gct and eft - wvlpca › assets › documents › andrew-counts...what it is, what it isn’t… 3...

GCT and EFT:Introduction

and Interaction

for Clinicians

ANDREW COUNTS, MA, LPC, ALPSCERTIFIED GOTTMAN METHOD COUPLES THERAPIST

EUGENIE TAYLOR, MSW, LICSWCERTIFIED EMOTIONALLY FOCUSED THERAPIST (CERTIFICATION PENDING)

Introductions

Introduce self to those

around

Question: What were the

BEST and the WORST

pieces of relationship

advice you ever

received?

What it is,

What it isn’t…

3

It IS an Introduction to the Gottman Method and

Emotionally Focused Therapy

It is NOT an official Gottman or EFT training .

It IS a review of some of the Gottman and

Johnson Research

It is NOT a comprehensive review or explanation

It IS an introduction to a couple of interventions

It is NOT a license to call yourself a Gottman

Trained or EFT Trained Therapist.

John and Julie Gottman

Susan Johnson

What is Different about Gottman Method Couples Therapy?

• New Approach to Conflict Management Versus Resolution

• Not All Conflicts are the Same: Hidden Agendas — Existential

• Building a Basic Relationship Skill Set in the Couple. What Should That Skill Set Be?

6

THE LOVE LAB

• Combining wisdom from four decades of research with over 3,000 couples

• Seven Principles toward building a strong, satisfying and meaningful relationship

Love Lab Film 8

9

10

Focus &

Aims of

Gottman

Therapy

Focus is on Emotion

Build Skills for Managing Conflict

Build Skills for Friendship

Create Shared Meaning

What is EFT?

A

Combination

of Theory

and

Techniques

Attachment Theory

Structural Theory (patterns)

Experimental Techniques

Rogerian Techniques

Distinctives of EFT

Humanistic, Experiential, Systemic

Attachment science based

Unlike anything we or our clients have experienced

Very high outcome rates (over 90% significant improvement; over 70% recovery)

On average, other couple therapy interventions have 35% outcome rates!

The Power of the Primary Other

View of Self:

Do I matter?

Am I worthy of love?

Do I have value?

View of Other:

Will you be here for me?

Can I trust you?

Will you respond to my needs?

Secure Attachment

BRIEF LAPSES INTO PURSUING

OR WITHDRAWING

BEHAVIORS

RESOLVED MORE QUICKLY

WITHOUT ENTRENCH-

MENT IN POSITION

LOWER LEVELS OF PHYSIOLOGICAL

AROUSAL

ABLE TO COPE WITH BRIEF

INACCESSIBILITY AND DISCONNECT

CAN SOOTHE THROUGH

INTERNALIZED ATTACHMENT

SECURITIES (POSITIVE MODELS OF SELF,

OTHER, AND RELATIONSHIP)

EFT Roadmap

Stage Three

Consolidation

Stage Two

Change Events:

• Withdrawer Re-Engagement

• Pursuer Softening

Stage One

Assessment, Change Event:

• De-escalation

Steps in Stage OneAssessment and De-escalation phase

Step 1: Identify the relational conflict issues

between the partners

Step 2: Identify the negative interaction cycle where these issues are expressed

Step 3: Access attachment emotions underlying

the position each partner takes in this cycle

Step 4: Reframe the problem in terms of the cycle,

unacknowledged emotions, and attachment

needs

Stage Two: Restructuring the bond

(changing interactional positions phase)

Step 5: Access disowned or implicit needs (e.g.,

need for reassurance), emotions (e.g., fear), and

models of self

Step 6: Promote each partner's acceptance of

the other's experience

Step 7: Facilitate each partner's expression of

needs and wants to restructure the interaction

based on new understandings and create

bonding events

Stage Three: Integration and consolidation

Step 8: Facilitate the formulation of new stories

and new solutions to old problems

Step 9: Consolidate new cycles of behavior

EFT: What’s The Problem?The negative cycle that

hi-jacks the relationship

Types of Cycles

• Pursue / Withdraw –almost all

• Withdraw / Withdraw

• Attack / Attack

• Complex

*De-escalation occurs when the couple comes to understand and view the negative cycle as the “enemy,” the barrier to connection, and attachment longings and fears drive it.

