Israeli Association for Couple and Marital Therapy

Presented by:

George Faller, LMFT

Developed with Dr. Sue Johnson

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If you don’t know where you are

going – you will wind up

somewhere else. Yogi Berra

Can’t find what you are not looking for!

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EFT – Couples Therapy For the first time we have a theory of love!

The couples therapist is in territory of the:

• Understandable

• Predictable

• Explainable

• Changeable

• These organize attachment behaviors in relationships

We Know:

The Territory – The Problem

The Destination – Goal

The Map – Key Moves/Moments

This new science is based on observation of distress, satisfaction, bonding in action, change in therapy. 3

EFT Assumptions

1) Accessibility and Responsiveness are the building blocks of a secure attachment bond. Consequently, couples therapy is about

a) the security of the attachment bond,

b) accessibility, and

c) the responsiveness of the partner.

ARE you there for me? Accessible, Responsive and Emotionally Engaged…..

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EFT Assumptions

2) In trying to connect, distressed couples get caught in negative repetitive sequences of interaction where partners express secondary emotions rather than primary emotions.

3) Insecure attachment leads to negative interaction cycles and, in return, negative interaction cycles lead to insecure attachment (it is circular).

4) Rigid interactions reflect and create negative absorbing emotional states. Negative absorbing emotional states reflect and create rigid interactions (it is circular).

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EFT Assumptions

5) Partners are not sick or developmentally delayed. They are stuck. Most needs and desires are adaptive.

6) Attachment needs are universal, although their expression is culturally defined. The way we seek and obtain support is defined differently in various cultures and even in different families and must be understood and respected.

7) Change involves new experiences and new relationship events. Therapy is about creating these new relational experiences.

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Research on EFT – Outcomes

EFT is one of only a few empirically supported treatments for couples therapy. (Snyder, Castellani & Whisman, 2005).

EFT studies demonstrate a 70 – 73% rate of shifting from distress to recovery for the four outcome studies composing the EFT meta-analysis (Johnson, 2003).

90% showed significant improvement

Two-year follow– results stable – 60% maintain gains or continue to improve.

Excellent Outcome (35), Process Research (15), Reviews (18) , Meta-Analysis (3)

Relationship between therapist and client vital for success

APA Gold Standard

Check website for studies – www.iceeft.com

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“All of us, from cradle to grave, are happiest when life is organized

as a series of excursions, long or

short, from the secure base provided

by our attachment figure(s).”

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Attachment Theory

John Bowlby A secure base (1988, p. 62)

The first and

foremost

instinct of

humans is

neither sex nor

aggression -

it is to seek

contact and

comforting

connection 9

Our ability to

reach for

others, to

seek

calming and

comfort, is

our strength

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MARY AINSWORTH

· Developed the Strange Situation Procedure

· Four Attachment Categories: A,B,C,D

Type A -- Avoidant

Type B -- Secure

Type C -- Ambivalent/ Anxious

Type D -- Disorganized

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The Paradox of Dependency

To be

emotionally

connected is to

be

STRONGER –

more resilient,

more

autonomous

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“ I have seen a lot of irrational cognitions but not a lot

of irrational emotions” ~ Sue Johnson

Attachment Theory is a map for Positive, Loving,

Stable Relationships which explains:

• The logic of our emotions

• The longings and needs guiding interactions

• A path for repair and renewal

• A language of love

• A guide to the pivotal moments in love relationships

•More than just survival, its how we thrive

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The New Science of Love A loving relationship is the best antidote to stress

Emotional connection with a loved one is a potent

source of resilience and strength

Emotional isolation is dangerous

“Suffering is a given; suffering alone is intolerable”

The worst part isn’t the pain but the lack of response. It’s

the baby crying without being picked up.

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Having a loved one hold your hand

really does take the hurt away =

Power of Attachment

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THE TRUSTING BRAIN: HOW YOU RESPOND TO

AMBIGUITY…… THE BENEFIT OF THE DOUBT

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IN A TRUSTING RELATIONSHIP, AN AMBIGUOUS

FACIAL EXPRESSION OR TONE OF VOICE IS NOT

“READ” IMMEDIATELY AS NEGATIVE. THE TRUSTING

BRAIN GIVES THE TRUSTED OTHER THE “BENEFIT

OF THE DOUBT” AND AUTOMATICALLY ASSUMES

MORE POSITIVE THAN NEGATIVE INTENT

VENTRO-

MEDIAL

PFC SHOWS

GREATER

ACTIVATION

THAN THE

AMYGDALA

MISTRUSTING

BRAIN: AMYGDALA

RESPONDS MORE

STRONGLY THAN

THE VMPFC TO

AMBIGUOUS

FACES AND VOICES

mistrust trust

How Big is the Hill?

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Cellular Level- Telomeres Dr. Elizabeth Blackburn

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From Atoms to Galaxies

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:Growth Index

Body

Keeps

Score

The people we love are the "hidden regulators" of

our bodily processes and our emotional lives.

