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Addiction and Attachment

What we thought we knew about addiction is not quite right as evidenced by the research indicated in this amazing video by Johann Hari, as he shares how imperative attachment is for recovery.

Here is another informative, yet brief video entitled ‘Rat Park’ to help you better understand the power of connection when it comes to recovery from addiction and what drives that.

Give a listen to Sam Tieleman’s presentation on Sexual Intimacy as it relates to addiction, in this case drinking, with a live couple who was willing to share their process to better understand what a couple therapy session sounds utilizing EFT.

Looking at attachment as it relates to addiction is a revolutionary concept that changes the way we see and treat addiction.  On this link JimThomas, LMFT from Colorado shares his expertise regarding shame and recovery as it relates to healing from substances.  If you want only his presentation, start at minute 14.

In this The Couch PodCast with Michael Barnett LCP  from Atlanta, Michael shares his experience working with couples struggling with addiction by utilizing the power of Emotionally Focused Therapy compared to other  forms of therapy in order to better help partners heal from substance issues.

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EFT and Negative Cycles

We all become caught in negative cycles, the EFT tern for arguments, from time to time, but when couples first come to see me, they are caught in them more frequently then not.  These negative cycles are more than toxic and can literally hijack the relationship, creating anger, distrust and disconnection.

This Youtube video by Sharon Mead LMFT is a lovely way to learn about the negative cycles that block couples from connection.

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How to Find the Best Couple Therapist for Your Relationship

At last, you’ve made the decision to find the right couple therapist focused on helping you with your relationship, but now you are faced with where to turn and whom to turn to?  Like most of us, you head to the internet, only to be bombarded by counselors, therapists, social-workers, psychologists, you name it, all claiming they all have the skills to help you with your relationship.  This makes the process even more daunting, and once again, you are left with the thought who is best suited to help me with the most important relationship of my life?

The following are all paid sites, that means a therapist pays to be there and there are no other requisite skills other than having a license in the field of counseling or psychotherapy:

  • The National Registry of Marriage Friendly Therapists
  • Psychology Today
  • All the postings with Ad in a square which indicates a paid ad. Again, these are posted by counselors who paid for an advertisement.  This includes Google, and now under Google, other therapists are rating the therapist, even though they have never had counseling with that therapist.

So now what do you do and where do you go since these are not really helpful?

I seriously pondered the process couples face in their search for a relationship healer, and realized how much partners really do need help with this very challenging and vexing conundrum.

Not long ago, two couples in one week told me they had seen 6 different therapists before arriving on my doorstep.  The fact that these couples, and many others have hit multiple walls when it comes to finding help for their relationship, broke my heart, because the matter of helping partners connect is not to be taken lightly, and in fact, is sacred.  Entering into this process with a therapist of limited experience or training does not have a neutral effect, despite the fact these couples may be limping along together.  It had taken a serious toll on their relationship and their ability to trust one another.  After six different therapists, my job becomes vastly more complicated, because, in addition to the complex but powerful EFT map I utilize in helping them heal,  they feel hopeless and helpless on what feels like and ‘endless journey’ when they arrive at my door after doing so much ineffective therapy.

On the positive side, I also realized that after seeing multiple therapists, there was an amazing bond between these partners, that even inadequate couple therapy couldn’t shake.  That said, after numerous therapists, most partners are more than reluctant, feel war weary from the process and are financially depleted.  This is the primary reason I am writing this blog, because it is my passion to help partners in distress and seeing multiple therapists for your relationship is tragic.  Please know, I am not perfect and will post more in a future blog regarding the limits of couple therapy success.  Don’t worry, many of the couples I work with make it and thrive because Emotionally Focused Therapy has a 70-90% successrate.

Keeping all of the preceding in mind, I thought I would do what I could to help partners find the best, most well suited therapist for their relationship. Here are some steps to follow when going to the internet in search of a healer for  your wounded partnership, this includes what to do if you have the name of a therapist from a friend or other referral.

 When googling ‘Couple Therapy in your area’, the listing will include organizations such as ‘Google’, ‘Psychology Today’, ‘Theravive’, ‘Thervo’ and ‘GoodTherapy’.  Again, these are sites where multiple paying therapists are listed, some of which may indicate training in the field of couples, relationships, marriage etc., and some may not have specific training in couple and family therapy.  Please look for certifications in the area of couple therapy on the therapists postings, such as ‘Certified Emotionally Focused Therapist’.  Above all, please know this, the therapists listed on these sites ‘pay money’ to be on these listings, which means they may not actually have the training and experience you are looking for to help your relationship.  Let’s face it, we all need to make a name for ourselves on the world wide web, but we also need to know what we are getting when we hire someone to help our disconnection.  

