Unit V:

Newer Approaches

Copyrighted. Conceptualised and Prepared by Grace Maria Jochan, 2024

Unit 5. Newer Approaches
Emotion focused couple therapy: Role of the Therapist,
Process and outcome, Unique Aspects. Treatment
-Techniques.
Gottman’s Couple and Marriage Therapy: Role of the
Therapist, Process and outcome, Unique Aspects. Treatment
Techniques
Emotion-Focused
Couple Therapy “Relationships are built,
not found”

EFT
❏ Introduction to EFT
❏ Evolution of EFT
❏ Theoretical Underpinnings
❏ Theoretical Concepts in EFT
❏ View of Family & Client
❏ Goals & Role of Therapist
❏ Working Template
❏ Contemporary thoughts and Criticism
Revisiting Human Emotions
Soft emotions- primary, biologically based, often not in awareness, may be
vulnerable and need to be hidden. e.g. sadness, fear, joy, anger

Hard emotions- secondary and culturally based or learnt, conscious and used to
cover up primary emotions. For e.g. jealousy, bitterness, rage, revenge.

Instrumental emotions- serve an interpersonal function and are often considered

manipulative. During an interactions cycle, these are easy to interrupt, as the
individual remains in control. For e.g. using helplessness to gain sympathy or
anger to avoid responsibility.

Note: Same emotion can be primary or secondary, based on the context in which it
arises. For e.g. anger as response to perceived threat is primary, whereas anger
covering up hurt is secondary. (Greenberg and Johnson, 1988).
Introduction to EFT
EFT is aimed at reducing stress and anxiety in adult relationships and
creating (recreating) more secure attachment bonds

EFT is based in attachment theory but also influenced from humanists’

approaches, general systems theorists, and gestalt approaches.

See the human as “becoming” and not “being,” capable of living in a flux
between what is and what can be- more “here and now” than traditional
psychodynamic approaches
 American
Psychoanalysis of
Evolution Behavioural Approaches
Changing behaviours
1930- 1950s of None emphasized on
Object relations, emotional connection,
Attachment theories EFT dramas, and pain that
people experience
Erik Erikson-
Sociological arena Harry Stack Sullivan -
of human Interpersonal theory; role
development of mother (caregiver) in
developing anxiety

Erich Fromm- Individual

struggle for individuality

Sue Johnson & Les Greenberg-

Emphasis on working on internal
emotional processes
Theoretical Underpinnings
Neohumanistic, experiential approach to therapy reformulated in terms of modern
emotion theory and affective neuroscience

Grew out of, and was a response to, the overemphasis on cognition and behavior
in Western psychotherapy
Theoretical Underpinnings: Influences
from Attachment Theory
Relationship of the “mother” (later interpreted by others as caregiver) to the child
must be warm, nurturing, intimate, and continuous- Attachment Theory, Bowlby

Each individual develops consistent interrelational patterns to regulate his or her

emotions in relationships- called attachment orientations- affecting both the
individual’s internal processes as well external relational behavior.

Individuals who have secure attachment orientation have both more

self-confidence ability to connect to other people in a more open manner.

Individuals who have insecure attachment orientation lack self-confidence

and relationship patterns are usually driven by fear of abandonment or
inability to get close to people in the relationships
Theoretical Assumptions
1. The therapist acts as a process consultant and helps couples to create
collaborative alliances that will allow them to create a secure bond and
explore their emotions.

2. Emotions are the key element in relationships. It governs attachment

behavior and influences how people feel about themselves and how they
experience intimate relationships.

3. Most of the time, attachment needs and desires are healthy and adaptive.
Problems occur when people are not able to enact those needs or perceive
their partner’s needs in a secure way. For example, a daughter wants to get
closer to her mother (which is a very appropriate desire), but she does it by
acting out (insecure behavior pattern).
Theoretical Assumptions
4. Problems occur when people develop their interaction patterns based on
negative emotions and experiences that each of them have in the
relationship- developing a self-reinforcing feedback loop.