– Sue Johnson "Hold Me Tight"

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Theory of Love: Attachment Theory

Bowlby, 1969-1988

Common Attachment Needs & Longings

To be & feel loved

To trust spouse/family member is going to be

there in time of need and/or desperation

To have (among others):

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A Safe Haven

Acceptance

Understanding

Empathy

Recognition

Validation

Protection

Comfort

We are created to need feedback

from others

Attachment needs are from cradle to grave. Not just for

babies! Dependency shouldn’t be a bad word.

We are focusing on intimate relationships but these

needs are met in many different kinds of relationships.

God, Kids, Friends, Co-workers, Pets, Self, Clients…

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Let’s Keep It Simple

Its all about responding to

each other!

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Good Enough Responding - %? 1. Attunement = Feels Good/ Marked by Positive Affect

2. Disruption = Feels Bad/ Marked by Negative Affect - Leads to Disconnection

3. Repair = Bridge Back to Feeling Good/ Opportunity to Repeat Bad or Emerge into New Good

Open Systems Theory

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What is a Healthy, Loving Marriage? Is it a friendship, a negotiation, a deal to make, a skill, or an

impossibility?

First and Foremost:

It’s a Special Kind of Emotional Bond

The answer to our basic, built-in need for a safe haven and secure base

Accessibility and responsiveness are key

Why do we not ask for it explicitly?

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John Gottman’s Research: Love

Lab

Master- Happy & stable couples can:

1. Turn toward

2. Rebound from conflict

3. Make successful repair attempts

4. Soothe self and other

5. Stay emotionally engaged despite negativity

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John Gottman’s Research Disaster- Distressed Couples are unable to:

1. Create sufficient positive interaction

2. De-escalate and repair

3. Soothe self and other

4. Stay emotionally engaged

5. Get out of intense all-consuming negative affect and rigid, repetitive interactional patterns

Simple solution switch complaint/ compliment 5:1 ratio

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Results of Disconnection = Poor health

Insecurity linked:

Increased risk of depression, anxiety, PTSD,

substance abuse, domestic violence, divorce, lower

education/ income, troubled children, and suicide

Mental, Emotional, Spiritual, Physical

Consequences

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What happens when we lose our

connection?

Wired in response: Still Face Experiment

1) Protest- fight

2) Hold On- wait

3) Depression- Loss- Give Up

4) Detachment

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What happens when we lose our

connection?

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Isolation and

loss are

inherently

traumatizing –

it is a danger

signal of

life or death

importance

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3 year Old Child Brain Scan-

Attachment Disorder

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What happens when we lose our

connection- Role Play 1

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• Start off responding and then go

still face when bell rings

Creating Secure Attachment-Inter-Subjectivity

Two people are in synch

when they are affectively and cognitively present to each

other;

when the vitality of their affective states are matched;

their cognitive focus is on the same event or object;

and their intentions are congruent.

In essence they are co-regulating emotion and co-

creating meaning of the events they are attending to.

Attunement leads to connection/organization

Mis-attunement leads to disconnection/ confusion

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Words Tones (Prosody)

Tempo Volume Pause

Body language Gestures Breathing

Eye Contact Proximity

Touch

Attunement- Paying Attention

When people don’t respond to our inner world then we

don’t develop words to speak about our experience.

Having no words, it is hard to describe feelings. The

inner world takes on a vague and nameless quality.

Subjective experiences continue to occur but they are

difficult to understand or communicate. They are not

trying to withhold or be difficult, it is a basic truth about

their life that they don’t know what to say about their

thoughts and feelings. They have a sense of self that

lacks coherence, continuity, clarity, and

comprehensiveness.

Dan Hughes

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Bowlby’s concept of developmental pathways

suggests that one can be brought back on to a

more secure pathway by adding the missing

component from life at a later date.

(Byng-Hall, 2000, p . 265)

We can provide this component through

1) therapist 2) partner 3) self-parts 4) higher power

5) friends, kids, pets, etc

Good News

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Embracing Emotions

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In order to connect and respond….

We need to understand our emotions.

Emotions are attachment language - right brain.

They are wired in - take precedence in our brains.

Hard to hide them -they seep out of every pore.

What % of a typical message is the actual word spoken?

Not illogical - perfectly reasonable if you get the context.

Our emotions are a compass - they communicate what matters, what we need, who we are.

Often multiple emotions simultaneously – soup.

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Primary and Secondary Emotion

Secondary Emotional Experience

Reactive, Defensive, Protective Emotion

Underlying Experience

Primary Emotion

Attachment Needs and Vulnerabilities

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Five Universal Emotions: 1. Joy- Surprise

2. Sadness

3. Shame

4. Fear

5. Anger- 2 kinds

1. Assertive Anger of Hope

2. Reactive Anger of Despair

Soft emotions pull others towards you. Hard emotions push others away.

