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Emotionally Focused Therapy (EFT) is a robust, empirically supported model for couple therapy (the main focus of this post), family therapy, and more recently individual therapy as well. I've been supervising Master's students (trainees) in the model since 2020. The ideal readership for this post is EFT therapists more than the lay public, even though couple therapy clients and those interested in relationships can also benefit from this post. So, if you're reading this, I assume you're familiar with basic EFT vernacular, as I don't define every term or concept. Here are five key errors and lessons for therapists that my trainees have taught me over the last few years.
1) Not referencing and acknowledging the negative cycle enough: Therapists should use the couple's cycle to help ground themselves and their clients in the session. EFT trainees often get stuck when they don't realize the cycle is controlling each client's behaviors, at least to a degree. The therapist can also get looped into the cycle, too. Out of the cycle, clients tend to feel more autonomous and more empowered to make their own choices in terms of what's best for them and their partners. In other words, the cycle usually restricts the variety of available options and responses to each other that couples can use when they are in conflict. It’s important that therapists point out to clients when they’re in the cycle, and help the couple to notice it. Clients noticing when they're stuck in their cycle is fundamental to their healing. When couples become fiery, tense, or emotionally distant in session and you start losing leverage, you can ask if they want to show you during the session how they argue out of session, or if they want you (the therapist) to intervene more proactively. It's a rhetorical question that's likely to solicit more client cooperation (and welcome your interventions) over time.
2) Trying to go too deep too fast: EFT trainees often get frustrated early when their clients aren't opening up at the speed they anticipated and push too quickly for emotional depth. Trainees are often excited to go deep with clients and want to get there quickly, and can become easily dismayed when it doesn't happen that quickly. This is because emotional depth isn't a choice. Only when clients feel safe enough, and trust the therapist enough, will they risk opening up on a deeper level. So I would recommend that most EFT trainees slow down and focus on identifying and mirroring a couple's blocks and the more superficial (secondary) emotions at first. Over time, clients will open up more as you (the therapist) earn their trust. As the adage goes, "slower is faster." The EFT way to get to depth is by honoring the defenses so much that they naturally and progressively disarm.
3) Not using enough reflection: Greener therapists can become easily overwhelmed by how many choice points there are in every session. Trainees have reported to me that it's not clear what the best response or therapist move is in many of the video clips of sessions they show me. A dirty little secret: Even well-trained therapists, along with very skilled ones, can feel stuck in session. So, often the best way to intervene is reflecting; "when in doubt, reflect" what clients are saying and/or what you're hearing. The important point here is to reflect the emotion and attachment salience behind their words, much more than the content. This can be surprisingly effective and powerful—often a lot more useful than reassuring or trying to fix the problem.
I personally know that I am stuck in a session when I find myself engaging in too much fixing or reassuring, and not enough reflection. Reflection also helps protect the therapist from burnout and overwhelm (as opposed to trying too hard to try to fix clients' problems), and clients almost always appreciate it. It also helps clients to understand themselves and organize their emotions in a way that grounds and emotionally regulates everyone in the session. We have to "name our emotional experience to tame it." With my new trainees, I'm most focused on this skill much more than other, more advanced EFT skills. Good reflections are what create the most attunement and the strongest therapeutic alliances because they best promote feelings of being deeply heard and understood. This is why, in EFT research, clients tend to drop out much less than average.
4) Not using enough RISSSSSC: Despite practicing and knowing that we are doing emotionally focused therapy, I can't tell you how many trainees don't work with much emotion at all. Often, I see trainees moving quickly in session and using a lot of interpretation, analysis, behavioral suggestions for change, and too much psycho-education that keeps clients in their logical brains and slows the pace of therapy. To bond and heal, clients need emotional activation, and emotions are slow to unfold and activate. Thus, RISSSSSC is is an acronym that refers to taking emotional risks to help clients bond and heal, create change, and repair emotional experiences in session. It stands for repetition (r), using images and metaphors (i), using slow, soft, somatic, specific, and simple language (5 s's), and lastly, using the client's words (c). Clearly it goes with #2 above. Using "rissssc language" can be awkward at first, but over time motor memory takes over and it can become natural.
*Note: the acronym EFT therapists will see more in the literature and EFT trainings is RISSSC, but I added two S's to also emphasize somatic and specific. This was influenced by EFT Core Skills training with EFT trainer, Ali Barbosa.
5) Getting lost in clients' content: EFT therapists should stay focused on the process in therapy, not topics of content. The process refers to emotions, their negative cycle, unmet needs, and most importantly what couples are fighting for, not what they are fighting about. What they're fighting about is a trap, and usually the wrong focus for therapists. For example, a trainee was recently working with a couple that was stuck in their sexual relationship. The trainee wondered if bringing novelty to their sexual life could help. Possibly, I replied, but that doesn't address the lack of trust and lack of safety in their relationship, which is what should be the focus. That's what is blocking their sexual bond—the process between them instead of content. Focusing on novelty would likely be what a behavioral therapist would do, or what the couple would find if they searched on Google for improving their sex life. And, of course, we would want therapy to offer more than what they would find in a generic Google search. In this example, EFT is about building a strong bond and breaking down the barriers to connection to facilitate more safety and trust so they can more openly explore and improve their sexual bond.
Conclusion
Overall, trainees can benefit from taking the pressure off themselves significantly, and just focusing on reflecting, validating, and attuning to clients initially. As they do this, along with practicing and reading EFT material consistently and getting good supervision and guidance, their skills will naturally fall into place over time.
I've seen such tremendous growth and improvement with all of my trainees, even the ones that I've had difficulties with. It is so exciting to think of all the relationships we'll be able to help strengthen, improving our communities, our countries, and the world in the next decades.
I want to extend a deep gratitude and appreciation to all of my 10 trainees over the last four years for making this post possible! You've inspired me in a way much more immense than you could possibly know!
