2/22/18 EMOTIONALLY FOCUSED THERAPY: HOW TO MAKE THE MOVES WORK FOR YOU IT S NOT ABOUT THE NAIL GOALS FOR TODAY

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1 EMOTIONALLY FOCUSED THERAPY: HOW TO MAKE THE MOVES WORK FOR YOU Tanya Radecker PhD, LPC-S, NCC, RN Certified EFT Therapist and Supervisor IT S NOT ABOUT THE NAIL 20Rk GOALS FOR TODAY u UNDERSTAND THE THEORY u REVIEW THE RESEARCH u STEPS & STAGES u INTERVENTIONS u PUT THEORY INTO PRACTICE u HAVE FUN 1

2 WHAT MAKES A HEALTHY & SUCCESSFUL RELATIONHSHIP ALL relationships have the same challenges Success Is Achieved by Engagement, Empathy & Repair ATTACHMENT THEORY Bowlby & Ainsworth 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). John Bowlby 1988 Bowlby & Mary Ainsworth We rely on our emotional connections to be Emotionally Accessible, Responsive, and Engaged If We Feel Uncertain, Threatened, Anxious, or Upset Reach Make Contact = Safe Haven, Comfort & Support Regulation of our own emotions & Connection to others with feelings of trust 2

3 The Physiologic Impact of Attachment u ISOLATION itself is TRAUMATIZING u ABANDONMENT = THREAT TO SURVIVAL u PHYSIOLOGICAL RESPONSES OF FIGHT, FLIGHT FREEZE u DISCONNECTION removes the main buffer against organizing healthy responses to stress >>> FEELINGS OF HELPLESSNESS u RESEARCH - Isolation is just as dangerous as smoking, high blood pressure, and cholesterol (House, Landis, & Umberson, 1988). DISCONNECTION EMOTIONAL STRESS/ANXIETY EMOTIONAL STRESS/ANXIETY PHYSICAL IMPACT Infant s facial expression goes from relaxed curiosity To fearful surprise They turn & look, Where are you? Then cries, screams, Someone, I know, please come get me! HEALTHY CAREGIVER RESPONSE Approach Physically & Verbally ENGAGE FULLY BE PRESENT Coo, use soft, sing-song tones, hold, pat, hug, sway, express concern 3

4 THE IMPORTANCE OF HEALTHY CARETAKER RESPONSE u Infants internalize the attention/ love response u Working model of self as lovable, valued, interesting, delightful, important OR NOT View the other as loving, protective, interested, delighted, present - OR NOT Interact with surrogate attachment figures (friends, toys) in same way Begin to create their own self story LACK OF NUTURING, ENGAGEMENT & VALIDATION RESULTS IN: VIEW OF SELF AS: UNLOVABLE BROKEN NOT DESERVING OF NEEDS NOT DESERVING OF COMFORTING STILL FACE EXPERIMENT 4

5 NEUROBIOLOGY OF ATTACHMENT Childhood experiences influences the brain development of organization of events and the related thoughts and feelings. This occurs particularly in the pre-frontal cortex. Forms basis intra-personal and interpersonal functioning FEELS GOOD! ATTACHMENT & SECURITY WE TRANSITION FROM ATTACHING TO OUR CAREGIVERS TO ATTACHING TO PARTNERS BUT WE USE THE SAME COMFORTING SKILLS THAT WE LEARNED AS CHILDREN AND WE OFTEN EITHER APPROACH FROM A PLACE OF SECURTIY OR INSECURITY 5

6 IN A SECURE/SAFE RELATIONSHIP A CURIOUS FACIAL EXPRESSION OR TONE OF VOICE IS PERCEIVED AS NEUTRAL THE TRUSTING BRAIN GIVES THE TRUSTED OTHER THE BENEFIT OF THE DOUBT AND AUTOMATICALLY ASSUMES POSITIVE INTENT A WOUNDED PARTNER PROTECTS & DOES NOT SEE POSITIVE INTENT IN ORDER TO PROTECT OURSELVES HUMANS ARE WIRED TO EXPRESS AND PERCIEVE THREATS AND FACIAL EXPRESSTIONS AT A SUB-CORTICAL LEVEL In an INSECURE RELATIONSHIP you might see your partner as Dangerous? 6

7 NEUROSCIENCE u Brain wires to adapt to environment u Goals: u Survive u Relieve Pain u Reduce Anxiety u Feel Comforted with Connection u Once wired the brain seeks similarity u Influences neuronal-systems of perception, sensation, cognition, behavior Feeling Safe is a Chemical Reaction: u Reduces stress hormones: epinephrine, norepinephrine, cortisol u Increases dopamine > enhances attention & pleasure u Increases serotonin > reduces fear & worry u Increases oxytocin > trusting of others CHRONIC ELEVATED LEVELS OF CORTISOL Suppress the Immune System Increase Blood Pressure and Sugar Decrease Libido Contribute to Obesity Ability to understand feelings or having words to describe them Regulation of Mood Impact Impulse Control Decrease the Ability to Connect 7

