Emotionally Focused Couple Therapy A Couple's Struggle with Infidelity

Abstract

The major purpose of this paper is to illustrate the theory, practice, and outcome of Emotionally Focused Couple Therapy. Emotionally Focused Therapy (EFT) has greatly influenced the world of marital therapy. It was developed by Susan Johnson and Leslie Greenberg in the early 1980s. This article involves emphasizing the formulation of EFT theory and application to a case example of a couple with infidelity. First, this paper will review the development of EFT and the influences of attachment theory. Next, it will illustrate how emotional interventions can influence the couple’s interactions and how key events create a change in couple’s interactions. In order to obtain a better understanding regarding EFT, theory of change, major clinical interventions, and structure of the therapy will be presented. Finally, this paper will present a clinical example, applying EFT to a couple who struggle with infidelity and discuss the outcomes.

Full text

Uluslararası Afro-Avrasya Araştırmaları Dergisi / Cilt: 4 Sayı: 8 /Haziran 2019
International Journal of Afro-Eurasian Research (IJAR) / Volume: 4 Issue: 8 /June
2019
e-ISSN 2602-215X
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DUYGUSAL ODAKLI ÇİFT TERAPİSİ: BİR ÇİFTİN
ALDATMA İLE MÜCADELESİ
ÖZ
Bu çalışmanın amacı, Duygusal Odaklı Çift Terapisinin teorisini, uygulamasını
ve sonucunu göstermektir. Duygusal Odaklı Terapi (EFT) evlilik terapisi
dünyasını büyük ölçüde etkilemiştir. Bu teori, 1980'lerin başında Susan Johnson
ve Leslie Greenberg tarafından geliştirilmiştir. Bu makale, EFT teorisinin
formülasyonunun vurgulanmasını ve sadakatsiz bir çift örneğine uygulanmasını
içermektedir. İlk olarak, bu makalede EFT'nin gelişimi ve bağlanma teorisinin
etkileri gözden geçirelecektir. Daha sonra, duygusal müdahalelerin çift
etkileşimlerini nasıl etkileyebileceği ve kilit olayların çift etkileşimlerinde nasıl
bir değişiklik yarattığı gösterilecektir. EFT’yi daha iyi bir kavrayabilmek için,
değişim teorisi, büyük klinik müdahaleler ve terapinin yapısı sunulacaktır. Son
olarak, bu makalede aldatma ile mücadele eden ve sonuçlarını tartışan bir çifte
EFT uygulandığı klinik bir örnek sunulacaktır.
Anahtar Kelimeler: Duygusal Odaklı Tedavi, Çift Terapisi, İlişki, Aldatma
Esra Nihan BRİDGE
esranihanbridge@gmail.com
Orcid: 0000-0001-5600-3129
Araştırma Makalesi
Başvuru Tarihi: 03.06.2019
Kabul Tarihi: 29.06.2019

Uluslararası Afro-Avrasya Araştırmaları Dergisi / Cilt: 4 Sayı: 8 /Haziran 2019
International Journal of Afro-Eurasian Research (IJAR) / Volume: 4 Issue: 8 /June
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EMOTIONALLY FOCUSED COUPLE THERAPY:
A COUPLE’S STRUGGLE WITH INFIDELITY
ABSTRACT
The major purpose of this paper is to illustrate the theory, practice, and outcome
of Emotionally Focused Couple Therapy. Emotionally Focused Therapy (EFT)
has greatly influenced the world of marital therapy. It was developed by Susan
Johnson and Leslie Greenberg in the early 1980s. This article involves
emphasizing the formulation of EFT theory and application to a case example of
a couple with infidelity. First, this paper will review the development of EFT and
the influences of attachment theory. Next, it will illustrate how emotional
interventions can influence the couple’s interactions and how key events create
a change in couple’s interactions. In order to obtain a better understanding
regarding EFT, theory of change, major clinical interventions, and structure of
the therapy will be presented. Finally, this paper will present a clinical example,
applying EFT to a couple who struggle with infidelity and discuss the outcomes.
Keywords: Emotionally Focused Therapy, Couple Therapy, Relationship,
Infidelity
* This paper is based on the thesis submitted by Esra Nihan Duman as part of
the requirements for her master’s degree in Master’s of Family Therapy Degree
at Thomas Jefferson University’s School of Health Professions.
Esra Nihan BRİDGE
esranihanbridge@gmail.com
Orcid: 0000-0001-5600-3129
Research Article
Date Received: 03.06.2019
Date Accepted: 29.06.2019

