Shadowing Practice: Emotionally Focused Therapy with Dr. Diane Gehart - Learn English Speaking with Video
Elige un modo de práctica
Cada modo abre una sala de práctica a pantalla completa.
418 oraciones
Si las oraciones son demasiado cortas o largas, haz clic en Editar para ajustarlas.
1
Hi, this is Dr. Diane Gayhard and this is my lecture on Emotionally Focused Couple and Family Therapy.
2
This lecture goes with my textbook series,
3
Mastering Competencies, specifically the text Mastering Competency in Family Therapy as well as Theory and Treatment Planning in Family Therapy.
4
So EFT is an evidence -based treatment and before I go on to describe the actual treatment,
5
I thought I would begin by addressing some myths and concerns people frequently have about evidence -based treatments.
6
Evidence -based treatments are manualized treatments that have been designed to treat a specific population or problem.
7
In the case of EFT, it is designed to treat couple and family problems,
8
basically, and And so, and the specific forms of those problems, we'll talk about that in depth.
9
And so, so they are manualized.
10
And so sometimes people have this vision that a manualized treatment is, has certain qualities.
11
And so I just wanted to go over
12
and address those in case you have some of those myths still in your head.
13
The first is, in this age of evidence -based treatments, we don't need traditional theories anymore more.
14
And you'll see as we go through this lecture on EFT
15
that EFT is a theory and it actually integrates three other commonly known theories
16
and put those theories together in a way that the evidence shows is particularly effective in treating couple and family distress.
17
And so yes, you still need theory.
18
In fact, you probably need to be trained in more theories in this age of evidence -based treatments,
19
and to be comfortable with moving between different approaches depending on the population you're working with.
20
As we develop more of an evidence base in the area of family therapy and psychotherapy more generally,
21
it'll probably be required that all of us get, not just pick our favorite theory or personal little theory of choice,
22
but that we learn how to get good at a range of theories.
23
The other myth is that MFT theories and research are separable.
24
The two inform each other.
25
There's no researcher out there developing a research approach, an evidence -based treatment that's not grounded in theory.
26
And MFT theories all began from observational research.
27
And so those theory and research in the world, especially in the 21st century,
28
are going to be two sides of the same coin as we move forward.
29
And so practitioners are going to have to get better at understanding and using research,
30
and researchers are going to need to focus their research on applicable treatments for populations in the real world.
31
There's also a myth out there that evidence -based treatments are rigid
32
and robotic and you have no freedom and they're extremely limiting.
33
This is simply not true.
34
I had that myth in my head when I actually went to my first four -day in -depth training,
35
the externship for EFT, and I quickly learned that that is simply not the case.
36
In fact, there are areas for the EFT
37
that are more flexible than other systemic approaches in terms of how they track the interactional sequence.
38
And so they're just like any other approach.
39
There are certain places where it's more kind of prescriptive, that you need to have some prescription for it to be a valid theory.
40
And there are other places that are much more, there is more flexibility and it's just different than other approaches.
41
So it's not necessarily more rigid or robotic than any other recognized traditional treatment out there.
42
Another theory is that you have to give up your personal theory of choice to use an evidence -based treatment.
43
I just simply don't think that's possible in the sense that as you train to be a therapist,
44
You're normally trained in one or two models that you closely identify with.
45
You learn to see people and problems through those lenses.
46
And the evidence -based treatments simply get added and integrated into this, and you learn to have just a more sophisticated, multi -layered, multi -faceted practice,
47
and that the evidence -based treatments inform that.
48
Another common myth is that researchers agree on what constitutes the research or the evidence -based for the field.
49
And there are actually multiple strands of research, and I describe these in some of my chapters in the books associated with this series,
50
but suffice it to say that not even everyone agrees, all the researchers agree on what constitutes valid research and meaningful research in the field.
51
There's also a myth that cognitive behavioral therapy is the only evidence -based treatment, and conversely, if you're doing cognitive behavioral, it's evidence -based for everything.
52
Again, that is simply not true.
53
Cognitive behavioral therapies have the most recognized evidence -based treatments associated with them but they certainly don't have it for everything.
54
And for example, with teenage conduct and substance abuse disorders, there are systemic structural approaches are really,
55
the research shows, are the primary approach for those.
56
And EFT is another wonderful example of where it's not a CBT.
57
It is a more humanistic approach, and it has a very strong evidence base associated with it.
58
So no, not every evidence -based treatment is cognitive behavioral.
59
And cognitive behavioral therapy is not evidence -based treatment for every possible presenting problem.
60
And then finally, the last myth is that standard practice is up to date.
61
And so you'll hear some therapists say, well, we've been doing it this way for years.
62
It's been good enough till now.