8 Goals of Therapy Based on Attachment Theory: Therapy Session Provides the Space for the Secure Base Identify and Express Attachment Wounds Identify and Express Needs Learn how to Engage and Disengage Honor the Emotion Create New Bonding Responses Old Attachment Injuries are Normalized as Blocks SECURE ATTACHMENT Ø Expresses full range of emotions Ø Ability to Self-soothe Ø Ability to share feelings Ø Ok with others feelings Ø Able to show Empathy Ø Reach & Receive Avoidant Attachment Ø Restricted emotions & empathy Ø Comfort self with things Ø Addictions common Ø Doesn t share feelings Ø Difficulty with commitment Ø Suppression of needs Ø Close is Uncomfortable 8

9 ANXIOUS/AMBIVALENT ATTACHMENT Ø Desires closeness, but never enough Ø Merges with other Ø Fear of Abandonment Ø Clings and criticizes Ø Cautious about depending on others Ø Difficulty feeling comforted Ø Pursuing to almost aggression to obtain a response DISORGANIZED/FEARFUL Ø Desires closeness, but fears so avoids Ø Merge/Distance Dance Ø Terrified of abandonment Ø Sabotages closeness Ø Attracted to people who victimize Ø No real sharing ability Ø Overwhelmed by others feelings Ø Dissociates when in face of strong emotion MAKING SENSE OF IT u Human Disconnection/Isolation leads to Discomfort/Panic u Children Adapt by Comforting Themselves u Adults Continue the Same Patterns Learned in Childhood 9

10 HOW HAS YOUR FAMILY INFLUENCED YOUR ATTACHMENT STYLE? ucomfort REACH OR WITHDRAW uemotions SHARE, IGNORE, SHAME utrauma NEGLECT, ABUSE, LOSS EMOTIONALLY FOCUSED THERAPY u Conceptualized by Dr. Susan Johnson and Leslie Greenberg in the 1980 s. u EFT for couples was developed primarily by Dr. Susan Johnson. It is backed by extensive research. u It is now being applied with families, individuals, and communities. u For resources, go to ICEEFT.com Emotionally Focused Therapy A CONVERSATION BETWEEN CARL ROGERS, SALVADOR MINUCHIN AND JOHN BOWLBY Sue Johnson u Focuses on present experience u CHANGE HAPPENS IN THE PRESENT u Connect the emotional experience > express emotions u Systemic - looks at the whole relationship u Negative patterns/cycles > Positive bonding patterns u Shift emotional signals - Change the music 10

11 It s About Creating Secure Bonds & Safe Attachments Collaborate Share Assertive not Aggressive Empathy Attunement Responsiveness VULNERABILITY EFT RESEARCH- HOLD MY HAND uexamined the effectiveness for modifying the social regulation of Neural Threat Response utilizing fmri u Altered the brain's representation of threat cues in the presence of a romantic partner uincreases threat-related brain activity in regions associated with self-regulation u Johnson, S.M., Burgess Moser, M., Beckes, L., Smith, A., Dalgleish, T., Halchuk, R., Hasselmo, K., Greenman, P.S., Merali, Z. & Coan, J.A. (2013). Soothing the threatened brain: Leveraging contact comfort with Emotionally Focused Therapy. PLOS ONE, 8(11): e RESEARCH OUTCOME OF COUPLES AFTER EFT 70 73% rate of improvement Two-year follow- up on relationship distress, depression- 60% report a maintenance of gains Check website for studies 11

12 CONTRAINDICATIONS TO USING EFT If you cannot create a safe relationship then is it safe to promote emotional vulnerability? 3 A s, 1. Abuse- physical or emotional 2. Addiction- addictions of all kinds (competing attachment) 3. Affairs- emotional, physical, or sexual contact (competing attachment) BASIC MOVES OF EFT VALIDATE, VALIDATE, VALIDATE GET OUT OF CONTENT PROCESS WHAT S RIGHT IN FRONT OF YOU IN THE ROOM Reflect Within and Between Interaction; CYLCLE/Pattern Deepen & Distill Reframe; Heighten Shape Enactments Simple; Slice it Thinner; Catch the Bullet Connect it/ Make Sense of it- Normalizing Removes Shame Neuroscience of Bringing it into the Room Ø Emotional need comes Alive in the Room ØBRAIN ENGAGES OLD NEURAL PATHWAYS Ø Client has a New Experience Ø Client receives New Response ØNEW PATHWAYS EMERGE 12

