Shadowing Practice: Emotionally Focused Therapy with Dr. Diane Gehart - Learn English Speaking with Video
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Hi, this is Dr. Diane Gayhard and this is my lecture on Emotionally Focused Couple and Family Therapy.
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This lecture goes with my textbook series,
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Mastering Competencies, specifically the text Mastering Competency in Family Therapy as well as Theory and Treatment Planning in Family Therapy.
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So EFT is an evidence -based treatment and before I go on to describe the actual treatment,
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I thought I would begin by addressing some myths and concerns people frequently have about evidence -based treatments.
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Evidence -based treatments are manualized treatments that have been designed to treat a specific population or problem.
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In the case of EFT, it is designed to treat couple and family problems,
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basically, and And so, and the specific forms of those problems, we'll talk about that in depth.
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And so, so they are manualized.
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And so sometimes people have this vision that a manualized treatment is, has certain qualities.
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And so I just wanted to go over
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and address those in case you have some of those myths still in your head.
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The first is, in this age of evidence -based treatments, we don't need traditional theories anymore more.
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And you'll see as we go through this lecture on EFT
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that EFT is a theory and it actually integrates three other commonly known theories
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and put those theories together in a way that the evidence shows is particularly effective in treating couple and family distress.
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And so yes, you still need theory.
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In fact, you probably need to be trained in more theories in this age of evidence -based treatments,
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and to be comfortable with moving between different approaches depending on the population you're working with.
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As we develop more of an evidence base in the area of family therapy and psychotherapy more generally,
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it'll probably be required that all of us get, not just pick our favorite theory or personal little theory of choice,
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but that we learn how to get good at a range of theories.
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The other myth is that MFT theories and research are separable.
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The two inform each other.
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There's no researcher out there developing a research approach, an evidence -based treatment that's not grounded in theory.
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And MFT theories all began from observational research.
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And so those theory and research in the world, especially in the 21st century,
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are going to be two sides of the same coin as we move forward.
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And so practitioners are going to have to get better at understanding and using research,
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and researchers are going to need to focus their research on applicable treatments for populations in the real world.
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There's also a myth out there that evidence -based treatments are rigid
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and robotic and you have no freedom and they're extremely limiting.
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This is simply not true.
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I had that myth in my head when I actually went to my first four -day in -depth training,
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the externship for EFT, and I quickly learned that that is simply not the case.
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In fact, there are areas for the EFT
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that are more flexible than other systemic approaches in terms of how they track the interactional sequence.
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And so they're just like any other approach.
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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.
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And there are other places that are much more, there is more flexibility and it's just different than other approaches.
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So it's not necessarily more rigid or robotic than any other recognized traditional treatment out there.
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Another theory is that you have to give up your personal theory of choice to use an evidence -based treatment.
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I just simply don't think that's possible in the sense that as you train to be a therapist,
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You're normally trained in one or two models that you closely identify with.
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You learn to see people and problems through those lenses.
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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,
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and that the evidence -based treatments inform that.
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Another common myth is that researchers agree on what constitutes the research or the evidence -based for the field.
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And there are actually multiple strands of research, and I describe these in some of my chapters in the books associated with this series,
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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.
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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.
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Again, that is simply not true.
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Cognitive behavioral therapies have the most recognized evidence -based treatments associated with them but they certainly don't have it for everything.
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And for example, with teenage conduct and substance abuse disorders, there are systemic structural approaches are really,
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the research shows, are the primary approach for those.
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And EFT is another wonderful example of where it's not a CBT.
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It is a more humanistic approach, and it has a very strong evidence base associated with it.
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So no, not every evidence -based treatment is cognitive behavioral.
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And cognitive behavioral therapy is not evidence -based treatment for every possible presenting problem.
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And then finally, the last myth is that standard practice is up to date.
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And so you'll hear some therapists say, well, we've been doing it this way for years.
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It's been good enough till now.
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Both in physical medicine and in psychotherapy, what constitutes standard practice has historically been about 17 years to 20 years,
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depending on what study you're looking at, behind the current evidence base.
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So standard practice is typically about 20 years behind.
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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,
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would like to narrow that gap.