5. Change occurs by creating new emotional experiences in the present

relationships that are based on secure attachment-driven interactions. This
theory does not focus on the insight to the past, catharsis, or negotiation.

6. The therapist views the relationship between the partners as a “client” in

the session. The goal of therapy is to create a relationship that is based on
secure bonding

(Johnson, 1996).
View of Family and Client
EFT defines “health” as flexibility, instead of being caught into tight patterns of
emotional and behavioral responses.

Fundamental tenet underlying EFT is that the organism possesses an innate

tendency toward maintenance, growth, and mastery

Pathology, in EFT terms, refers to repetitive emotional, behavioral, cognitive,

and perceptual responses that do not account for the reality of the current
context (Johnson, 2002)

EFT views the family as healthy but with currently stuck patterns of repetitive
behaviors that are based in an attachment injury, or some other loss of a
sense of safety and security
View of Family and Client
Emotionally focused therapists believe that a “bond” exists between persons,
and if a couple or family comes in for therapy, this bond has been
compromised in some form (Johnson & Talitman, 1997)

Treatment strategy in EFT is to heal the broken bond, to repair the trust, and
help recreate a safe environment for its members, and not to resolve
childhood introjects and projections

Change happens when the family is able to restructure their interactions so

that affiliation and autonomy are both accepted and nurtured in the
relationship
Goals in EFT
Goals in EFT include dealing with

projective identifications;

providing attachment opportunities,

constructing or rebuilding healthy couple relations,

discovering and clarifying individual needs,

encouraging autonomy and working in the developmental life task stages

Role of an EFT Therapist
Sue Johnson describes the EFT therapist as a “process consultant”- collaborative
role
Greenberg and Johnson (1988) summarized appropriate therapist skills in
emotional assessing and reformulation as below
- attending,
- refocusing,
- immediacy (here & now),
- expression analysis (teaching client about non-verbal communications),
- intensification (experience of heightened awareness through repetition or
metaphor),
- symbolization (helping the client to grasp the essence of what has happened in the
therapeutic environment.), and
- establishing intents (client is able to formulate new behaviors based on new
experiences found in the therapy)
Role of an EFT Therapist
Johnson describes the EFT therapist as a “process consultant”- collaborative
role

Therapist using EFT has three main tasks:

1. To create and maintain a therapeutic alliance, a “safe base” in the

therapeutic environment for each member of the family to explore his or
her self and others.
2. To access client emotions and then to reformulate those emotions into a
new and more positive basis between the family members.
3. To restructure interactions between family members by changing
problematic patterns of behavior into more positive patterns
Working Template
EFT therapist takes a three-stage and nine-step process (Johnson et al., 2005). The
three stages of EFT are as follows:

Stage 1: Cycle de-escalation

Step 1: Identify relational conflict issues between partners.
Step 2: Identify negative interaction cycle where these issues are expressed.
Step 3: Access the unacknowledged emotions underlying the interactional
position each partner takes in this cycle.
Step 4: Reframe the problem in terms of the cycle, accompanying underlying
emotions, and attachment needs.

Clients gain broader understanding of their relationship patterns; validates each

person’s reality and encourages them to cooperate in overcoming this negative
cycle
Working Template
Stage 2: Changing interactional positions

Step 5: Promote each partner’s identification with disowned attachment

needs and aspects of self ( . . . ).
Step 6: Promote acceptance by each partner of the other partner’s
experience ( . . . ).
Step 7: Facilitate the expression of needs and wants to restructure the
interaction based on new understanding and create bonding events.

Bonding events start to occur and clients are ready to create different forms of
emotional engagement- withdrawn partners to reconnect; blaming response
cycle to soften
Working Template
Stage 3: Facilitate consolidation and integration

Step 8: Facilitate the emergence of new solutions to old problems.

