Emotion-focused therapy (EFT) is a therapeutic approach based on the idea that emotions play a central role in one’s sense of self and ability to make healthy choices.
EFT assumes that lacking emotional awareness or avoiding difficult emotions can be harmful by depriving people of important information emotions provide.
Therapists trained in EFT help clients become more attuned to their emotions and better able to use adaptive emotions to guide their behavior, while also learning to manage maladaptive emotions.
Theory
EFT is collaborative in nature, with therapist and client viewed as equals in interpreting the client’s emotional landscape.
The theory draws on scientific research into emotion, including how emotions arise physiologically, their evolutionary purpose in promoting human functioning and survival, and their connections to cognition and behavior.
Core to EFT is the concept of “emotion schemes” – networks linking bodily sensations, action urges, ways of thinking, and behavioral tendencies associated with specific emotions.
EFT helps clients accept and transform personal emotion schemes.
Example
Grief is an emotion scheme that involves a complex network of bodily sensations, thoughts, action urges, and behaviors centered on the experience of loss.
For example, when a close friend moves away, one might feel an empty sadness in their chest, thinking that no one understands them anymore and life lacks joy without this friendship.
There is an urge to withdraw from social connections and ruminate endlessly on what was lost, potentially leading to behaviors like staying at home, looking sadly at old photos, and crying into a pillow.
The grief emotion scheme channels attention towards what is missing rather than present support. It prompts withdrawal rather than engagement. Over time, grief generally subsides as the person emotionally adjusts to the loss.
But initially, the coordinated experience across physical, mental, motivational, and behavioral levels focuses awareness on irreplaceable absence.
An emotion-focused therapist helps clients mindfully accept and express their grief while rediscovering underlying needs and more adaptive means of getting support.
This transforms the maladaptive closed loop of the grief emotion scheme into emotionally attuned action promoting self-care.
Techniques
EFT sessions focus on increasing clients’ awareness and acceptance of their emotions.
Therapists employ empathic, reflective listening to help clients symbolize and make meaning of their feelings. Specific interventions aimed at “emotion coaching” are then utilized.
In initial sessions, the goal is to foster emotional awareness. Therapists guide clients through focusing exercises to tune into somatic markers of emotions and symbolize the “felt sense” using words and imagery.
Dialogues explore different layers of feelings to identify primary reactions versus secondary responses or instrumental emotions used to influence others. Mindfulness techniques help clients allow and regulate strong or painful emotions as they are accessed.
Once emotions can be clearly described, therapists prompt consideration of their functionality – how they orient clients towards meeting (or not meeting) needs.
Emotions viewed as helpful or adaptive are further intensified through methods like chair dialogues, where clients dialogue between parts of self, to clarify their message and motivational power in guiding actions.
Maladaptive emotions are explored for their origin stories and self-protective purposes, even as their detrimental impacts are acknowledged.
Clients then work to transform difficult feelings by accessing alternate underlying emotions that promote health and self-care, or directly meet the unfulfilled needs perpetuating distress.
This changing emotion with emotion creates new action urges, allowing clients to behave differently in triggering situations.
Emotion transformation is reinforced through practicing coping thoughts and making step-by-step plans to break dysfunctional patterns connected to harmful feelings. In all phases, the therapist provides empathy, validation, and guidance to sustain client’s motivation and hope.
Applications
Attempting unsuccessfully to control emotions can worsen many mental health issues.
EFT may alleviate conditions where avoidance or disproportionate responses are central by reframing emotions as valuable insights rather than to-be-suppressed states.
EFT was first applied to depression, and later anxiety disorders, trauma, eating disorders, borderline personality disorder, relationship problems, and more.
It is generally contraindicated for impulse control issues and requires client honesty and compassionate self-examination.
While not focused on symptom reduction per se, EFT shows empirical support in enabling adaptive emotional awareness and regulation across presenting issues.
Limitations
While effective for many issues, EFT may not be optimal for problems rooted specifically in disproportionate responses to internal experiences like panic attacks or impulse control disorders.
The encouragement to turn towards and accept all internal experiences could exacerbate symptoms driven by exaggerated reactivity.
EFT also relies heavily on client willingness for honest self-examination and compassionate stance toward their emotions. Manipulative, deceptive, or hostile clients are unlikely to benefit.
Additionally, EFT focuses more on improving overall emotional relating rather than targeting acute symptoms directly.
So, while enhanced well-being and functioning may alleviate symptoms as a byproduct, clients seeking very rapid or marked reductions in specific psychiatric symptoms may prefer other approaches.
The extensive emphasis on articulating emotions in words and imagery also will not appeal to all; some clients express emotions more through art, movement, or music.
Exploring emotionally laden issues can be temporarily destabilizing before becoming helpful – so extra support may be needed during the process.
While shown effective as a short-term treatment of under 30 sessions, longer-term or open-ended therapy is not uncommon, and EFT must adapt traditional timeframes to each case.
Finally, EFT remains young among therapeutic modalities, so dissemination lags behind CBT and psychodynamic therapies. However, its orientation matches cultural trends favoring emotional awareness and mindfulness.
History
EFT founder Leslie Greenberg sought to elucidate how people change, intentionally developing the approach over 30 years.
Beginning publishing in 1979, EFT integrates person-centered, cognitive-behavioral, Gestalt, and problem-solving frameworks, along with systemic perspectives when applied to couples.
It centers on compassionately understanding one’s own emotions to improve overall well-being and relationships. Similar-sounding emotionally focused therapy differs in concentrating on perceiving others’ emotions within family systems.
Nonetheless, intrapersonal and interpersonal emotional attunement likely facilitate one another.
References
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