Category: EFT Blog

I went to workshops and talks by Daniel Wile, the Gottmans, the Hendrixes, Bader & Pearson, Cloe Madanes, Michele Weiner-Davis, and Terry Real. And those are just the ones I remember. Yes, I saw them all in person. And while all of them had something useful to say, nothing “clicked.” So I kept searching for the couple therapy approach that I felt would be worth my time and investment into further training. In the meantime, I was still floundering in my couple work, yet still doggedly trying to figure it out.

And then I found it.

Enactments – pt. 2

Enactments are key to partners establishing and deepening engagement, so it pays to know when and how to use them for maximum impact, from the first session through stage 2. To paraphrase what Chicago ward bosses used to tell their constituents on election day, ‘vote early – and vote often’.

Stage 1 Enactments
It’s your first session, and during a brief moment in an otherwise high conflict exchange, one partner says, “It’s been really hard to get stuck in the same spot over and over again.” ‘Really hard’ is generalized and vague, but it’s an opening. Catching the moment, you say, “When the conflict as been so draining and near-constant, it must have eroded some of the best parts of your relationship. How do you tell her it’s been so hard to be stuck in such an arduous rut?” “I don’t, it wouldn’t make a difference and it would still end in a fight.” You say, “Sure, it would be a stretch to open up even a little bit when things have been so hot, so you keep it the feelings inside. Can you try something a little different, and tell her directly, ‘it’s been so hard, and draining, to keep getting stuck in exactly the same awful spot and how much you want to find a way out of it?”
It’s a small step, but you’re noticing and bringing out emotion. Since it’s an early enactment, you structure it carefully, scripting more than in later stages. You’re not asking them to take the risks that you will in later stages, but you’re slowing down the interaction. Even if the listening partner says, “Well it wouldn’t be so hard if you just showed up from time to time!”, it’s ok. Take a breath, then validate and put the response in their cycle, “ I get it; you’ve been locked in this pattern for so long that it’s not only hard, but almost impossible to slow down and hear each other’s hurt. Instead, it’s the anger that comes across and it pushes you away from each other”.

Stage 2 Enactments
These have a very different flavor. Partners are now able to identify and talk from primary emotion. The goal is to help them get to a depth of vulnerability they rarely express and they need your encouragement to get there. The cues are unmistakable: the change in vocal tone, the downward glance, a shift in posture, poignant images. They’re all openings to more tender emotions – often fear or shame – and you help them drop deeper into them. They’re de-escalated and ready for bonding events. Believe in them, it’s time to gently press forward.
You notice the heavy sadness in one partner’s face as she talks about how she keeps a protective distance and say to her, “This is the place where you’ve felt so hurt, but it hasn’t felt safe to show it, is this right?” She says, “That’s right, I’ve just never felt I mattered. I’ve wanted to say, ‘I need to know you still love me’, but haven’t been able to say the words.” You let yourself feel her sadness and the tip or her fear. It’s time to heighten more, using her words and images: “To feel like you don’t matter to him and not know to say it. It must be very lonely, like you’re in your own world, cut off from him. And if you try to tell him, you might get missed, so the words stick in your throat; you could fall without him there to catch you and it would be crushing.” She starts to tear up and you give her a moment to let her emotions catch up. Time slows down.
Her partner is watching, listening; you know he’s present and engaged. Quietly, you say, “His eyes have been fixed on you. Can you turn to him now, look in his eyes for a moment, and when you’re ready, talk from your heart about this dark, overwhelming fear?” She hesitates and you wait – emotions need time to work – lending your quiet presence. Eventually, voice breaking, she says to him, “When we met, I never let myself believe it would last. I never had anyone who said I was special. I finally let myself believe in you – in us – and then you started up with someone else. I felt like a fool to have ever believed. What is it about me?” You validate her courage for taking the risk to share her most vulnerable self. “That took a lot for you to put yourself out there like that. You didn’t give up or back down.”
Her partner seems stunned, glances down at the floor and searches for words. It’s time to bring alive his experience in the moment. Evoking and heightening, you ask, “What’s going on inside for you now as she shares with you this deep, raw hurt, her face full of sadness?” He says, “I don’t really know what to say. I know I’ve hurt her, but I’m not going anywhere without her.” You note he’s talking to you; he needs your help to respond to her with support and acceptance. Continuing the enactment you ask, “Can you turn and tell her you hear and see her hurt? And how much you want to ease her pain?” Finding his footing he says, “I know I’ve hurt you and I can’t forgive myself for it. I let you down and you deserve better”. Her body relaxes and she softens a bit. Keep the enactment going, “Tell her please, what it means to you for her to let you in in such a big way”. You can keep processing the interaction because these are moments of engagement.
Enactments are essential to creating bonding events in stage 2. Talking about sadness or shame isn’t enough. Partners need to talk from a place of vulnerability. After all, the block to re-engagement isn’t feeling sadness or fear, it’s being unable to safely talk about those emotions.
One of the biggest challenges in learning EFT is to continue heightening and expanding emotions when doing enactments. Trust the process, it’s easy to stop too early and miss the depth of emotion needed to heal wounds. Couples need our attunement and persistence to create the engagement that strengthens lasting bonds. Try it. Access and heighten primary emotion, then heighten even more. Now they’re ready to take risks.