63
Both in physical medicine and in psychotherapy, what constitutes standard practice has historically been about 17 years to 20 years,
64
depending on what study you're looking at, behind the current evidence base.
65
So standard practice is typically about 20 years behind.
66
And you can imagine how when people hear this, maybe people outside the field, stakeholders, people who are either paying for this or receiving the services,
67
would like to narrow that gap.
68
And that's a major priority, both in the fields of physical health as well as mental health and behavioral health.
69
And so that is an overall goal.
70
And some of what these evidence -based treatments are trying to
71
do is to make the current evidence base more readily available to the everyday practitioner to close the gap
72
so that standard practice is closer to the current state of knowledge in the field.
73
And for the rest of this lecture, we're going to focus on introducing you to emotionally focused couple and family therapy.
74
In a nutshell, the least you need to know.
75
So EFT originally actually began with the work of Sue Johnson and Les Greenberg, and
76
each has kind of focused on their own variation with Les Greenberg working more with individuals
77
and Sue Johnson working more with couples and families.
78
And so this workshop is really going to focus on the later work of Sue Johnson, although So certainly
79
Les Greenberg and Sue Johnson started out with these ideas together.
80
And EFT is an integrative approach that combines attachment theory,
81
experiential therapy theory, and systems theory.
82
And you'll see all three of these in action together.
83
And the focus really is on conceptualizing couples and families as emotional systems systems that have both interpersonal and intrapsychic processes,
84
systemic processes that interrelate and interact.
85
And if you've listened to the systemic lectures in this series, you will recognize the interactional sequence.
86
And so Sue Johnson focuses on the interactional sequence between couples and families, has found very easy ways to actually assess these,
87
are relatively easy compared to maybe some of the traditional approaches and conceptualizes it using attachment theory as well as experiential.
88
And so you will see many of the traditional elements of a systemic approach adding in attachment theory with some humanistic elements,
89
particularly in how she intervenes.
90
And so most of the research with EFT has been conducted with couples.
91
This has been extensively researched with couples for over three decades.
92
But many of these principles can also be used in family therapy, and it definitely has been studied with families,
93
but most of the research has been with couples.
94
And it's one of the two readily identified evidence -based treatments for distressed couples,
95
this along with integrative behavioral couples therapy.
96
Those are the two primary evidence -based treatments for couples.
97
So next we're going to talk about the juice,
98
which is one of the most significant contributions of this theory to the field of mental health in general.
99
The one thing that
100
Sue Johnson does in this EFT theory that is truly unique is that she
101
She has applied attachment theory, which has primarily been used with infants and young children from one to three,
102
one to five, and applied that theory to adult love.
103
She is really a leader in this area of applying attachment theory to adults and developing an intervention based on this.
104
As you may recall from some introductory psych classes, attachment research and attachment theories about both the physiological, emotional, and survival needs.
105
that we've always known, or have known for a very long time in psychology,
106
let's say, that an infant needs to literally physically survive in this world.
107
And Sue Johnson is a leader in identifying adult attachment theory,
108
in that adults have the same need for secure relationships, to feel emotionally safe, to help them regulate their emotions,
109
and for adult health.
110
And there's a lot of evidence also that shows that adults really do need to have secure attachments to,
111
it enhances both their quality and length of life.
112
And so this has been an exciting place both in physical as well as mental health research looking at adult attachment.
113
And the whole heart of her theory is based on this conceptualization,
114
this understanding understanding that adult attachment is as necessary in couple relationships as the primary driving factor in understanding couple relationships.
115
It helps to make sense of what is often very confusing when we look at couple relationships.
116
Next let's talk about the big picture, an overview of what treatment looks like in EFT.
117
Now, as you may remember, EFT is an evidence -based treatment, and you may recall it is manualized.
118
And so yes, there are very concrete stages and steps that go with EFT that help the therapist navigate treatment,
119
monitor progress, and basically structure the treatment as efficiently as possible.
120
So it's this outline that is used in the evidence -based studies.
121
So in the first stage is the de -escalation of the negative cycle, and this involves four different steps.
122
The first step is for the therapist to create an alliance and identify the attachment struggle with the couple.
123
And so this is kind of developing a very important therapeutic alliance that will be relied on quite heavily,
124
as you see, because it is a very emotionally intense approach.
125
And so the therapist has to create an extremely safe therapeutic environment for the couple or all members of the family.
126
And so that's a very important process.
127
Then the next step is to identify the negative cycle.
128
And this is basically tracking the interactional sequence, which we do in the more traditional forms of systemic approaches.
129
Very similar tracking that systemic interactional cycle.
130
Step three is accessing unacknowledged emotions and positions.
131
We'll be talking about secondary emotion and primary emotion.
132
The secondary emotions are the ones we most readily recognize.
133
We're angry, we're frustrated, we feel attacked, we feel defensive.