Step 9: Consolidate new positions and cycles of attachment theory

Therapist reviews the couple’s achievements in the session and promotes

consolidation of new relationship responses and cycles of interactions;

Review the specific problems that created hurts in their relationship and helps
them to apply new interactional cycles to different situations;

(Johnson & Denton, 2008)

Working Template
Stage 3: Facilitate consolidation and integration

Step 8: Facilitate the emergence of new solutions to old problems.

Step 9: Consolidate new positions and cycles of attachment theory

Therapist reviews the couple’s achievements in the session and promotes

consolidation of new relationship responses and cycles of interactions;

Review the specific problems that created hurts in their relationship and helps
them to apply new interactional cycles to different situations;

(Johnson & Denton, 2008)

Working Template through a case
Susan and Tom have been married for 5 years. They had a close and safe
bond at the beginning of their marriage, but it all changed when Tom lost his
job and Susan got pregnant with their first child. Susan and Tom made a
conjoint decision that, after the birth of the child, Tom will stay home and
Susan will pick up a few more shifts in the hospital. This arrangement turned
out to be very stressful for both partners, but in the decreasing economy,
Tom’s attempts to find a job were unsuccessful and Susan had to continue
picking up more shifts and spending less time with her family. After 2 years of
this arrangement, the couple sought therapy.

contd.
Working Template through a case
During the first session, Tom shared that he continuously experienced Susan
as angry and not available emotionally, and he was concerned that she was
going to leave him. Every time he would bring up his concerns, Susan would
get upset, complain that she was not able to spend more time with the child
(according to Tom, she never talked about her desire to spend more time with
him), and then distanced herself from Tom. In the same session, Susan
shared her doubts about not being an adequate mother and said that her
feelings of unworthiness led her to react in an angry and withdrawn manner
toward her husband.
Working Template through a case
The therapist spent the first two sessions building a therapeutic alliance,
closely observing the couple’s interactions and identifying their problematic
cycles. Tom complained about Susan’s unavailability, and she would translate
his complaint as a criticism of her as a mother and become angry. She would
then withdraw, which would increase Tom’s feelings of insecurity in the
relationship. Therapist observes that they were not enemies, and that the
negative cycle of their interactions was causing them to feel pain and
insecurity.

Stage 1: Cycle De Escalation- Identify relational conflict; Identify negative

interaction cycle; Access the unacknowledged emotions; Reframe the problem in
terms of the cycle;
Working Template through a case
During the second stage of therapy, Tom and Susan were encouraged to
reunite against their negative cycle of interactions and conceptualize that this
cycle is maintained by their unmet attachment needs. (Tom would criticize and
then be afraid, and Susan would get angry and then withdraw.) Once the
couple understands the cycle and are ready to reunite against it, the therapist
starts to restructure the couple’s interactions, where they become more open
and responsive to each other. These new interactions will lead Tom and
Susan to form a more secure emotional bond.

Stage 2: Changing interactional positions- partner’s identification with

disowned attachment needs and aspects of self; Promote acceptance by each
partner of the other partner’s experience; Facilitate the expression of needs
and wants to restructure the interaction
Working Template through a case

In stage 3, the process of change continues and the couple is able to apply
new learned cycles to specific situations. Tom and Susan were able to
recognize and identify their response patterns that trigger negative cycles and
feel secure with each other to openly discuss it and ask for specific
reassurance from each other

Stage 3: Facilitate consolidation and integration- Facilitate the emergence

of new solutions to old problems; Consolidate new positions and cycles of
attachment theory
Working Template
Phase 1: Joining and Building Rapport

“What has brought you in to talk with me? I would like for each one of you to tell
me what you came to talk to me about.”