Jeff Hickey, LCSW
Director Chicago Center for EFT

Enactments – pt.1

Have you been doing enactments with your couples? Having any questions about how, why and when to do them? You’re not alone. Read on…

Enactments are the face-to-face sharing of primary emotions – such as fear or shame. Or needs, like being accepted, loved or seen as ‘enough’; and they’re used throughout the course of EFT. In stage one, when partners begin to access vulnerable emotions, often for the first time, they help facilitate de-escalation. The listening partner sees the sharing partner in new ways, not just demanding or defensive, but hurting.
Enactments prime the pump for moving into stage two, when enactments are not just helpful – they’re the lifeblood of change. Here, partners have broken the negative cycle and share more deeply, and in the moment, their poignant, tender emotions and underlying needs. For instance, a pursuing partner expresses core doubts that she is lovable. With heightening and well-attuned empathic conjectures she is able to talk fromher fear, “As long as I can remember, I’ve felt alone, unseen… unworthy of love. I’ve told myself ‘don’t ask for love, it’s not for you and you’ll just be disappointed all over again’”.  The fear? If she shows her need for love, her partner will not respond or may see her as too demanding and difficult to love. She would be devastated. She has a negative view of other – ‘I won’t get a response’ – mixed with a negative of her self – ‘I’m unworthy and unlovable’.
Taking in her fears, the listening partner may struggle at first with this new way of hearing her, “This is so new to me, I’ve never heard you talk this way”, but is drawn in by her vulnerability. The partner is accessible, responsive and engaged – A.R.E. And hearing her in this previously unknown and surprising way, the listening partner responds with acceptance and support to her underlying need to feel worthy of love, and to be loved. She has taken the risk to reach out and share from a place of profound vulnerability and receives assurance and emotional support in return. The bids for connection are clear and the call and response begin to redefine the relationship as emotionally safe, creating a lasting bond. They feel the connection in their hearts and it builds trust and security.
This is the ‘why’ of using enactments. Next time, we’ll look at the ‘how’, including making your enactments powerful and transformative.

