

Empathy and emotion validation play a crucial role in effective Emotionally Focused Therapy.

• Empathy is the ability to understand others’ feelings and share your feelings with them. In therapy, this means the therapist can “stand in the client’s shoes” and understand their experiences from the inside. Empathy creates a deep emotional connection, helping clients feel understood and accepted, which is essential for healing and change.
• Emotion validation is acknowledging and confirming the client’s emotions. It doesn’t mean the psychologist agrees with everything the client feels or does but confirms their right to those feelings. Validation helps clients know that their feelings make sense and are important, which also contributes to their emotional well-being.

Together, empathy and emotion validation create a safe emotional space where clients can explore and transform their emotions. This is a central aspect of the Emotionally Focused Therapy approach.

Application of Emotionally Focused Therapy

Emotionally Focused Therapy is widely used in psychotherapy with individual clients, couples, and families. It is particularly effective in working with people suffering from anxiety disorders, depression, PTSD, and relationship problems.

Through EFT, clients learn to explore their internal conflicts, manage emotions more effectively, improve communication, restore healthy interpersonal relationships, and strengthen psychological well-being.

EFT in Individual Therapy

In the context of individual therapy, Emotionally Focused Therapy (EFT) helps clients explore, understand, and manage their emotions. The goal of EFT is to help people establish a connection between their emotions, thoughts, and actions, allowing them to respond more effectively to life situations.

EFT is especially beneficial for people suffering from anxiety disorders, depression, PTSD, or relationship difficulties. During therapy, clients learn to identify and appropriately express their emotions, helping them resolve internal conflicts, boost self-esteem, and improve overall mental health.

With the therapist’s support, clients can safely explore their feelings and replace negative or destructive emotional states with more positive and adaptive responses.

Emotionally Focused Therapy helps not only cope with current problems but also provides clients with tools to manage future emotional challenges.

EFT in Family and Couples Therapy

Emotionally Focused Therapy is widely used in family and couples therapy. It is a model based on attachment theory, helping partners and family members better understand their emotional needs and responses, improve communication, and restore closeness.

In couples therapy, EFT helps partners better understand and express their emotional needs, enhancing emotional contact between them. This includes exploring and understanding recurring interaction patterns that cause conflicts or disconnection.

In family therapy, EFT is used to strengthen bonds between family members and resolve family conflicts. This involves working with each family member’s emotional reactions to various situations and teaching more effective ways of communication and conflict management.

EFT for Treating Specific Disorders

Emotionally Focused (EFT) has proven effective in treating a wide range of mental disorders, including PTSD, depression, anxiety disorders, eating disorders, and personality disorders.

• In the context of PTSD, EFT helps people process and integrate traumatic memories and experiences, reducing their emotional charge and understanding how they affect current life. It allows clients to explore their emotions related to psychological trauma in a safe and supportive environment, then change emotional responses to make them less painful and destructive.
• For depression, Emotionally Focused Therapy helps clients understand their emotional reactions that exacerbate depressive symptoms, such as despair, sadness, or helplessness. EFT also helps establish a more positive attitude towards themselves and their feelings, improving mood and overall mental state.
• For anxiety disorders, often associated with excessive or uncontrollable anxiety, EFT helps clients explore their emotional reactions to anxiety-provoking situations and develop new ways to manage these feelings.
• For eating disorders, such as anorexia or bulimia, EFT helps clients understand their emotions often related to self-perception and body image and develop healthy ways to manage these feelings.
• Finally, for personality disorders, such as borderline personality disorder, EFT helps clients improve interpersonal relationships and reduce overall emotional distress.

Stages of Emotionally Focused Therapy: Understanding the Process

The process of Emotionally Focused Therapy (EFT) is typically divided into two main stages.

1. In the first stage, known as the de-escalation stage, the psychologist works with the client or clients to identify negative interaction patterns and behaviors. Together, they explore the emotions and feelings underlying these factors. The goal of this stage is to help clients better understand their emotions and how they are connected to their behavior.
2. In the second stage, known as the reorganization or consolidation stage, the psychologist helps clients develop new, healthier forms of interaction and behavior patterns. This involves working on specific emotional reactions and responses identified in the first stage. The aim of this stage is to help clients change their behavior based on a new understanding of their emotions.

Exploration Stage: Working with Current Emotions

The exploration stage in Emotionally Focused Therapy involves in-depth work with the client’s current emotions. The primary goal of this stage is to help the individual better understand and become aware of their feelings, as well as their connection to their behavior and relationships.

The therapist strives to create a safe and supportive space where the client can freely express their feelings and thoughts. It is important to ensure the acceptability of all emotions—both positive and negative—so that the client can accept and understand their significance.

To explore and express emotions, the therapist may use various techniques and exercises. This can include reflection and validation of the client’s feelings, as well as the use of different strategies for self-awareness and self-regulation.