EFT in Action

https://www.youtube.com/watch?v=xaHms5z-

yuM

Avoidant:Withdrawer Position

Emotional Regulation: Over-regulate / emotional numbing

Action tendencies in response to relational distress: shut down, distance, distract, defend, disengage

Classic Statements: eg. “No matter what I do, it never seems good enough.”

Negative Model of Other: others aren’t dependable

Childhood soothing strategies: be alone, distract

Likely Family of Origin Hx : emotional neglect or dismissiveness

Preoccupied:Pursuer Position

• Likely Family of Origin Hx: inconsistent responsiveness of caregiver

• Childhood soothing strategies: try to get attention and responses from caregiver

• Negative Model of Self: I don’t matter; I’m not worthy of love

• Classic Statements: eg. “I feel shut out/alone”

• Action tendencies in response to relational distress: talk, cry, scream, cling, criticize, demand

• Emotional Regulation: under-regulate –emotional escalation

Debrief

What comes up for you as you listen to each partner’s distress?

01How is the negative cycle making it impossible for each to see and respond to one another’s longings and fears?

02How does the attachment view impact how you see each partner, and guide the way you would help them?

03

Bottom-up vs. Top Down“It’s all about attunement.”

• Therapist attunes to client’s experience (focusing in on attachment needs and primary emotion)

• Client attunes to own experience (primary emotion; attachment longings)

• As client attunes, therapist “holds” client in the emotional experience and comes alongside the client’s experience allowing full engagement in experience

• Client crystalizes experience, articulates it, and shares it with partner.

• Empathic attunement and responsiveness of partner rewires the brain (neurons that fire together wire together)

• This results in new thoughts/new understanding

Still Face

Gottman on Relational

Dysfunction

What is “Dysfunctional” in Relationships?

Busting a few Common

Myths

Quid pro Quo

Lowering Expectations

What’s True, based on

Research?

More Negativity than Positivity

Escalation of Negative Affect

The Four Horsemen

The Four Horsemen Film 30

High Conflict

Physiological Arousal“Primal Panic”

Both are experiencing the same emotional

flooding (fight/flight/freeze)

Threat of loss of connection/safety with

primary attachment figure is registered in the brainstem in the same

way at threat to physical safety

Increased heart rate (100 BHM+)

Increased skin conductance

Increased levels of stress hormones (urine tests)

Withdrawers demonstrate more

rapid, more intense, and longer lasting

physiological arousal (outwardly, they tend to

look calm)

FLOODING

• The result of perceived criticism and contempt from your partner

• Stonewalling is a defense against flooding

• Can lead to disengaging emotionally

Too Upset?

How fast is Upset?

Heart Beat 100 BPM or Greater

A Song to remember...Stayin' Alive

A View into

Primal Panic

Expert Video Clip – Deeper exploration of the underlying longings and fears that drive the cycle; helping the couple toward reframing the “problem” in these terms

Attachment Based Approaches

In EFT therapist is veryactive and involved.

Forget the dictum “never work harder than your clients”. In EFT, you are

working harder than your clients in stage one (they

are in the brain stem- think crisis stabilization), and its not until stage 3 that they are working harder than

you?

“Catching the bullet” –through the attachment lens, all behavior makes

sense so even the harshest interactions can be reframed in terms of

attachment longings, fears, and related primary

emotion. This is in itself de-escalating.

Contraindications

Untreated Substance Abuse or

Mental Health Issue

Violence (Characterological vs.

Situational)

One Partner planning to Exit the

Relationship

An Ongoing emotional or physical

affair.

The Gottman Approach: Assessment First!

Session Four

Joint Feedback/

Goal-Setting Session

Sessions Two & Three

Individual Sessions

Session One

Joint Session

39Assessment: Session 1

Sampling Couple Conflict Interaction

Setting Up the Conflict Discussion

Critical Behaviors to Observe

Escalation: The Four Horsemen

Emotional Engagement or Disengagement

Accepting Influence

Repair (Pre-Emptive or after Negativity)

Positive Affect (Humor, Affection, Empathy)

Use of Video Tape

Physiological Arousal

Compromise

40Assessment: Session 2

Individual Sessions

Assess:

Individual Narratives

Commitment to Relationship

Hopes and Expectations and Fears

Prior Therapy

Cost/Benefit Analyses

Potential Co-morbidities (Domestic Violence, Depression, Addictions, Ongoing Affair, Psychopathology)

Relevant Family History

41Assessment: Session 3

Conjoint Session

What is the Nature of the Couple’s

Friendship?