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INTRODUCTION
Johnson and Greenberg (1987), the originators of EFT, describe it as a synthesis of experiential,
humanistic and systemic perspectives and interventions that modify negative interaction patterns and
emotional responses of distressed couples (Johnson, Hunsley, Greenberg & Schindler, 1999). EFT is
one of the most acknowledged, researched, empirically validated, and effective therapies for improving
distressed couple relationships (Johnson et al., 1999). While Johnson and Greenberg were working
with couples, they noticed the lack of delineated techniques in couple interventions and recognized
how emotions shape the relationship (Johnson& Greenberg, 1987). With this motivation and the
influences of many approaches, they created this new therapy modality.
Attachment theory guides EFT in understanding partners’ needs, such as comfort, security, and
intimacy (Burgess-Moser, Johnson, Dalgleish, Lafontaine, Wiebe & Tasca, 2015). Based on this
theory, relationship distress is related to separation distress and an insecure bond between partners
(Johnson, Hunsley, Greenberg, & Schindler, 1999).While partners who have secure bonds are capable
of recognizing and responding to the partner’s needs, couples who have insecure bonds might not be
responsive to each other’s protests (Johnson& Greenman, 2006). Insecure couples might demonstrate
more avoidance, less openness, less respect, and more negative emotions (Seedall &Wampler, 2013).
Based on attachment theory and its crucial role in adults’ romantic relationships (Johnson, 2004), EFT
emphasizes that present sensitivities might represent family of origin issues. In other words, “here and
now interaction” might have origins in early attachment bonds with a caregiver (Johnson, 2004). EFT
therapists believe that people's attachment injuries have a dramatic impact on how people perceive
themselves, others, and the world at large (Johnson, Makinen& Millikin, 2001). Those who felt
threatened or felt distressed in the past and did not obtain comfort and response from attachment figures
might struggle with attachment issues (Seedall & Wampler, 2013). They might become highly anxious
if they do not receive a response from the attachment figure (Johnson & Greenman, 2006). Those who
were consistently rejected by attachment figures might avoid emotions and deny their attachment
needs, struggle to open up emotionally (Seedall & Wampler, 2013).
These traumatic experiences can cause extreme vulnerability, feelings of isolation, abandonment and
separation, and they can play a pivotal part in a relationship (Johnson, Makinen& Millikin, 2001).
These attachment injuries can violate a partner’s trust and they can emerge whenever a partner does
not obtain a positive response to their attachment needs, in particular during times of loss, transition,
danger and uncertainty (Johnson, Makinen& Millikin, 2001). These negative experiences prevent them
from relying on their attachment figures and maintaining a secure bond. Hence, past attachment injuries
might not allow partners to experience secure relationships (Johnson & Greenman, 2006).
Johnson (2001) states that dealing with specific types of betrayals or past or present relationship
traumas interfere with treatment. Johnson (2001) emphasized that attachment injuries can be treated
by EFT, and secure attachment can develop as a result of resolving attachment injuries. For this reason
these events need to be addressed and resolved in couple’s therapy. Otherwise, they will keep
influencing the negative interactional cycles, and prevent the experience of safe emotional engagement
(Johnson, Makinen& Millikin, 2001).
According to EFT, accessing, expressing, and reprocessing the emotions behind couples’ negative
interactions create a change (Dalgleish, Johnson, Moser, Wiebe, &Tasca, 2015). In the pursuer-
withdrawer cycle, the most common negative interaction between couples, one partner pursues and