The exploration stage is an important step in the EFT process, as it helps the client better understand their emotions and subsequently work on changing their reactions and behavior.

Deep Transformation Stage: Reworking Emotional Schemas

The deep transformation stage in Emotionally Focused Therapy aims to rework and change deeply rooted emotional schemas that negatively affect the client’s behavior and relationships.

In this stage, the psychologist provides the client with the opportunity not only to explore their emotional reactions and behavioral connections but also to change these schemas, helping the individual experience and express their emotions differently.

To help people transform their reactions, the therapist may use techniques such as reframing, experimenting with new ways of interacting, meditation, relaxation, as well as strategies for self-awareness, self-regulation, and changing negative thinking.

Integration Stage: Consolidating New Emotional Reactions

The integration stage in Emotionally Focused Therapy involves consolidating and reinforcing new, healthier emotional reactions and behavior patterns developed in the previous stages. This stage helps the client ensure long-term changes in their behavior and relationships.

In the integration stage, the therapist helps the client see how new forms of interaction and behavior serve their needs and goals. The joint work aims to help the client start using these new ways of responding to their emotions in real-life situations outside the therapeutic setting.

Additionally, in this stage, the psychologist and the client together explore possible obstacles that may arise in the way of using new emotional reactions and behavior patterns and develop strategies to overcome them. This helps the individual feel more confident in their ability to apply what they have learned in therapy to their everyday life.

Ultimately, the integration stage allows the clients to see how new ways of emotional responding and interacting with others can improve the overall quality of their life.

Practical Application of Emotionally Focused Therapy

The practical application of Emotionally Focused Therapy includes a wide range of techniques and methods aimed at improving the client’s emotional well-being. This includes working with the client’s current emotions, exploring their connection to behavior and relationships, and creating new, more adaptive ways of interacting and responding to emotions.

A key aspect of the practical application of EFT is the partnership between the therapist and the client. Together, they explore the client’s emotional experience and recognize the connections between their emotions, thoughts, and behavior.

Examples of Effective Techniques and Exercises

1. Reflective listening: The therapist actively listens to the client, reflects, and validates their emotions. This helps the client deepen their understanding of their own emotions and improve emotional self-awareness.
2. Validation of emotions: The therapist acknowledges the client’s feelings, showing that they are important and deserve attention. This helps the client feel respected and understood.
3. Reframing: The therapist helps the client look at their emotional reactions or relationships in a new way, offering different interpretations or perspectives.
4. Exploring emotional schemas: The therapist helps the client explore deeply rooted patterns or “schemas” in their emotional experience and relationships.
5. Working with images and metaphors: This can include creating images or metaphors that reflect the client’s emotions or experiences to help them better understand and express their feelings.
6. Emotional saturation: A technique where the therapist helps the client fully experience and express their emotion so that they can better understand and work with it.
7. Techniques for self-awareness and self-regulation: This can include teaching meditation, relaxation techniques, or cognitive strategies for managing emotions.
8. Working with emotional triggers: The therapist helps the client identify and work with situations or stimuli that trigger strong emotional reactions.

Advice for Psychologists and Psychotherapists on Applying Emotionally Focused Therapy

• Build trustful relationships with clients: Safety and trust are the cornerstones of EFT. Therapists should strive to create a safe and supportive space where clients will feel comfortable expressing their feelings and emotions.
• Focus on emotions: Emotions are at the heart of EFT, and therapists need to learn to recognize and validate their clients’ emotional reactions. Help them explore their feelings and understand how they relate to their thoughts and behavior.
• Be flexible in your approach: Each client is unique, and what works for one may not work for another. Be ready to adapt your methods and techniques to meet the individual needs and goals of your clients.
• Continuously learn and develop: Emotionally Focused Therapy is a dynamic and evolving field, so for effective application, psychologists need to constantly learn and develop to stay informed about the latest research and methodologies.
• Do not fear deep emotions: Sometimes working with emotions can elicit strong reactions. It is important to be prepared for this and to provide support to clients, helping them safely disclose their feelings.
• Use feedback from clients: Your work with clients will be even more effective if you establish feedback, asking what works for them and what does not.
• Utilize supervision and consultations: Regular supervision or consultations with more experienced colleagues or EFT specialists are very useful for discussing complex cases, getting new ideas, and maintaining your skills at a high level.
• Consider cultural and social contexts: Cultural, social, and personal factors can significantly affect people’s emotional experience and interactions. Do not forget about this when working with clients from different social strata and cultures.
• Be patient and empathetic: Working with emotions takes time. Sometimes progress is slow, but that is normal. Therapists should be patient and empathetic towards their clients, even if positive changes occur more slowly than expected.