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And that's a major priority, both in the fields of physical health as well as mental health and behavioral health.
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And so that is an overall goal.
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And some of what these evidence -based treatments are trying to
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do is to make the current evidence base more readily available to the everyday practitioner to close the gap
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so that standard practice is closer to the current state of knowledge in the field.
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And for the rest of this lecture, we're going to focus on introducing you to emotionally focused couple and family therapy.
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In a nutshell, the least you need to know.
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So EFT originally actually began with the work of Sue Johnson and Les Greenberg, and
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each has kind of focused on their own variation with Les Greenberg working more with individuals
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and Sue Johnson working more with couples and families.
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And so this workshop is really going to focus on the later work of Sue Johnson, although So certainly
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Les Greenberg and Sue Johnson started out with these ideas together.
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And EFT is an integrative approach that combines attachment theory,
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experiential therapy theory, and systems theory.
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And you'll see all three of these in action together.
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And the focus really is on conceptualizing couples and families as emotional systems systems that have both interpersonal and intrapsychic processes,
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systemic processes that interrelate and interact.
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And if you've listened to the systemic lectures in this series, you will recognize the interactional sequence.
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And so Sue Johnson focuses on the interactional sequence between couples and families, has found very easy ways to actually assess these,
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are relatively easy compared to maybe some of the traditional approaches and conceptualizes it using attachment theory as well as experiential.
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And so you will see many of the traditional elements of a systemic approach adding in attachment theory with some humanistic elements,
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particularly in how she intervenes.
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And so most of the research with EFT has been conducted with couples.
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This has been extensively researched with couples for over three decades.
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But many of these principles can also be used in family therapy, and it definitely has been studied with families,
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but most of the research has been with couples.
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And it's one of the two readily identified evidence -based treatments for distressed couples,
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this along with integrative behavioral couples therapy.
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Those are the two primary evidence -based treatments for couples.
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So next we're going to talk about the juice,
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which is one of the most significant contributions of this theory to the field of mental health in general.
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The one thing that
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Sue Johnson does in this EFT theory that is truly unique is that she
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She has applied attachment theory, which has primarily been used with infants and young children from one to three,
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one to five, and applied that theory to adult love.
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She is really a leader in this area of applying attachment theory to adults and developing an intervention based on this.
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As you may recall from some introductory psych classes, attachment research and attachment theories about both the physiological, emotional, and survival needs.
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that we've always known, or have known for a very long time in psychology,
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let's say, that an infant needs to literally physically survive in this world.
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And Sue Johnson is a leader in identifying adult attachment theory,
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in that adults have the same need for secure relationships, to feel emotionally safe, to help them regulate their emotions,
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and for adult health.
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And there's a lot of evidence also that shows that adults really do need to have secure attachments to,
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it enhances both their quality and length of life.
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And so this has been an exciting place both in physical as well as mental health research looking at adult attachment.
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And the whole heart of her theory is based on this conceptualization,
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this understanding understanding that adult attachment is as necessary in couple relationships as the primary driving factor in understanding couple relationships.
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It helps to make sense of what is often very confusing when we look at couple relationships.
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Next let's talk about the big picture, an overview of what treatment looks like in EFT.
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Now, as you may remember, EFT is an evidence -based treatment, and you may recall it is manualized.
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And so yes, there are very concrete stages and steps that go with EFT that help the therapist navigate treatment,
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monitor progress, and basically structure the treatment as efficiently as possible.
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So it's this outline that is used in the evidence -based studies.
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So in the first stage is the de -escalation of the negative cycle, and this involves four different steps.
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The first step is for the therapist to create an alliance and identify the attachment struggle with the couple.
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And so this is kind of developing a very important therapeutic alliance that will be relied on quite heavily,
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as you see, because it is a very emotionally intense approach.
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And so the therapist has to create an extremely safe therapeutic environment for the couple or all members of the family.
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And so that's a very important process.
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Then the next step is to identify the negative cycle.
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And this is basically tracking the interactional sequence, which we do in the more traditional forms of systemic approaches.
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Very similar tracking that systemic interactional cycle.
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Step three is accessing unacknowledged emotions and positions.