What Kind of Sentiment Override is

There?

What is the Nature of Conflict and

Its Regulation?

Do They Honor Life Dreams?

Do They Create Shared Meaning?

Potential Resistances (e.g., Chaos)

Section 4Written Assessment: Questionnaires

42

Locke Wallace:

Relationship Satisfaction

Weiss-Cerretto: Breakup

Potential

The Sound Relationship

House Questionnaires

Sound Relationship House Questionnaires

• Love Maps

• Fondness and Admiration

• Turning Towards

• Negative Sentiment Override

• Harsh Startup

• Accepting Influence

• Repair Attempts

• Compromise

• Gridlock on Perpetual Issues

• Four Horsemen

• Flooding

• Emotional Disengagement and Loneliness

• Sex, Romance, Passion• Shared Meanings

– Rituals– Roles– Goals– Symbols

• Trust

• Commitment

43

19-Areas Checklist for Solvable and Perpetual Problems

• Emotional Connection

• Handling Stress

• Disagreements

• Romance and Passion

• Sex

• Critical Incident

• Children

• In-laws

• Jealousy

• Affair(s)

• Unpleasant Fights

• Values and Goals

• Hard Times

• Teamwork

• Power Struggles

• Finances

• Fun

• Community

• Spirituality

44

Three “Detour” Scales

These Scales Provide Additional Clinical Information

• Chaos

• Meta-Emotion

• Family History

45

Section 4Additional Questionnaires

46

Gottman Emotional Abuse Questionnaire (EAQ)

Control, Fear, Suicide Potential, and Acts of Physical Aggression

Questionnaire

SCL-90: Psychopathology Screen

CAGE AID

Brief Michigan Alcohol Screening Test (b-MAST)

• Constructive Conflict

• Friendship/Intimacy/Positive Affect Systems

• Shared Meaning

Gottman’s Three Domains of Therapy:

47

Discussing and Deciding About Goals

• Importance of Therapeutic Alliance with Both People

• Clinician’s Checklist for Couple Assessment

• Setting Therapeutic Goals as a Partnership with the Couple

48

Key Interventions from the Gottman Library

• Gottman-RapoportIntervention

• Eliminate the Four Horsemen

• Dreams Within Conflict

• Aftermath of a Fight

• Build Love Maps

• The Stress-Reducing Conversation

• Build Rituals of Connection

• Create Shared Meaning

49

Conflict Goal #3Move from Gridlock to Dialogue

Help the Partner Understand the Underlying Dreams

• Getting at Underlying Dream or Meaning Behind Position on the Issue

• Speaker — State Position without Blame, with Depth

• Listener — Ask Questions About History, Meaning, and Dream Within Partner’s Position (Don’t Try to Solve the Issue)

50

Conflict Goal #4Develop Six Skills

1. Gentle Start-Up

2. Accept Influence

3. Make Effective Repairs During Conflict

4. De-Escalate

5. Compromise

6. Physiological Soothing

51

Section 6.4.5

Conflict Goal #5Process Fights and

Regrettable Incidents

• Two Subjective Realities, Both Right

• Feelings List

• Validate Each Other’s Realities

• Triggers

• Admitting Mode

• How to Make It Better Next Time

52

New Tools?

• How might what you learned today make working with couples or families different?

• How you view couple distress?

• How you view what they are doing in response to the distress?

• How this new understanding might change the way you approach your sessions with them?

How do I learn more? EFT:

• Contact your in-state resources:• Christie Eastman: christie.eastman@chhi.org• Shelley Coleman: shelley.coleman@chhi.org

Look up ICEEFT (The International Center for Excellence in Emotionally Focused Therapy):

Iceeft.com- trainings- certification- resources (books, articles, training DVDs, etc.)

What’s Next? CGT:

• Level 1 – Bridging the Couples Chasm

• Level 2 – Assessment, Intervention, and Co-Morbidities

• Level 3 –Practicum Training

• Becoming a Certified Gottman Therapist

• Learn to Present “The Art & Science of Love” Workshop for Couples

• See: gottman.com