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blames the other to receive a response while the other partner withdraws and dismisses. This negative
interaction does not meet attachment needs of either partner and also creates insecurity in the
relationship (Dalgleish et al., 2015). Johnson (1999) reported that the change in couple’s interaction
appears in three events: negative cycle de-escalation, withdrawer engagement, and blamer softening
(Johnson et al., 1999).
Cycle de-escalation helps partners identify problematic interaction patterns as the root cause of difficult
in their relationship. In this event, couples begin to be aware of their negative interaction pattern and
see this pattern as their enemy (Johnson, 2004). When the couple becomes aware of their automatic
responses they are able to respond to each other’s distress more consciously (Johnson& Greenberg,
1987).
The blamer-softening event causes a decrease in attachment anxiety, and attachment avoidance, and
helps build secure attachment in the relationship (Dalgleish et al., 2015). This event requires critical
partners to be vulnerable and share their needs. By sharing their attachment needs, blamer partners ask
their significant others for reassurance and comfort, which leads to the withdrawn partner to be more
engaged and responsive (Dalgleish et al., 2015). Withdrawer re-engagement helps the withdrawer
partner learn to signal and to express their fears, vulnerabilities, and attachment needs (Greenman
&Johnson, 2013).
EFT suggests that change comes through new emotional experiences. From the perspective of EFT,
“Change occurs by helping people make sense of their emotions through awareness, expression,
regulation, reflection, transformation and corrective experience of emotion.”(Greenberg, 2010).
Restructuring and reinforcing the emotional bond between partners facilitate them to feel secure and
allows for greater closeness (Johnson, 2004).
EFT considers emotional responses as the main target of change. The theory indicates that emotions
guide our perception and they also activate attachment behaviors. They motivate us to communicate
our needs and longings to others, and respond to them. Based on this idea, emotions are primary sources
and emotional experience has the power to change how partners see themselves and others in the
relationship (Johnson, 2004).
The theory divides emotions into two categories: primary emotions and secondary emotions. While
primary emotions are considered as a key agent in the relationship, secondary emotions usually appear
as defensive coping strategies (Johnson, 2004). EFT focuses on reaching out to primary emotions and
expressing them. Insecure couples might struggle feeling emotionally safe with one another and this
prevents them from being vulnerable in front of each other. For this reason, many times insecure
couples might not be aware of partner’s primary emotions.
Johnson (2004) states that validation of primary emotions and attachment needs are key factors to
initiate emotion regulation. In sessions, EFT therapists focus on emotional processing by exploring
individuals’ emotional experiences, reflecting, and validating them. As emotional processing
continues, EFT therapists reframe the partner’s emotional experience and address vulnerable emotions.
This helps the couple to see each other’s from different perspective and helps their connection. EFT
therapists, then, create enactment and facilitate partners to express their feelings to each other.
The theory emphasizes that the process of change involves generating emotionally corrective
experiences (Johnson, 2004). A corrective emotional experience is characterized by ventilation of
emotions and creating new responses to them in the session. This experience is considered very

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powerful for the transformation of partners’ views of themselves and others. This new perspective
initiates the change (Johnson, 2004).
MAJOR TECHNIQUES OF CHANGE IN EFT
In order to generate change, EFT uses experiential and systemic interventions (Zuccarini, Johnson,
Dalgleish& Makinen, 2013), which are also called emotion and process interventions. EFT explains
process interventions as tracking and reflecting the process of interaction, reframing the interaction in
terms of attachment context, and using enactments. These interventions facilitate therapists to use
emotional interventions.
Emotional interventions in EFT are known as empathic reflections, validation, evocative responding,
heightening, and empathic conjecture. These techniques explore attachment related emotions and
needs, and enable the client’s experience of feeling to be understood (Zuccarini, et al., 2013).
Reflection helps tracking and reflecting on the present emotion and validation helps affirm this
emotional experience. EFT therapists also use evocative responding to expand client’s emotional
experience and use heightening to highlight particular responses. The theory also encourages tentative
use of empathic conjecture by making hypothesis about client’s emotions. This helps clients express
their emotions through the help of therapist. These techniques will be further demonstrated in the case
study.
STRUCTURE OF THE THERAPY
Johnson and Greenberg stated that EFT sessions consist of three stages: de-escalation of problematic
cycles, restructuring the bond, and consolidation (Johnson, 2004).
Stage 1. Cycle De-escalation
The purpose of this stage is to identify negative interaction patterns and help partners to be aware of
this as a problem in their relationship (Dalgleish et al., 2015). This stage consists of four steps:
Step 1. Assessment: The first session in therapy focuses on assessment of the core issues in the couple’s
relationship. The EFT therapist also creates an alliance with the couple and attempts to understand
conflict from an attachment perspective (Johnson & Greenman, 2006).
Step 2. In this step, the EFT therapist continues to build the therapeutic alliance with both partners and
focuses on the negative interactional cycle that maintains attachment insecurity (Johnson & Greenman,
2006).
Step 3. In this step, the EFT therapist aims to access unacknowledged emotions which cause this
negative interactional cycle (Johnson & Greenman, 2006).
Step 4. In this step, the EFT therapist aims to reframe the problem in terms of the cycle, the underlying
emotions, and attachment needs (Johnson & Greenman, 2006).
Stage 2. Restructuring Interactional Positions
The purpose of this stage is changing interactional positions. Johnson & Greenman (2006) suggest that
withdrawer engagement and blamer softening occur in this stage.

