What to Expect in Emotionally Focused Therapy for Couples

Entering couple therapy can be a nerve-wracking experience for most people. They often expect that it will turn into an arguing match and make things worse, or fear that the therapist will choose sides and pass judgments. Whew! That can provoke a lot of dread!

The following article may help ease fears for couples considering relationship therapy. First, bravo for having the courage to consider therapy and work on your relationship! It can be unsettling or even frightening to discuss relationship problems with a therapist, so congratulations on overcoming that fear.

I have two levels of advanced training in and practice Emotionally Focused Therapy for Couples, which is abbreviated EFT.  Go to www.iceeft.com for more information on “What is EFT?”.

What Emotionally Focused Therapy is Not…

To address those common, initial fears: EFT is not designed to encourage excessive arguing or conflict. In fact, the therapist should actively regulate that type of behavior in therapy, because the goal is to make the relationship feel emotionally safer and more connected. (Arguing rarely achieves that goal!) In addition, the therapist generally should avoid showing favoritism, passing judgments, or offering opinions about the future of the relationship, although he or she may gently challenge an individual at times.

EFT focuses on the PROCESS of your relationship, especially the emotions and patterns in the relationship.

Do not come to sessions armed with long lists of faults you want to discuss about your partner. That is not the process used in EFT. Instead, come to sessions with an accepting attitude, a warm heart and as much emotional openness as you can muster. I realize that these can be difficult to generate in the midst of a relationship that may be in turmoil, but please attempt to do so. You’ll have the best results if you do!

EFT is the most-researched and most-effective framework for conducting couple therapy. I truly believe in the effectiveness of EFT and have seen it work well with all types of couples.

WHAT IS Emotionally Focused Therapy?

Emotionally Focused Therapy (EFT) will involve discussing specific incidents that may occur in your relationship, but merely as a way to help each of you learn about your emotions and the behaviors that result from those incidents. For example, we may discuss your partner reminding you to take out the trash and how that makes you feel. Do you feel angry?  What else might you feel? Are you ashamed because you forgot, so that makes you want to lash out in anger? Do you feel judged as “not good enough” by your partner and that makes you feel as if you disappointed her? Does this then make you want to pull away from her?


We will be exploring emotions that you each experience at specific times during your relationship.

The English language has hundreds of words for emotions, but the six main emotions are:

Strong emotions such as anger, sadness and shame often arise at times when one feels a relationship is at risk or when one feels judged and shamed.

SECONDARY EMOTIONS:  Secondary emotions are the emotions most often expressed during an interaction. Anger is the most common secondary emotion in distressed relationships. Secondary emotions push partners away from each other.

PRIMARY EMOTIONS: Primary emotions are deep, tender, unacknowledged emotions such as shame, fear, sadness and loss. Primary emotions pull people toward each other. When partners see the open expression of vulnerable emotions they often feel tender and caring toward their partner and this can de-escalate angry attacks. Most people are unaware of or hide primary emotions.

We are each of us angels with only one wing 

and we can only fly by embracing each other 

– Lucretius


EFT is based on a concept called ATTACHMENT THEORY, originally developed by psychologist John Bowlby in the 1950s. Early research was conducted on how babies bonded with mothers and noted that it is a biological need for infants to feel safe. As social creatures, all humans are born looking toward our caregivers to protect us, feed us and nurture us. This ancient survival code is wired into our brains and actually is our greatest strength. Our ability to team up, cooperate and care for each other has led to the success of the human species. We continue to have this need to connect emotionally and physically with others throughout our lives.

In the research, different ATTACHMENT STYLES were identified based on the mother’s warmth and caring.

1.   A baby who is SECURELY ATTACHED has learned that when she cries a parent responds quickly with warmth, care and reassurance. This teaches a baby that her needs will be addressed in a prompt manner and she will feel safe. A securely attached child believes her parent is available and responsive when she is in distress. The caregiver’s presence helps the infant learn to regulate distress. Eventually, even if the parent isn’t always available, the child will learn to self-regulate. Securely attached children grow into resilient, emotionally healthy adults who can feel trust and vulnerability in relationships and enjoy interdependent relationships.