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We'll be talking about secondary emotion and primary emotion.
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The secondary emotions are the ones we most readily recognize.
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We're angry, we're frustrated, we feel attacked, we feel defensive.
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Those are the secondary emotions.
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Those are usually the first ones that are readily identified by the couple or family when they're presenting the problem.
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Then you'll see there's a period where you go and you track the primary emotions, and those are the attachment -based emotions.
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That's the longing for connection, the wanting to feel safe.
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Those emotions then get tracked.
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So first you identify the negative interaction cycle, both in terms of behaviors as well as what is called secondary emotion.
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And then you go back through and you track the primary attachment emotions underneath that.
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And then finally in stage one, you reframe the presenting problem that the couple has in terms of attachment and the negative cycle.
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And to a certain extent, this externalizes the problem instead of,
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you know, the problem is that my wife nags or the problem is that my husband withdraws.
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Now in step four, we get the couple to see, and I'll use couples as the primary example,
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that the problem is not his or her behaviors,
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but that the couple has a very negative interaction cycle that they get into.
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And when they get into this, it triggers their attachment fears.
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And so they get into these kind of survival positions in order to kind of manage the threat
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to what feels like that their partner's no longer a safe attachment figure, essentially.
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So basically, this negative interaction cycle happens when one or both partners begins to perceive the other as no longer being safe.
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Then in stage two is where you begin to change this negative interaction pattern and create emotional engagement and emotional safety.
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You repair the attachment or strengthen the attachment for the couple or family.
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So typically, you go through step five, six, and seven you start with partner who tends to withdraw.
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I think this is one of Sue Johnson's most brilliant contributions.
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It must have come out through the research because I don't think it's intuitive.
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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.
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Because the pursuer is usually the one complaining,
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most of us naturally start with the one who's complaining because the withdrawer will often not have too many complaints.
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And what Sue Johnson has found is that
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if you begin with the person who is withdrawing from connection and you reengage that person, you make them feel safe again,
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you make them feel present, then the pursuer doesn't need to pursue because the other person's open and available emotionally.
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And so she generally will begin this process with the person who tends to withdraw more in the interaction sequence,
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get them re -engaged, and then work with the pursuer.
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Step five is you promote the identification of disowned attachment needs.
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That's working first with the pursuer,
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then with the pursuer, on identifying their attachment needs and expressing those to their partner in an open,
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direct, congruent way.
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Then in step six, you promote the acceptance of that partner's experience by,
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for example, the withdrawers expressing, we'll say, his needs.
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Then his partner would need to acknowledge and accept that.
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And then step seven is having direct expression of the needs while strengthening attachment.
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And so you would do this with both partners as often as necessary to get them kind of reconnected
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and out of that negative interaction pattern.
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And then in stage three, you're facilitating new solutions to those old problems.
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And in step nine, you consolidate the new positions and attachments.
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And this does not happen in a perfectly linear way.
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Most clients are going to move back and forth.
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It's more fluid than the nine steps.
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It's not literally a checkbook thing.
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But this is generally the basic progression and how therapists conceptualize and move through and track progress.
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And because of this very clear outline of the therapy process, it's very clear when
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therapy is not progressing or it isn't working
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because you can see you're stuck in stage three or four
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and you're not moving past or moving into the next step or stage.
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And so in EFT, there are three primary therapeutic tasks.
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The first is creating and maintaining the therapeutic alliance with both partners or all members of the family,
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which is extremely challenging when working with couples and families in such an intense and intimate way.
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The second task is assessing and formulating emotions, so understanding that primary and secondary level of emotion and how they're interacting.
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And then the third task is restructuring the problem interaction cycles that the couple or family is stuck in.
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So those are the three critical tasks that are the focus of EFT treatment.
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So now we're going to move on to making connection and developing the therapeutic relationship in EFT.
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And overall, you'll notice that the relationship in this approach is very much grounded in humanistic
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principles and it requires a lot of the therapists.
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It's a very actually intense therapeutic relationship.
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If you get a chance to watch
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Sue Johnson in action or any EFT therapist in action,
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you will notice that there's a very particular therapeutic relationship and
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that the therapist is exceptional in terms of empathic attunement with the client and expression of empathy.
