What is Emotion-Focused Therapy?

Emotion-Focused Therapy (EFT) is a type of psychotherapy that puts emotion at the centre of the work. This might sound strange because all talking therapy is supposed to be about emotion. So, what makes EFT different?

To understand this, we need to first explore what the wider field of counselling looks like before we can understand why EFT was developed.

A short history of counselling

The first widely recognised psychotherapy was Sigmund Freud's psychoanalysis. This was the dominant form of therapy available in the first half of the twentieth century.

As time went on, behaviourism (later to evolve into cognitive-behavioural) took hold and has today become the most widely available psychotherapy in the world. However, some argued that it treated people like simple machines: change what you do and your feelings will follow.

Humanistic therapies, such as Person-Centred Counselling and Gestalt Therapy then arrived as the so-called "third force" in psychology. They emphasised treating people as individuals rather than a collection of diagnostic labels.

The dominance of CBT

Today, many different forms of psychotherapy are available. However, most public healthcare choose to go with cognitive behavioural therapy (CBT) because it has the largest evidence base.

A criticism of CBT is that it ignores emotions. Emotions form one corner of the thoughts-feelings-behaviours triangle, but most CBT textbooks would say that you cannot modify the feelings directly. Instead, they suggest you must change your thoughts and your actions and hope that the emotions change as a result.

Third-wave CBT therapies such as Acceptance and Commitment Therapy and Mindfulness-Based Cognitive Therapy go even further and suggest you cannot change the feelings at all and can only change your interpretation of the feelings.

Humanistic psychotherapists thought the CBT model of distress wasn't good enough. They believed that people did have the power to resolve difficult feelings if they were provided with the right conditions for change.

The arrival of Emotion-Focused Therapy

Emotion-Focused Therapy was developed to put emotion back at the centre of the work. It wanted to work directly with emotion rather than just talking about it.

EFT says that emotions are a way of making sense of the world and help tell us what we need. A basic example would be that if we feel lonely, that is our body telling us we need to connect more with others.

These feelings are adaptive if they help us, "I am lonely so I will go see my friends", and maladaptive if they hurt us, "I am lonely so I am giving up and going to bed." In EFT, we are looking to access these maladaptive emotions and transform them into adaptive emotions.

Theory of emotion

Because EFT is focused on emotion, it puts more effort into understanding emotions than other talking therapies typically do.

EFT distinguishes between primary emotions and secondary emotions. For example, a child feels shamed and lashes out. On the surface, it may look like an anger problem. But the root of the problem is the overwhelming shame and the anger is only a reaction to that. In this case, the shame is primary and the anger is secondary.

EFT also says that emotions reveal needs. If we go back to the previous example of being lonely, this reveals a need to be loved and to be connected to others. Once we identify this feeling, we can then understand and address the need to be loved.

EFT for individuals

EFT for individuals is a semi-structured therapy. Clients have the space to talk about whatever is troubling them at that moment. However, at certain times, the therapist will spot something that starts a specific task.

The most famous of these are taken from Gestalt Therapy. These are the two-chair dialogue and the empty chair for unfinished business.

In these tasks, an additional chair is set up and the client moves between the two chairs taking it in turn to play different parts of themselves having a conversation with each other. The advantage of this is that it is very evocative: the client will experience the painful feelings in the therapy room and thereby have the power to transform them.

EFT for couples

Emotion-Focused Therapy for Couples uses the same underlying theory of emotion used in individual therapies.

In the room, the therapist will help each member of the couple get past their partner's secondary emotions and connect with their primary emotions. The therapist will encourage each partner to reveal feelings of vulnerability to allow their partner to soothe their distress rather than attacking it.

The therapy will explore both the problematic patterns the couple have developed and any injuries brought in from previous relationships.

Conclusion

Emotion-Focused Therapy is a type of talking therapy that emphasises helping clients understand and respond to their emotional needs. It has the power to transform difficult feelings rather than merely cope with them and is suitable for both individuals and couples.