What is emotion-focused therapy?

Emotion-focused therapy (EFT) is an evidence-based form of psychotherapy, according to the American Psychological Association (APA) for the effective treatment of a number of clinical conditions, such as depression and complex trauma, as well as for interpersonal and intimate problems encountered in couples. Today, many other conditions may be treated with EFT.
It was developed in the 1980s by Leslie S. Greenberg and his collaborators at York University, Toronto, Canada. The development of EFT was influenced by client-centered psychotherapy, focusing, Gestalt therapy, and marked by systemic and existential psychotherapy, along with major influences from psychotherapy research, cognitive and affective sciences and constructivism.
Emotion-focused therapy is characterized by its direct therapeutic work with emotion. Whereas emotions certainly appear in all kinds of psychotherapies, very detailed video-analyses of therapy sessions, carried out in process research, helped to flesh out how productive emotional experiences and processes look like and how they can be fostered in psychotherapy. Such detailed analyses enabled to the identification of specific events in the therapy process (i.e., called „markers“) which represent each a potentially problematic underlying emotional state. The resolution of such emotional states are fostered by a series of therapeutic tasks which are defined in a step-by-step manner. Over 10 specific therapeutic tasks have been empirically validated within EFT; psychotherapy process research constantly pushes the limits of what we know from emotional processes in psychotherapy and contributes to the development of emotion theory and intervention technique in EFT.
For example, a woman who presents with lingering and unresolved feelings towards her mother, may benefit from a specific version of a two-chair dialogue where she first expresses initial resentment toward her mother (talking to an imagined mother in an empty chair: „You were so selfish when I needed you as a child“), then, in the process, transform it into deep grief over the fundamentally neglecting and dismissing relationship with her mother („I am so sad … so shattered… I missed you being there for me at this important moment.“).
Together with the demonstrated effects to reduce symptoms, EFT has demonstrated in a systematic way how therapy works. For example, therapists and clients alike sometimes wonder whether „crying all session“ is what happens in therapy – or whether it should happen at all– and whether this contributes to a good outcome for therapy. Whereas this question is probably best answered for each therapy session individually, research gives us some guidance. Carryer and Greenberg in 2010 analyzed good and poor therapy processes and showed that the sessions in which the clients were able to have an optimal emotional arousal (or „activation“) in about a quarter of the time they talked about their feelings were the ones which benefitted the most from therapy. The researchers also observed that the clients who had less optimal emotional arousal in therapy session, for example, those who had an emerging emotional experience that was instantly suppressed or avoided (by talking about other contents, instead of focusing on the emotion in the moment) were the ones who benefitted the least from therapy. This research indicates how important it is for the client, together with the help of the therapist, to experience and make sense of his or her emotional experience in therapy. The core of psychotherapy might therefore not necessarily be to learn how to regulate or control emotions, but rather – courageously – be able to go « through » a difficult emotional experience and construct a new meaning from this experience.
Productive therapeutic work with emotion requires certain conditions, and chief among them is a warm, accepting and welcoming therapeutic relationship. A welcoming therapeutic relationship is an important piece EFT therapists foster. Different forms of empathic interventions are used in order to increase the felt and actual safety in the therapeutic relationship and foster emotional change. Therapist’s presence in the actual moment is key to emotional change related to any difficulties presented in psychotherapy.
All these interventions require a certain type of advanced psychotherapy training, guidance and supervision. In Switzerland, EFT is practised throughout the country by several groups of therapists affiliated with the Swiss Society for Emotion-Focused Therapy (EFT-CH). Many of these are integrative psychotherapists and practice other models of psychotherapy as well, and they experience that EFT has something unique to offer. Training is structured and experiential in nature and can be done in German and French, combined with English. Therapists interested in EFT are advised to check regularly the training offer on this website, the website by the EFT training institute in Bern (www.emotionsfokussiertetherapie.ch), or contact any of us.