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And often you will notice that the therapist speaking and engaging the clients in a very particular way.
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And so EFT is not an approach where the therapist kind of remains aloof, emotionally detached.
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The therapist is right there with the client feeling and tuning into not just the surface level emotions,
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but those very primary attachment needs and putting into words these very primary attachment needs
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that often the client almost experiences without language sometimes.
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The therapist is sometimes putting this into words for the client for the first time.
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The approach very much relies on a lot of the principles that
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Carl Rogers introduced, such as genuineness and acceptance of the client.
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The therapist will often use self -disclosure just like other humanistic therapists as a way to talk about emotion,
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share about emotion, help clients explore emotion.
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And because it is an extremely intimate and emotionally intense relationship, there is a constant monitoring of the alliance,
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making sure that the therapist is both aligned with all members of the therapeutic system,
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so each of the partners and are all members of the family system.
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There is still a concept of joining the system, learning to talk and interact in ways that are comfortable for them.
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And the therapist's role is very much that of not just being empathetically attuned,
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but helping the clients learn how to work with these very difficult emotions that we all have in our most intimate relationships.
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I mean, anyone who's human, I think, has been paying attention.
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But our relationships with family and partners are both some of the most wonderful
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and some of the most deep and painful emotions one can experience.
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And so the EFT therapist is right there with clients in all of that in a very intense and intimate way.
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So next we're going to move on to talking about the viewing, case conceptualization, and assessment in EFT.
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And here you're going to see a lot of the attachment theory as well as the systemic case conceptualization
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that they use to understand the dynamics and where couples and families get stuck.
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So in EFT, they are very conscious about assessing both intrapsychic, how individuals are processing their experiences,
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particularly focusing on key attachment -oriented emotional responses, so their attachment patterns, as well as looking at the interpersonal,
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interpersonal, interactional patterns about how two partners or a family organize into both negative and positive interaction cycles.
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And so the therapist is constantly monitoring what's going on within the individuals emotionally,
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as well as how they are interacting to create the broader systemic dynamics.
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So primary and secondary emotions, as I mentioned earlier, play a significant role in the conceptualization in EFT.
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So as I mentioned earlier, primary emotions typically represent attachment fears and needs.
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So these are usually softer, more vulnerable emotions.
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You fear abandonment from somebody else.
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You want to be attached.
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You're afraid to show your true self to somebody else.
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These are generally very vulnerable emotions and fears of being rejected and also the fear of needing someone.
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For a lot of people, that's a very scary to acknowledge that you need someone else to be okay
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or that you have a sense of being okay, that you want someone else and that you need them at that emotional attachment level,
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especially for those who come from cultures where there's a sense of independence and I can take care of myself,
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I don't need someone else.
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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,
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I don't need anyone else.
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And so these emotions can be particularly difficult to just recognize because of social cultural norms.
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The secondary emotions are our emotions about the primary emotions, and they often take the form of anger, frustration, withdrawal.
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And so these secondary emotions allow you to not feel the sense of vulnerability associated with those primary emotions.
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And so if you can get angry and frustrated, you don't feel the scarier emotions of being vulnerable,
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of being abandoned, that often feels worse.
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So we tend to be more conscious of these secondary emotions.
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And so early on in therapy, we track, like I mentioned, the secondary emotions because that's what the clients initially present.
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And once that becomes clear and those patterns are clear,
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then you can go back in and try to begin to identify and have clients identify with those more primary emotions,
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which are much more difficult to access for most people.
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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,
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they assessed a negative interaction cycle and sue johnson does this also in eft
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but the way she does it is quite frankly a bit easier because she focuses on ultimately
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If you conceptualize around adult attachment needs, there is one partner who's pursuing for attachment and another person who's withdrawing.
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And that's the basic dynamics, at least at how relationships start.
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And this still fits with traditional systemic theory
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that the pursue -withdraw has always been viewed as there's only a certain amount of intimacy a given couple can tolerate.
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And so that even when we were looking at first and second order change, you can flip who's pursuing and withdrawing,
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but the same level of intimacy is generally tolerated.
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It takes a major second order intervention to shift how much intimacy can be tolerated within the couple.