2.   INSECURELY ATTACHED children do not feel confident that a caregiver will be attuned and responsive to their needs. Insecure attachment can result if a child is raised by parents who themselves are insecurely attached, which may lead them to be harsh, critical, emotionally distant or self-absorbed. It can also occur in cases of trauma, where a child is neglected, abused, harshly punished, witnesses violence or abuse in the home, is exposed to substance abuse, is exposed to crime, or just has a chaotic home environment.

Insecure attachment is divided into two types:


For securely attached children, the thought is: “If I call, someone will come and that feels warm and safe.” For insecurely attached children, relationships can become an emotional or physical danger: “If I call, no one will come (consistently)” or “If I call and they come, they are threatening.”

ADULT ATTACHMENT STYLE: Later, psychologists discovered that the attachment style learned in infancy and childhood forms a model for relationships in adulthood.

“The way individuals connect with the people close to them reveals what they’ve learned from past relationships. The problems they have in establishing and maintaining bonds are informative. On the simplest level, these problems demonstrate whether they’ve learned that relationships are safe and people can be trusted, or that being close to others is dangerous and people are likely to end up hurting you….It’s a cognitive shift for most people to understand that almost all negative behavior is the result of psychic injuries that have not healed. Being quick to anger or excessively self-absorbed, for example, is more often a symptom of unhealed wounds than a character defect. When people are mistreated, especially as children, they don’t know they’ve sustained a hit that strongly shapes the way they will connect to friends and other intimates in the future.” (“Receiving Love,” by Harville Hendrix, PhD, and Helen LaKelly Hunt, PhD, 2004, p. 73)

Many adults are capable of “secure attachment,” meaning that they value close relationships but do not become overly distraught at being separated for a period of time.

Insecurely attached adults, in contrast, are overly sensitive to cues that their partner will abandon them.

In her book “The Undervalued Self,” Elaine N. Aron, PhD, uses the terms “linking” and “ranking” to define relationships. “Linking” is attached, connected, secure relationship. “Ranking” is about gaining or maintaining power to avoid feelings of insecurity. “Insecure attachment is the enemy of long-term relationships; where love should be, ranking exists instead, without either of you knowing it. You have lived so long with your insecure view of close relationships, which began when you were very young, that now of course you unconsciously repeat the same patterns. If you are anxiously insecure, you feel lower in rank, powerless to stop the other from abandoning you, or you feel you cannot stand up for yourself out of fear of abandonment. If you are the avoidant type, you work to stay in charge and rank higher than the other to keep from realizing how attached you really are, which leaves you feeling unbearably vulnerable.” (p. 234)

If you are anxiously attached, you may place a high value on relationships as a way to feel good about yourself. As a result, you may become overly dependent on your romantic partners and needy for their approval. If you sense or imagine your partner is rejecting you, it can cause a PURSUE behavior. This may lead you to constantly check on your partner, to control your partner, or a need to get reassurance.

Avoidant attachment causes people to be uncomfortable developing close emotional bonds with their partners. They value independence, perhaps to the point of isolation, and are uncomfortable with interdependence. If they sense a rejection or slight from their partner, their preference is to WITHDRAW from the relationship either physically or emotionally. Those with avoidant attachment patterns have learned to “turn off” their caring or pro-social reactions to others, because they have learned that it is dangerous to care about someone who then may treat them harshly or with rejection. As a result, they are less sensitive to a partner’s needs and less emotionally supportive. They tend to disown their ATTACHMENT NEEDS — their needs for closeness, connection and emotional intimacy.

Caution! Before you go down the road of blaming yourself or your partner, know this: These attachment styles are ADAPTIVE behaviors based on upbringing. A child who is taught that relationships are untrustworthy or even frightening naturally learns to have SELF-PROTECTIVE BEHAVIORS in relationships. If you learned in childhood that relationships are conditional, shaming, unstable, threatening, withdrawing or rejecting, it may cause you to be uncertain about relationships and leads to anxious or avoidant behaviors.