134
Those are the secondary emotions.
135
Those are usually the first ones that are readily identified by the couple or family when they're presenting the problem.
136
Then you'll see there's a period where you go and you track the primary emotions, and those are the attachment -based emotions.
137
That's the longing for connection, the wanting to feel safe.
138
Those emotions then get tracked.
139
So first you identify the negative interaction cycle, both in terms of behaviors as well as what is called secondary emotion.
140
And then you go back through and you track the primary attachment emotions underneath that.
141
And then finally in stage one, you reframe the presenting problem that the couple has in terms of attachment and the negative cycle.
142
And to a certain extent, this externalizes the problem instead of,
143
you know, the problem is that my wife nags or the problem is that my husband withdraws.
144
Now in step four, we get the couple to see, and I'll use couples as the primary example,
145
that the problem is not his or her behaviors,
146
but that the couple has a very negative interaction cycle that they get into.
147
And when they get into this, it triggers their attachment fears.
148
And so they get into these kind of survival positions in order to kind of manage the threat
149
to what feels like that their partner's no longer a safe attachment figure, essentially.
150
So basically, this negative interaction cycle happens when one or both partners begins to perceive the other as no longer being safe.
151
Then in stage two is where you begin to change this negative interaction pattern and create emotional engagement and emotional safety.
152
You repair the attachment or strengthen the attachment for the couple or family.
153
So typically, you go through step five, six, and seven you start with partner who tends to withdraw.
154
I think this is one of Sue Johnson's most brilliant contributions.
155
It must have come out through the research because I don't think it's intuitive.
156
Because the pursuer is the one who's usually complaining, who wants connection, and the withdrawer is the one who's pulling away, wanting distance.
157
Because the pursuer is usually the one complaining,
158
most of us naturally start with the one who's complaining because the withdrawer will often not have too many complaints.
159
And what Sue Johnson has found is that
160
if you begin with the person who is withdrawing from connection and you reengage that person, you make them feel safe again,
161
you make them feel present, then the pursuer doesn't need to pursue because the other person's open and available emotionally.
162
And so she generally will begin this process with the person who tends to withdraw more in the interaction sequence,
163
get them re -engaged, and then work with the pursuer.
164
Step five is you promote the identification of disowned attachment needs.
165
That's working first with the pursuer,
166
then with the pursuer, on identifying their attachment needs and expressing those to their partner in an open,
167
direct, congruent way.
168
Then in step six, you promote the acceptance of that partner's experience by,
169
for example, the withdrawers expressing, we'll say, his needs.
170
Then his partner would need to acknowledge and accept that.
171
And then step seven is having direct expression of the needs while strengthening attachment.
172
And so you would do this with both partners as often as necessary to get them kind of reconnected
173
and out of that negative interaction pattern.
174
And then in stage three, you're facilitating new solutions to those old problems.
175
And in step nine, you consolidate the new positions and attachments.
176
And this does not happen in a perfectly linear way.
177
Most clients are going to move back and forth.
178
It's more fluid than the nine steps.
179
It's not literally a checkbook thing.
180
But this is generally the basic progression and how therapists conceptualize and move through and track progress.
181
And because of this very clear outline of the therapy process, it's very clear when
182
therapy is not progressing or it isn't working
183
because you can see you're stuck in stage three or four
184
and you're not moving past or moving into the next step or stage.
185
And so in EFT, there are three primary therapeutic tasks.
186
The first is creating and maintaining the therapeutic alliance with both partners or all members of the family,
187
which is extremely challenging when working with couples and families in such an intense and intimate way.
188
The second task is assessing and formulating emotions, so understanding that primary and secondary level of emotion and how they're interacting.
189
And then the third task is restructuring the problem interaction cycles that the couple or family is stuck in.
190
So those are the three critical tasks that are the focus of EFT treatment.
191
So now we're going to move on to making connection and developing the therapeutic relationship in EFT.
192
And overall, you'll notice that the relationship in this approach is very much grounded in humanistic
193
principles and it requires a lot of the therapists.
194
It's a very actually intense therapeutic relationship.
195
If you get a chance to watch
196
Sue Johnson in action or any EFT therapist in action,
197
you will notice that there's a very particular therapeutic relationship and
198
that the therapist is exceptional in terms of empathic attunement with the client and expression of empathy.
199
And often you will notice that the therapist speaking and engaging the clients in a very particular way.
200
And so EFT is not an approach where the therapist kind of remains aloof, emotionally detached.
201
The therapist is right there with the client feeling and tuning into not just the surface level emotions,
202
but those very primary attachment needs and putting into words these very primary attachment needs
203
that often the client almost experiences without language sometimes.
204
The therapist is sometimes putting this into words for the client for the first time.
205
The approach very much relies on a lot of the principles that
206
Carl Rogers introduced, such as genuineness and acceptance of the client.