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So typically, the pursuer protests any type of separation or distancing relationship.
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And so this tends to be associated with a more anxious attachment style.
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And so the emotions that this person typically feels is feeling hurt, feeling alone, and feeling unwanted by their partner.
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The withdrawer tends to distance, protect himself from whatever perceived lack of safety that they're seeing in the relationship.
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And this person tends to have a, this is typical of the avoidant attachment style well.
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This person typically feels rejected, inadequate, or judged by the pursuer.
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And so you typically get that pattern.
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It is possible, particularly one of the partners has been traumatized, that they can actually flip roles in the cycle.
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And so you get almost like a figure eight, I think of it.
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But one pursues and the other distances, and then as part of their cycle, that actually changes and then that flips around.
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And then they actually flip roles within the same kind of argument or cycle that they go through.
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That tends to be indicative of trauma, according to Sue Johnson's research.
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But you can just, if you just track this pattern, and this is the basic pattern,
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who's pursuing for closeness and who's withdrawing. And this can change.
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I always like to joke that typically you can assess this relatively quickly because usually
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Usually it's the pursuer who's calling to set up therapy appointment, unless the pursuer just threatened to force,
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in which case the withdrawer would be picking up the phone to call you.
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But that's generally, I joke about that, I say that jokingly, but I encourage you, if you use this approach,
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to consider that as you take your intake phone calls and tell me if that seems to match up with your experience,
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because that's been my experience.
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So early on in the therapeutic relationship, the EFT therapist will do an attachment history if they're working with a couple or family.
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And often this is done in individual sessions.
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Usually there's a single individual assessment with each partner.
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And what they try to get is a sense of what
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was their attachment like with their primary caregivers as an adult and as adolescents,
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an intimate relationship that they had in their early dating years or wherever their dating years, whatever phase of adulthood they're in.
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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.
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What has been in particular that person's experience in terms of secure attachment, avoidant, and anxious attachments.
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And so as part of this, you're looking for how accessible were the other people,
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how How responsive and how engaged are they used to experiencing in their intimate relationships?
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Another thing that EFT therapists assess for is something that's called an attachment injury.
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And they're looking for a significant attachment event.
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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,
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that the other partner did not offer support in this moment of particularly high need.
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This is a very specific type of betrayal or abandonment or a sense of violation in the relationship.
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This fundamentally redefines the relationship for the injured party as unsafe.
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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.
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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,
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but it's also something assessed for early in the relationship to get a sense, because that needs to be repaired,
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and yes, they have a specific process for that.
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But that's something that they're assessing here and repairing this
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if it needs to be in order before they can move into the more intense work of the second stage.
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So in terms of the initial assessment sessions, which I alluded to a couple slides ago,
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is that there is an initial assessment to just make sure the couple is appropriate for EFT.
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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.
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So in the conjoint session, you're assessing for both the perceptions of problems in the relationship as well as strengths.
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You're looking for both the negative and positive interaction cycles.
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You're looking at the key relationship history and key events, including those attachment injuries.
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And you're getting a very brief attachment history for each partner.
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Then typically, if all looks good there, they would move on to an individual session.
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You can take one session divided in half or have two full one -hour sessions with each.
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But you're assessing for each partner's commitment to the relationship, the potential for past or current affairs.
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You're trying to get a trauma history as well as a detailed attachment history, screening for violence and such,
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but just overall making sure that they are appropriate for the EFT process.
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So there are contraindications to EFT.
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So this means, and through the assessment, if a therapist discovers some of these key elements that they would not proceed with EFT.
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So EFT is not for every couple that walks in the door.
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So one is if the couple has different agendas for the relationship in therapy.
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So if one member of the couple is really ready to end the relationship or mostly out the door,
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this may not be an appropriate treatment for them.
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This takes someone who's really committed because you have to be vulnerable and that takes a high level of commitment.
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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,
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maybe I'll give it one last try, but I don't think there's much of a chance.
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That's probably not it.
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And they're the right couple for this because this does require quite a bit of commitment from both parties.
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If there's any type of physical or even emotional abuse, then EFT is not indicated,
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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.