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Speed of Emotional Processing

James Gross

1. 100 millisecond brain to react/respond & show on face

2. 600 millisecond for the frontal cortex to register

response and shut down the facial expression

3. 500 millisecond lag time which is written on the face

so when partner says “nothing is wrong” the face

says otherwise

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Speed of Emotions

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Benefits/ Costs of Each Emotion

1. Anger – makes people scared and pushes away

+ increases focus, confidence, performance, creativity, optimism, assertiveness and sense of control

2. Fear – makes us hide, feel small & not be in moment

+ helps us focus (air traffic controllers) , stay in control,

and opens the doorway to vulnerability

3. Sadness – it hurts and overwhelms others

+ tears relieve our distress hormones and pulls others closer

4. Shame – cuts us off from others & we turn on self

+ provides energy and sense of hope to fix problem

5. Surprise/ Joy – less resilient to discomfort & stress

+ open, curious, playful- eustress

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Many Therapists have an Energy

Problem

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2. Demonstrate Role Play Attuning Emotions

EFT Steps and Stages Overview

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Throughout the EFT Stages the focus is (The 4

P’s) : Integration= Linking different elements

into well functioning whole SYSTEMIC - Dance - Cognitive - Details - Elevator Up -Top

down - Left Brain - Verbal - Explicit Self

PROCESS (time) instead of content Rigidity

POSITIONS / PATTERNS (structure) – circular vs. linear causality

EXPERIENTIAL - Music - Emotions - Big picture - Elevator Down - Bottom up - Right Brain - Non Verbal - Implicit Self

PRESENT MOMENT (Emotion brings past alive. Past is used to validate present blocks, styles, fears).

PRIMARY AFFECT – Focus on / Validate Chaos

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Between the chairs

Between the ears

New Conversations

Implicit – Explicit

E.F.T. is “bottom-up” activating the implicit domain,

making the hidden regulation system visible as an

experiential approach; “felt-sense” of cycle.

Uses the explicit domain/top down to delineate cycle,

develop the attachment narrative as couples’ comes in

and out of emotional experience in the room.

Experiential-Emotions

Systemic-

Zoom In/ Zoom Out, Background/ Foreground

Attachment

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Neuroscience

Much of our experience runs on automaticity

The higher brain takes a tremendous amount of energy to run

so it is efficient to have much that runs outside of our

awareness

The downside is that much of our emotional lives function on

automatic pilot and we get into trouble

With automaticity emotions easily overrun our thoughts

left brain can be hijacked by more primitive responses

Doing the same old same old makes the cycle more

entrenched and doesn’t allow for new experiences and new

emotions to emerge NO CHOICE

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Change in EFT

Therapy creates the opportunity for choice

vs. automaticity

Change in EFT includes a left brain

understanding and a right brain

experience (Co-Co) even as we, the

therapists, remain emotionally attuned

throughout

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Connection

Keep Your Focus

9 Steps of EFT - 3 Stages Stage One- De-escalation

1) Assessment

2) Identify negative cycle/attachment issues

3) Access underlying attachment emotions

4) Frame problem – cycle, attachment needs

Stage Two- Restructuring - Withdrawer Re-engagement/ Pursuer Softening

5) Assess implicit needs, fears, model of self

6) Promote acceptance by other

7) Structure emotional engagement

Stage Three- Consolidation

8) New positions/cycles -- enact new stories

9) New solutions to pragmatic issues

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Pursuer Withdrawer

Criticizes-Attacks

He Doesn’t Care- shift

from self to other

Anger

Fear Abandonment-Sadness

To Be Loved-Important

Shut Down-Avoid

She’s Too Demanding –shift

from self to other

Numbness-Frustration

Fear Failing-Not Good Enough

To Be Loved- Important

The cycle circles from Action Tendency in one partner to triggering unmet attachment needs in the

other partner, then up and around.

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1.Permission for Survival

2.Explore Vulnerability

3.Allow to exit if too difficult

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Keeping It Simple

Replacing Reactive

Conversations with Deeper,

Vulnerable Conversations

3. Role Play Exercise - Dyads

Imagine saying to your partner or family member:

When you _________ (specific concrete cue, action tendency – criticize, blame, shut down), I do not feel safely connected to you, I tend to then ______________ (action tendency). I do this with the hope that ______________________________ (protection of relationship).

When it does not work, I decide that ____________________________________(name catastrophic conclusion, attachment fear). I realize that the more I ____________________ (action tendency), the more you seem to __________________________ (action tendency). Then we are more cut off from each other.

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“When you understand the implicit positive, connection- seeking intent in the destructive behaviors of the negative cycle, you will be able to see the couples’ distress more clearly through the attachment lens. The EFT cycle is rigidly maintained by each partner’s way of managing the disconnection between them, while searching for closeness.”

Sue Johnson

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When relationships are unsafe..

If temporary & specific - it can be repaired

If it’s chronic, general, automatic, habitual:

Breaks connection

Increases isolation/ distance

Can be disastrous to relationship

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When relationships are unsafe…

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Route One-

Turn up the

emotional heat

•Push, Pull

•Poke, Demand

•Worry, Fret

•Fight

•Catastrophize

•Mobilize

Route Two-

Turn off the

emotional heat

•Turn off needs

•Deny

•Suck it up

•Shut down

•Hide

•Withdraw

Only Two Routes to cope with lack of safety:

Going Deeper- Helping

Withdrawers & Pursuers

Reach Out to Each Other

Through Enactments

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Two Different Realities of Being on a Island

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Different Goals:

Get Closer Less Fighting

Sometimes we need to fix it!