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Step 5. In this step, the EFT therapist promotes identification with disowned needs and aspects of self
and integrates these into relationship interactions (Johnson & Greenman, 2006).
Step 6. In this step, the EFT therapist promotes acceptance of the partners’ new construction of the
relationship and new interactional behavior (Johnson & Greenman, 2006).
Step 7. In this step, the EFT therapist facilitates both partners expression of their needs. The purpose
of this step is to create emotional engagement for couples (Johnson & Greenman, 2006).
Stage 3. Consolidation/Integration
Step 8. In this step, the EFT therapist facilitates the emergence of new solutions to old relationship
problems (Johnson & Greenman, 2006).
Step 9. In this step, the EFT therapist consolidates new positions and new cycles of attachment behavior
(Johnson & Greenman, 2006).
Having elaborated the development of the theory and deconstruction of the theory, this paper will now
review the case study of Tasha and Kerim.
CASE STUDY
Tasha is a twenty-five year-old, Christian, high school graduated African-American female. She has
never been married and has a three year-old son from her previous relationship, which ended after she
started dating Kerim. She is a stay at home mother. Kerim is a twenty-seven year-old African-American
male. He has never been married nor had kids. While his father is a Muslim and his mother is a
Christian, Kerim sees himself as a spiritual person. He is attending a college works part time.
Tasha and Kerim have been in a relationship for two and a half years. They met online and they started
dating when they were both in other relationships. Even though they ended their relationships with
other partners to focus on each other, the previous partners were still in their lives. Kerim’s family was
very close to Kerim’s ex-girlfriend and they continued talking to her. They kept inviting her to family
events and treating her like a family member after the break-up. Also, Tasha was frequently seeing her
ex-boyfriend who is her son’s father. Kerim and Tasha have been living together for more than a year
in Tasha’s aunt’s house. Since they first attended couple therapy in April 2016, they had recently gotten
engaged and have been seen on a weekly basis for twenty-three sessions.
Tasha grew up living with her mother; her parents were never married and they broke up when she was
a baby. Tasha said the reason for her parents’ separation was her father’s infidelity. Kerim said he grew
up with his family consisting of his mother, father, and his two younger brothers. He indicated that his
mother was a dominant woman and she was responsible for disciplining kids in the house. He added
that he has a very close relationship with his mother.
Tasha and Kerim started therapy in order to prepare for marriage. They stated that they just got engaged
and Tasha had some concerns about their future plans and communication problems related to their
relationship. However, in the third session, they said they broke off their engagement and continued
therapy as a couple. They stated goals for therapy were improving their communication, conflict
resolution, and sexual intimacy. It seemed like each partner agreed on the therapy goals and they
wanted to solve their problems and stop fighting.

