The Session: Understanding Emotion-Focused Therapy (48:19)
Professor Robert Elliott meets with Peter about his relationship with his emotionally absent father. With Elliott's direction, Peter imagines his father present in the session and expresses regret about not helping during his illness. Then, he imagines he is his father, asking Peter to let him die. As Peter once again, he says goodbye to his father.
Introduction: Understanding Emotion-Focused Therapy (02:16)
Elliott says he was distracted by the film crew during his session with Peter; normally, he enjoys focusing entirely on one person's story for an hour.
Elliot enters into empathic attunement and focuses on client agency. Peter came in with unfinished business with his father; Elliot had him speak to an empty chair. Another possible task would have been addressing his misbehavior as a child.
Elliot organizes sessions into therapeutic work organized around tasks. Peter's session was split into connecting and finding his task, two rounds of empty chair work with his father, and closure work. Elliot analyzes Peter's guilt and unfinished business with his father through each episode.
Peter wants to discuss his relationship with his father. He provides an overview of his upbringing in 1950s Britain as a difficult middle child. He and his father never expressed their feelings; Elliott proposes he do an empty chair exercise.
Commentary: EFT Marker (02:37)
Elliott discusses the unfinished business marker in Peter's session, indicating something was missing in his relationship with his father. This led to the first round of empty chair work. This task usually generates an emotional reaction on the client's part.
First Empty Chair Work Round (13:29)
Peter envisions his father at the end of his life, evoking sadness and regret at their lack of emotional communication. He recalls the one time his father said he loved him after he had misbehaved to attract his attention.
Commentary: First Empty Chair Work Round (02:32)
Elliott discusses Peter's attempt to resolve the secondary task of his childhood misbehavior, including identifying an insight marker that he did so to attract his father's attention. EFT values awareness over insight, but insight is a powerful emotional process.
Preparing to Die (03:40)
Elliott explores Peter's emotions around his father expressing love. Peter feels sadness at his father's decline and regret at not taking his mental and physical breakdown seriously.
Commentary: Preparing to Die (02:42)
Elliott discusses how Peter's unmet need is around something he has not done. Elliott sees primary adaptive guilt as an indication of having injured someone important to us; in Peter's case, the challenge is repairing guilt towards someone who is dead.
Experiential Teaching during the Empty Chair Exercise (06:05)
Peter tells his father that he wishes he had been more supportive during his decline. He comes out of his "role" to ask whether he is doing the exercise correctly. Elliott comments on reassuring him before redirecting him to the task.
Second Empty Chair Work Round (04:26)
Peter describes visiting his father in the hospital, and wishing he had held his hand. Elliott offers his own hand to simulate physical contact and fulfill Peter's unmet need.
Father Simulation (05:16)
During the empty chair exercise, Elliott asks Peter to pretend to be his father. Peter says his father feels desperate to die, and wants his family to let him go. As himself again, Peter tells his father he accepts his decision.
Providing Closure Space (02:22)
Elliott explains that he gave Peter an early five minute warning during the empty chair exercise to check for unfinished business. This prompted Peter to simulate saying goodbye to his father and transform his final image of him.
Concluding the Empty Chair Exercise (04:04)
Elliott supports Peter in telling his dying father he is surrounded by people who love him, and in letting him go. He feels catharsis and a sense of physical relief.
Checking in with the Client (05:49)
Elliott asks how Peter is feeling about his session. He explains that he uses contact reflections during Peter's self-requested deep breathing exercise in order to maintain an empathic connection.
Session Themes (05:27)
Elliott reflects on empathic tracking and physically resonating with the client's experience while directing his process. He explains the EFT principle of changing emotion with emotion as it occurred in Peter's case.
Learning through Reflection (03:50)
Elliott enjoys continuing to learn new things while interacting with clients. In Peter's session, he experimented with the idea of subtasks, encountered a new situation with Peter's breathing exercise, and carefully offered his hand to provide physical contact.
Concluding Remarks (01:52)
Elliott discusses the mutual nature of the change process. EFT subscribes to a philosophy of dialectical constructivism, in which both the client and therapist are transformed. Peter's session reminded him of his relationship with his own parents.
A counselor himself, Peter found the empty chair work useful; Elliott's constant commentary helpful him stay focused. His inner voice questioned whether he was doing the task correctly. Elliott's experience brought up memories of his own parents, increasing empathic attunement.
Barry Kopp Interviews Robert Elliott (02:38)
Elliott was trained in clinical psychology in the U.S. In 1985, he worked with Les Greenberg and Laura Rice to develop EFT, combining humanistic therapy aspects. He came to the U.K. to teach at University of Strathclyde.