Phase 2: Understanding the Presenting Issue

“You become aware of a problem and when you bring it up, somehow (to the other
partner) you feel criticized, and you were telling me that you have found that the
best thing to do is just say nothing and (to the first partner) you told me this drives
you crazy and try harder to get a response until (to second partner) you end up
leaving.”
Working Template

Phase 3: Assessment of Family Dynamics

“What happens to you when your partner clams up? What are you experiencing
right now as your partner is saying these things?”

Phase 4: Goals

“Now that you have shared with Susan that it is hard for you to think of taking the
new job when you are not sure you can depend on her, what can she do to show
you she is there for you?”
Working Template

Phase 5: Amplifying Change

“Tom and Susan, now that you are able to recognize and identify emotions, words,
or actions that trigger negative responses to each other, what do you suggest
doing together when you make decisions together?”

Phase 6: Termination

“How will you keep a lookout for the negative cycles that trapped you into feeling
separate and alone, and how will you keep the cycles away when they threaten to
interfere?”
Techniques/ Core Interventions in EFT
Once the alliance is established, there are two basic therapeutic tasks in
EFT:

(1) Exploration and reformulation of (2) Restructuring of interactions

emotional experience
Tracking, reflecting, and
Reflecting emotional experience replaying interactions

Validation Reframing in the context of the

cycle and attachment processes.
Evocative responding:
Restructuring and shaping
Heightening
interactions
Empathic conjecture or interpretation
Techniques/ Core Interventions in EFT
(1) Exploration and reformulation of emotional experience

Reflecting emotional experience.

Example: “Could you help me to understand? I think you’re saying that you
become so anxious, so “edgy” in these situations that you find yourself wanting to
hold on to, to get control over everything, that the feeling of being “edgy” gets so
overwhelming, is that it? And then you begin to get very critical with your wife. Am
I getting it right?”

Main functions: Focusing the therapy process; building and maintaining the
alliance; clarifying emotional responses underlying interactional positions.
Techniques/ Core Interventions in EFT
(1) Exploration and reformulation of emotional experience

Validation.

Example: “You feel so alarmed that you can’t even focus. When we’re that afraid,
we can’t even concentrate, is that it?”

Main functions: Legitimizing responses and supporting clients to continue to

explore how they construct their experience and their interactions; building the
alliance.
Techniques/ Core Interventions in EFT
(1) Exploration and reformulation of emotional experience

Evocative responding:

Expanding, by open questions the stimulus, bodily response, associated desires

and meanings or action tendency.

Examples: “What’s happening right now, as you say that?”; “What’s that like for
you?”; “So when this occurs, some part of you just wants to run, run and hide?”

Main functions: Expanding elements of experience to facilitate the reorganization

of that experience; formulating unclear or marginalized elements of experience
and encouraging exploration and engagement.
Techniques/ Core Interventions in EFT
(1) Exploration and reformulation of emotional experience

Heightening:

Using repetition, images, metaphors, or enactments.

Examples: “So could you say that again, directly to her, that you do shut her out?”;
“It seems like this is so difficult for you, like climbing a cliff, so scary”; “Can you
turn to him and tell him? ‘It’s too hard to ask. It’s too hard to ask you to take my
hand.”

Main functions: Highlighting key experiences that organize responses to the

partner and new formulations of experience that will reorganize the interaction
Techniques/ Core Interventions in EFT
(1) Exploration and reformulation of emotional experience

Empathic conjecture or interpretation.

Example: “You don’t believe it’s possible that anyone could see this part of you
and still accept you, is that right? So you have no choice but to hide?”

Main functions: Clarifying and formulating new meanings, especially regarding

interactional positions and definitions of self.
Techniques/ Core Interventions in EFT
(2) Restructuring Interventions

Tracking, reflecting, and replaying interactions.

Example: “So what just happened here? It seemed like you turned from your
anger for a moment and appealed to him. Is that OK? But Jim, you were paying
attention to the anger and stayed behind your barricade, yes?”

Main functions: Slows down and clarifies steps in the interactional dance; replays
key interactional sequences
Techniques/ Core Interventions in EFT
(2) Restructuring Interventions

Reframing in the context of the cycle and attachment processes.