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Important to Understand

Survival Benefits of Withdrawal

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Emotionally Shutting Down:

• Adaptive for dangerous / competitive environments that demand

cognitive focus on tasks

•Valued by peers, get feedback you fit in and are appreciated

•Values such as toughness, assertiveness, task orientation, logic,

fearlessness, confidence, and perseverance become the measures for

success

•.Easier to be independent

•Discipline works well, excellent performance

•Honor the avoidance

Important to Keep Your Cool

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Disadvantages of Emotional

Avoidance

Success at work comes at a huge price at home

Being self-reliant leaves little room for healthy dependency

Emotional inhibition becomes a habit applied automatically across all settings

Distancing from feelings guarantees large gap in experience of self

The armor used to carry out the mission/fight the battle makes it difficult to feel alive when off duty

Price to not feel bad is less good!

Increased risk of depression, anxiety, PTSD, substance abuse, domestic violence, divorce, suicide

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Common Underlying

Emotions

Withdrawers often feel:

Pressure

Inadequate

Afraid of failure

Overwhelmed

Numb – frozen

Tension – on egg shells

Confused

Judged, criticized

Defensive

Empty

(Information obtained from the EFT Workbook, p. 148) 70

De-Activating Strategy: flight reactions characterize avoidant attachment- distance and control in

close relationships

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Meet them in their Head

What is it like to not know, not be able to fix, not understand?

Help them put words to the racing thoughts and confusion- there you find the anxiety/ helplessness

What does helplessness feel like?

Good at Compartmentalizing

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Key is withdrawers being loved regardless of performance

Trained not to want emotional conversations and instead trying to

keep it positive

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Placating avoids Escalation

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Upwards Path Towards Nowhere

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Pressure to Perform

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Key is withdrawers being loved regardless of performance

Relationships = Minefield

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Understanding Withdrawer’s World

For the withdrawer, emotional engagement is a minefield in which staying present and engaged can result in unintended and possibly disastrous consequences to himself, his partner, or his relationship.

Staying present means walking-on-eggshells and being uncomfortable; rather be at work than home.

Try always to be two steps ahead- anticipating- future focus, not in the present moment. It’s exhausting, reading a book a break from pressure.

Unfair- taught to shut down emotions and then blamed for not being able to express them and they come to believe there is something wrong with them.

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Great on Defense leaves little room for Offense

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Choosing Between Two Bad Options

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Only Safe When Getting It Right

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Trying to Outrun Failure/ Escalation

Worst Feeling is often Helplessness

If you can get away or block the negative messages, would you do it?

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Real Play 5- Honoring the Function of

Defenses- If you could get away from the

negative messages, would you?

Withdrawal- Imagine

Driving Alaska- initials someone critical with you (feel trapped-

can’t escape)

What do you feel (in your body), what do you tell yourself, want to

do want to do?

Turn and share/ honor function of the withdrawal

Anger- Imagine moment when most angry

Honor Function

Classic Withdrawer Moves I don’t know

Anger to push away message

Humor to relieve stress

Focusing on positive

Intellectualization

Deflection

Minimizing

Capture the moment right before they retreat

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And when you Fail……………….

Scaffolding Deeper Withdrawer Misunderstood, Can’t Fix

Not Knowing, Confusion

Pressure to Perform, Egg Shells

Frustrated

Stuck

Helpless

Failing, Deflated, Disappointed

Rejected, Sad

Unloved, Shame, Pain

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Down

&

Over

Key To Withdrawer

Re-engagement is:

1st - Confront Avoidance in Self- Shadow Boxing- shift from other focus to self focus

2nd - Withdrawer stands up for his/her needs and comes forward to assert himself, not to placate the pursuer

Key is withdrawers being loved without performance

3rd - Appreciate the risk- standing up with insecurities when best attempts to show self already have failed

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Spock Video- Protect self by

choosing not to feel

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The only reason they try so hard is they care so much

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Choice Not to Feel because Feelings

usually don’t end so well

To survive withdrawers learn to hide the vulnerable

parts of themselves and fail to respond just like

their caregivers who caused the initial problem

Withdrawers must experience success around

vulnerability otherwise they shouldn’t engage

If partner can’t therapist needs to stand in the gap

Learning to run from pain creates a template that

cause 1) aloneness in their pain & 2) not being

able to be there in partner’s pain

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Your Courage Today will Change how

Future Generations do Vulnerability

Withdrawer’s Needs Being Met

Feeling Successful

Confident

Decisive

Engaged

Calm

Relaxed

Energized

Joy opens up curiosity

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6. Role Play

Withdrawer Reengagement- Step 5 & 7, Pursuer not reactive

Honor protection

Using interventions- conjectures

Get Primary- Helpless, Failure

Set up Enactment

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Common Underlying

Emotions Pursuers often feel:

Hurt

Alone

Not wanted

Invisible

Isolated

Not important

Abandoned

Desperate

Disconnected

Deprived

(Information obtained from the EFT Workbook, p. 148)

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Important to Understand

Survival Benefits of Pursuing

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Protesting / Pursuing:

• Spend more time talking = more practice at communicating and

expressing feelings

•Confronting problems is reaching for connection; often more sensitive to

relationship issues

•Easier to be dependent, part of team

•Power / control in going forward

•Better focus, drive, need to fix

•Honor the anxiety

Costs of Pursuing

103

Protesting / Pursuing:

• Too Much

•Mean, Resentful

•Desperate, Isolating

•Crazy Making

•Shame

Hyperactivating

Strategy: fight responses characterize

anxious attachment; heightened desire for

closeness & security

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Understanding the World of Pursuers

Lost in crowd in foreign country!