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The therapist explored how each partner experienced the relationship. Tasha’s focus was on Kerim.
She said she called of their engagement in part because of Kerim’s refusal to tell his family about it.
She also disliked Kerim’s ongoing contact with his ex-girlfriend, in spite of her protests. Tasha also
described Kerim’s unwillingness to have sex as a problem. She stated that it was her choice to end the
engagement and Kerim accepted it.
From Kerim’s perspective, he said Tasha did not get along with his family and for this reason it was
not easy for him to announce this engagement. He also said he was not having an affair with his ex-
girlfriend and felt Tasha’s demands were unfair. He added that his ex-girlfriend was his best friend, his
family loved her, and he could not prevent them from seeing each other. Kerim talked about having a
lower sex drive than Tasha, and Tasha’s criticism and pressure about sex was the problem. Kerim also
said the reason why he accepted ending this engagement was perhaps so he could leave Tasha and not
hurt her.
INITIAL ASSESSMENT
In sessions it was easy to observe that Tasha was very good at expressing her thoughts and feelings,
and sometimes, dominated the sessions. On the other hand, Kerim usually preferred remaining silent
and accepted what Tasha said to him. While Tasha was blaming Kerim’s attitudes for their conflicts,
Kerim accepted her critiques and saw himself as a problem in the relationship.
From an EFT perspective, it can be observed that this couple was trapped in a pursuer versus
withdrawer negative interaction cycle. This cycle left each partner feeling angry, unhappy, and distant
from the other. While Tasha appeared as the pursuer, Kerim was withdrawn. Tasha and Kerim’s
pursuer and withdrawer negative interaction cycle can be considered highly related to their attachment
styles. Tasha’s worries about Kerim’s family’s feelings and her worries about Kerim’s ex-girlfriend
might indicate that Tasha is occupied with the concerns of abandonment. On the other hand, Kerim’s
not picking up the clues and his not taking a step to solve the problems might be considered avoidance.
While both partners described their mothers as attachment figures, it can be predicted that Tasha has
anxious preoccupied attachment style while Kerim has characteristics of dismissive avoidant
attachment style. This cycle was articulated to the couple and identified as responsible for the current
relationship distress.
MAJOR CRISES
During sessions, the couple frequently argued because of Kerim’s ongoing communication with his
ex-girlfriend. Tasha was frequently criticizing him and believed that Kerim was still in love with his
ex. During one particular session, she said that at the beginning of their relationship, Kerim admitted
that he still had feelings for his ex-girlfriend. She showed strong emotional responses with her body
and tone of voice and the therapist focused on Tasha’s feelings and acknowledged those emotions.
Tasha explained she felt like she was not the only one for him; that he loved his ex-girlfriend more
than he loved her, and she was not as good as the ex. She also mentioned her fear that he would leave
her, which made her cry. This event might be considered a blamer softening event. The therapist
validated Tasha by saying, “It is very hard for you when you think he loves someone else; it is very
painful and you keep thinking he will abandon you.” Kerim looked at the floor and remained silent. It
appeared that he withdrew. The therapist used evocative responding by asking Kerim, “What happened