Example: “You freeze because you feel like you’re right on the edge of losing her,
yes? You freeze because she matters so much to you, not because you don’t
care.”

Main functions: Shifts the meaning of specific responses and fosters more positive
perceptions of the partner.
Techniques/ Core Interventions in EFT
(2) Restructuring Interventions

Restructuring and shaping interactions:

Enacting present positions, enacting new behaviors based upon new emotional
responses, and choreographing specific change events.

Examples: “Can you tell him? ‘I’m going to shut you out. You don’t get to devastate
me again’”; “This is the first time you’ve ever mentioned being ashamed. Could
you tell him about that shame?”; “Can you ask him, please? Can you ask him for
what you need right now?”

Main functions: Clarifies and expands negative interaction patterns, creates new
kinds of dialogue and new interactional steps/positions, leading to positive cycles
of accessibility and responsiveness.
Contemporary Thoughts & Criticism
One of the best empirically validated models in the field of couples therapy.
Evidence based effectiveness found in treating couples who experience
marital distress, working with couples who struggle with hypersexual behavior,
families who have chronically ill children, families who have a member
suffering from bulimia

EFT effectiveness is not affected by client’s age, education, income, or

cognitive complexity

Works better with less severe forms of distress, where the commitment and
basic bond is present.

Brought emotional focus back to relational work.

Contemporary Thoughts & Criticism
The primary contraindication to the use of EFT occurs when the therapist
believes that such vulnerability is not safe or advisable. The most obvious
situation involves ongoing physical abuse

EFT is designed to improve relationships for couples who wish to stay

together and have a better relationship
In Practice
Carl and Sandra EFT Session: Initial Phase https://youtu.be/uzPSXZ-6DKY

Carl and Sandra EFT Session: Towards end of treatment

https://youtu.be/aii0WCY9afA

EFT in stages:
https://youtu.be/xaHms5z-yuM?list=PLVos6g_wPuQdROs86eL9E09znWkC274
OU

Food for thought!

EFT emphasizes the importance of nonverbal communication in understanding

emotions. Reflect on a time when you were able to effectively communicate
your emotions nonverbally, or when you misinterpreted someone else's
nonverbal cues. What did you learn from this experience?
Gottman’s Couple
and Marriage
Therapy

Dr. John Gottman

Dr. Julie Schwartz Gottman

Introduction to Gottman Method
Research-based approach to couples therapy that aims to strengthen and improve
relationships.

To understand couples, one must follow them for long periods of time to
investigate change and stability. We wanted to observe not only distressed
relationships but also well-functioning heterosexual and same-sex relationships.

Seven non-intervention studies by Robert Levenson, John Gottman, and their

colleagues with over 3000 couples in a time span of 18 years to identify- “masters
of relationships”.
Introduction to Gottman Method
Observed phases of relationships included everything from the newlywed years
through retirement.

The “masters of relationships” were those couples who remained stable and
relatively happy across time. The “disasters” of relationships were couples who
either broke up or stayed unhappily together.

Levenson and Gottman were surprised by the enormous stability of couples’

interaction over time and the data’s ability to predict the longitudinal course of
relationships.
 The Love Lab (*dubbed “The Love Lab” by the media)
The Gottman Love Lab is the world’s original couples laboratory, first opened in
1986 at the University of Washington by Dr. John Gottman.

What’s inside original Gottman Love Lab at the University of Washington:

https://youtu.be/1oB6zNcLIH0

A multimethod approach characterized this research. Couples were videotaped in

various contexts of interaction, including a discussion of the events of the day after
being apart for at least 8 hours, a conflict discussion, a positive discussion, and 12
consecutive hours with no instructions in a specially designed apartment
laboratory .
 The Love Lab (*dubbed “The Love Lab” by the media)
The studies have also yielded:

(1) an understanding of how relationships function or fail;

(2) an ability to predict newlyweds’ adaptations to the transitions of

parenthood, midlife, and retirement; and

(3) nonlinear dynamic difference and differential equations for

mathematical modeling of marital interaction.
 Four
Horsemen of
the
Apocalypse
White horse: The rider has a bow and
crown, and symbolizes conquest.
Some scholars interpret this rider as
Christ or the Antichrist.