Emotional constriction presents as rigid reactivity, panic, and desperation

Being alone, feeling unimportant and vulnerable are pursuers’ worst nightmares - much safer/more control to be angry

No response is worse case scenario

Good at message “I’m right, you’re wrong”

Go for pain under fear -- don’t stop short 105

Understanding the World of Pursuers

When people we love stop paying attention, stop

investing, stop fighting for the relationship, trust

begins to slip away and hurt slowly seeps in.

Disengagement triggers shame and fears of

abandonment.

Its insidious slowness is often worse than a

traumatic event like an affair because there is no

event to point to the separation / brokenness. It

can feel crazy making.

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UNFAIR!

108

Just Stop Talking

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I thought you weren’t coming home so I

panicked & I don’t believe you!

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Racing Mind- Crazy Making

Rejection on so many Levels

111

Scaffolding Deeper Pursuer Angry, Misunderstood, Shut Out

Unfair, Righteous, Tricked

Frustrated, Bad Hair

Stuck, Unsure

Anxiety, Helpless, Unheard

Powerless, Exhausted

Rejected, Abandoned

Sad, Alone

Unloved, Broken, Shame, Pain

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How many times will you risk?

113

Set up to Mistrust and then blamed for being negative

Help make meaning out of Anger

Appreciate the Risk What we are asking pursuers to do is crazy:

To go to their scary, shameful, hiding place where they feel ugly/small and share it with someone who is unreliable and has already rejected the best presentations of themselves

If the worst fear is abandonment then what is the most likely outcome of revealing their warts?

Ultimate Confirmation!

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So painful to be so physically close

but emotionally miles away

The external criticism of Pursuer often

reflects the internal critic

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The Key for Pursuers is Asking from a

Softer Place:

Pursuer comes forward in vulnerable way to

seek comfort not assign blame!

Shift focus from the other to the self. Learn to

plug into and listen to softer emotions.

Unfair- Left alone with no responses- normal to

be anxious-survive by fighting for response- then

blamed for being too combative/ anxious.

119

Unpack the moment right before they get angry or when their partner leaves

121

The cure for rejection is love and

acceptance in broken places

Pursuer’s Needs Being Met

Feeling Connected, Grounded

Understood

Seen, Heard

Wanted

Calm, Warm

Relaxed

Energized

Hopeful 122

5 Hold Me Tight Exercise

Part 1

What am I most afraid of? What are the fears that leap out at

moments of disconnection and pull me into our Demon Dialogue?

Take the elevator down. Own and order your fears.

Focus inside and find a felt sense. Name it using simple image,

adjective or emotion such as “shattered”, or “helpless.”

I would describe this felt sense as:

___________________________________________

____________________________________________________

____________________

Explore and share the “Terrible Ifs” embedded in the fear. Start

with these words, “When I am afraid I think about…”

The listener just attends (listens intently) and tunes in.

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Part 2: Making Needs Explicit- Speaking Aloud

What do I need from you? How can you help me

to feel a secure connection?

Listen to and own the longing in you fear—the

Hold Me Tight message.

Shear this “I need” with your partner (keep it

simple, no more than two sentences) When,

deep inside, I feel _________, I need you to ( you

do have to ask!)

Listener just attends, tunes in. Offers a response

to this stated need.

Share what it was like to have this conversation.

What have you learned about each other? What

touched you? 124

Secure Connection:

Key Learning

In love, you don’t have to be rich or

smart or talented or funny.

You just have to be there.

Robert Karen

125

Deep and lasting love is

within the reach of all of us.

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WORKING WITH FAMILIES

What if …. As a family therapist you were in the territory of the… Understandable, Predictable, Explainable, Changeable We Now Know: • The Territory – The Problem • The Destination – Goal • The Map – Key Moves/Moments

New Science- based on observation of distress, satisfaction, bonding in action, change in therapy.

128

Thomas Video

129

Aligning the Parents’ Caregiving with Child’s Attachment

130

Autonomy Connection

Attachment Needs

Often 2way Block Parent Responding to Needs Or Child Expressing

Parents Care Giving System

We Change and Explore Together

Being a family requires a life long process of change.

A parent’s role and influence may change but a parent’s importance remains.

Growth requires exploration and exploration is more likely from relationships of safety and security

Emotionally Focused Family Therapy

EFFT is a brief process experiential approach that is designed to transform negative interaction patterns by restructuring attachment bonds and increasing parental accessibility and responsiveness to children .