207
The therapist will often use self -disclosure just like other humanistic therapists as a way to talk about emotion,
208
share about emotion, help clients explore emotion.
209
And because it is an extremely intimate and emotionally intense relationship, there is a constant monitoring of the alliance,
210
making sure that the therapist is both aligned with all members of the therapeutic system,
211
so each of the partners and are all members of the family system.
212
There is still a concept of joining the system, learning to talk and interact in ways that are comfortable for them.
213
And the therapist's role is very much that of not just being empathetically attuned,
214
but helping the clients learn how to work with these very difficult emotions that we all have in our most intimate relationships.
215
I mean, anyone who's human, I think, has been paying attention.
216
But our relationships with family and partners are both some of the most wonderful
217
and some of the most deep and painful emotions one can experience.
218
And so the EFT therapist is right there with clients in all of that in a very intense and intimate way.
219
So next we're going to move on to talking about the viewing, case conceptualization, and assessment in EFT.
220
And here you're going to see a lot of the attachment theory as well as the systemic case conceptualization
221
that they use to understand the dynamics and where couples and families get stuck.
222
So in EFT, they are very conscious about assessing both intrapsychic, how individuals are processing their experiences,
223
particularly focusing on key attachment -oriented emotional responses, so their attachment patterns, as well as looking at the interpersonal,
224
interpersonal, interactional patterns about how two partners or a family organize into both negative and positive interaction cycles.
225
And so the therapist is constantly monitoring what's going on within the individuals emotionally,
226
as well as how they are interacting to create the broader systemic dynamics.
227
So primary and secondary emotions, as I mentioned earlier, play a significant role in the conceptualization in EFT.
228
So as I mentioned earlier, primary emotions typically represent attachment fears and needs.
229
So these are usually softer, more vulnerable emotions.
230
You fear abandonment from somebody else.
231
You want to be attached.
232
You're afraid to show your true self to somebody else.
233
These are generally very vulnerable emotions and fears of being rejected and also the fear of needing someone.
234
For a lot of people, that's a very scary to acknowledge that you need someone else to be okay
235
or that you have a sense of being okay, that you want someone else and that you need them at that emotional attachment level,
236
especially for those who come from cultures where there's a sense of independence and I can take care of myself,
237
I don't need someone else.
238
There's often gender meant to have more of that, at least in Western American society, They're women, but this idea that I can be totally independent,
239
I don't need anyone else.
240
And so these emotions can be particularly difficult to just recognize because of social cultural norms.
241
The secondary emotions are our emotions about the primary emotions, and they often take the form of anger, frustration, withdrawal.
242
And so these secondary emotions allow you to not feel the sense of vulnerability associated with those primary emotions.
243
And so if you can get angry and frustrated, you don't feel the scarier emotions of being vulnerable,
244
of being abandoned, that often feels worse.
245
So we tend to be more conscious of these secondary emotions.
246
And so early on in therapy, we track, like I mentioned, the secondary emotions because that's what the clients initially present.
247
And once that becomes clear and those patterns are clear,
248
then you can go back in and try to begin to identify and have clients identify with those more primary emotions,
249
which are much more difficult to access for most people.
250
So if you've been following along in the text, you will maybe remember earlier on the traditional systemic approaches like MRI, Milan, and strategic,
251
they assessed a negative interaction cycle and sue johnson does this also in eft
252
but the way she does it is quite frankly a bit easier because she focuses on ultimately
253
If you conceptualize around adult attachment needs, there is one partner who's pursuing for attachment and another person who's withdrawing.
254
And that's the basic dynamics, at least at how relationships start.
255
And this still fits with traditional systemic theory
256
that the pursue -withdraw has always been viewed as there's only a certain amount of intimacy a given couple can tolerate.
257
And so that even when we were looking at first and second order change, you can flip who's pursuing and withdrawing,
258
but the same level of intimacy is generally tolerated.
259
It takes a major second order intervention to shift how much intimacy can be tolerated within the couple.
260
So typically, the pursuer protests any type of separation or distancing relationship.
261
And so this tends to be associated with a more anxious attachment style.
262
And so the emotions that this person typically feels is feeling hurt, feeling alone, and feeling unwanted by their partner.
263
The withdrawer tends to distance, protect himself from whatever perceived lack of safety that they're seeing in the relationship.
264
And this person tends to have a, this is typical of the avoidant attachment style well.
265
This person typically feels rejected, inadequate, or judged by the pursuer.
266
And so you typically get that pattern.
267
It is possible, particularly one of the partners has been traumatized, that they can actually flip roles in the cycle.
268
And so you get almost like a figure eight, I think of it.
269
But one pursues and the other distances, and then as part of their cycle, that actually changes and then that flips around.