Red horse: The rider has a sword,

and symbolizes war and bloodshed.

Black horse: The rider has a balance

scale, and symbolizes famine.

Pale horse: The rider is Death, and

Hell follows with him.

Gottman used this metaphor from Biblical apocalypse (Book of Revelation) to

describe four destructive communication patterns leading couples to divorce
Four Horsemen of the Apocalypse_ Gottman Model
● Criticism
● Contempt
● Defensiveness
● Stonewalling

Their combined effect of these ‘horsemen’ lead to increased negativity,

hostility, and the likelihood of relationship breakdown
4 Horsemen of Apocalypse_Gottaman Model
Criticism

Criticism is attacking the other person’s

character.

Instead of focusing on the specific problem

causing frustration, it puts complete blame on the
other person.

Not just something they did, but who they are;

Different from complaining

“You never listen to me.”

“You always forget to do things.”
“You are a mess”
4 Horsemen of Apocalypse_Gottaman Model
Contempt

Contempt can be a result of an accumulation of

negative thoughts and emotions towards your
partner- sarcasm, being mean and disrespectful

Does not allow the opportunity to make amends

or resolve conflict.

Contempt takes it further than criticism- taking

the position of moral superiority

“How would you like it if I did that to you?”

“I’d never do that to you!”
“No one would do that!”
4 Horsemen of Apocalypse_Gottaman Model

Defensiveness

Defensiveness is a reaction to criticism and

contempt- counter-attack that can greatly
escalate the conflict

When we become defensive, we attempt to deny

responsibility and deflect the blame back onto our
partner.

Those who are defensive are likely to engage in

self-victimization

“it’s all your fault!”

4 Horsemen of Apocalypse_Gottaman Model
Stonewalling

Stonewalling is tuning the other person out,

ignoring, or sometimes it’s a fear-based shutting
down that occurs when a person doesn’t have
emotional resources to engage

Might look like silence.

Stonewalling can lead to “bottling up emotions,”

resulting in explosive outbursts later on if left
unattended

Examples include “the silent treatment,” walking

away from an argument, or leaving a partner’s
texts on “read.”
Emotional Command
Systems
Based on Jaak Panksepp’s book
Affective Neuroscience (1998),
Gottman & Claire (2001) introduced
the seven emotional command
systems in their book ‘The
Relationship Cure’

The science of emotions: Jaak

Panksepp at TEDxRainier:

https://youtu.be/65e2qScV_K8
Emotional Command
Systems
Jester: play and fun
Sensualist: attraction and lust
Nest-Builder: affiliation, friendship,
care, and nurturing
Commander-in-Chief: dominance,
control, and power
Explorer: searching, learning, and
goal setting
Energy Czar: getting rest, finding
food, and staying healthy
Sentry: vigilance, defense, and
avoiding danger

https://www.gottman.com/conversations/
Emotional Command Systems
Command systems are shaped by your temperament, family of origin and life
experiences

If one is raised in a family where parents were always on the lookout for
danger, one is likely have a more highly developed Sentry system than
someone who was raised in a home that was focused more on play, joking,
and laughing, resulting in a more evolved Jester system for that person.
Emotional Command Systems
Because every individual possesses these systems to varying degrees, they
color the relationships between individuals

These systems plus environmental factors create an individual’s attitudes,

values, and feelings about the expression of various emotions, known as
“meta-emotion.”

When individuals enter into relationship with one another, they form unique
meta-emotion combinations.