Jeff Hickey LCSW   Director, Chicago Center for EFT

I wanted to alert everyone that Sue has made the text of her recent talk available for a limited time on her website. I encourage you to stop by and read her comments on how attachment is still the defining contribution to sexuality – despite huge recent changes in the role of sex in our culture.
You can find the complete text here at drsuejohnson.com:
http://www.drsuejohnson.com/attachment-sex/attachment-and-the-dance-of-sex-integrating-couple-and-sex-therapy/#more-1957

Jeff

by Jeff Hickey LCSW, CST

Remember a time as a therapist when you’ve had that ‘we’re not in Kansas anymore’ feeling? Like something very new and different has replaced what you’re comfortable with as a clinician? I had it a lot while going through sex therapy training. It wasn’t the information related to sexual functioning, or practices or treatment, although that expanded my horizons some. It was in actually using it with clients as we worked together to resolve sex related problems. Like most therapists new to sex therapy, I wasn’t accustomed to asking people questions about what they do sexually, how it goes when they do it and then getting even more specific when there’s evidence of a problem. Some of it was that I’d always drawn too broad of a line between sex and other relational problems so it was hard to see them overlapping as much as they really do. But to be honest, the main reason was I just felt nosy and embarrassed. I can wade into deep emotional waters with clients, but it just took some practice of asking about vaginas, oral sex, erotic fantasies, etc. to feel more comfortable. In fact one of the key reasons sex therapists have an easier time talking about sex is they do it a lot. Basic desensitization.

What if you’re not there yet? What if it still feels awkward or even taboo to bring up the topic of sex with your clients?

A great place to start is to simply allow the discomfort. It’s always about something, right? Respect it and give it some room to be felt and heard. In fact, embrace it – the last thing we want is to get heavy handed with ourselves, because sex is often such an emotionally laden aspect of our identity. And often the feelings that arise can make it difficult to step back and see where we are.

Next, look at your attitudes about the gamut of sex: how it gets expressed culturally; practices you can accept and where you draw the line; feelings about sexual minorities; how your own background and other experiences shape you values about all of the above, just to name a few.

Now, reflect on the role of sex in your own life: where you learned what you know; how your beliefs came to shape your sexual expression; your feelings about the role of sex in your relationships, again just to name a few.

Finally, take a moment and ask your self what, if anything, you’d like to change about these attitudes, beliefs and feelings. The answer might point the way to what you need to begin to feel more comfortable discussing sexual concerns with your clients. I can almost guarantee you that as you become more at ease, they will too, and they’ll appreciate you opening that door.

In the previous entry we covered some of the basics on heightening. This time I’m giving some examples of heightening language and the small interventions that help heighten experience in the moment.

