practice of emotionally focused couple therapy (2nd ed.), The
Nelson, Thorana S
Johnson, S. M. (2004). The practice of emotionally focused couple therapy (2nd ed.). New York: Brunner Routledge, 361 pp., $34.95.
Emotionally Focused Couple Therapy (EFT) is a deceptively simple approach to work with couples in therapy: “Simple” because the tenets, practices, and integration are so clear; “deceptive” because there clearly is a lot of art to doing this work.
Emotionally Focused Therapy is based on an attachment view of romantic love and integrates elements of both intrapsychic and interpersonal theories of relationships. Focusing on emotions as reflective of attachment needs, the approach is quite elegant in its basic form: Form a safe therapeutic alliance, understand and expand emotional bases of each partner, and then help them interact differently. The approach is recursive in its intertwining of the two foci (internal and interactional) and effective at helping couples by reframing behaviors as adaptive ways of coping with attachment needs. Secondary emotions are understood as covering awareness of primary emotions (such as helplessness) and as leading to interactional behaviors that tend to “pull for” certain behaviors in a partner, thus apparently validating the emotions but not resolving the attachment insecurity issues. The therapist’s reframes of anger, for example, as a desperate protest against hurt or withdrawal as a protection against further hurt helps the partners see each other in different ways and to respond to each other in ways that elicit closeness rather than distance. The couple’s dance is reflected and modified in therapy in ways that help the couple to develop new music (emotions) and dance steps (the interaction).
The early chapters describe the assumptions and tenets of the approach in detail as a way of laying the context of an attachment view of romantic love. Change is then described as occurring both within and between persons. Chapters follow that delineate the basic tasks of therapy (creating a safe therapeutic alliance, expanding each partner’s experience of themselves and the other, and restructuring the couple’s interactions). The focus is on emotions as adaptive, not pathological, and thus leading to protective responses that increase distance rather than closeness in the couple relationship. Each step is described in detail with many examples.
Additional chapters give advice for the reader on becoming an Emotionally Focused therapist, using the model with families, and using the model when there are attachment injuries arising from trauma. A final chapter provides a detailed transcript with commentary on an EFT session.
The book is nicely written with sufficient technical language to be useful and at the same time eminently accessible and enjoyable to read. This edition provides more detail than the first about the processes involved both internally and interpersonally between partners. The steps in therapy also are described in more detail and the chapters on working with trauma and families are new. Finally, research that has occurred since the first edition is described and provides a nice evidence base for the approach.
I believe that the book would be useful for both those new to the approach and as a reference for more experienced therapists. The integration language makes it particularly accessible to systemic therapists and its collaborative nature is refreshing for an approach that focuses so much on internal processes. There are times when some issues seem to be repeated more than necessary, but the book so clearly describes this important emerging approach that I did not mind; it has been very easy to begin to incorporate the ideas that go beyond cognitive behavioral therapy into using emotions as entrees to effective therapy. Recommended for graduate students and experienced therapists.
Thorana S. Nelson, PhD
Utah State University
Copyright American Association for Marriage and Family Therapy Apr 2005
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