Emotional reactions and the resulting behaviors are a natural adaptive response to feeling insecure in an important relationship.

When you consider your childhood for any attachment injuries, be aware that parents do not have to be highly abusive to have a negative effect on their children. Parents who are over-protective and intrusive, who are judgmental and have high expectations, or who are dismissive of a child’s thoughts and feelings can also cause a distrust of relationships into adulthood for that child.


When someone senses a relationship is at risk the most common primary emotional reaction is fear.

When humans detect a threat, the signals go to various parts of the brain, which triggers the adrenal glands to release hormones such as epinephrine (adrenaline). The body instantly responds with increased blood flow, heart rate, breathing, and sweating, all preparing the body to quickly retreat or attack (“fight or flight”). This process happens at a biochemical level that we are unaware of, yet is so powerful it allows us to instantly jump out of the way of a runaway car.

These hormonal responses also heighten the emotions. When you feel threatened, your emotions are on high alert and can feel overwhelming.

In modern society we now use our fear response to react almost entirely to emotional threats, rather than physical threats. We tend to respond to imagined danger, rather than real danger. And that imagined danger tends to center on our relationships with others, especially if we feel we are at risk for rejection by a partner.

People are social animals who have an inborn desire to be connected to other people, to be approved of by others, and to get along with others. When we feel victimized, rejected, criticized, judged or shamed, this can make us feel this connection to others is at risk and can trigger the fight-or-flight response.

Those with insecure attachment patterns learned in childhood can be very easily triggered into the fear response when a relationship rupture appears. Strong emotions will come up (fear, anger, sadness, shame, distress) when a primary attachment figure, such as a spouse, is perceived as unavailable or unresponsive. Again, this fearful response is self-protective — but not very helpful in relationships!

When partners are preoccupied with regulating fear and protecting the emotional self, they are unable to recognize and respond to partner’s emotional cues. They also tend to label behaviors as rejecting.

Fear is considered a PRIMARY OR CORE EMOTION, along with emotions such as shame, hurt, humiliation, and sadness. Core emotions are often acted out in as REACTIVE OR SECONDARY EMOTIONS such as anger, irritation, frustration or rage. Reactive emotions push a partner away and cause relationship problems. Expression of core emotions usually pulls partners closer together.

The more you can recognize and calm your immediate fearful reaction when you feel a primary emotion of fear, loss, shame or rejection, then the more likely you will be to have successful relationships. You will be less likely to feel or express feelings of being rejected (“you are never there for me” or “I am never good enough for you.”) during fights.


We know that close, connected relationships can actually reduce anxiety and fear by easing our primal fear of abandonment. Strong, attached relationships reduce feelings of fear (threat activation) and help “calm the brain”.

Attachment to others is our primary protection against feelings of helplessness and meaninglessness. Research shows that emotional isolation is more dangerous for health than smoking or lack of exercise. People who live alone experience three times as many strokes as those who are married. Those who feel the safety of a comforting relationship actually are more resilient in life and can go out and take more risks. Quite simply, loving and being loved makes one stronger. Those who have trust in each other can turn to each other in distress and this creates even more emotional safety.


Western culture teaches us to be independent, strong, and self-sufficient. However, this goes against human biology. We are encoded to turn to each other for help both with physical tasks and emotional support. The strongest of us know how to be vulnerable and turn to others as a resource, especially for comfort and reassurance. Vulnerability promotes contact and trust in relationships. Lack of vulnerability creates distance, which is unhealthy for relationships.

Securely attached people can seek support when they are distressed and know how to ask for their needs to be met in way that pulls their partners toward them.

Both partners need to be:



Emotionally engaged

To remember “ARE” think of the saying that summarizes attachment needs: “ARE you there for me?”