Norm has been aggressively pursuing his wife for a more active sex life and justifying it by saying his desire level is just normal and that it shows how much he loves her. Eventually he began to realize how emotionally threatened she felt and acknowledged his part in their conflict cycle, (timing is promising…), but he wasn’t fully engaged emotionally so I asked her about the threatened feeling.
She offered the image of being pushed to the edge of a cliff by him. I asked him to feel the impact of her words “emotionally threatened by him” for a moment (slowing down) and he said it wasn’t what he wanted her to feel, looking slightly wide-eyed (entry point). Then I asked him to let himself imagine her at the edge of that high jagged cliff, feeling threatened by him (using her image and bringing it into the moment).
At first he just said, ‘you know, I feel bad’. I said, ‘I get that it feels bad, but it sounds like more, like knowing you’re scaring her is especially gut-wrenching’ (heightening and blocking an early exit). ‘Yeah’, he said, ‘who would want to be that kind of husband?’
‘Exactly’, I said, ‘it would be like pushing her to the very edge of that cliff over and over again, and not knowing how scary it is for her. It must fly in the face of wanting to be her safe, reliable partner (seeding attachment wish). How is it to sit with the feeling that you’re seen as an emotional threat to your own wife?’ (more evoking, emphasizing present moment and heightening). ‘Like I must be a selfish oaf who’s just been making it all about me, but it’s not the way I see myself. I think of myself as a good guy!’
‘No wonder it feels so painful to you’ I said Like a selfish oaf who’s pushing his wife to the edge of that jagged cliff over and over again. How is it to hear these words back from me?’ (more evoking and bringing back to the present). ‘Well it doesn’t feel good!’  ‘I bet’, I say, ‘but stay with the feeling please (block the exit) and notice what’s going on inside (focus on internal experience). Let yourself go there if you can’ (be persistent).
‘Well, you know’…, he says immediately. I interrupt (blocking the exit), ‘Can you let yourself sit quietly and notice what’s happening in your body right now? (ask about somatic experience to slow down), this is new for you so take a minute to let yourself feel it’ (slow it down). He sits quietly for about half a minute before saying, ‘I feel all this tension in my chest, like a clamping pressure.’ ‘Okay, I say, ‘thanks for staying with it. And the clamping pressure, does it have a message?’ (slowing down). ‘Yeah, I feel bad about myself, I don’t like myself right now.’
‘Yes, I wonder if this is the part you don’t let yourself feel when you’ve seen her pull back from you (empathic conjecture). And as I sit here with you now (emphasize presence) I’m guessing some of your pursuit comes from you losing a sort of contact with her – the sex closeness – that’s meant so much to you, so you keep putting on pressure as the way to keep her close’ (empathic conjecture).
He replies, ‘I do sometimes worry we’ve lost our sexual buzz for good – what if we can’t get back there? That doesn’t feel like a good way to be together’ ‘I hear you, Norm, but this time it also sounds a little different, like you’re talking about being scared of losing a part of what makes your partner so important to you (heighten fear and use attachment language). From the place of heightened primary emotion and newly accessed vulnerability I ask him to share his fears with her (enactment) and she is able this time to hear a partner who misses her, in a much less demanding and threatening way. Soon we can return to his complaints and worries about the lack of a vibrant sex life.
You can read in this example than Norm wasn’t unwilling to talk from his primary, vulnerable emotions nearly as he just needed help in the form of attunement, slowing down, blocking exits, persistence, evoking and some empathic conjecture. In the end, he was able to give his partner a much less threatening and more accessible message about her importance to him – not a bad outcome for the piece of work they did together.

Jeff Hickey, Director, Chicago Center for EFT

Jeff Hickey, Director Chicago Center for EFT

Without a doubt, the hardest part for most therapists learning EFT, even experienced ones, is heightening emotion. I’ll share a couple of thoughts about why in a minute, but first a few reasons why this key intervention is so crucial to a good therapy outcome, especially with couples. First, emotions tell us, and those close to us, what matters. Second, they communicate our inner lives in a way that words alone just can’t match – Hollywood knows this well. Finally, they serve as icebreakers that crack open protective shells, letting partners see, touch and feel the experiences that have been long buried by numbness or fear and fueling the bonding events that change relationships. It’s not surprising that substantial research in EFT and beyond has shown that a higher level of emotional expression is positively correlated with favorable treatment outcome. The challenge for the EFT therapist is that many clients don’t easily go to deeper, vulnerable emotions – even after their conflict cycle has de-escalated. Therapists can start to feel discouraged or even helpless when all their great de-escalation work doesn’t result in emotion-driven enactments in stage 2. Here are a couple of ideas to keep in mind as you work with couples to bring more emotion in the room.

• Check your timing – Partners are especially cautious about expressing vulnerability when they don’t safe and supported in the room. Are they sufficiently de-escalated as a couple and do they feel a strong alliance with you?
• Notice the entry points – we all know them: the word, phrase or image that conveys strong emotion. Listen and look for them and don’t let yourself get distracted by content.
• Evoke more – When you notice these entry points for emotion, linger and ask, ‘What’s coming up now for you, inside, as you say…?’ ‘What is happening now for you as you…?’
• Gently block or at least note their exits – how they touch primary emotion and retreat to a narrative that dilutes it, or an explanation – and refocus. Be persistent.
• Keep your focus on emotion – It’s surprisingly easy to revert to explaining emotions to help clarify, but it takes them out experiencing emotion in the moment. I had to remind myself early on that EFT wasn’t Explanation Focused Therapy.
• You exit too soon – You’re right on track, evoking, and the client is responding, but you just stop too soon. You just need to make sure the emotion is more vividly felt and conveyed.
• Finally, you don’t use the heightened emotion to create interpersonal change. This is where enactments come it. At the moment one partner has that ‘holy crap, I’m out on the end of a limb!’ feeling is the time to ask them to share it with their partner. It heightens the experience even more since they’re sharing something that has often remained covered or disguised.

