EmotionallyFocusedTherapyConnectGonzagaUniversity情绪聚焦疗法连接学课件

1、EMOTIONALLY FOCUSED THERAPYInterventions and Techniques第1页，共54页。EFT AssessmentTasks1. Create a collaborative therapeutic alliance2. Explore client(s) agendas for:a. The relationship b. Therapy3. Present therapy contract第2页，共54页。4. Assess prognostic indicatorsa. Degree of reactivityb. Strength of att

2、achment c. Openness or response to therapist engagement with therapy5. Note trust/faith of female partner 第3页，共54页。Taking History of the RelationshipSample questions:How long they have been together? What attracted them to each other?What was it like when things were good between them?When they figh

3、t/argue, do they feel they resolve issues? How do they make up?What prompted them to come for therapy at this time? What changes would they like to see?第4页，共54页。Assessing Attachment StyleAssessing Attachment HistoryAssessing Partners InteractionsSelf-report questionnairesIndividual sessions第5页，共54页。

4、Identifying & Delineating Negative Interactive CycleIdentifying the cycleLook for predominant patternDelineating the cycle第6页，共54页。Identifying & Delineating Negative Interactive CycleBasic Negative Cycles & Interactive PositionsPursue/WithdrawWithdraw/WithdrawAttack/AttackComplex cyclesReactive purs

5、ue/Withdraw第7页，共54页。Common Underlying Emotions of the Withdrawers and PursuersRejectedInadequateAfraid of failureOverwhelmedNumb frozenAfraid scaredNot wanted or desiredJudged, critizedHurtAloneNot wantedInvisibleIsolated/disconnectedNot importantAbandonedDesperate第8页，共54页。Key Movements in Assessmen

6、t Process Focus PointsClients narrative is interrupted by strong affectAffect is conspicuous by its absencePersonal landmarkInteractional landmarkPosition markersResponses to positive contact第9页，共54页。Key Movements in Assessment Process Focus PointsClients narrative is interrupted by strong affectFoc

7、us on emotional responseGive message that it is safe and appropriate to share this experience in the session第10页，共54页。Key Movements in Assessment Process Focus PointsAffect is conspicuous by its absenceExplore lack of engagement in the personal experience being relatedDiscover the significance in te

8、rms of the couples engagement in and definition of their relationship第11页，共54页。Key Movements in Assessment Process Focus PointsPersonal landmarkFocus on and explore storyUncover the meaning of the story from clients perspectiveAsk if the partner understands the clients experienceLabel story as unres

9、olved issue for couple and validate associated primary or secondary emotion第12页，共54页。Key Movements in Assessment Process Focus PointsInteractional landmarkObserve this interactionIf alliance is developing well, refer to interaction in this sessionOtherwise, simply take note of the interaction第13页，共5

10、4页。Key Movements in Assessment Process Focus PointsPosition markersGet a clear picture of the position each partner takes in response to the otherAsk how each partner perceives and feels about such positions第14页，共54页。Key Movements in Assessment Process Focus PointsResponses to positive contactExplor

11、e the exit from the contactAcknowledge attempts to comfort and ability to receive comfort as a strength of the relationship第15页，共54页。Basic Skills in AssessmentCreating a therapeutic alliance a safe haven in therapy.Empathic AttunementAcceptanceGenuineness第16页，共54页。Therapy skills used in assessmentRe

12、flectionValidationReframing & catching the bullet第17页，共54页。ReflectionReflecting clients experienceReflecting nonverbal communicationVerbal and nonverbal communication incongruence第18页，共54页。ValidationValidating clients experienceCareful validation第19页，共54页。ReframingNeed to understand issues the clien

13、ts are struggling with.Shifts focus, validates and redirects.Catching the bulletInterrupting hurtful comments/negative cycles works to create safety第20页，共54页。Remember the 3 Tasks of EFTCreate and maintaining a therapeutic alliance.Accessing and reformulating emotion.Restructuring key interactions.第2

14、1页，共54页。Core InterventionsOnce alliance is established, there are two basic tasksExploration and reformulation of emotional experienceRestructuring of interactions第22页，共54页。Core InterventionsExploring & Reformulating EmotionReflecting emotional experienceValidationEvocative RespondingHeighteningEmpa

15、thic Conjecture or Interpretation第23页，共54页。Exploring & Reformulating EmotionReflecting Emotional ExperienceFocusing the therapy processBuilding & maintaining the allianceClarifying emotional responses underlying interactional positions第24页，共54页。Exploring & Reformulating EmotionValidationLegitimizing

16、 responses and supporting clients to continue to explore how they construct their experience and their interactionsBuilding the alliance第25页，共54页。Exploring & Reformulating EmotionEvocative RespondingExpanding, by open questions, the stimulus, bodily response, associated desires and meanings of actio

17、n tendencyExpanding elements of experience to facilitate the re-organization of that experienceFormulating unclear or marginalized elements of experience and encouraging exploration and engagement第26页，共54页。Exploring & Reformulating EmotionHeighteningUsing repetition, images, metaphors, enactmentsHig

18、hlighting key experiences that organize responses to the partner and new formulations of experience that will re-organize the interaction第27页，共54页。Exploring & Reformulating EmotionEmpathic Conjecture or InterpretationClarifying and formulating new meanings, especially regarding interactional positio

