• an effective short term approach
• to modifying distressed couples rigid interaction patterns and emotional responses
• foster development of a secure emotional bond or creation of secure bonds
• use to address marital distress complicated by other problems PTSD, depression, chronic illness
• most widely validated and also use with families

• it should have empirical validate theory of dysfunction -targets of interventions and goals of change should be specific as possible
• interventions should be clearly specified
• clr to know what to do, when particular interventions are required, and how to do it
• clr should know he or she is on the right track
• tx model should also be able to deal with marital distress often occurs with other problems or symptoms

• it (EFT) integrates the intrapsychic and interpersonal use power of emotion to restructure the drama of distressed relationships
• facilitate powerful bonding events that redefine the attachment bond between partners

• key factors in marital distress are distressed affect, and destructive interactional pattern, intrapsychic focus on inner experience (affect), systemic focus on cyclical self-reinforcing interactional responses - and how they create and reflect each other John Gottman
• Gottman emphasizes the power of negative affect, to predict long term stability and marital satisfaction in relationships
• and the destructive impact of repeated cycles of interaction as criticism, contempt, defensiveness, and stonewalling and inability of distressed couples to sustain emotional engagemt
• Gottman noted the difference betw men and women-women seem more able to regulate their affect in interpersonal conflict -take the complainer position but males withdraw to contain affect
• Gottman thorough research tx outcome suggest that emotional responses and interaction patterns are most target for interventions in marital therapy

• in understanding adult intimacy we look at - attachment theory Bowlby
• from attachment perspective -as it apply to adults - understood in terms of separation distress and insecure bond - an emotional tie, a set of behaviors to create and manage closeness to attachment figure or schemas
• attachmt theory states - fear, anger, sadness will rise asap when attachment figure is perceived as inaccessible (no access) or unresponsive (no feedback)
• these emotions have control precedence; they override other cues Tronick
• When attachment security is threatened affect organizes attachment responses into predictable sequences; protest and anger is 1st response to threat followed by clinging and seeking, then gives way to depression and despair. Bowlby
• if attachmt figure does not respond, detachmt and separation will occur

• the potential loss of the attachment figure or inability to define relationship as secure trigger automatic fight, flight, or freeze responses that limits info processing and constrict interactional responses
• attachment styles, expectations, and responses formulated in the past relationships help to create present interactions
• and in turn, present interactions tend to mitigate or intensify a person's habitual style.

• many partners basically believe that significant others will be there if they need them and are able to trust their partners-they have a secure attachment style
• they tend to see others as reliable and themselves as lovable and worthy of care
• they are able to process attachment info, give clear emotional signals when attachmt needs arise
• they tend to feel confident enough to assert themselves in the face of the difference that arise in any relationship
• if and when a bond is threatened, they can respond with resourceful flexibility

• if answer is tentative "maybe" and attachment is defined as anxiously insecure, partners tend either to cling to attachment figures or aggressively demand reassurance, often fearing that they are somehow deficient or unlovable
• if the answer to the question is "no" partners tend to avoid closeness with others exhibiting an avoidant, fearful style
• tend to deny their need for attachment and from others as untrustworthy, displaying an avoidant dismissing attachment style

• predispose people to certain predictable emotional responses and behavior and
• ways of  experiencing self and other that make the repair of distressed relationships more difficult and help maintain marital distress
• ex. husband says, it not that I don't care. I get overwhelmed. I'm not sure how to comfort you. I'm scared of getting it wrong. So I freeze and withdraw

• provides a map for adult relationships
• it outlines attachmt needs  for contact, security, and closeness as features that define this landscape; these needs are adaptive and inherent- not immature and pathological.
• considers both self and system, inner experience and organized interaction with others
• it takes into account both the past, reflected in habitual attachment styles and the present ongoing interactions, which may modify such styles
• its nonpathologizing and interactional

• focuses the clr on attachment insecurities, longings, and needs
• it stresses the significance of experiences - deprived, lost trust and connection
• it directs the therapy process toward creating access and responsiveness that foster safe emotional engagemt; allows partners to express their attachmt needs
• also gives a potent and useful way of reframing typical problematic behaviors to make them accessible to reorganization
• ex. angry blaming is viewed most often as an attempt to modify the partner's inability to access and a prtoest reponse to abandonment
• distancing is framed as a way of regulating fears of loss or avoiding anticipated feedback about the self's unworthiness
• also allows us to reframe each partner's responses in a manner that fosters compassion and contact
• ex. an anxious partner's critical pursuit of the other may be framed as fear of loss and compelling desire for reassurance rather than a desire for control or hostility-helps the other partner to respond more positively
• in general placing distressed responses in an attachmt context allows spouses to see and relate to their partner's pain
• Some partners talk in life and death term when facing basic concerns about security and contact and how their partner defines them e. You watch me thrown. you don't respond. You throw me away like I'm nothing
• in term of process of change, the clr should attend to accessing and reprocessing attachmt affect, mofifying interactions that block contact and creat bonding interactions
• it also stresses the need for exploring and modifying working models of self and other that undelie neagtive patterns - that help maintain marital distress