EFFT is a natural extension of EFT .

The key difference is that there are multiple relationships that are horizontal and vertical and change over time.

EFFT Treatment Goals

“The goal of EFFT is modify relationships in the direction of increased accessibility and responsiveness, thus helping the family to create a secure base for children to grow and leave from.” (Johnson, 2004, p. 245) • Change problematic interactional patterns that sustain attachment

insecurity among family members. (ID Negative Cycle)

• Create new patterns of accessibility and responsiveness that promote felt security for children and secure connections between caregivers.

• (Replace with Positive Cycle)

EFFT Key Assumptions

• Fixed Patterns: Rigid patterns of negative interaction create states of fear, grief and anger. Working together these emotions and patterns limit communication and increase insecurity.

• Felt Security: The enactment of typical attachment needs for security, protections and contact are adaptive – yet in a context of insecurity the enactment of these needs may prompt restraint or rejections.

• Reorganizing: Accessing a reorganizing key emotional experiences is the most powerful route to new interactional sequences and intra and interpersonal change.

Fixed Patterns of Family Distress

Escalating emotional tensions result from secondary emotional responses - Over and under responding to attachment signals.

• Lack of caregiver availability

• Disruption in caregiving alliance

• Increased insecurity in partner’s relationship

• Increased defensiveness/ acting-out behaviors in children with unmet attachment needs

135

“The attachment perspective views a secure emotional connection to significant others as an adaptive, wired-in survival mechanism that fosters optimal development and mastery of the environment (Bowlby, 1969) … families ability to balance needs for individual growth and connectedness while providing nurturance…” (Johnson, et al. 1998, p. 244(

136

Dependency Paradox Accepting Dependence Independence (Feeney 2007)

Building Blocks of Felt Security Safe Haven – Going to another for comfort, help, and reassurance in time of need .

Secure Base - Three characteristics are necessary )Feeney & Thrush, 2010 (

• Being available in case security is needed

• Not necessarily interfering with exploration

• Encouraging and accepting exploration

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Care Seeking - Caregiving

Complimentary system: Attachment figure’s response to the goals and needs of another’s attachment behaviors / signals of discomfort and distress. Stronger – Wiser Other .

• Attunement: Involves evaluation of signals and threat appraisal.

• Representational flexibility and balance - relationship specific.

• Caregiving Support – resource for repair. Change in families more likely when a “caregiver establishes greater confidence in the availability of

another adult.” (Kobak & Mandelbaum, 2004 p. 158 (

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Tapping Into the Care Giving System

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An availability and supportive attachment figure in a times of need:

Reduces a person’s distress

Engenders positive feelings:

• Being loved

• Being grateful

• Being at peace

For adults accessing these positive feelings can be done by thinking about a responsive and supportive attachment figure.

Shaver & Mikulincer, 2016

ATTACHMENT SECURITY

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Exercise

Think of a time when you experienced ”felt security” from an attachment

figure – a “stronger wiser other”.

• What words would you use to describe that experience?

• What thoughts did you have about that person?

• What thoughts did you have about yourself?

Inter-Subjectivity

In essence they are co-regulating emotions (experiential) and co-creating meaning (systemic) of the events they are attending to.

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Importance of Emotional Engagement 3 year Old Child Brain Scan- Attachment Disorder

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When people don’t respond to our inner world then we don’t develop words to speak about our experience. Having no words, it is hard to describe feelings. The inner world takes on a vague and nameless quality. Subjective experiences continue to occur but they are difficult to understand or communicate. They are not trying to withhold or be difficult; it is a basic truth about their life that they don’t know what to say about their thoughts and feelings. They have a sense of self that lacks coherence, continuity, clarity, and comprehensiveness.

Dan Hughes

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Bowlby’s concept of developmental pathways suggests that one can be brought back on to a more secure pathway by adding the missing component from life at a later date. (Byng-Hall, 2000, p . 265) We can provide this component through: 1) therapist 2) family member 3) self-parts 4)higher power 5)friends, kids, pets, etc

GOOD NEWS: ATTUNEMENT= HEALING

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PLACE

Playfulness: A light, hopeful, open and spontaneous

Loving: Delight, Enjoyment

Acceptance: Unconditionally directed at all of the experience of the other

Curiosity: Nonjudgmental, not-knowing, active interest in the other’s experience

Empathy: Felt sense of the other; actively experienced and communicated.

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EFT Stages and Markers of Change

• Process experiential: Present focus

• Emotion focus = Language of attachment

• Systemic: First-order and second order change

• Re-engaging attachment and caregiving systems

Stage 2 Restructuring

Stage 1 De-escalation

New meaning Child Reaching Parent Responding

De-escalation Openness

Stage 3 Consolidation

Identify Blocks & Negative Cycles

Create Positive Cycle

Repir Without Therapist

Key Differences in EFT with Families

Family Process – Developmental System – Changing Needs - Attunement

– Hierarchy – Needs reciprocal not mutual

– Generational Influences – Parental attachment histories

Complexity – Role of the therapist – Flexible, Leading

– Treatment modes – Moving between dyad, triads, family

– Intensity of EFFT – Moves quickly, enactments

EFFT Steps and Stages

.