In the masters of relationship, partners are often well-matched in

meta-emotion

But in couples who experience distress, meta-emotion mismatches have

often disrupted the relationship
Types of Couples
Drawing from over four decades of
studying how couples handle conflict,
researchers have been able to
categorize couples into five types:
Conflict-Avoiding, Validating, Volatile,
Hostile, and Hostile-Detached.

Maintaining the 5:1 positive to negative

interaction ratio during conflict- thing all
three successful couple types had in
common

https://www.instagram.com/gottmaninst
itute/p/CFaaq8pH4DV/?img_index=2
Sound Relationship
House Theory
Seven principles of making marriage
work

This theory became the basis of the

design of clinical interventions for
couples in John Gottman’s book, The
Marriage Clinic, and Julie Gottman’s
book, The Marriage Clinic Casebook.

Generally extend to the masters and

disasters of gay and lesbian
relationships
Sound Relationship House Theory
Build love maps. A love map is a road map of one’s partner’s inner world, built
by asking open-ended questions.

Nurture Your Fondness & Admiration. Build the fondness and admiration
system by expressing affection and respect in small, everyday moments.

Turn Towards Each Other Instead of Away.Turn toward instead of away or

against by noticing a partner’s bids for emotional connection.

Let Your Partner Influence You. Allow positive sentiment override, which
means not taking neutral or negative partner actions personally (if processes 1,
2, and 3 are not working, negative sentiment override results, in which even
neutral acts are perceived as negative).
Sound Relationship House Theory
Solve Your Solvable Problems. Take a two-pronged approach toward
managing conflict by using a gentle approach in presenting complaints,
accepting influence, physiological soothing, and compromise, and by
establishing a dialogue with perpetual problems that examines the existential
dreams within conflict.

Honor one another’s life dreams.

Create Shared Meaning. Build the shared meaning system by establishing

formal and informal rituals of connection, supporting one another’s life roles,
creating shared goals and values, and common views of symbols.
Therapeutic Process
Therapeutic Process
Down-Regulate Negative Affect during Conflict

First consistent finding that emerged from longitudinal studies by Gottman and
Levenson is that higher levels and escalation of negative affect predict
relationship instability.

Escalation of mild negative affect, particularly to one of the Four Horsemen of

the Apocalypse (criticism, defensiveness, contempt, and stonewalling), did
predict instability and increasing dissatisfaction with the relationship.

Physiological arousal of the autonomic nervous system predicted a decline in

relationship satisfaction, whereas physiological calm predicted increased
relationship satisfaction over a 3-year period
Therapeutic Process
Down-Regulate Negative Affect during
Conflict

Conflicts among couples are perpetual- over

years same same issues in different forms

Wile (1988) wrote, “Choosing a partner is

choosing a set of problems”
Therapeutic Process
Interventions to down-regulate negative
affect

● Processing fights and regrettable

incidents- processing the anatomy of the
fight to understand trigger points
● Reducing the four horsemen
● Speaker- Listener Roles
Therapeutic Process
Interventions to down-regulate
negative affect

● Problem-solving, Persuasion and

Compromise
● Perpetual unsolvable conflicts-
conflicts that are deal breakers-
unearthing the symbolic meaning
and dreams
● Physiological Soothing- methods
for muscle relaxation, deep
breathing, meditation, and
biofeedback- using an oximeter in
a session
Therapeutic Process
Up-Regulate Positive Affect during Conflict

The stable couples did not wait to repair negative affect until it escalated. They
repaired before the cumulative negative affect became too negative.

Turning toward bids for emotional connection- building love maps/ expressing
fondness and admiration
Therapeutic Process
Up-Regulate Positive Affect during Non- Conflict

Once negative affect is down-regulated, positive outcomes in relationships are a

result of being able to savor positive affect.