AAMFT (American Association for Marriage and Family Therapists) had been the only organization designated to support and regulate Marriage and Family Therapists across the country, but their standards have significantly dropped.  If you go to the AAMFT page link here you will see one listing for MFTs posted adjacent to a ‘Psychology Today’ listing all on one page.  Here are posting of all levels of therapists, some with training in couple and family and others listed with without training, yet they are members of AAMFT, again because they paid a fee.  The point is, AAMFT was initially designed for MFTs, similar to the National Association of Social Workers who represents social workers, but AAMFT  has opened its doors to all disciplines, regardless, and as long as new members pay their dues and support AAMFT, they are listed as being able to work with relationships.   That’s because AAMFT, a  national agency designated to further the profession of Marriage and Family Therapists is now focused on membership rather than the advancement and specialization in marriage and family therapy.  

When doing your search, the next step is to focus on the couple therapist, or couple counselor’s credentials.  Marriage and Family Therapists or MFTs have attended graduate school with the specific focus on relationships and family systems.  Additionally, there are two prominent psychotherapy models in the field of couple and family therapy. 1)  Emotionally Focused Therapy (EFT)  and 2) Cognitive Behavioral Therapy (CBT).  I was initially trained in CBT over 25 years ago, and provided this approach to couples for many years.  Sadly, CBT didn’t have nearly the success I have experienced with couples providing a pure ‘EFT’ approach, which the research bares out.  EFT has a 70-90% success rate,  which is why it is my modality of choice for helping partners connect at a deep and profound level.  I have gone well beyond my grad school focus of Marriage, Family Therapy, to include an advanced certification in Emotionally Focused Therapy which took several years to obtain. This indicates a much more advanced skill set than simply taking some additional course work or and having attended several trainings.

In many ways, EFT has been pushed into the background, because it’s been around since the 80’s, wait, that means it has been a focus for 30 years with tons of research to back it up.  While CBT is considered the granddaddy of couple therapy,  it only began being utilized in the 60’s and not much has changed.  The challenge is, CBT is supported by the old guard of most Universities and Departments at Grad Schools, where it hasn’t moved to open the doors to new, more effective therapeutic modalities, such as EFT.  This means, CBT is what most American therapists are taught at most Universities and colleges.  Conversely, EFT is flourishing around the globe and is close to replacing the old CBT model everywhere but the U.S.  I am well am aware of many American graduate students who only know about EFT from Dr. Johnson’s books and journals, because they did a paper on it rather than an entire course focused on it, which is very unfortunate.

This old guard, who maintains the CBT approach in grad school, also affects the way insurance companies view therapy.  Most insurance companies are more than happy to provide the names of individual therapists or therapists who provide CBT, which is only effective for the one partner, which in reality, doesn’t really help the relationship.  An EFT therapist working with a couple can not only drastically help the primary relationship, but can help create a ripple effect by positively affecting the couple’s children and extended family members.  When we are deeply connected, we can work through just about anything together, but when we aren’t, life can be so very challenging.  We are meant to connect with our partner and not turn to our therapists for help and support in our marriage once EFT therapy is completed.

The gold standard search for a couple therapist, relationship therapist or marriage counselor is The International Centre for Excellence in Emotionally Focused Therapy (ICEEFT linked here), because you can be assured, the Certified EFT Therapists in your area have undergone rigorous  training needed to help you and your partner salvage and deepen your relationship.  At this site you will also find the research to support the high effectiveness rate of EFT along with the parts of the world where EFT is thriving.

In addition, you may want to research the therapist you choose by doing an on line search on Google, or the search engine of our choice.  If you do have a therapist in mind, type the prospective therapist’s name and credentials followed by ‘reviews’ or if you want to be very thorough, type ‘negative reviews’.   If the reviews are negative,  you may want to continue your search.  Positive reviews can help narrow down the process of finding a good fit for you and your partner. If however, there are no positive or negative reviews, that is a cautionary sign, and I would recommend you continue your search.

Finding a therapist trained to help you with your relationship is one of the most important decisions of your life. Please make yourself and your relationship top priority by doing thorough research to ensure you are comfortable with the person you hire to restore your connection with your parter.   Some couples give up after one therapist, a select few hang on to see six or more therapists, you don’t want to do either. Start the process of therapy by doing all you can to ensure the best possible fit for your relationship and do your research.