270
And then they actually flip roles within the same kind of argument or cycle that they go through.
271
That tends to be indicative of trauma, according to Sue Johnson's research.
272
But you can just, if you just track this pattern, and this is the basic pattern,
273
who's pursuing for closeness and who's withdrawing. And this can change.
274
I always like to joke that typically you can assess this relatively quickly because usually
275
Usually it's the pursuer who's calling to set up therapy appointment, unless the pursuer just threatened to force,
276
in which case the withdrawer would be picking up the phone to call you.
277
But that's generally, I joke about that, I say that jokingly, but I encourage you, if you use this approach,
278
to consider that as you take your intake phone calls and tell me if that seems to match up with your experience,
279
because that's been my experience.
280
So early on in the therapeutic relationship, the EFT therapist will do an attachment history if they're working with a couple or family.
281
And often this is done in individual sessions.
282
Usually there's a single individual assessment with each partner.
283
And what they try to get is a sense of what
284
was their attachment like with their primary caregivers as an adult and as adolescents,
285
an intimate relationship that they had in their early dating years or wherever their dating years, whatever phase of adulthood they're in.
286
And so you want to look at the various attachment, major attachment figures they've had in their life and what have been their patterns.
287
What has been in particular that person's experience in terms of secure attachment, avoidant, and anxious attachments.
288
And so as part of this, you're looking for how accessible were the other people,
289
how How responsive and how engaged are they used to experiencing in their intimate relationships?
290
Another thing that EFT therapists assess for is something that's called an attachment injury.
291
And they're looking for a significant attachment event.
292
And what this means is that in a moment of high need, such as when a woman is pregnant or a partner lost their parent,
293
that the other partner did not offer support in this moment of particularly high need.
294
This is a very specific type of betrayal or abandonment or a sense of violation in the relationship.
295
This fundamentally redefines the relationship for the injured party as unsafe.
296
This is something that the EFT therapist assesses for, and this needs to be identified and addressed before moving on to the second stage of intervention.
297
And so certainly if the therapy process becomes stuck, this is something that they would look for to see if they missed one of these,
298
but it's also something assessed for early in the relationship to get a sense, because that needs to be repaired,
299
and yes, they have a specific process for that.
300
But that's something that they're assessing here and repairing this
301
if it needs to be in order before they can move into the more intense work of the second stage.
302
So in terms of the initial assessment sessions, which I alluded to a couple slides ago,
303
is that there is an initial assessment to just make sure the couple is appropriate for EFT.
304
And typically, this initial assessment will include first a joint couple session, then some individual sessions, and then a return to regular ongoing conjoint sessions.
305
So in the conjoint session, you're assessing for both the perceptions of problems in the relationship as well as strengths.
306
You're looking for both the negative and positive interaction cycles.
307
You're looking at the key relationship history and key events, including those attachment injuries.
308
And you're getting a very brief attachment history for each partner.
309
Then typically, if all looks good there, they would move on to an individual session.
310
You can take one session divided in half or have two full one -hour sessions with each.
311
But you're assessing for each partner's commitment to the relationship, the potential for past or current affairs.
312
You're trying to get a trauma history as well as a detailed attachment history, screening for violence and such,
313
but just overall making sure that they are appropriate for the EFT process.
314
So there are contraindications to EFT.
315
So this means, and through the assessment, if a therapist discovers some of these key elements that they would not proceed with EFT.
316
So EFT is not for every couple that walks in the door.
317
So one is if the couple has different agendas for the relationship in therapy.
318
So if one member of the couple is really ready to end the relationship or mostly out the door,
319
this may not be an appropriate treatment for them.
320
This takes someone who's really committed because you have to be vulnerable and that takes a high level of commitment.
321
So couples who have very different agendas for the relationship or therapy or who are really in the process of committing, people, well, I'm not sure,
322
maybe I'll give it one last try, but I don't think there's much of a chance.
323
That's probably not it.
324
And they're the right couple for this because this does require quite a bit of commitment from both parties.
325
If there's any type of physical or even emotional abuse, then EFT is not indicated,
326
as well as if there's an untreated addiction for one or both partners, that also would not be an appropriate treatment for those couples.
327
And so the therapist really needs to, doesn't just jump right in and start with EFT,
328
but make sure that the couple is well suited and appropriate for the treatment.
329
So once the therapist has assessed the couple, then the next process is to set the goals for treatment.
330
Now, as an evidence -based treatment, EFT has some very basic, consistent, overarching goals, because after all,
331
most of the people using this approach are using it for the similar population.
332
So the first is to create a strong, secure attachment for both partners.
333
The second overarching goal is to develop new interaction patterns that are nurturing and supportive for each partner.
334
And then third basic goal is to increase direct expression of emotion, especially those related to attachment needs.