Guide to this world of savoring positive affect- using EFT’s focus on emotion,
emotional reprocessing of attachment needs & injuries
Therapeutic Process
Bridge Meta-Emotion Mismatches

People could be divided into two broad categories: emotion dismissing/out of

control, and emotion coaching.

Emotion- dismissing people believed that they could decide which emotion
they would have through a force of will- power of positive thinking
Effective at compartmentalizing and suppressing emotion
Resembles the anxious– preoccupied insecure attachment

Emotion- coaching people believe that emotions are a guide for how to
proceed through life
All feelings and wishes are acceptable, but not all behavior is acceptable
More lexicon on different emotions
Therapeutic Process
Bridge Meta-Emotion Mismatches

Most couples, arrive at some balance of emotion- dismissing/ out-of-control

and emotion- coaching behavior

Meta-emotion mismatch can lead to loneliness and to secrets in the

relationship, largely in the interest of avoiding more conflict

Example- Couple having baby- husband being open to female colleague

about wife’s apathy- secrecy in not telling wife about the colleague-
colleague having a window into marriage- beginning of a secrecy in central
relationship
Therapeutic Process
Create Shared meanings

Building rituals of connection- formal or informal ways of connection like dinner

time, yearly holidays, celebrations of birthdays, anniversaries etc

Shared meaning through supporting life’s roles- honoring the roles they play in
life like father, mother etc.

Partners also create meaning in the goals they set for their family and for
themselves.
Minimal Conditions for Long-Term Relationship

Gottman identify six minimal beliefs for long-term relationships:

(1) a belief that commitment is necessary for a long-term relationship to succeed;

(2) an agreement of romantic and sexual exclusivity;
(3) an agreement that there will be no secrets, deceptions, or betrayals;
(4) an agreement of fairness and care (e.g., when a person is sick, he or she will
be cared for);
(5) an agreement to treat one another with respect and affection;
(6) an agreement in principle to try to meet one another’s wants and needs.
Practical Considerations
For couples seeking relationship enhancement, it averages 5–10 sessions;
for distressed couples, 15–20 sessions; for couples with serious comorbidities
or a recent extramarital affair, it averages 25–50 sessions

Termination is handled in by talking to the clients in the first session about

phasing out the therapist toward the end of therapy and following couples for 2
years after termination- Couples can return on an as-needed basis for a
checkup and some repair.
Additional materials
Even Healthy Couples Fight — the Difference Is How | Julie and John Gottman |
TED: https://youtu.be/nBN9zG1JNPg

Making Marriage work: https://youtu.be/AKTyPgwfPgg

Overview of
Different
Models of FT
Issues in Marriage and Family Therapy
Confidentiality

Informed Consent

Record Keeping- Identifying/intake information, Assessment information,

Treatment Plan, Case notes, Termination summary/letter, Other data (Informed
Consent, No harm contract, Release of information)

Dual Relationships

Treating Minors

Cross-cultural Differences
Issues in Marriage and Family Therapy
Associations- American Association for Marriage and Family Therapy

Supervision- issues of who is a supervisor, dual relationships, confidentiality,

background and experience, therapeutic orientation

Research & Clinical Practice- gap between practice and research, problem
centred research, cross-cultural differences

Issues in Integrative models- Eclecticism and Selective Borrowing

Issues in Marriage and Family Therapy
“Almost every treatment runs into difficulty at some point. When this happens,
beginners may be tempted to shift to a different model. If a structural approach
isn’t working, maybe a narrative one will. The problem here is that almost any
strategy will work for a while—and then stall. Getting stuck isn’t a reason to
change models; rather, it may mean you and your clients may be getting to the
heart of their problems”

- Linda Metcalf
Reflection Activity
Write a note about one concept you learned in Marriage, Family
and Couples Therapy without checking your books and internet
and substantiate why do you remember this concept more than
the others. You may submit the same anonymously.
 Thank you!

Kindly address your feedback or

questions to
grace.maria@sju.edu.in |
gracemariajochan.psychology@g
mail.com