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EFT Meaning

“If we can reveal our inner vulnerability to our partner, we can have a corrective emotional experience if our partner empathically and compassionately responds. So I can say to you, “Here I am with all of my blemishes.” And if I can experience that you love me, in my nakedness I begin to feel lovable. This is the deepest and scariest place for couples to go. And yet EFT couples therapy can produce much deeper change than individual therapy, because it is your actual partner who can confirm and validate you. So it is a corrective emotional experience that disconfirms your negative beliefs about yourself, and your negative feelings about yourself.”  Les Greenberg

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The Costs of Divorce vs. the best Couple Therapy

Awhile back, you discussed couple therapy with your partner, but for whatever reason, it didn’t happen then.  Turns out most couples come to therapy a good 6 years later then when it would have been ideal to start. But, because the negative cycles between you were so bad, you couldn’t even decide on someone together, and now ‘it is crunch time’.  No pressure here, but it is important to know how divorce can affect your relationship and your future compared to effective, and by that I am referring to, Emotionally Focused Therapy for couples as one of the best, and well researched, couple therapy currently.

Nancy Michaels has written an eye-opening article entitled ‘Divorce = $1000,000 Love is Grand, but When It’s Gone, Divorce Can Cost More Than Twenty Grand’,  In this article Nancy paints the picture for the average couple regarding the average costs of divorce, depending on your situation.

In another article by Frank Ginzburg, there are other financial costs to consider when comparing divorce to couple therapy:

  • Splitting property, investments and income.
  • Retirement accounts will need to be separated, which will likely incur fees.
  • After divorce, you will probably need to obtain two separate medical benefits packages.
  • child custody and visitation, as well as babysitting, may have financial implications.
  • Legal fees can become a major factor in divorce. Legal fees can range in the tens of thousands or more.
  • Compared to extensive EFT couple therapy with a certified EFT therapist, which can cost as little as a few thousand dollars.
  • The same income you and your spouse receive now will need to support two separate households – making it unlikely that you and your spouse will be able to continue on in the level you have been accustomed to.
  • Disagreements, complicated settlements and/or complicated custody decisions can cause legal fees to be become exorbitant.
  • At times, one person, either by intention or obstinacy or even misunderstanding, can drive up the legal expenses for both partners considerably.

You do the math, because at the end of the day there is no comparison.  Besides, returning to a loving, healed relationship with your partner and creating a space for your child or children to witness parents who can work through struggles and stay connected is worth it on so many levels.

 

 

 

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What can you expect from EFT for couples?

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Being caught in a relationship where your needs are not being met and where you don’t feel heard or understood, is debilitating.  Now there is help in the form of Emotionally Focused Therapy. Couples who successfully complete the process of Emotionally Focused Therapy counseling can expect many of the following results: 

  • Improved communication
  • Feeling supported and understood by their partners
  • Finally being able to connect with each other again
  • Understanding the types of cyclical, intense, heated, fights they get into and learning how to stop them, thereby allowing them to enjoy their relationship and begin to get closer
  • Healing deep unresolved wounds together

A happy and healthy relationship affects all aspects of one’s life. So, depending on how your relationship problems are manifesting, you may experience some or many of the following as a result of a secure and happy relationship:

  • Improved sleep
  • Improved mood
  • Better and more frequent intimacy
  • More confidence, decreased stress and more energy
  • Improved performance at work
  • Reduced symptoms of anxiety, depression and or PTSD
  • Better physical health and wellbeing
  • Feeling cherished by your partner and actually cherishing him/her in return

If you are parents, you will have the added benefit of knowing that you are becoming positive role models for your children, showing them what a healthy, loving, relationship looks like and in turn setting your kids up for success in their future relationships.  But, the best part is your kids won’t feel caught in the middle not knowing what to do and feeling so helpless not knowing how to help.

Basically, the goal of EFT couples therapy is to assist you, as a couple, understand the old patterns that hijack your relationship and help you find new ways to alter those emotional and behavioral patterns together. This allows you to feel better understood and no longer feel emotionally out of control in your relationship. Once safe enough to understand your relationship patterns and how you got off track with each other, you will be further aided to create a deeper more meaningful level of connection where you will begin to build a bridge to each other’s hearts and compassionately face one another in new and healthier ways.

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Who is EFT Couples Therapy not intended for:

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If you and your partner are experiencing the following problems, EFT is unlikely suited for you until these issues are resolved:

Domestic Violence/Intimate Partner Violence

In cases where the couple has ongoing and current relationship violence or aggression, therapy may ill advised or may be seriously contraindicated, as this could pose a safety issue. In those cases, it may be best to seek individual therapy with a therapist trained to work with relationship aggression or to go to your local Domestic Violence Shelter. If this information is withheld, during the assessment phase and aggressive behavior occurs, therapy is contraindicated and will be terminated, for safety reasons. That said, if there has been aggressive behavior which occurred years ago, due to discovering an affair or due to a trauma, and the aggression has stopped, that may be a better indicator for a positive outcome with EFT.