Next time, I’ll offer some specific suggestions for how to heighten. The words, images, etc. that I’ve found helpful with many couples.

Guest blogger Dr. Jennifer McComb Phd, LMFT, CST

jennifermccomb.com

As couple therapists we often hear our clients complain about experiencing a desire discrepancy.  Sexual desire is complex and is known to be difficult to treat due to the numerous factors that influence one’s interest in sex, including relationship dynamics, physical and mental health concerns and the medications used to treat them.

By the time I see these couples in my office, familiar patterns have often emerged, with the higher desire partner generally blaming the lower desire partner for their failing sex life and the lower desire partner defending him or herself and or criticizing their partner’s approach to sexual intimacy.  These cycles are painful for couples, erode attachment security, and create even more distance between partners that makes intimacy and vulnerability difficult to achieve. They’re exactly the sort of cycles we address in stage 1 of EFT.

It is not surprising that one or both partners think something is “wrong”, as spontaneous desire, fantasizing and yearning for sexual activity have often, until recently, been accepted as evidence of healthy sexual desire. Rosemary Basson and her colleagues at the University of British Columbia have done pioneering work in the area of sexual desire – with a focus on understanding the differences between female and male desire. We now know that there are two different kinds of desire: spontaneous and responsive. Spontaneous desire occurs more in the moment, without a clear trigger and is a more common experience for men. Responsivedesire tends to be triggered in response to a particular context – typically low stress and high connection. Many women report experiencing responsive desire, but little to no spontaneous desire, with the exception of early in a new relationship.

“I don’t yearn for sex with my partner in the way that he/she wants me to, but I notice that after we have enjoyed a night together and I am feeling more emotionally connected, I feel more open to sexual intimacy. Once we get started I am able to get aroused, feel desire and derive pleasure from the experience and often wonder why I don’t desire this more often!”

“I have always thought there was something wrong with me as I never really think about sex. I enjoy it when it happens, but I never feel the desire to initiate it.  My partner thinks this means I have no interest in sex, which I don’t agree with, but I guess that is how it seems.”

Although these differences are typically thought of as gender specific with women experiencing more responsive desire and men experiencing more spontaneous desire, I have worked with same sex couples where one partner experiences responsive desire while the other experiences more spontaneous desire and heterosexual couples where the typical experiences are reversed. From my perspective, it is the concept of normative variability in the experience of sexual desire that is most helpful as it moves away from pathologizing clients to understanding that they experience sexual desire differently.

This new understanding of sexual desire is important to EFT therapists because it will help you hear your clients’ stories of desire differently. Next time someone is in your office complaining of (or being blamed for) having no sexual desire, I encourage you to explore this further, as very often what clients are really saying is that they experience no spontaneous desire. This is an opportunity for you to explore how their conflict cycle impacts desire and how feeling connected, safe, and secure in their relationship can foster openness to sexual intimacy. But most importantly, you will have the opportunity to validate their experience as normal and help them (and their partner) understand that there is nothing wrong with them. This experience alone can be transformative for individuals and couples and help them re-establish a strong emotional bond as it relates to their sexual relationship.

“I feel normal for the first time in my life and now my husband is starting to believe that my lack of spontaneous desire is not a reflection of his lack of desirability. We are starting to figure this out and I have noticed moments of openness to sex, which feels great. We’re no longer locked in the cycle of his pursuit and my defending.”