STAGE 1 DE-ESCALATING FAMILY DISTRESS STEP 1 Building alliance and family assessment STEP 2 Identifying and processing negative interactional patterns. STEP 3 Accessing primary emotions underlying rigid positions associated with family patterns. STEP 4: Reframing negative interactional patterns in terms of the stuck patterns and in terms of attachment needs and responses.

Step 1. Alliance and Assessment

Making room for all to be seen and heard Sub-system assessment (caregiving system and sibling system) Join and prioritizing parent initiative Assessing safety and decision

Contraindications

• Domestic violence: Patterns of power and control making vulnerability unsafe among members.

• Substance abuse/addiction: Acting out parents and / or youth require treatment for these disorders prior to family treatment.

• Disengaged parents who refuse to actively participate in treatment or hostility at caregiver level

• Very young children: Play therapy and parent sessions are indicated.

Decision Tree Flexibly tailor sessions to meet needs of each family.

• Some families may demand mostly family sessions while others call for

an emphasis on dyadic work.

Focus where major change events occur / needed.

• In best case scenario it occurs in family but some factors dictate the need

to break up into smaller units (e.g. Dyads, Triads)

Target is moving but same target- attachment is dyadic.

Invite Family into decision tree process, be clear about process

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Assessment: Parental Balancing Act- raising kids with a high degree of connection and

consistent, clear limits

Structure Care

Balance = Flexibility

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No Drama Discipline

• “Our children need repeated experiences that allow them to develop wiring in their brain that helps them delay gratification, contain urges to react aggressively toward others, and flexibly deal with not getting their way. The absence of limits and boundaries is actually quite stressful and stressed kids are more reactive. So when we say no and set limits for our children we help them discover predictability and safety to an otherwise chaotic world” xxiii

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Step 2. Identifying Negative Patterns

• Identifying the negative patterns that create and fuel attachment

insecurities-shifting focus from problem individual to problem between individuals

• Various overlapping and reactive cycles amongst all family members are made explicit and reframed as an attachment struggle that is shared by all family members

• Therapist gives clarity and attachment meaning to family distress

Common Negative Patterns

Pattern 1. Over-functioning

• Critical / Intrusive Parent - Anxious

• Withdrawn/Depressed or Defiant Child – Avoidant

Pattern 2. Under-functioning

• Overwhelmed/Unavailable Parent - Avoidant

• Parentified or Symptomatic Child

Pattern 3. Mixed

• Indulgent/Ineffective parent-Hostile/demanding child

Pursuer Withdrawer

Criticizes-Attacks

He Doesn’t Care

Anger

Fear Abandonment-Sadness

To Be Loved-Important

Shut Down-Avoid

He’s Too Demanding

Numbness-Frustration

Fear Failing-Not Good Enough

To Be Loved- Important

The cycle circles from Action Tendency in one partner to triggering unmet attachment needs in the other partner, then up and around.

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Mom Dad Dylan CJ

Rigid Patterns

Multiple Infinity Loops

Secondary

Universal Attachment Needs

Behavior

Trigger

other

self

Reverse direction from secondary

to secondary to primary to primary.

Behavior

Trigger Behavior

Trigger

Primary

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Step 3 Accessing Underlying Emotions

Working with parental blocks Accessing caregiving vulnerability Accessing child vulnerability

Secure

Attuned

Flexible

Predictable

Preoccupied

Over Critical

Over Protective

Over Permissive

Dismissive

Indifferent

Absent

Rejecting

Fearful

Inconsistent

Chaotic

Disorganized

High

High

Low

Low Anxiety

Avo

idan

ce

Anxiety

Avo

idan

ce

Parental Blocks to Caregiving

Degrees of Blocks

ID Block/ Resistance to Buy In

Negative View of Child

Negative View of Self

Help to See It

Make sense of It and Intentions Behind

Work through It/ Success in Vulnerability

Care Seeking Intent • When you understand the implicit positive, “care- seeking intent” in the

destructive behaviors of the negative cycle, you will be able to see the family members distress more clearly through the attachment lens .

Problematic Attempts for Connection • The EFT cycle is rigidly maintained by each member’s way of managing

the disconnection, while searching for care, connection, and closeness.

Step 4: EFFT Reframe

• Family system is less emotionally reactive.

• Patterns are acknowledged.

• Parent(s) is more accessible and responsiveness to child’s vulnerabilities.

• Parent(s) express intent to do thing differently- unlatched from blaming IP child.

• Parental goal alliance .

Markers of Family De-escalation

STAGE 2 RESTRUCTURING FAMILY INTERACTIONS

STEP 5 Accessing and deepening child's primary emotion and attachment needs. STEP 6 Promoting caregiving responsiveness and acceptance of child’s pain and attachment needs. STEP 7 Restructuring family positions. STEP 8 Processing and expanding impact of change event to other family members.

Accessing and deepening child’s attachment related affect / needs means getting specific about emotions and needs.

Accessing vulnerability with parents and children may have a similar relationship impact but key difference in focus.