Ongoing Infidelity

If the affair has just been discovered, or is an old wound that goes way back, working on the relationship is very difficult when there is ongoing infidelity. Couples therapy can become extremely complicated and may stall if the affair continues during the therapy. This can result in a waste of time, money and energy because it does not make the process of therapy safe, for either one of you. If you or your partner are still maintaining outside relationships and are unwilling to stop, this creates an impasse that needs to be resolved prior to the start of therapy. EFT Therapy can be highly effective for many couples to heal from the trauma of infidelity, but when the primary relationship is not the focus, therapy may be ineffective.

Ongoing extreme substance abuse struggles

Serious substance abuse issues may exacerbate the couples therapy and the couples therapy may worsen the substance issues initially. Therefore, a thorough assessment may be warranted and if in excess, the therapy may be delayed until an appropriate time. More recent research shows that early trauma and or neglect from primary relationships may be at the root of many substance issues. When children don’t receive the love and connection so necessary to thrive, substances such as alcohol and drugs, become a replacement form of connection as children become adults. Attaching to substances is not a healthy lasting connection, but when partnering at a deeper level becomes safer and more stable the substance can then be replaced by a caring, loving attachment.  If however, the substance continues to be the main focus of the therapy, it is best if the partner receive treatment focused on recover while doing the couples work.  If they are not willing to seek help for recovery, EFT couple therapy will need to end.

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Which couples are best suited for EFT Therapy?

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  • Couples struggling with one another by finding themselves in the same circular fights again and again.
  • Partners who don’t know how to communicate their deeper feelings with one another and are stuck in anger or shut-down.
  • Partners who are so frustrated with their relationship and yet, not sure what to do next.
  • Recovery from affairs, when the third party is no longer in the picture.
  • Significant others desperate to connect with each other  but have no idea how to, which can lead to helplessness and failure because nothing they have tried has worked.
  • Partners who are interested in deepening an already strong relationship.
  • Couples considering married or a serious commitment but are plagued by difficulties, even though they know they love each other.
  • Blended families, where parents experience difficulty coming together on parenting issues.

Emotionally Focused Therapy (EFT) is designed for couples who are committed to trying to work things out, regardless of how much distress they are in.  Please be advised, while EFT is highly effective for helping many couples struggling with disconnection, the relationship between EFT therapist and couple is essential so please unsure a good fit.

Success in couples counseling requires a commitment because the sessions are weekly in order to prevent the couples from falling back into their automatic, negative cycles. For this reason, if you are someone who has a difficult time following through with what you start, please let me know and we can explore together what gets in your way and find ways to help you stay committed to your relationship journey.  If the sessions are spread out, progress may not only become slow, but may be halting.  A substantial amount of research has been done to learn what makes EFT therapy work, just showing up weekly for therapy can make a big difference.

If you are ready to prioritize your relationship and take steps toward improving it, EFT couples counseling may be just what you need to help you connected to your partner.

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EFT Outcome Studies

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Much of the statistics on Emotionally Focused Therapy, as established in a recent meta-analysis (a compilation of several academic studies):
* Roughly 9 out of 10 couples who complete EFT will improve their relationship more than an untreated couple. (1)
* More than half of distressed couples who complete EFT wind up not just improved, but recovered. (See definitions below.) (1) UPDATE: A second meta analysis has raised the recovery rate with EFT to up to 73 percent. (3)
* Participants in EFT complete the process with higher ratings of adjustment, intellectual intimacy, and improvement on their target complaints than couples who complete a therapy focused specifically on problem-solving.(1)
* EFT is designed to be completed in 15 to 22 weekly sessions.(1) Trauma, substance issues, prior DV and infidelity may delay progress, but can still be effective.

Definitions

Distressed – A couple is said to be “distressed” if their scores on measures of relationship satisfaction place them at major risk for separation or divorce, based on long-term studies of other couples. Distressed couples have historically been the hardest for therapists to treat successfully; Emotionally Focused Therapy seems to work quite well.

Improved – A couple completing treatment is considered “improved” if their scores on relationship satisfaction measures have increased beyond what could be expected by chance. “Improved” is one way of saying a couple’s relationship has gotten better.

Recovered – A couple completing treatment is said to have “recovered” only if all of the following are true: They entered therapy as a “distressed” couple; they made significant and reliable improvement through the course of therapy; and at the end of therapy, they no longer qualify as “distressed” on measures of relationship satisfaction.

