More than most psychotherapists that I know, I am indebted to psychoanalytic roots. I personally love the study of unconscious dynamics, psychodynamic conflict, transference/countertransference, dreams, and object relations, to name just a few fertile areas of psychoanalytic thought. However, as a therapist who typically works in a once or twice weekly model, I also have the therapist’s committment, as distinquished from the five times per week psychoanalyst, to accurately distill what is most essential in psychological theory for effective positive change/growth in our patients lives.
As most other current day therapists, I have long believed that it is relationship that heals. Said differently, since emotional problems are created in relationship, it makes sense that they are healed in relationship. To distill things further, it is attachment that provides the skeletal foundations to relationship. Perhaps it is a bit of an overstatment, but not by much, to say “so goes attachment… so goes relationship.” What this understanding suggest is that an effective working with deep attachment dynamics is the surest way to bring about the deepest therapeutic change, whether it be with individuals, couples or groups.
Though I honor my psychoanalytic roots with ongoing deep attention to unconscious transference and countertransference dynamics, I count myself among that minority of therapists who believe that the therapy relationship is itself, a deeply real relationship; it is every bit as real, often more real, as our patients have in their outside lives. It is my understanding that human beings have a particular ability to make deep human contact every bit as real anywhere else in their lives, even though the context for the interaction is professional fee-for-service. Perhaps akin to the “willing suspension of disbelief” that occurs in the appreciation of literature/movies/plays/video games/virtual reality, the human attachment with the therapist is fully real at a deep psychological level. From this perspective, when either patient or therapist minimize the therapy relationship because “I pay you” or because “I only see you an hour or two a week” they in fact are engaging in “attachment defense” likely analogous to how they defend against attachment wounds in their life generally.
Amidst a conversation with Nancy Aikin PhD & Paul Aikin PhD of Davis CA, the topic of “shame” came up, especially the question as to whether shame is a primary emotion or a secondary reactive emotion.
Nancy made a very intersting point; that shame is reactive because it emerges from “fear of reaching out.” Upon reflection, this view is compelling because… every situation of shame that I am aware of in patients and friends is hugely helped by vulnerable reaching out to others who are empathically safe. This fits with a generally understood distinction between shame and guilt; that guilt results when we view ourselves to have caused hurt/suffering to others, whereas shame is connected to how our behavior or very being appears deficient/negative/bad in the eyes of others watching on (or potentially watching on). That our reaching out for reassurance or expression of need would be met with disregard, coldness, correction, criticism, punishment, disdain, or contempt. A question… is shame the inevitable feeling when we cannot reach to other for fear of such consequences?
As I have recently steeped myself in the attachment literature on marriage I am reminded once again of certain fundamental understandings regarding the marriageofopposites. One such understanding is that the pursuer’s escalation into anger/rage is founded upon a desperate seeking of positive attachment reasurance and is not, at base, a desire to hurt anyone. When the pursuer encounters emotional walls in the distancer they enter into an internal crisis within themselves regarding their inner feeling of attachment safety; even mild walled-off-ness can evoke within the pursuer, often unconsciously, a sense that love has gone away and nothing of emotional connection remains. Their confrontive escalation, which often begins is a toned-down fashion but can quickly escalate when met with defensiveness, is simply an attempt to “shake the other person” into their “proper” emotional attachment senses, and come forth with concern, warmth and empathy. Of course, it all plays out terribly wrong and damage ensues for both partners, but that is not the fundamental intent.
There are some aspects of EFT that remind me of just good general marital therapy practice. And then there are additions.
First the commonalities. First, slow the couple down as they begin to escalate with each other in the session. This is necessary in order to even begin the work. Second, describe back to the couple their interactive process as they begin to escalate. “When he said this you felt what? And then you responded with this… and when she did this, you felt what and responded with this. Then you reacted with this, and then you reacted with yet this. And so on.” This describing and taking-apart-the-process generally calms things down as the couple sees they are caught up in interacting that is bigger than the particulars, allows an initial taking down of personalization and polarization. This process begins to “unpack” or “deconstruct” the locked-in, enmeshed conflict and fight. Both this describing back to the couple their enmeshed process and the unpacking of that process is common to most approaches to couples therapy.
Perhaps what is different from most schools of thought is the way that the eft therapist then deliberately goes into the individual internal process of one or the other partner, while the other partner watches on. And how often the first in-depth focus is on the more distanced, emotionally avoidant partner, often engaging the pursuing partner only long enough to calm things down to then bring forth the avoidant partner. Sometimes, at that point, much of the hour is spent exploring and “unpacking” the upper and middle layers of the avoiders feeling intimidated, fear, hopelessness, closing down, hurt, wishing it was different but helpless to make it different, etc.
On the face of it, the going into the individual process would strike many as a departure from couples therapy, which many schools of thought view as primarilly interactive. But in actuality, this “unpacking of whats inside of each as they interact” actually addresses the more profound issue of lost empathy and lost emotional connection so powerfully hurting and eroding the marriage.
This steadfast focus on taking apart the layers of individual experience within the context of the marriage characterizes EFT and stands it apart from most other approaches. In posts to follow I will begin to consider how such a process can unfold in highly therapeutic ways.
In this and posts to follow I will be sharing my digested understanding of the impact of Sue Johnson’s Emotionally Focused Marital Therapy approach to my own therapeutic work with couples generally, and the marriage-of-opposites in particular.
To begin with, the attachment model of marital treatment places the establishment of attachment safety ahead of separation/differentiation/individuation. Developmentally this makes sense as the creation of an attachment homebase predates the emergence of separation-individuation in the individual life cycle. The thinking in the attachment research going back to Bowlby is that the internalization of homebase safety is a necessary foundation for a secure moving out into the larger world. While many make their movement into the outer world without a reliable home base, the general understanding is that they suffer a costly attachment wound in the process.
Often in the marriage-of-opposites the therapeutic work begins with a core-styled pursuer’s intense anger at the outer-styled’s avoidant behavior. Not uncommonly the avoider shuts down even more as they recieve the pursuers angry confrontation, resulting in many conflicts going to escalated levels far beyond the original conflict of the moment. Intuitively, many therapists are then inclined to focus upon containment of the pursuers escalative feeling in order to create safety in the room for the avoider. As an initial approach this is probably necessary. However, from the perspective of the EFT approach, to continue with a focus upon the pursuer’s containment or impulse-control deficits is a mistake because the pursuer is reacting to the avoider’s fundamental abandonment of the attachment field-of-play. Hence, the challenge for the therapists is to manage their own countertransference evoked by the pursuers hostility and to nevertheless find their way to focus upon the avoider’s wounded/fearful/avoiding/blaming experience that causes them to crucially check out on an interactive marriage. In focusing much of the early work upon the avoiders inner experience the therapist is doing many things at once; first, this provides the pursuer with a tacit recognition of the legitimacy of their deep hurt related to the avoiders abandonment of connection, second, when done empathically it provides the avoider with a meaningful voice for there fear-based attachment wound, third, it invites empathy within the pursuer towards the avoider’s interior fear/hurt/shame thereby reestablishing an empathic attachment bridge where it did not exist before. Unconsciously, the pursuer has the hope that the therapy will “open up and bring forth” their avoider partner so that “they could then feel attached to them.” Commonly at these times the esclated anger in the pursuer melts away.