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to you when you heard Tasha’s feelings?” Kerim said he does not feel good when he sees her unhappy;
he did not want to make her sad. He also said he was just friends with his ex and he did not want to
make his ex-girlfriend sad either. He thought he should just leave and stop communicating with
everyone. The therapist intervened and asked, “Do you want to move away?” Kerim answered, “If I
remove myself from this relationship, it will be better for her.”
The therapist intervened and reframed the problem. Tasha was feeling unloved and felt as though she
could be abandoned by Kerim at any moment. This was making both of them unhappy. Even though
Kerim did not name his feelings, it could be assumed that Kerim was overwhelmed with feelings of
inadequacy. These feelings made it difficult for them to be close and feel safe. After describing the
struggle, the therapist used empathic conjecture and said, “So when you heard her, you could not
respond to comfort her. You said you should remove yourself from the relationship to make her happy.
You might have felt inadequate. In your situation, many would feel that way.” In this session
underlying emotions were acknowledged for both partners. Kerim was more accessible and responsive.
He said that “Tasha is a great person and I chose to be with her, not with my ex.” He added that, “I am
very sorry that I made her feel this way.” The therapist also added, “Tasha seems that she is in pain.
Since you admitted that you still have feelings for your ex-girlfriend, she feels unloved. It is not fair to
expect her to accept your feelings for your ex.” Kerim seemed to understand Tasha and how his
communication with his ex-girlfriend damages their relationship. He said he was going to talk to the
ex-girlfriend and explain to her that they should not talk.
In this session, one of the important change events occurred. First of all, Tasha was able to leave her
defenses behind and be vulnerable and expressed her fear to Kerim. She expressed by crying that she
felt inferior to Kerim’s ex and feared that Kerim would abandon her. This was a blamer softening event
and this made Tasha vulnerable. Even though Kerim heard Tasha and he verbalized sad feelings when
he saw her, he did not reach out to her to comfort her. Withdrawer re-engagement did not occur;
however, he expressed the sense of failure he felt. He also said he was willing to take a step to make
changes in his communication with his ex.
In the next session, Kerim said he stopped talking to his ex-girlfriend; however, Tasha did not believe
Kerim and started to engage in detective-like behaviors such as secretly checking his cell phone and
social media accounts. Kerim indicated that he was very tired of her checking on him constantly and
being repeatedly blamed for the same thing. He said he was doing whatever she wanted and he did not
want to be criticized by her anymore. Even though there was no affair, this did not help to reduce the
negative interaction pattern and the couple continued to be stuck in pursuer-withdrawer cycle. Tasha’s
pressure, Kerim’s increased stress level, and his ex-girlfriend’s reaching out to him triggered Kerim to
going back to messaging with his ex and meeting with her. During that time, Tasha believed Kerim
had an affair with his ex and they talked about separation. Even though they continued living in the
same house and sleeping in the same bed, they said they broke up and indeed that they came to a session
after they “broke up.” Even though blamer-softening event occurred, this did not help the couple to get
out of their negative cycle.
THERAPY AFTER THE COUPLE’S REUNION
Tasha and Kerim broke up and stopped coming to sessions for three months. After they got back
together, Tasha reached out to the therapist again. The therapist learned that after they broke up, they
continued staying together; Kerim dated his ex-girlfriend and Tasha dated another man. After they had

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a huge fight and they stopped communicating, they decided to give each other one more chance. During
the first session after their reunion, therapy goals were revisited. They wanted better communication
and conflict resolution skills. They also wanted to make sure there were no unidentified problems to
uncover prior to their marriage. Despite their stated goals, it was also recommended that rebuilding
trust in this relationship should be one of the goals and the couple agreed. The therapist also wanted to
ensure that the couple would not fall into the same negative pattern and aimed to work on clear
boundaries.
MAJOR CHANGES ACCOMPLISHED
Since Kerim’s ongoing communication with his ex-girlfriend and his attitude of keeping the
engagement as a secret from his family threatened their relationship before, these areas required
intervention for progress in therapy. It was crucial for therapy to define the boundaries. Both partners
seemed supportive to each other and they were willing to face the challenges. As a first step, Kerim
talked to his family and announced their engagement. As a second step, Tasha and Kerim both stopped
texting and meeting with their previous partners. Another step the couple took was choosing a wedding
date.
After their reunion, the couple showed significant progress. They were no longer in a negative
interaction pattern. They were trusting each other, and they were willing to be more vulnerable in front
of each other. They also said that they were satisfied with their sex life. The change in their interaction
suggest that Kerim was re-engaged and he was expressing his feelings more willingly. Sometimes in
the sessions, they made jokes about each other or flirted with each other. After EFT interventions, they
were able to directly and openly discuss their fears with one another. Kerim was able to tell her how
insecure he felt and Tasha instantly responded by holding his hand and saying “I love you.”
MAJOR CRISIS
Even though the couple started preparation for the wedding, Kerim’s mother was dismissive of Tasha
and was “sabotaging” their relationship. They invited Kerim and his ex-girlfriend for Christmas dinner
and asked Kerim not to bring Tasha. Kerim went to dinner without Tasha. This pulled a trigger in their
relationship. This was very similar to Tasha’s negative experience and evoking Tasha’s attachment
injury. Tasha started criticizing Kerim for not standing up for her to his family and she said she felt
angry and was worried that Kerim’s family would not attend the wedding or do something crazy at the
wedding. This session Kerim seemed withdrawn and he said he cannot control his mother.
In the next sessions, the couple seemed more distant to each other. Tasha started to bring up the
dissatisfaction with their sexual life. She said Kerim’s low sexual drive and his unwillingness to have
sex was bothering her. This was surprising because a few sessions before she indicated that she was
satisfied with their sexual intimacy.
This demonstrated that when Tasha’s attachment injury was triggered, she became the pursuer again.
After Tasha turned into the pursuer, this lead Kerim to be distant. Tasha seemed frustrated. The
therapist asked how she felt. She said “Unwanted, unloved, and unattractive.” The therapist asked her
how she dealt with those feelings. Kerim jumped in and said Tasha left home in the middle of the night
and went to bars and slept with a random guy when she got angry at him. This was surprising for the
therapy session because Tasha’s infidelity was not mentioned in previous sessions. At first, Tasha