335
So those are direct expression of primary emotions.
336
So next we're going to talk about interventions in EFT, the doing.
337
So as an evidence -based treatment, the link between specific goals and interventions is much closer than many other approaches.
338
And there are actually certain interventions that are used in each phase, and some of them are used differently across phases.
339
So in this early phase of intervention, when you're de -escalating and identifying the problem interaction cycle,
340
there's a lot of validation of each person's experience and their emotions.
341
There's a lot of reflecting of emotions and helping clients identify both the secondary and the primary emotions.
342
There is a lot of tracking of the cycle.
343
This can be done in multiple ways.
344
This is my insight as to realizing that there is quite a bit of flexibility.
345
If you look at other systemic approaches, many of them are more limited.
346
And in EFT, they don't care if you track the interactional cycle on a single event,
347
on a general hypothetical event, or a typical event.
348
But they're just tracking the cycle.
349
You can do it more behaviorally.
350
You can do it with circular questions.
351
You can do it more solution -oriented using the video talk questions.
352
You can do it any way that makes you happy.
353
It makes a couple happy as long as you're tracking that full cycle, just like you do and all the others from basic homeostasis,
354
rise in tension, the conflict or symptom, and then how they get back to homeostasis again.
355
And so you're tracking that cycle, whatever it looks like, and you can do it behaviorally.
356
And then you will certainly, in one of your passes through the cycle, look at the interaction of the secondary emotions.
357
And then ultimately, the goal is to go through and track how the primary emotions are underlying this cycle.
358
Evocative responding is responding in a way that evokes deeper emotions, often primary emotions.
359
And then empathetic conjecture is where you might offer up in a tentative way,
360
you know, might you have been feeling rejected at that point when you were looking so angry?
361
And so that empathetic conjecture is used to help clients identify both their primary and secondary emotions.
362
Then in the working phase, again, you're going to see these are interventions that are used to restructure their interactions.
363
So again, you're seeing that evocative responding, responding in a way that evokes emotion and helps them to get in touch with their emotions.
364
The empathetic conjecture, helping them to identify by tentatively putting out some possibilities for the emotions
365
that might be both primary and secondary emotions that might be fueling the interactions.
366
Heightening emotions, helping when clients indicate there's something there to help heighten and help them express that,
367
reframing their emotions, often using primary emotions as a way to reframe and or the interaction sequence,
368
and then restructuring interactions.
369
And so this would be using very much the enactments that are familiar to us from structural family therapy,
370
but specifically focusing on restructuring the interactions to keep them engaged
371
and to help them get in touch with and directly express their more primary emotions that are fueling these negative interaction cycles.
372
And then finally in the closing phase, there's again a lot of validation, this time often validating the new interactional patterns that they're developing,
373
using again evocative responding, using reframing to help them understand these new patterns,
374
and again restructuring interactions for more positive interactions between the couple or family.
375
And so finally we're going to close by talking about diversity considerations when working with EFT as well as the evidence base.
376
So EFT has been studied on a range of ethnically diverse couples.
377
Generally the basic premises are used across diverse couples.
378
Research has not indicated that different protocols are necessarily required for different ethnicities.
379
In general, attachment needs have been found to be universal across the theory
380
and across cultures in terms of just studying attachment needs across cultures.
381
Cultural norms generally have very specific rules for how to handle emotional expression.
382
And so therapists need to be very well aware of the expression norms for both males
383
and females within the client's cultural group to accurately assess what's going on and how to best help them reconnect.
384
And so the therapist may need to be, when working with diverse clients,
385
identifying specific cultural meanings and functions of various expressions and also for attachment behavior.
386
So even though the need for attachment is cross -culturally documented,
387
how that gets done and how attachment happens across cultures can look very different.
388
And there have been special studies working with same -sex couples.
389
So EFT has been researched for almost three decades, and it's one of two empirically validated couples therapy approaches.
390
So it's very highly regarded as an evidence -based treatment.
391
In clinical trials or in Sue Johnson's research,
392
they have a very impressive 70 to 73 percent recovery rate for distressed couples in 10 to 12 sessions,
393
with 90 percent of couples showing significant improvement.
394
That is extremely impressive, especially if you've ever worked with couples.
395
Once you work with your first few, you'll be even more impressed.
396
And to be fair, this is not typical in the sense of these are highly trained EFT therapists,
397
what the studies have been conducted on.
398
But still, even with more average trained people in the field, the recovery and improvement rates just take a little bit more time,
399
more like 20 sessions.
400
But still, that is extremely impressive in the area and the realm of couples treatment.
401
And like I said, if you haven't worked with a couple yet, it's more impressive the more you do it.
402
And what's interesting is
403
that the couple's initial level of the stress doesn't seem to
404
matter as much as their level of engagement in the session or the male partner's level of trust in general.