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And so the therapist really needs to, doesn't just jump right in and start with EFT,
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but make sure that the couple is well suited and appropriate for the treatment.
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So once the therapist has assessed the couple, then the next process is to set the goals for treatment.
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Now, as an evidence -based treatment, EFT has some very basic, consistent, overarching goals, because after all,
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most of the people using this approach are using it for the similar population.
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So the first is to create a strong, secure attachment for both partners.
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The second overarching goal is to develop new interaction patterns that are nurturing and supportive for each partner.
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And then third basic goal is to increase direct expression of emotion, especially those related to attachment needs.
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So those are direct expression of primary emotions.
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So next we're going to talk about interventions in EFT, the doing.
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So as an evidence -based treatment, the link between specific goals and interventions is much closer than many other approaches.
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And there are actually certain interventions that are used in each phase, and some of them are used differently across phases.
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So in this early phase of intervention, when you're de -escalating and identifying the problem interaction cycle,
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there's a lot of validation of each person's experience and their emotions.
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There's a lot of reflecting of emotions and helping clients identify both the secondary and the primary emotions.
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There is a lot of tracking of the cycle.
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This can be done in multiple ways.
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This is my insight as to realizing that there is quite a bit of flexibility.
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If you look at other systemic approaches, many of them are more limited.
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And in EFT, they don't care if you track the interactional cycle on a single event,
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on a general hypothetical event, or a typical event.
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But they're just tracking the cycle.
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You can do it more behaviorally.
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You can do it with circular questions.
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You can do it more solution -oriented using the video talk questions.
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You can do it any way that makes you happy.
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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,
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rise in tension, the conflict or symptom, and then how they get back to homeostasis again.
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And so you're tracking that cycle, whatever it looks like, and you can do it behaviorally.
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And then you will certainly, in one of your passes through the cycle, look at the interaction of the secondary emotions.
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And then ultimately, the goal is to go through and track how the primary emotions are underlying this cycle.
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Evocative responding is responding in a way that evokes deeper emotions, often primary emotions.
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And then empathetic conjecture is where you might offer up in a tentative way,
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you know, might you have been feeling rejected at that point when you were looking so angry?
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And so that empathetic conjecture is used to help clients identify both their primary and secondary emotions.
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Then in the working phase, again, you're going to see these are interventions that are used to restructure their interactions.
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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.
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The empathetic conjecture, helping them to identify by tentatively putting out some possibilities for the emotions
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that might be both primary and secondary emotions that might be fueling the interactions.
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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.
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Vocabulary and speaking notes for this lesson
This speaking lesson is built on the video “Emotionally Focused Therapy with Dr. Diane Gehart”. The speaker keeps coming back to these words: couple, attachment, emotion, eft, treatment. This video has 418 sentences and 6088 words to shadow. The speech runs for 41:21. The speaker talks at a steady 147 words per minute, a comfortable pace for shadowing. 82% of the words are among the 3,000 most common in English; the rest is worth studying before you start.