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denied the accusation but then she admitted that she had sexual intercourse with someone other than
Kerim.
In the next and last session, the couple said they broke up and that they did not pay the deposit for the
wedding venue, which meant the wedding was cancelled. They said their relationship was over and
they also wanted to end the therapy. The last session focused on how they plan to deal with break up
and how they will move out. They were both recommended to individual therapy.
THERAPIST’S PERSPECTIVE
A therapeutic alliance was relatively easy to build with Tasha and Kerim. Even though they were
committed to therapy, sometimes they showed resistance to see their own role in conflict and taking
steps to resolve it. Nevertheless, the alliance had some challenges. One challenge to the therapeutic
alliance was that Kerim kept part of himself as secret. He was not honest about some of his behaviors.
He said he stopped speaking with his ex; however, Tasha saw his messages and eventually I learned
that Kerim was lying in the sessions too. This might indicate that he did not fully trust the therapist.
On the other hand, Tasha's detective-like behaviors and her criticism of Kerim were unstoppable. The
therapist tried not to be defensive about their attitudes towards each other, but this was a challenge.
Additionally, Tasha’s desire to have the therapist take her side by using female solidarity was very
challenging. She was constantly asking, “What woman would accept this? Would you accept that?”
A major theme in the therapeutic relationship with this couple was that Tasha would often blame Kerim
for all the problems in the relationship and Kerim would often give off a feeling of helplessness. In the
sessions, this pattern was overwhelming and it complicated the therapeutic work.
CONCLUSION
The purpose of this paper was to explain the formulation of EFT theory including its history, literature
review, structure of therapy, theory of change, and major clinical interventions. EFT demonstrates
efficacy in helping couples with infidelity and focusing on helping them find safety, security, and
comfort in relationships. Previous studies on attachment injuries in couples suggest that one of the
challenges of couple therapy can be that infidelity might negatively affect the healing of attachment
injuries.
The case study of Tasha and Kerim illustrates the clinical effectiveness of EFT with a couple
confronted with infidelity. The case study demonstrates how the couple was assisted in processing their
emotional experiences by use of major clinical interventions of EFT and important change events. As
previously cited, many studies address the importance of blamer softening event to create a change in
the couple’s interaction. In this case study, blamer softening event occurred and it increased the
relationship satisfaction in this couple. The implementation of EFT showed that the couple gained
closeness during therapy; however, the change was not consistent. They were both willing to be
vulnerable in front of each other and they were both reaching out to each other for comfort. However,
falling back into the negative interaction pattern led them to lose their intimacy.
In terms of the relationship cycle, even though the couple was able to get out of the cycle and create a
new response for a short period of time, increased tension in the relationship led them to return to their
negative interaction cycle. When they encountered stressors which triggered their past negative