405
So those are two of the indicators they have found, which is again kind of surprising and counterintuitive.
406
You would think the more distressed couples would take longer to treat.
407
Not necessarily so.
408
It's the more engaged, the more willing the couple is, especially the male partner, to engage in addressing these attachment needs,
409
the more quickly the couple responds.
410
So nearly two -thirds of the couples resolving attachment injuries are able to do so with a brief intervention,
411
which is quite impressive and important, and the results do tend to be stable.
412
So, in terms of using, there is a special protocol you can read about using EFT with attachment injuries.
413
Again a very positive outcome.
414
And again, they have a very specific treatment and it is for a specific type of problem and population.
415
But overall, EFT is a very well respected couples approach that has very impressive outcomes,
416
considered within the world of mental health.
417
So hopefully this was a useful and helpful introduction to EFT for you and I encourage you to do further reading.
418
There are more details obviously in the chapter.
Descargar app
Todo lo que necesitas para hablar con fluidez
Pronunciación con IAEvalúa cada oración
Práctica de IPADomina cada sonido
VocabularioConstruye tu banco de palabras
Juego de vocabularioAprende mientras juegas
FOR YOU
Recomendar Video
C174 oraciones
Coping skills and Psychological Defenses - An Introduction
American AccentDaily ConversationUniversity Students
C11
108 oraciones
LTEC 782: Design-Based Research in Education (Session 01)
Daily ConversationUniversity Students
C11
699 oraciones
3. Foundations: Freud
Daily ConversationUniversity Students
C11
982 oraciones
Theology of the Body Crash Course w/ Fr. Mike Schmitz — Session One: From the Beginning
Daily ConversationUniversity Students
C11
358 oraciones
I did 2 years of TRE, here's what happened (Trauma Release Exercises)
Daily ConversationUniversity StudentsWorking Adults
C11
345 oraciones
Ethics of Care Lecture
Daily ConversationUniversity Students
C11
311 oraciones
A typical day of a school psychologist | Interview with a school psychologist: Dr. Charles Barrett
Daily ConversationUniversity Students
C15
96 oraciones
Theories of Emotion | Processing the Environment | MCAT | Khan Academy
Daily ConversationUniversity Students
C13
214 oraciones
Fawning: The Survival Strategy That Turns Into Self-Abandonment | Fawning #2
Daily ConversationUniversity StudentsWorking Adults
C11
21 oraciones
Susan David 2min Ted talk
Daily ConversationUniversity StudentsWorking Adults
C12
249 oraciones
How to Present a Patient Case: The Signpost Method
Daily ConversationUniversity Students
C12
141 oraciones
The Seven Traditions: Mapping the Field of Communication Theory
Daily ConversationUniversity Students
Vocabulario y notas de pronunciación para esta lección
Esta lección de conversación se basa en el vídeo “Emotionally Focused Therapy with Dr. Diane Gehart”. Las palabras que más se repiten: couple, attachment, emotion, eft, treatment. Este vídeo tiene 418 frases y 6088 palabras para practicar shadowing. La parte hablada dura 41:21. El hablante mantiene un ritmo constante de unas 147 palabras por minuto, cómodo para el shadowing. El 82 % de las palabras está entre las 3.000 más comunes del inglés; conviene repasar el resto antes de empezar.
Vocabulario clave de este vídeo
15 palabras del vídeo que vale la pena aprender, con su pronunciación y significado:
| Palabra | Pronunciación | Significado |
|---|---|---|
| attachment sustantivo | /əˈtæt͡ʃmənt/ | prensión |
| emotion sustantivo | /ɪˈməʊ.ʃən/ | afecto, emoción |
| therapist sustantivo | /ˈθɛɹəpɪst/ | terapeuta |
| interaction sustantivo | /ˌɪn.təˈɹæk.ʃən/ | interacción, interrelación |
| assess verbo | /əˈsɛs/ | evaluar, estimar |
| systemic adjetivo | /sɪˈstɛm.ɪk/ | sistémico |
| intervention sustantivo | /ɪntɚˈvɛnʃən/ | intervención |
| therapeutic adjetivo | /ˌθɛɹ.əˈpjuː.tɪk/ | terapéutico |
| myth sustantivo | /mɪθ/ | mito |
| emotionally adverbio | /ɪˈməʊʃənəli/ | emocionalmente |
| withdraw verbo | /wɪðˈdɹɔ/ | retirar |
| behavioral adjetivo | /bɪˈheɪvjəɹəl/ | del comportamiento, conductual |
| impressive adjetivo | /ɪmˈpɹɛsɪv/ | impresionante |
| assessment sustantivo | /əˈsɛsmənt/ | evaluación, expertización |
| intense adjetivo | /ɪnˈtɛns/ | intenso |
Phrasal verbs que vas a escuchar
| Palabra | Pronunciación | Significado |
|---|---|---|
| go through verbo | atravesar | |
| come out verbo | /ˌkʌm ˈaʊt/ | revelarse, salir a la luz |
| get back to verbo | responder / contestar (en un rato), volver / tornar a contactar | |
| give up verbo | rendirse, entregar | |
| go over verbo | sentar, pasar | |
| move forward verbo | ir adelante, adelantar | |
| pass through verbo | atravesar | |
| pick up verbo | coger, asir |
Frases que vale la pena repetir
Frases cortas y completas del vídeo que puedes reutilizar en la conversación diaria:
- We'll be talking about secondary emotion and primary emotion.