“I understand her better now and for the first time ever I feel hopeful that we can figure this out.”

You, and your clients, can read more about this new way of understanding desire in the New York Times article “There is nothing wrong with your sex drive” by Emily Nagoski: www.nytimes.com/2015/02/27/opinion/nothing-is-wrong-with-your-sex-drive.html?_r=0

Guest blogger: Amy Steinhauer, LCSW, CST, Evanston Relational Psychotherapy

A late 60s heterosexual couple enters my office. They have turned away from each other sexually since his surgery for prostate cancer several years ago. He has tried the doctor’s recommendations: oral medication, injected medication, a pump. But all of those things he found cumbersome, not very effective, and disheartening. She doesn’t want to upset him by asking for more closeness, for seeking an erotic connection together, even if it looks different now.

An early-30s lesbian couple enters my office. They love each other, but things have changed since the birth of their children two and four years ago. They have little time together when they’re not exhausted, and sex, well, that just doesn’t happen these days.

A late 20s woman enters my office. She has a medical problem that leads to pain during penetration, and it’s not expected to go away. She has been furious at her husband’s sexual advances. Her husband has become more withdrawn, or occasionally provocative.

Life strikes. And sex changes. Don’t get me wrong, sometimes it changes for the better. But people who land in my office have found that it has changed in ways they find problematic.

As a sex therapist, I am trained in the behavioral techniques. I can talk to men about start-stop exercises to help rapid ejaculation, talk to women about strategies to reduce painful sex, teach wax-wane and non-demand pleasuring exercises for erectile dysfunction, and encourage people to explore pleasure in ways that support orgasm. That’s often what people are coming to my office looking for. But it won’t surprise us as EFT therapists that those techniques are just part of the story.

s an EFT therapist, I want to know the impact of the sexual concerns. What does it mean to this couple if he loses his erection? If she withdraws in the face of pain or flashbacks? If orgasm becomes more difficult? If medical problems sap libido? How do they reach to each other, protect their connection, help one another feel secure? What role does the sexual difficulty play in their negative cycle?

Some of my favorite research in the field of sex therapy is done by Peggy Kleinplatz at the University of Ottawa on “Optimal Sexuality.” Kleinplatz studied people from several diverse populations who reported having had great sex in their lifetimes. None of her conclusions were about performance, fancy techniques, or erotic gymnastics. Among the top components of optimal sexuality? Being present, focused, and embodied. Connection, alignment, being in sync. Extraordinary communication and heightened empathy. Authenticity, being genuine, uninhibited, and transparent. Vulnerability and surrender. Do those sound an awful lot like EFT goals to you?

Much of our professional training has little to say about sex, unless we specifically seek that out, and sex ends up an ignored topic in the therapy office. While it’s true that a specific sex therapy skill set is sometimes needed, it’s clear to me that EFT therapists have a great deal to offer couples experiencing sexual problems. This potentially great pairing has inspired us, as a trio of certified sex therapists who also practice EFT, to develop a training tailored for our EFT community on working with sexual issues.

Over the past eight years of involvement in EFT trainings, I’ve heard a wide variety of ways that people learn of the model: a conference workshop, a one-day training, a course in grad school, etc., But after all this time, I still hear people mention an article Sue Johnson wrote for the Psychotherapy Networker in 2006,  back when it was still called the Family Therapy Networker. Sue describes her early efforts to understand couple conflict and the eventual recognition that it comes out of a rupture to couples’ attachment bond. She goes on to say that she learned to closely track process in the moment and that key to lasting change was helping partners access and share vulnerable emotions. The resulting endpoint of EFT is re-establishment of a strong emotional bond that helps couples work through conflict more easily, deepen felt security and added resilience to handle the inevitable bumps and potholes of couple life. It’s still a great intro to EFT with couples and if you’re already well acquainted, a good reminder. Here’s the link to the article, “Are You There for Me?” on the Psychotherapy Networker website. Enjoy.