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experiences, each partner fell back into their negative interaction pattern. They were unable to go away
from the negative cycle and unable to respond differently to each other.
From a systemic perspective it was evident that this couple lacked clear boundaries in their relationship.
Even though they defined their relationship as a monogamous relationship, Kerim still continued daily
communication with his ex-girlfriend, visiting her, planning vacations with her, and expressing his
ongoing romantic feelings for her. On the other hand, Tasha was seeing her ex because of their child.
Kerim said she flirted with her ex and there was a time in the beginning of their relationship she had
sex with her ex-boyfriend for revenge. Also, the couple did not clearly define their separation. They
were staying in the same house, sleeping in the same bed, having sex, coming to couple therapy, and
saying that they broke up. Furthermore, their relationship was vulnerable to third parties’ influences.
Kerim’s mother was easily interrupting the relationship. She was talking about Tasha in a negative way
and asking Kerim to break up with her and date his ex-girlfriend.
It can be assumed that Kerim’s role in his family was negatively influencing his romantic relationship.
His pleasing attitude toward his mother and his mother’s dominance made it difficult for Kerim to be
assertive and express his emotions. In his relationship with Tasha, Kerim was following the same
pattern and accepting what Tasha wanted from the relationship and disregarding his feelings. Since he
minimized and ignored his emotions, he fell into a pattern of disappointment and confusion.
This case study also illustrates the conceptualization of problems from an attachment perspective and
it elucidates that the couple was able to seek comfort, safety, and security from one another for a while.
However, ongoing betrayal was detrimental for them and it was also a difficult process to work on in
the therapeutic setting. Even though both partner benefited from couples therapy, they could not carry
their relationship into marriage.
REFERENCES
BURGESS-MOSER, M., JOHNSON, S. M., DALGLEISH, T., LAFONTAINE, M., WIEBE, S., &
TASCA, G. (2015). Changes in relationship-specific attachment in emotionally focused couple
therapy. Journal of Marital and Family Therapy, 42(2), 231-245. doi:10.1111/jmft.12139
DALGLEISH, T., JOHNSON, S. M., BURGESS MOSER, M., WIEBE, S.A. & TASCA, G. (2015).
Predicting key change events in emotionally focused couple therapy. Journal of Marital and Family
Therapy, 41(3), 260-275. doi: 10.1111/jmft.12101
DALGLEISH, T.L., JOHNSON, S. M., BURGESS MOSER, M., LAFONTAINE, M.F., WIEBE, S.A.,
TASCA, G.A. (2015). Predicting change in marital satisfaction throughout emotionally focused couple
therapy. Journal of Marital and Family Therapy, 41(3), 276-291. doi:10.1111/jmft.12077
GREENBERG, L. (2010). Emotion-focused therapy: A clinical synthesis. The Journal of Lifelong
Learning in Psychiatry, 8(1), 32-42. doi: 10.1176/foc.8.1.foc32
GREENMAN, P., & JOHNSON, S. (2013). Process research on EFT for couples: Linking theory to
practice. Family Process, Special Issue: Couple Therapy, 52(1), 46-61. doi:10.1111/famp.12015
JOHNSON, S.M. (2004). The practice of emotionally focused couple therapy: Creating connection.
New York, NY: Brunner Routledge.

Uluslararası Afro-Avrasya Araştırmaları Dergisi / Cilt: 4 Sayı: 8 /Haziran 2019
International Journal of Afro-Eurasian Research (IJAR) / Volume: 4 Issue: 8 /June
2019
e-ISSN 2602-215X
166
JOHNSON, S. M., & GREENBERG, L. S. (1987). Emotionally focused marital therapy: An overview.
Psychotherapy, 24(3S), 552-560. doi:10.1037/h0085753
JOHNSON, S.M., & GREENMAN, P. (2006). The path to a secure bond. Journal of Clinical
Psychology: In Session, 62(5), 597-609. doi:10.1002/jclp.20251
JOHNSON, S. M., MAKINEN, J. A. & MILLIKIN, J. W. (2001). Attachment injuries in couple
relationships: a new perspective on impasses in couples therapy. Journal of Marital and Family
Therapy, 27: 145–155. doi:10.1111/j.1752-0606.2001.tb01152.x
JOHNSON, S. M., HUNSLEY, J., GREENBERG, L., & SCHINDLER, D. (1999). Emotionally
focused couples therapy: Status & challenges (A meta-analysis). Journal of Clinical Psychology:
Science & Practice,6(1), 67-79. doi:10.1093/clipsy.6.1.67
SEEDALL, R.& WAMPLER, K. (2013).An attachment primer for couple therapists: Research and
Clinical Implications. Journal of Marital and Family Therapy, 39(4), 427-440. doi:10.1111/jmft.12024
ZUCCARINI, D., JOHNSON, S. M., DALGLEISH. T. L. & MAKINEN, J. A. (2013). Forgiveness
and reconciliation in emotionally focused therapy for couples: The client change process and therapist
interventions. Journal of Marital and Family Therapy, 39(2), 148-162. doi:10.1111/j.1752-
0606.2012.00287.x