Each of us has a physiological impact on others. Our brains are designed to tune into (ATTUNE) to the emotions, needs, facial expressions and body language of others. In a relationship, this attunement or “neural duet” can directly affect the emotions of each partner. It can even impact the cardiovascular system and the immune and endocrine systems. Healthy bonding increases oxytocin (the “cuddle hormone”) and decreases cortisol (the “fight-or-flight” hormone).

Research shows that emotional responsiveness is the most powerful predictor of marital satisfaction.

The clearest indicator of potential marital difficulty?  The look of fear or contempt on the faces of the partners when they interact.

Belligerent and conflictual relations increase stress hormones (cortisol), which weakens the immune system.


All relationships have times when they have BREAKS IN CONNECTION that need to be REPAIRED.
Conflict is natural in human relationships. However, conflicts aren’t the problem, it’s that they are not repaired soon enough or with emotional connection. It’s not conflict but disconnection that sinks relationships.


Most insecurely attached couples develop a negative interaction cycle. This often brings them into therapy with a complaint of “communication problems.” EFT therapists often call this the couple’s “DANCE” or “PATTERN” of relating.

I’ll be asking you to learn to identify this dance or pattern when it occurs. It is most obvious during arguments.

The main patterns couples use are:

  1. Pursue/Pursue: Both partners “pursue” each other for connection or to repair the relationship. Pursuit behaviors include critical arguing, over-texting or over-calling, demands for affection or sex, clinging.
  2. Withdraw/Withdraw: Both partners “withdraw” from each other when they fear the attachment is broken. Withdraw behaviors include lack of communication, physical isolation, conflict avoidance.
  3. Pursue/Withdraw: One person tends to pursue, the other withdraws.
  4. Mixed Pursue/Withdraw: Both partners alternate between pursue and withdraw behaviors.

In the dance, perhaps one person pushes and argues, one withdraws. Each begins to see each other as dangerous. Fear of loss of the relationship then may trigger secondary emotions, usually anger.

Often these patterns are done for a good cause:

    • Withdrawers may believe they are “protecting the relationship” by avoiding arguments.
    • Pursuers may be “fighting for connection” by trying to engage their partner.

In EFT we will look at how each partner is trying to get his or her attachment needs met, and how each may rely on secondary emotions that push each other away, leaving both feeling alone. Conflict in relationships is actually about loneliness and disconnection that you don’t know how to bridge. The dance leaves partners feeling alone, unhappy, angry, hurt, and far apart. “The dance is the enemy that keeps you from having a safe, responsive connection”.

Through EFT, I will help you understand your relationship pattern, understand the emotions underlying it, and discover how to relate to each other in new, deeper way. Good luck!


Recommended: Book: “An Emotionally Focused Workbook for Couples,” by Veronica Kailos-Lilly and Jennifer Fitzgerald, 2015

Recommended: Book: “Hold Me Tight: Seven Conversations for a Lifetime of Love,” by Dr. Sue Johnson (developer of EFT). (Or any books by Dr. Sue Johnson)

Article: Emotionally Focused Couples Therapy: What It Is and Who It Can Help

Article: 7 Ways to Harness Your Emotions to Have More Powerful Conversations:

Article: The Mindful Guide to Straight Talk

Book: “Insecure in Love: How Anxious Attachment Can Make You Feel Jealous, Needy, and Worried and What You Can Do About It,” Leslie Becker-Phelps, PhD

Book: “8 Keys to Building Your Best Relationships,” by Daniel A. Hughes.

Book: “Receiving Love,” by Harville Hendrix, PhD, and Helen LaKelly Hunt, PhD, 2004

Book: “Getting Past the Affair: A Program to Help You Cope, Heal, and Move On — Together or Apart,” by Douglas K. Snyder, PhD, and Donald H. Baucom, PhD

Book: “Ten Lessons to Transform Your Marriage: America’s Love Lab Experts Share Their Strategies for Strengthening Your Relationship,” by John M. Gottman, PhD, and Julie Schwartz Gottman, PhD (Or any books by the Gottmans)

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