Engaging with EFT as a Social Psychologist

I – Olivier – am a PhD student. My research is in social psychology. However, the end goal of my thesis is to improve how responsive couples are towards each other after they go through relationship therapy. Diving into relationship therapy is a big step for a research-focused social psychologist. To try to improve partner responsiveness, I try to identify the psychological and physiological mechanisms that constitute partner responsiveness. This is part of a series of two blog posts in which I explain my research. In this first blog post, I explain the basic dynamics of romantic relationships from the perspective of EFT and how therapists currently help improve them. In the next blog post, I will discuss how and why we investigate temperature responsiveness to reach our goal.

Attachment dynamics in romantic relationships

People’s attachment orientations are important for how people engage and maintain their  relationships. In early life, people “regulate” their relationships by screaming, crying, hugging (Bowlby, 1969/82). Such attachment behaviors are ways to increase closeness to the caregiver and can help the infant signal threats (such as cold, any type of risks, or starvation) from which it seeks protection. When the caregiver provides that protection, it serves as a secure base from which the infant can explore its environment. Mary Ainsworth built on Bowlby’s (1969) work by identifying that infants’ attachment style may differ from each other, developing a method (the Strange Situation) that helps psychologists identify how the infant is attached. When they were first discovered, “attachment styles” were divided into three categories: A (Avoidant), B (Secure), C (insecure/ambivalent). Another category: D (disorganized) was later added to these three (Main & Solomon, 1986).

These attachment styles transfer, at least to some extent, from relationships with parents to relationships with romantic partners (Fraley, 2019). While for children, caregivers are the main source of security, this is often a romantic partner for adults. In the social psychological literature, we usually measure people’s attachments by asking them about their romantic relationships. The Experiences in Close Relationships (ECR) scale is currently the best validated measure of attachment in adulthood (Fraley, Heffernan, Vicary, & Brumbaugh, 2011) and relies on statements like “I prefer not to show my partner how I feel deep down”, and “I often worry that my partner doesn’t really care for me”. People indicate how well each statement applies to them on a scale ranging from 1 – strongly disagree to 7 – strongly agree.

People’s attachment in their romantic relationships is scored on two continuums: from anxious to secure and from avoidant to secure. If you score low on both, you are pretty secure in your romantic relationships (if you want to test how secure you are, you can do so by going here). A person with a high score on anxiety will more frequently try to seek closeness with their partner, but will also often feel like they can lose them at any time. In contrast, a person with a high score on avoidance will less frequently try to seek closeness with their partner, and will prefer not to rely on their partner in stressful or threatening situations. People who are more avoidant are more likely to distance themselves from potential threats and disengage from their emotional reactions. In contrast, people who are more anxious tend to focus on stressful situations, which exacerbates their stress, increases their negative moods, and anxious thoughts.

How attachment theory is connected to therapy: Emotionally Focused Therapy.

Such attachment dynamics can certainly play a role in adult romantic relationships. Humans are, after all, social animals; we need connection and safety throughout our entire life. But despite this necessity, we don’t always know how to connect in our relationship. This is why some couples seek therapy. Emotionally Focused Therapy (EFT) for couples relies on a brief protocol therapy developed by Sue Johnson (2004) that is based on principles from attachment theory combined with a humanistic, and systemic approach. EFT focuses on how people experience their love relationships, and on repairing adult attachment bonds (Johnson, 2004, 2013). Specifically, the goal of the therapy is to create positive cycles of interaction between partners, so that individuals are able to safely ask for and offer support to their partner. Knowing how to be responsive to one another in turn also facilitates the regulation of interpersonal emotions.