Key vocabulary in this video
15 words from the video worth learning, with pronunciation and meaning:
| Word | Pronunciation | Meaning |
|---|---|---|
| attachment noun | /əˈtæt͡ʃmənt/ | The act or process of (physically or figuratively) attaching. |
| emotion noun | /ɪˈməʊ.ʃən/ | A person's internal state of being and involuntary physiological response to an object or a situation, based on or tied to physical state and sensory data. |
| therapist noun | /ˈθɛɹəpɪst/ | Someone who provides therapy, usually professionally. |
| interaction noun | /ˌɪn.təˈɹæk.ʃən/ | The situation or occurrence in which two or more things act upon one another to produce an effect; the effect resulting from such a situation or occurrence. |
| assess verb | /əˈsɛs/ | To determine, estimate or judge the value of; to evaluate; to estimate. |
| systemic adjective | /sɪˈstɛm.ɪk/ | Embedded within and spread throughout and affecting a whole system, group, body, economy, market, or society. |
| intervention noun | /ɪntɚˈvɛnʃən/ | The action of intervening; interfering in some course of events. |
| therapeutic adjective | /ˌθɛɹ.əˈpjuː.tɪk/ | Of, or relating to therapy. |
| myth noun | /mɪθ/ | A traditional story which embodies a belief regarding some fact or phenomenon of experience, and in which often the forces of nature and of the soul are… |
| emotionally adverb | /ɪˈməʊʃənəli/ | In an emotional manner; displaying emotion. |
| withdraw verb | /wɪðˈdɹɔ/ | To draw or pull (something) away or back from its original position or situation. |
| behavioral adjective | /bɪˈheɪvjəɹəl/ | Of or relating to behavior. |
| impressive adjective | /ɪmˈpɹɛsɪv/ | Making, or tending to make, a positive impression; having power to impress. |
| assessment noun | /əˈsɛsmənt/ | The act of assessing or an amount (of tax, levy or duty etc) assessed. |
| intense adjective | /ɪnˈtɛns/ | Of a characteristic: extreme or very high or strong in degree; severe; also, excessive, towering. |
Phrasal verbs you will hear
| Word | Pronunciation | Meaning |
|---|---|---|
| go through verb | To travel from one end of something to the other. | |
| come out verb | /ˌkʌm ˈaʊt/ | To be discovered; to be revealed. |
| get back to verb | Return to (an activity) | |
| give up verb | To surrender (someone or something); to inform on (someone). | |
| go back verb | To return to a place or state after having been there at a previous time. | |
| go over verb | To look at carefully; to scrutinize; to analyze. | |
| move back verb | To reschedule (something) to a later date or time. | |
| move forward verb | To cause to make progress. |
Sentences worth repeating
Short, complete lines from the video that you can reuse in everyday conversation:
- We'll be talking about secondary emotion and primary emotion.
- I don't need someone else.
- I don't need anyone else.
Grammar in this video
The structures the speaker uses most, with the exact words from the video:
| Structure | In the video |
|---|---|
| Present perfect continuous have/has been + -ing — an action that started earlier and is still going on | we've been doing · has been paying · you've been following |
| Conditional sentences if + clause, will/would + verb — a condition and its result | if all looks good there, they would move |
| Present perfect have/has + past participle — a past action that still matters now | have been designed · It's been · has historically been |
| Passive voice be + past participle — the focus is on what happens, not who does it | are manualized · is designed · be trained |
Pronunciation to watch
The speaker uses 75 contractions and reduced forms, such as you're, they're, don't. Say them the short way, as you hear them.
- The “th” sounds: therapist /ˈθɛɹəpɪst/, therapeutic /ˌθɛɹ.əˈpjuː.tɪk/, myth /mɪθ/, withdraw /wɪðˈdɹɔ/, threaten /ˈθɹɛt.n̩/
- The “sh” and “zh” sounds: emotion /ɪˈməʊ.ʃən/, interaction /ˌɪn.təˈɹæk.ʃən/, intervention /ɪntɚˈvɛnʃən/, emotionally /ɪˈməʊʃənəli/, contribution /ˌkɑntɹɪˈbjuʃən/
- Long words — get the stress right: interaction /ˌɪn.təˈɹæk.ʃən/, intervention /ɪntɚˈvɛnʃən/, therapeutic /ˌθɛɹ.əˈpjuː.tɪk/, emotionally /ɪˈməʊʃənəli/, behavioral /bɪˈheɪvjəɹəl/
How to practise with this video
- Listen to the whole video once without speaking and note the words you do not know.
- Shadow it sentence by sentence at normal speed, repeating each one until your rhythm matches the speaker.
- Record yourself and compare with the original, paying attention to words like attachment, emotion, therapist.
What is the Shadowing Technique?
Shadowing is a science-backed language learning technique originally developed for professional interpreter training and popularized by polyglot Dr. Alexander Arguelles. The method is simple but powerful: you listen to native English audio and immediately repeat it out loud — like a shadow following the speaker with just a 1–2 second delay. Unlike passive listening or grammar drills, shadowing forces your brain and mouth muscles to simultaneously process and reproduce real speech patterns. Research shows it significantly improves pronunciation accuracy, intonation, rhythm, connected speech, listening comprehension, and speaking fluency — making it one of the most effective methods for IELTS Speaking preparation and real-world English communication.