• emotion may be seen as alerting partners to significant and natural key relational experiences
• evoking working models in a state-dependent fashion ex. when i am anxious, I easily formulate all my fears about myself
• in constructivist terms, emotion is seen as an organizing force in the processing of attachmt info and defines the nature of the bond between partners
• emotion is the music of  the attachmt dance
• this interactional dance and each partner's experience of the relationship are restricted by attachmt fears and insecurities
• refers to small basic affects: anger, fear, hurt, distress, sadness, despair, and joy - an emotional response integrates  physiological arousal, meaning schemed, and action tendencies e. I decide its a tiger and I run.

• to expand attachmt-related affect and so expand interactional positions ex. so when I experience and express my fear than anger, I take a less dominating and more contactful stance with my partner
• to do it in a manner that fosters emotional engagemt - to express bonding needs and attain comfort and security
• 8-20 sessions, clr uses experiential techniques to explore and restruct the key emotional responses that arise in session
• systemic techniques to shape new interactions
• change strategies occur in context of a positive therapeutic alliance that provides a secure base for therapy process
• role the clr is a process consultant working with partners to construct new experiences and interactions that define their relationship

• the process of change splits into 9 tx steps
• (1-4) involve assessment and deescalating of problematic interactional styles
• (5-7) middle steps emphasize creating specific change events where interactional positions shift and new bonding experiences occur
• (8-9) last steps address the consolidating of change and integrating of these changes into couple's qday life
• clr circles thru them in spiral fashion as 1 step incorporate and leads to another
• mildly distressed-securely attached couple - the partners work quickly thru the steps - at parallel rate
• more distressed couple - the more passive and withdrawn the partner is advise to go slightly ahead of the other.
• clr helps partners crystallize their emotional experience in the present, tracking, reflecting, then expanding this experience
• second setting interactional tasks that add new elements and reorganize the interactional cycle
• clr 1st assist the withdrawn spouse to formulate his sense of paralyzed helplessness that primes his withdrawal then his partner/wife to hear his experience - then move to structure an interaction around this helplessness
• ex. Clr - so can you tell her, I feel so helpless and defeated. i want to hide -1st step to move away from passive withdrawal to active emotional engagemt

Cycle Descaltion:

1. Assessment - creating an alliance and exploring the core issues in the marital conflict using attachmt perspective
2. Identifying the problem interactional style that maintains attachment insecurity and marital distress
3. Accessing the unacknowledged emotions undelying interactional positions
4. Reframing the problem in terms of the cycle, the underlying emotions, and attachmt needs

Changing interactional positions (5-7)

1. Promoting identification with disowned needs and aspects of self and integrating these relationship interactions
2. Promoting acceptance of the partner's new construct of experience in the relationship and new interactional behavior
3. Facilitating the expression of specific needs and wants - creating emotional enagemt. *****Key change event -withdrawer reengagemt and blamer softening evolve here. Partners will form a new bonding

Consolidation / Integration (8-9)

1. Facilitating the emergence of new solutions to old problematic relationship issues
2. Consolidating new positions and cycles of attachmt behavior

• clr  - to do brief structured interventions
• 1st shift - is deescalating the negative cycle - this is 1st order change. Reactive emotional responses are less intense; negative attributes about partner are less rigid, responses toward partner are less extreme. couple more cooperative in clg-feel its a safe place to learn-they take more risks in engagemt -view cycle as the enemy than spouse. Clr clarify nature of present relationship. This sets the stage for 2nd order change.
• ex. partner: well things are better, we're fighting less-I see him differently. he still runs and hides
• 2nd shift - 2nd order change - 1st the withdrawer reengages-his partner changes perception and interactional position -becomes more active and accessible ex. silent partner may become angry and assert her need for respect and support-2nd change partner softens -express her vulnerabilities and needs - begin to trust and engage partner differently. Shifts critical partner position. The couple are able to form new bond-initiate new cycle of engagemt and responsiveness - shift from isolation to connectedness - from problem cycle to new relationship
• Couple move to consolidation and begins problem-solving issues of conflict between them