EFT is an empirically supported, 8 to 20-session therapy (Wiebe & Johnson, 2016). A meta-analysis shows some empirical support for EFT couples therapy (Johnson et al., 2006). Studies for example have shown that the EFT protocol can be effective for stress management in couples (Lebow et al., 2012) and for increasing couple satisfaction (Denton et al. 2000).1EFT therapy is evidence-based and we like the idea of EFT. We believe in the principles of the theory and the therapy. But that the therapy is evidence-based does not mean we are not critical. The entire field of psychology has been faced with a replication crisis and that means that many of our most precious findings are uncertain, as has been evidenced by many studies (see e.g., Klein et al., 2018). However, the replication crisis in psychology has taught us that the results of empirical studies are not always replicable (that is found again when the conditions in which we found the first evidence are reproduced identically). This is partly due to small sample sizes in our studies and publication bias (which in turn is caused by an overrepresentation of positive – significant results) and a lack of pre-registration. It would be surprising to us if EFT has escaped the crisis, because doing high-quality research is incredibly hard! In our lab, we only consider research that has been done via “Registered Reports” to provide stronger evidence and we are not aware yet of any EFT research that has been conducted via the Registered Report route. Therefore, we think that studies that show positive effects from EFT should be replicated prior to being convincing, at least to us. Effectiveness findings should be replicated so as to provide stronger evidence (and ideally, they should follow these Evidence Readiness Levels. We are not sure yet whether the EFT work is at ERL3. We have not done a systematic review on EFT).

EFT follows three basic stages, in which the couple engage in conversations. During Stage 1, “De-escalation”, both partners mindfully observe their pattern of interaction during conversations. Sue Johnson calls the negative emotional cycle partners are caught in “the dance”. From an attachment point of view, they may discover that the negative cycle creates feelings of abandonment and rejection. During that phase, the purpose is to discover that these feelings are a common enemy and that they can help each other step out of it. During Stage 2, (“Restructuring the bound”) arguably  the most powerful conversations take place. These conversations are also called the “Hold Me Tight conversations”. Partners discover and share their attachment fears in ways that allow the other to offer reassurance and safety. Then partners express their need to create deeper emotional responsiveness. When they express that need, they are ready to move to Stage 3, which is the “Consolidation of treatment gains”. The couple there examines the changes they have made and how they have fixed the negative cycle. The therapist supports them in looking to the future, and helps them to reflect on how they achieved greater responsiveness. 

During the therapy and during each session the first step for an EFT therapist is to help the couple focusing on the present process by asking “what is happening right now?”. By letting the partners focus on the present, the therapist puts the emotions of both partners together so that they focus on their interaction. The second step for the therapist is to help deepen the emotions, by for example asking what happens when they see tears on their partner’s face. The focus on connection and on the partner’s need can help create a new interaction that is really based on the attachment dynamic. The next step is to have one partner express what happens (e.g., “I don’t trust him/her”) when faced with the other. This helps the couple process the new step in the interaction. The therapist can then help identify what the expression of this sentiment does to the other (e.g., by asking, “What did it feel like to tell him/her that?”). The lack of being able to express one’s primary emotions are often based on demand and withdraw dynamics in relationships. Acknowledging the fear of abandonment helps to break the negative cycle. At the end of each session the therapist points out how well the couple did this process. The therapist tries to repeat and recreate these dynamics during the session at various levels of intensity. 

If you are interested in EFT, you can find training tapes, research on EFT, and where to do the basic training on their website

Conclusion: patterns of responsiveness in mind, but also in body.

The EFT protocol helps us understand how important discussions are in relationships to create deeper emotional interactions. But saying to your partner that you fear abandonment is not the only part of partner responsiveness. As it may be, John Gotmann and his colleagues have spent several years on understanding how people are also physiologically tied to each other. He found that couples that regulate each other physiologically are more likely to stay together.2Note, again, that this is in the Era Pre-Replication Crisis (19 years EPRC), so we are unsure about the strength of the evidence.

Where Gottman often focused on heartbeat, we are focusing on temperature. This may not be so intuitive for humans. A pretty easy way to understand this is when thinking of penguins. Penguins, when they get cold, huddle with each other (see a timelapse video here) to drastically increase the temperature inside the circle. Even if it is -20°C or below in the environment, inside the huddeling circle the temperature can raise up to 37.5°C (Ancel et al., 2015).

We (the Co-Re Lab) think humans do the same things, although it is true that in modern times we often regulate temperature often without each other. And yet, questions that concern people’s desire to warm up with one another correlate reliably with whether people want to share their emotions with their partner (or not; Vergara et al., 2019). And we suspect such regulation of basic needs is at the core of our partner responsiveness. In a next blog post, we will tell you how we investigate this during relationship therapy. 

This blog post was written by Olivier Dujols and Hans IJzerman

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