In the practice of EFT attachment injuries (infidelity, perceived abandonment and or rejection, betrayals, constant criticism, etc.) often block the progress in couple’s therapy. In moments where there is a high need for connection with one’s partner, these attachment injuries block connection and trigger panic and insecurity instead. Studies conducted on the outlined steps for forgiving attachment injuries (2006) used in a brief EFT intervention show: 63% of the couples were able to forgive the injury and complete the therapy events that predict success in EFT: these results were found to be stable in a follow-up study (2010). Less effective results were reported in couples who: had multiple attachment injuries: had lower levels of initial trust: reported the intervention was too brief.

Finally, EFT research indicates that a couple’s engagement in the therapy sessions is more significant as a predictor of treatment success than their level of distress at the time they initiated therapy (1996).

References
Note: These are in order of their appearance above.

1. Byrne, M., Carr, A., & Clark, M. (2004). The efficacy of behavioral couples therapy and emotionally focused therapy for couple distress. Contemporary Family Therapy, 26(4), 361-387.

2. Cloutier, P. F., Manion, I. G. Walker, J. G., & Johnson, S. M. (2002). Emotionally focused interventions for couples with chronically ill children: A two year follow-up. Journal of Marital and Family Therapy, 28(4), 391-398.

3. Johnson, S. M. (2002). Marital problems. In Sprenkle, D. H. (Ed.), Effectiveness research in marriage and family therapy. Washington, DC: AAMFT.

*Much of the information provided above is by Dr. Benjamin Caldwell

Insightful Adult attachment questionaire

You can learn about your own attachment style.

EFT is:

Empirically validated: It’s one of the few approaches to couple therapy shown by research to be effective – even with highly distressed couples. An impressive 90% of couples experienced at least some improvement in their relationship.
See EFT research PDF.

Based on John Bowlby’s Attachment Theory: As applied to adult love relationships, it recognizes the ongoing need we all have for reliable attachment figures in our intimate relationships and assumes that a secure attachment with our partner provides the solid base that helps us manage emotional distress.
An experiential approach: Couples change by identifying and expressing their ongoing need for strong, accessible, responsive emotional connections. Emotions are the focus because they are compelling and instructive; they tell us what’s important to us.
Growth oriented: The focus is on individual and couple strengths and recognizes that human beings have an inherent drive towards growth and healthy relationships.
Collaborative: A strong alliance – where couples are the experts on their own experience and can express this in therapy – is key. The therapist’s role is that of process consultant, helping partners connect their own internal experience with their couple interactions.
Focused on the present: While history often plays an important role in shaping our ways of relating, it is the emotionally driven interactions in the here and now that are the focus of therapy.
Emotionally engaging: The active, evocative approach is especially effective at drawing out men, who often have more difficulty accessing and expressing their emotions.
Clear and concise: Susan Johnson, the principal developer of EFT for couples, has clearly elaborated a therapy model that relies on attachment theory as the basis for understanding adult love relationships, including the nature of conflict and the change process in couple therapy.
“Rigorous studies during the past fifteen years have shown that 70 to 75 percent of couples who go through EFT recover from distress and are happy in their relationships. The results appear lasting, even with couples at high risk for divorce.”
-Dr. Sue Johnson, Professor of Clinical Psychology, University of Ottawa; Director of Ottawa Couple and Family Institute and International Centre for Excellence in Emotionally Focused Therapy (www.iceeft.com); Research Professor, Alliant University (www.alliant.edu).

“EFT is a proven road map to the process of change in couple therapy.”
-John M. Gottman, Ph.D., world-renowned marriage expert, cofounder of the Seattle Marital and Family Institute, Professor of Psychology, University of Washington, and bestselling author of The Seven Principles for Making Marriage Work. (www.gottman.com)

“EFT is one of the best documented, most substantive and well researched approaches to couple therapy.”
-Alan S. Gurman, Ph.D., Emeritus Professor of Psychiatry and Director of Family Therapy Training, University of Wisconsin Medical School, and a leading authority on the clinical practice of couple therapy.

EFT is “one of the few approaches to marital therapy that has been proven to be effective.”
-Jay Lebow, Ph.D., LMFT, ABPP, Past President, Division of Family Psychology, American Psychological Association (www.apa.org); Research Consultant, The Family Institute, Northwestern University (www.family-institute.org).

For more information about EFT, EFT training and EFT research, read Hold Me Tight: Seven Conversations for a Lifetime of Love, by Dr. Sue Johnson and go to www.iceeft.com, www.emotionallyfocusedtherapy.us, and www.holdmetight.com.