EFT – It Starts From Within…the Self-of-the-therapist

I‘ve heard some therapists say that learning EFT dramatically changed the way they work with couples and improved their clinical skills in the process. The EFT model calls us to walk into the emotional waters with our couples to help them experience and understand how they get caught in chronic negative cycles.

For some clinicians, taking our clients deeply into their emotional experience can be a challenge.

For me personally, it has taken some real soul searching and a willingness to explore personal blocks and vulnerabilities. Stepping into the role of process consultant has been challenging in the couples arena. Learning EFT requires us to become comfortable addressing affect in the room as it unfolds moment by moment.

I decided to write this blog post to hopefully offer some insight to some of what I have learned about the importance of addressing some of my own challenges in becoming an EFT therapist and the importance of use of self in EFT.

Judy: I am really tired of not being able to reach you. All I want is to know what you are feeling. I just don’t feel supported or cared about. It’s like you’ve left the marriage. I might as well be living by myself. (She crosses her arms firmly and turns her back to her husband, Ken.)

Ken: (He sighs and slumps deep into his chair. He responds in almost a whisper.) What? Yes, I do. It’s just…

Judy: (Her face flushes red, her eyes squint and brows furrow.) That’s just great. This is hopeless. You don’t love me or even want to be around me. I just can’t stand you sometimes. What are we even doing here?

Comment: The therapist in the room shifts uneasily in his chair. Inside he feels the torrent of angry energy unleashed in the room. His body tenses and breathing becomes shallow. He feels almost blown back by Judy’s anger. He becomes aware of tightly clutching one arm of his chair. He senses a sinking feeling in his stomach and an urge to run. Thoughts rush in, “This is a mess. Where do I go next? I’m feeling a bit confused and thrown off. She’s really angry and he doesn’t seem to want any part of this.”

Therapist: Can we slow things down for a minute? (He physically moves his chair back.) Let’s back up.

Comment: In a split second, the therapist moves to his own internal felt sense and says silently to himself, “OK, slow down. Let’s sort this out. Take a deep breath.” He notices a feeling of hopelessness and deep sadness located in his stomach. “Judy’s anger is there for a reason. What must it feel like to be in Judy’s body right now? It seems she is desperately trying to reach Ken and is fearful of not feeling connected to him. Her anger communicates her attachment alarm bells are ringing. She is unable to find reassurance from Ken and feels scared and alone. This is a familiar experience for her.”

Therapist: Judy, this seems so hard for you. It’s like your reaching your hand out to find Ken and he isn’t there. You can’t find him and his unresponsiveness is sending you a strong message. A message that appears to leave you feeling angry and hopeless. Do I have that right?

Judy: Well, yes. I am very alone. He’s so distant and doesn’t seem to care if I’m here or not. I am beside myself. (She pushes her hands out and up over her head.)

Therapist: Alone, yes. That makes sense that you would feel that way if you are reaching for him and unable to find him. Can you tell me more about what it feels like when you get to this place of being beside yourself? Can you feel that now?

Judy: Oh, I don’t know. It’s just hard.

Therapist: Yes this must be a very hard place. When I imagine being beside myself, I am probably quite upset and feeling pushed to the limit. I might even strike out in anger in an effort to get someone’s attention. I keep pushing and it just doesn’t seem to work. I want to throw up my hands. Does this fit?

Judy: Yes, that’s it. I hit a brick wall and I throw up my hands. I can’t seem to get through. (Judy softens and starts to cry.)

I’m certain some version of the above scenario plays out daily in couple therapy sessions around the globe. There are often times when we find ourselves triggered and left scrambling (much like the therapist above) to get back on track. The fact is, working with couples can prove to be quite a complex endeavor, especially in EFT.

The therapist must be aware of all that happens in the intersubjective arena – meaning having awareness of the inter-relational patterns between – the partners, each partner and the therapist and also the therapist and the couple as a unit.