Effectiveness of EFT: Review of Research and Effectiveness Indicators

Numerous clinical studies confirm the effectiveness of Emotionally Focused Therapy. Here are some of them:

1. An article in the Journal of Marital and Family Therapy (2016): The study showed that couples undergoing EFT demonstrated significant improvements in the quality of their relationships and stability of these improvements for two years after completing therapy.
2. A review of studies published in the Journal of Clinical Psychology (2012): A review of 16 studies covering over 1,000 clients showed that EFT is effective in improving the quality of marital and family relationships.
3. An article in the Journal of Traumatic Stress (2014): The study showed that EFT can be effective in treating post-traumatic stress disorder (PTSD), leading to significant symptom reduction and overall quality of life improvement.
4. A study in the Journal of Consulting and Clinical Psychology (1998): The study showed that EFT can be beneficial in treating depression, showing statistically significant improvements in depression symptoms after the course of therapy.
5. An article in Clinical Psychology & Psychotherapy (2008): The study showed that EFT can be useful in treating panic disorder, leading to significant improvements in symptoms and overall anxiety levels.
6. A study in the Journal of Clinical Psychology (2011): In a study involving clients with obsessive-compulsive disorder (OCD), EFT helped reduce OCD symptoms and improve the overall quality of life of the participants.

Emotionally Focused Therapy also demonstrates effectiveness in various areas of psychotherapy. Below are some areas and corresponding effectiveness indicators:

• Family and Couples Therapy: Research shows that most couples (70-75%) who undergo EFT move out of distress, and improvements remain stable for a long time after therapy.
• Trauma Processing: Studies on people suffering from post-traumatic stress disorder (PTSD) show significant symptom reduction and overall quality of life improvement after the EFT course.
• Depression Treatment: EFT has been successfully applied to treat depression, showing statistically significant improvements in symptoms after the course of therapy.
• Panic Disorder and Anxiety Treatment: Studies show that EFT helps people with panic attacks and other anxiety disorders, leading to significant anxiety symptom reduction.
• Obsessive-Compulsive Disorder (OCD): Studies show that Emotionally Focused Therapy helps people with OCD reduce symptoms and improve the overall quality of life.
• Eating Disorders Treatment: Preliminary studies show that EFT can be effective in treating eating disorders, including anorexia and bulimia, although this area requires further research.
• Working with Individual Clients: Although EFT was initially developed for working with couples, it is also effectively applied when working with individual clients, especially in areas related to psychological trauma, anxiety, and depression.

Critical View of Emotionally Focused Therapy

While Emotionally Focused Therapy is a popular and widely used approach, it also faces criticism. One of the main remarks concerns the limited research confirming its effectiveness.

Many of these studies are based on small samples or subjective reports from patients and therapists, which may affect the reliability of the results. Moreover, more research is needed to assess the long-term effectiveness of EFT.

Some researchers also point out that EFT may be more effective in working with certain types of clients, for example, with couples experiencing emotional intimacy problems, but may be less effective in working with people with severe mental health disorders.

In addition, some critics believe that EFT may not take into account social and cultural factors affecting people’s emotional experience and interactions.

Thus, while Emotionally Focused Therapy is a valuable and effective approach for many clients, it is important to consider its limitations and critical remarks.

Potential Challenges and Limitations of Applying EFT

1. Therapist’s Level of Training: A specialist applying Emotionally Focused Therapy must possess a high level of empathy and the ability to finely perceive and understand the client’s emotional states. This requires extensive and intensive training.
2. Dealing with Strong Emotions: In the process of EFT, clients experience deep and intense emotions. If these emotions are not carefully processed, it can lead to additional stress or psychological trauma.
3. Unsuitable Clients: Some individuals may not be ready or able to accept and process their deeply hidden emotions. For example, people with certain types of mental illnesses, such as psychosis or specific personality disorders, are very difficult to engage in EFT.
4. Progress Speed: Emotionally Focused Therapy is a process-oriented approach that can take a long time. Clients expecting quick results may feel frustrated or disappointed in the absence of rapid changes.
5. Lack of Research: Despite many positive reports of successful EFT use, the lack of large-scale and long-term research limits our ability to fully understand and assess its effectiveness in various contexts.

The Role of Emotionally Focused Therapy in Modern Psychotherapy

Emotionally Focused Therapy plays a key role in modern psychotherapy due to its unique approach to emotions in the context of health and well-being.

First, EFT stands out for its direct and active involvement in working with emotions. Instead of focusing solely on cognitive processes or behavior, as in some other therapeutic approaches, EFT recognizes and emphasizes the importance of emotional experience.

Second, EFT is used in various contexts. It has proven effective when working with individual clients, couples, and families, and is applied to address a wide range of problems and treat disorders, including depression, anxiety, and post-traumatic stress disorder.

Third, EFT complements and expands other psychotherapeutic approaches. For example, it can be integrated with cognitive-behavioral therapy for deeper and more comprehensive treatment.

There is also potential for further expansion of the areas of application of Emotionally Focused Therapy. It can be adapted to work with different age groups, including children and the elderly, or to treat various types of mental disorders that are currently not the primary areas of application.