• Similar Impact: Vulnerability is a door that opens both ways – primes a softer response.

• Key Difference:

• Allowing someone into my experience - (Parent and Child Focus)

• Making a bid for care, contact, and comfort - (Child Focus)

Step 5: Deepening Child Vulnerability

Working with Child’s Blocks

Anxious • Aggressive/ Critical- negative view of parent • Unworthy/ Shame- negative view of self • Parentified child- need put self aside to take care of parent

Avoidant • Cold/ Shutdown- dismissive, minimalize, joke • Placate/ compliant

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Expand and organize a parent’s response to child

• Promoting parental confidence and making explicit parental accessibility

• Organizing parental responses to child’s needs

• Processing parental fears and blocks to engagement

• Engaging caregiving alliance as a caregiving resource

Step 6: Promoting Parental Responsiveness

What is blocking the care-giving system?

• Caregiver relationship distress

• View of self; failure, shame, over-focus on self

• View of child; bad, spoiled

• Contextual issues: poverty, traumatic loss

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Blocks to Engagement

Parent Insecurity - Fear hijacks parent responsiveness

• Fears: Not sure how to respond (e.g. Distrust of emotion); Fear of Failure (e.g. Will I get it right?) and Possible Rejection (e.g. She won’t want what I have to give).

• Caregiving alliance – Resistance and distress between partners about responding to child’s vulnerability.

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Blocks to Engagement Parent Shame - Negative View of Self Making of past failures and perceived inadequacies through acceptance and ownership of what was avoided – (e.g. self compassion)

• Normalizing parent reactive responses – survival instincts.

• Acknowledging protective role of shame.

• Child feared that their behavior meant they were bad.

• When seen and accepted by another one can begin to accept self.

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Working with Blocks

Therapist uses primary emotion to prime motivational systems in the present moment.

• Caregiving Instinct: Parents looking to care for their children by providing contact, care, and comfort.

– Therapists honors “intent to care” – parent’s best intention.

• Attachment: Children are looking for care from their parents.

– Child’s behavior seen in attachment terms. (Therapist honors primary responses: Protest, Pain, Fear.)

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Responsiveness to Child’s Vulnerability

Keep Your Focus

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Therapists’ Relationship to Blocks

Try Talk Out of Block

Interferes with Therapist Focus- Exit Process

Permission leads to Greater Attunement & Reveals the Very Obstacle to Security

Slice Thinner

Block Becomes Bridge

Ready for Parent’s Responses 1. Empathetic & Jumping In 2. Empathetic & Giving Space

3. Mixed-Mistrust & Jumping In 4. Mixed-Mistrust & Giving Space

5. Hostile & Jumping In 6. Hostile & Giving Space

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Keeping Focus with Interruptions • Parent jumps in and therapist not sure what to do. • Decision Tree for Transitioning

Green Light - If empathy for child, great - facilitate support Yellow Light - Often both mistrust/empathy, try validate mistrust and then go for empathy. Turn into green light if cannot then dealing with red light Red Light - If hostile response then we need to explore block- make sure tie bow/ tourniquets around child’s vulnerability before exploring/ decision tree

Therapist transitions w/o typing bow = abandonment Therapist getting permission with tying bow = help

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Restructuring family positions focused on parent responding and child receiving.

• Making caregiving intentions explicit.

• Structure parental enactment with attuned response to child or child’s

vulnerable reach to the parents.

• Promoting child receiving parental response.

• Processing impact of child response with parent.

Marker: Child receiving parental response.

Step 7: Restructuring

Children must experience success around vulnerability otherwise they shouldn’t engage

If parent can’t therapist needs to stand in the gap

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• Exploring parental availability to other family members – systemic

assessment .

• Exploring impact of family vulnerability on other children / family

members .

• Refocusing on emerging blocks to caregiving responsiveness and

child vulnerability .

• Spring board to additional restructuring. (Steps 5 – 6 - 7.(

• Inviting members to explore vulnerable engagement in the family .

Step 8: Exploring Impact of Change Event

Step 9: Strengthening new patterns of secure responding in the family and promoting new understanding of family as secure base .

• Creating new narratives of family connection

• Highlighting ways they are making repairs and confidence in new patterns .

Stage 3 Family Consolidation

A secure emotional connection does not stop fights, differences, or hurt feelings in relationships…

A strong bond gives us the best place to rest, to heal, and to thrive with the challenges of life.

Building Strong Bonds Together

Transformation- look for Physical Markers Proof of Clinical Success - Install Positive Emotions

• Feels Good, Joyful, Happy, Warm • Cheerful, Excited, Elated • Calm, Peaceful, Safe • Curious, Playful, Flirtatious, Confident • Loving, Affectionate, Touched • Connected, Attuned, Empathetic • Grateful, Thankful, Satisfied, Big Smile • Lighter, Easiness, Expansiveness

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Simple Rule: Connect before Fix

Add the missing component!

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Similarities

Sacred Stress

George Faller, LMFT Certified EFT Supervisor and

Trainer President NYCEFT.ORG

914-434-0520 george@hopeandrenewal.org

www.georgefaller.com

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