13 WHY IS THIS IMPORTANT? Neuroplasticity CREATE NEW NEURAL CONNECTIONS NEW EXPERIENCES MUST BE REPEATED The power to direct our attention has the power to shape the brain s firing patterns as well as the power to shape the architecture of the brain itself Dan Siegel, 2010 Couples in Conflict Get Hijacked Operate from a place of ANGER, SHAME, HUMILIATION, ISOLATION, GUILT, REJECTION, DISSAPPOINTMENT Often ANTAGONIZE each other Overwhelmed by emotions >Difficult Communications STUCK IN A CYCLE Basic Negative Cycles & Interactive Positions Pursue/Withdraw Withdraw/Withdraw Reactive Pursuer/Withdraw Burned Out Pursuer/ Withdraw 13

14 1.Permission for Survival 2.Explore Vulnerability 3.Allow to exit if too difficult The Cycle in Real Life The Break Up Secondary Emotion in the Negative Cycle Reaction to Need Not Being Met Scenario: Partner comes homes from work after a overwhelming day & ignores partners attempt to connect u Appraisal: Does not care about me. u Arousal: Anger (secondary emotion) >>> Tension in body u Reappraisal: Always rejecting me. I ve got to fix this. u Action Tendency: Pursue to get attention by raising voice or insisting engagement. 14

15 Working with the Cycle Ø Assess ability to risk going to their partner > ENACTMENT Ø Catch the Bullet Ø Process the Resistance > Slice it thinner Ø So it s very difficult for you to turn Maybe you could just let your partner know Ø Validate Stuck Place Ø Go Back Up STAGE 1 Step 1. Alliance Step 2. Identify negative cycle / Attachment issues: SECONDARY RESPONSES TO DISCONNECT Step 3. Access underlying primary attachment emotions: SAD, FEAR, PAIN, LONELY Step 4. Reframe from an Attachment Lens cycle, attachment needs/fears. : So when you partner shuts down and turns away you feel unimportant and maybe unlovable? ESTABLISHING ALLIANCE u ATTUNEMENT u BALANCE u EMPATHY u UNDERSTANDING 15

16 IDENTIFY THE CYCLE REMOVING THE CONTENT uidentify the Top uwhat is the thought uwhat is the behavior uwhat is the secondary emotion Accessing Emotion JUMP ON THE TRAIN- BE ATTUNED ulook for entry points to the primary, vulnerable emotions uidentify Secondary uconnect to the Primary Emotions Common EFT Reframes Critical pursuer can be reframed as trying to: Close the distance in the relationship, get closer. Fighting for the relationship to survive. Protesting the disconnection. Anxiety about the distance in the relationship. Withdrawers can be reframed as trying to: Calm the relationship down and restore peace. Protect the relationship from fights, avoiding expected disappointment. Protect self and/or partner from further burden or stress. 16

17 PROCESS MARKERS WHAT S HAPPENING IN THE ROOM EXPERIENTIAL IN THE PRESENT IDENTIFY/EXPLORE VERBAL AND NON-VERBAL u Tone Changes u Sighs/ Deep Breaths u Body Movements u Facial Movements u Laughter; Humor u Silence u Reactivity/Anxiety u Touch Stage 1- De-escalation Markers of Completing Stage 1 uidentify Cycle is the Enemy upause or Step Out of the Cycle uidentify and Understand Primary and Secondary Emotions for Self & Other uempathy STAGE 1 EFT INTERVENTIONS uempathetic REFLECTION uvalidation utracking, REFLECTING & REPLAYING INTERACTIONS ureframing CONTEXT OF THE CYCLE & ATTACHMENT PROCESS uevocative QUESTIONING 17

18 STAGE 1 & 2 INTERVENTIONS RISSSC Repeat Images Slow Pace Simple Words Soft Voice Client s Words ROLE PLAY STAGE TWO RESTRUCTURING THE BOND Step 5. Identify deep underlying fears and needs Step 6. Promote acceptance by other Step 7. Structure deeper and responsive enactments Attachment needs expressed and received 1 ST - Withdrawer re-engagement 2 ND - Blamer Softening *If necessary, resolution of attachment injuries 18

19 STAGE 2 EFT INTERVENTIONS HEIGHTENING EVOCATIVE RESPONDING REFLECTING THE EMOTIONAL EXPERIENCE EMPATHETIC CONJECTURE & INTERPRETATION RESTRUCTURE & SHAPE INTERACTIONS - ENACTMENTS STAGE 3 CONSOLIDATION Step 8: Facilitate the emergence of new solutions to old relationship problems. Step 9: Consolidate new positions and new cycles of attachment behaviors Consolidate new cycles of trust, connection and safety, and apply them to old problems that may still be relevant THE TAKE AWAY VALIDATE! VALIDATE! VALIDATE! EMPATHY REFLECT & REFRAME SLOW IT DOWN KEEP IT IN THE ROOM PROCESS EVERYTHING IT S NEVER ABOUT THE NAIL 19

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