19、ns and definitions of self.第28页，共54页。Core InterventionsRestructuring InterventionsTracking, reflecting, replaying interactionsReframing in the context of the cycle and attachment processesRestructuring and shaping interactions第29页，共54页。Restructuring InterventionsTracking, reflecting, and replaying i

20、nteractionsSlows down and clarifies steps in the interactional danceReplays key interactional sequences第30页，共54页。Restructuring InterventionsReframing in the context of the cycle and attachment processesShifts the meaning of specific responses Fosters more positive perceptions of partner第31页，共54页。Res

21、tructuring InterventionsRestructuring and shaping interactionsEnacting present positions, enacting new behaviors based upon new emotional responses and choreographing specific change events.Clarifies and expands negative interactional patternsCreates new kinds of dialogue and new interactional posit

22、ions leads to positive cycles of accessibility and responsiveness第32页，共54页。Interventions are ExperientialIt is all about emotional engagementWe slice it thinner until we find a level where they feel secure to engage.Once they engage we can then move to other levels.Insight is not enough to change em

23、otions/patterns第33页，共54页。Expanding Emotional ExperienceClient statement: “I feel numb/empty.”Therapist:Can we just stay there a moment? (focus on process)You feel numb. (reflection)When Mary says “” you feel numb. (repeat in context of cycle/interaction)第34页，共54页。Expanding Emotional ExperienceAnd th

24、ey you stay silent, say nothing? (action primed by numb withdrawal)Whats that like for you, to go numb, stay numb?How do you feel as you talk about this right nowWhats happening for you as you talk about this? About going numb?第35页，共54页。Expanding Emotional ExperienceHow do you do that? (frames clien

25、t as agent in creation of experience)Thats how you protect yourself? (conjecture about function/attachment behavior)If you didnt do that what would happen?As you say that, you clench your fist tight, like holding on.That must be hard, to feel you have to numb out all the time.第36页，共54页。Expanding Emo

26、tional ExperienceThats the way you have of protecting yourself here.You shut down, shut off, go somewhere else, go away, hide, chill out.Its like, I dont want to feel, is that it? You cant get me?And you feel like hes not there with you? (speaking to other partner)You cant stay and here her say “,”

27、you have to go away?第37页，共54页。Expanding Emotional ExperienceCan you tell here “I shut you out?” (enactment)For you its like you feel so battered, so criticized that you are numb.第38页，共54页。Key Change EventsSofteningRe-engagement第39页，共54页。SofteningPre-requisites: De-escalation of negative cycle (Stage

28、 1)Withdrawer re-engagement (Stage 2 change event)A previously hostile, critical partner accesses “softer” emotions and risks reaching out to his/her partner who is engaged and responsive.In this vulnerable state, the previously hostile partner asks for attachment needs to be met.第40页，共54页。Softening

29、At this point, both partners are attuned, engaged and responsive (accessibility & responsiveness)A bonding event then occurs which redefines the relationship as a safe haven and a secure base.第41页，共54页。What counselor does in softeningHeightening emotionsEvoking respondingCreating a new dialogueModel

30、 a secure attachment (helps take a short cut for the couple)第42页，共54页。Levels of change in SofteningShe expands her experience and accesses attachment fears. Emotions tell us what we need.She engages her partner in a different way.She articulates emotional needs and changes her stance (position) in t

31、he dance.New emotions prime new responses第43页，共54页。Levels of change in SofteningHe sees her differently (afraid rather than dangerous) and is pulled towards here by her expression of vulnerabilityShe reaches and he comforts. She sees him differently.A new compelling cycle is initiated an antidote to

32、 previous negative cycle a redefinition of the relationship as a secure.第44页，共54页。Levels of change in SofteningThey exhibit more open communication, flexible problem solving and resilient coping.Couple resolves issues/ problems (stage 3)There are shifts in both partners sense of self. Both can comfo

33、rt and be comforted.Both are defined as “lovable”第45页，共54页。Change EventsThere is a relentless focus, while helping client feel safe/supportedMay be more directiveAfter a change event validate every aspect of what they did be specific on what they did that worked.第46页，共54页。Contraindications of EFTDif

34、ferent AgendasSeparating CouplesAbusive RelationshipsSubstance AbuseDepression and Other Psychiatric Illness第47页，共54页。Impasses and other clinical issues: Attachment InjuriesA betrayal of trust or abandonment at crucial moment in need.A form of relationship trauma defines relationship as insecure.An

35、impasse in repair processAttachment significance is key not content.Indelible imprint only way out is through.第48页，共54页。Resolution of Attachment InjuriesArticulate injury and impact.The other acknowledges hurt partners pain and elaborates on the evolution of the event.The hurt partner integrates nar

36、rative and emotion.He/She accesses attachment fears and longings.The other owns responsibility, expresses regret, while staying attuned and engaged.Relationship is redefined as a safe haven.New narrative is constructed.第49页，共54页。Therapist Checklist: Beginning an EFT Session1. What is the cycle that characterizes this relationship?2. What are the hypothesized or acknowledged primary emotions embedded in this cycle?3. What are the attachment issues/fears/needs?4 Where are they in the process of change in the 9 steps? The next step/task is?5. Are there pivotal incidents that crys