• brief therapy - not for abusive couples - offered after prior treatment
• effective with traditional couples where the husband is independent and inexpressive
• couples work with marital distress with other symptoms and problems - family with chronic stress and grief- with ill children, with couple where 1 partner is experiencing PTSD

• initial sessions - nature of problem and strengths of relationship
• by listening to couple's hx, current difficulties, problematic responses; brief personal hx from each partner - focus on attachment hx - who were you close to growing up? did they experience safe attachmt
• we track and reflect sequences of interaction and begin to formulate and reflect partner's habitual position in the relationship
• we validate each partner's construct of his emotional experience - this focus assessment on affect and interaction and encourages disclosure - begins to forge strong alliance
• both partners are viewed as victims and the cycle becomes the enemy
• assess strength of relationship and form hypotheses - key underlying emotions and defining of self and other that operates within the the couple's interaction
• clr direct disclosures toward attachmt-salient interactions, attributes, and emotional responses - viewed as consultants -8 to 15 sessions
• create alliance is based on Rogerian principles - empathic, acceptance, genuineness -alliance is a secure base allows for exploring and reformulating emotional experience and engagemt...

• refers to small basic affects: anger, fear, hurt, distress, sadness, despair, and joy - an emotional response integrates physiological arousal, meaning schemed, and action tendencies e. I decide its a tiger and I run.
• gives compelling feedback as to how our environment is affecting us, organizing and priming us to respond to this impact
• it often take control precedence and overrides other cues -
• in relationships emotion is the 1st organizer of responses to our partner and 2nd emotional expression is a regulator of key dimensions of social interaction such as closeness/distance and control/submission
• is design to rapidly reorganize behavior interests of security and fulfill basic needs
• orients us to our own needs and colors environment cues and meanings
• ex. so when I'm angry, I focus on my injury
• primes attachment behavior and activates core definitions of self and other
• when regulating social interactions, emotional expression i.e. voice tone, facial expression communicates to others in a manner that defines the nature of the relationship and pulls for particular responses
• power of emotion if unaddressed can also easily undermine or block shifts in cognition and behavior by igniting fight or flight responses
• also has the power to elicit key responses that cannot be elicited by another means, such as affection and compassionate that can rapidly redefine the attachmt relationship and prime new positive behaviors

2 basic tasks: exploring and reformulating emotional experience - restructuring the interactions

Tracking and Reflecting emotional experience:

• focusing on the therapy process; building and maintaining the alliance; clarifying responses underlying interactional positions
• ex. could you help me to understand what you said about....?

Validation:

• legitimizing responses and supporting clts to continue to explore how they construct their experience and their interactions; build the alliance
• ex. you feel so alarmed that you cant focus. when we're that afraid, we can't even concentrate is that it?

Evocative Responding: Expanding by Open questions

• expanding elements of experience to facilitate the reorganizing of that experience; formulating unclear elements of experience and encouraging exploration and engagement
• ex. what's happening right now as you say that?

Heightening: Use Repetition, Images, Metaphors or Enactments

• highlighting key experiences that organize responses to partner and new formulations of experience that will reorganize the interaction
• ex. so could you say that again, directly to her that you do shut her out?

Empathic Conjecture or Interpretation:

• clarifying and formulating new meanings, esp regarding interactional positions and defining of self
• ex. you dont believe its possible that anyone could see this part of you and still accept you is that right?

Tracking, Reflecting and Replaying Interactions

• slows down and clarifies steps in the interactional dance; replays key interactional sequences
• ex. so what happened here? It seemed like you turned from your anger for a moment and appealed to him Is that okay?

Reframing in Context of the Cycle and Attachmt Processes:

• shifts the meaning of specific responses and fosters more positive perceptions of the partner
• ex. You freeze b/c you feel that you are right on the edge of losing her Yes?
• Restructuring and Shaping Interactions:
• clarifies and expands negative interaction patterns, creates new kinds of dialogue and new interactional steps/positions, leading to positive cycles of accessing and responsiveness.

• clr is less directive
• couple begin to consolidate new interactional positions and find new solutions to problematic issues in a collaborative way
• clr emphasize partners shift in position-support constructive patterns of change occurred in tx and nature of new relationship-stress ways the couple have found to exit from problem cycle and create closeness and safety
• relapse are discussed and normalized
• couple's future goals are discussed
• couple express more confidence in their relationship-are ready to leave therapy