- I don't need someone else.
- I don't need anyone else.
Gramática en este vídeo
Las estructuras que más usa el hablante, con las palabras exactas del vídeo:
| Estructura | En el vídeo |
|---|---|
| Present perfect continuous have/has been + -ing — una acción que empezó antes y continúa | we've been doing · has been paying · you've been following |
| Oraciones condicionales if + oración, will/would + verbo — una condición y su resultado | if all looks good there, they would move |
| Present perfect have/has + participio pasado — una acción pasada que sigue importando ahora | have been designed · It's been · has historically been |
| Voz pasiva be + participio pasado — importa lo que ocurre, no quién lo hace | are manualized · is designed · be trained |
Pronunciación a tener en cuenta
El hablante usa 75 contracciones y formas reducidas, como you're, they're, don't. Dilas en su forma corta, tal como las oyes.
- Los sonidos de “th”: therapist /ˈθɛɹəpɪst/, therapeutic /ˌθɛɹ.əˈpjuː.tɪk/, myth /mɪθ/, withdraw /wɪðˈdɹɔ/, threaten /ˈθɹɛt.n̩/
- Los sonidos de “sh” y “zh”: emotion /ɪˈməʊ.ʃən/, interaction /ˌɪn.təˈɹæk.ʃən/, intervention /ɪntɚˈvɛnʃən/, emotionally /ɪˈməʊʃənəli/, contribution /ˌkɑntɹɪˈbjuʃən/
- Palabras largas — cuida el acento: interaction /ˌɪn.təˈɹæk.ʃən/, intervention /ɪntɚˈvɛnʃən/, therapeutic /ˌθɛɹ.əˈpjuː.tɪk/, emotionally /ɪˈməʊʃənəli/, behavioral /bɪˈheɪvjəɹəl/
Sonidos difíciles para hispanohablantes:
- s + consonante al inicio — sin añadir una “e” delante: structural /ˈstɹʌk(t͡)ʃəɹəl/, stable /ˈsteɪ.bəl/, strategic /stɹəˈti.dʒɪk/, scary /ˈskɛə.ɹi/
- /v/ — no es /b/: los dientes tocan el labio inferior: intervention /ɪntɚˈvɛnʃən/, behavioral /bɪˈheɪvjəɹəl/, impressive /ɪmˈpɹɛsɪv/, cognitive /ˈkɑɡ.nɪ.tɪv/, vulnerable /ˈvʌln(ə)ɹəbl̩/
- /dʒ/ — no es la “y” ni la “ch”: encourage /ɪnˈkʌɹ.ɪd͡ʒ/, engagement /ɪnˈɡeɪd͡ʒ.mənt/, agenda /əˈd͡ʒɛn.də/, acknowledge /əkˈnɑ.lɪd͡ʒ/, rigid /ˈɹɪd͡ʒ.ɪd/
Cómo practicar con este vídeo
- Escucha el vídeo entero una vez sin hablar y anota las palabras que no conoces.
- Haz shadowing frase por frase a velocidad normal, repitiendo cada una hasta que tu ritmo coincida con el del hablante.
- Grábate y compara con el original, prestando atención a palabras como attachment, emotion, therapist.
¿Qué es la Técnica de Shadowing?
Shadowing es una técnica de aprendizaje de idiomas respaldada por la ciencia, desarrollada originalmente para la formación de intérpretes profesionales y popularizada por el políglota Dr. Alexander Arguelles. El método es simple pero poderoso: escuchas audio en inglés nativo y lo repites en voz alta de inmediato, como una sombra que sigue al hablante con solo 1-2 segundos de retraso. A diferencia de la escucha pasiva o los ejercicios de gramática, el shadowing obliga a tu cerebro y músculos de la boca a procesar y reproducir simultáneamente patrones de habla reales. Las investigaciones muestran que mejora significativamente la precisión de la pronunciación, la entonación, el ritmo, el habla conectada, la comprensión auditiva y la fluidez al hablar, convirtiéndola en una de las metodologías más efectivas para la preparación del IELTS Speaking y la comunicación en inglés en el mundo real.