Because of this stance, we are highly susceptible to vulnerabilities (or “internal noise”) that can impact our attunement and empathic connection. Some of this “noise” may include the therapist’s attachment history, cultural background, current life stressors and intrapsychic dynamics.

Most importantly and possibly the most challenging is the EFT therapist’s personal experience and perceptions about emotions. As Sue Johnson says, our job is to remain focused on the emotional music playing within and between the couple and how this communicates the attachment needs and longings of each partner. To accomplish this, we must be present and help the couple remain connected to the unfolding process that occurs between them keeping what clinical psychologist David Wallin, author of Attachment in Psychotherapy describes as binocular vision – having one eye on our clients and one on ourselves.

It’s the one eye on ourselves that we are talking about here – the self-of the therapist.

As implicit regulators of the couples’ affect in the therapy room, it is important that we are aware of our internal biases and perceptions that may be activated within the treatment process. Our own attachment system and the proclivity we have regarding distancing or pursuing strategies are important to consider.

If we fall somewhere outside the secure attachment spectrum, we must know how this can impact or bias our work with each partner. For instance, if I know I have tendencies towards a more avoidant attachment then I know that working with high conflict couples may trigger anxiety and the desire to move away from the “hot” emotions and more toward dampening strategies – i.e. performing a quick emotional bypass as I did in my family of origin.

My instinct may be to dig into my bag of therapeutic tricks in an attempt to get things back on track. In my family of origin, getting things “back on track” was always code for “calming everybody down”.  In session, this may look like moving toward content and into a “teaching moment”, offering psychoeducation or explaining.

When working from an EFT stance, I have to continuously ask myself to what extent am I in touch with my bodily sensations, emotions and am I attuned and actively reflecting the client’s emotional experiences. I do this by checking in and using my own emotional experience as it is generated.

Working with our client’s emotional expression and experiences automatically cues our own arousal system. As emotions are communicated to us (i.e. through tone of voice, rate of speech, volume, body posture or facial expressions), we may experience physiological symptoms like increased heart rate, perspiration, rapid speech, etc. and feel an urge to either fight, take flight or freeze. This response can take us away from the important moment-to-moment emotional work with the couple. In instances like these we need to be able to identify ways to practice self-regulation strategies and get ourselves back on our emotional feet.

It is especially important to know our own window of tolerance and to have a practice or strategies that we can readily connect with in session like:

  • Use of compassionate self-talk – (e.g. “You’re doing fine. Remember, you don’t have to have all the answers. Just stay curious. You can always slow things down.”)
  • Mindful breathing – I like to focus my attention down on my belly and take a few deep inhalations saying to myself “soft” as I breathe in and “belly” as I breathe out. As I do this, I envision my abdomen becoming soft and open. Relieving the tension and tightness that accompanies my anxiety. (This is something I learned from Dr. James S. Gordon from the Center for Mind Body Medicine);
  • In the moment visualization – I sometimes visualize multiple sets of arms wrapping around me in a warm embrace. Any visual that brings with it a calming sense may be effective in shifting out of the amygdala’s fight, flight or freeze response.
  • Modeling transparency – Slow things down by saying something like, “Can we slow down for a minute? I am not sure I have things straight here. Can you help me? “
  • Highlighting emotion – Sue Johnson suggests that one might return focus to the most recent emotion expressed in the room and highlight that as an entry back into the present moment. For example, “Husband, I noticed a moment ago when wife said X, you appeared angry. Can you tell me what was going on for you in that moment?”
  • Remain curious –Remain curious and maintain in a non-expert stance.

These have all been quite helpful on occasions when I have found myself triggered and disconnected from the process.  It is through our continuous learning and self-exploration in and outside the therapy room that will help us maneuver through these challenging waters and continue to grow as EFT therapists to provide positive experiences and outcomes for our clients. David Wallin, from Attachment in Psychotherapy, reminds us that, “We are the tools of our trade, the primary creative instrument with which we do the work.”

In EFT, it’s not just showing up, it’s how we show up that makes the difference.

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