Defining Emotion-Focused Therapy (03:32)
Elliott distinguishes EFT from the emotional freedom technique. It accepts emotions as central to the change process, and understands them as organizing other life experiences. However, people can also become paralyzed by their emotions.
Emotion-Focused Therapy Philosophy (02:33)
The underlying philosophy of EFT is dialectical constructivism. Elliott outlines the constructivist view and explains the concepts of internal and external dialogue. For instance, our rational sides often criticize our emotional sides.
Emotion-Focused Therapy and the Person (01:57)
Emotions are constructed, self-organizing processes that appear stable but are constantly changing. Elliott explains the emotion schemes concept.
Emotional Difficulties (04:19)
Elliott explains how emotions can be problematic if they are under or over-regulated; not fully elaborated; if one emotion covers another, causing a secondary reactive emotion; or involve a past event, becoming a primary maladaptive emotion.
Building a Therapeutic Relationship (04:20)
Elliott discusses establishing an emotional connection, identifying client goals, and using tasks, or therapeutic work, to reach those goals. The relationship itself is healing and enables deeper emotional work. Elliott describes using the empty chair exercise for clients with unfinished business.
Experimentation in Therapy (01:47)
EFT sees the client as an expert on their experience; therapists are experts on processes and try different techniques. Elliott discusses how therapists use active talking to work with clients—often getting things wrong.
Task Selection (02:48)
EFT therapists use the empty chair process to resolve internal conflicts; focusing processes to identify hidden issues; organizing processes to calm clients overwhelmed by emotion; self-soothing to comfort raw emotion; and re-experiencing events, or unfolding.
In the 1960s, experiential therapy diverged from person-centered therapy. In the 1970s, Greenburg and Rice collected data on successful client tasks and reverse engineered them. In the 1980s, they studied therapeutic reactions and outcomes to understand the change process
Future of EFT (02:50)
Emotion-focused therapy began with treating depression, and added trauma and anxiety in the 1990s. Therapists are now working with clients with psychoses, cancer, and eating difficulties, developing the therapy in the process.
Counseling for Depression (04:07)
Elliott explains that the counseling for depression model attempts to balance traditional, person-centered therapy and EFT. He thinks of depression as getting stuck; therapists must avoid getting stuck with clients. Clinical depression can result from a negative event.
Depression Tasks (03:04)
The feeling of being stuck is the depression; clients make themselves depressed. Main presenting tasks include self-criticism and unresolved grief, or unfinished business. The process of depressing oneself often involves emotional blockage or interruption.
Self-Criticism Task (03:09)
Therapists must listen for the depressed client's critical and experiencer voices. We are all self-critical, but depressed people collapse under self-criticism. Depression is usually constructed and is often a self-generated message to fix something broken in the client’s life.
Different Kinds of Emotional Response in EFT (06:07)
Primary adaptive emotions like adaptive anger are evolutionary responses. Primary maladaptive emotion is an over reactive response based on historical events. Secondary reactive emotions tend to damage relationships. Instrumental emotions are displayed for intended effect. Hear examples of each type.
Emotional Deepening Process (04:02)
A recently formed EMT model attempts to integrate complexity. Clients present in regular sequences, beginning with an undifferentiated "bad" emotion that therapists help them to identify. Secondary emotional reactions are symptoms and often cover primary maladaptive emotions.
Addressing Core Pain (03:58)
Therapists help clients identify their core pain in the primary maladaptive emotion and its unmet needs—allowing them to bridge to an adaptive emotion. Primary adaptive emotions meeting these needs include protective anger, connecting sadness, self-compassion, love, curiosity, and humor.
Process Differentiation: Differences between Person-Centered Counseling and EFT (06:11)
EFT differentiates between good client processes and different kinds of therapist empathy. Person-centered counselors can find concepts overwhelming to think about during sessions. Concepts help with reflection, but identifying and working with client tasks is most important.
Unfinished Business / Unresolved Grief (04:21)
EFT therapists address unresolved relationships in depressed clients blocking them from new relationships. They go through the emotional deepening process from the secondary reactive emotion to access the core pain and its unmet needs. A self-soothing process helps them to recover.
Why Emotions are Important and Why We Get Stuck in Them (08:05)
Elliott describes the evolutionary purpose of emotions. They contain information about our situation, provide a sense of continuity and direction, and connect to action. Difficulties include emotional regulation problems, emotional underdevelopment, and blockage or interference by another emotion.
Credits: Understanding Emotion-Focused Therapy (50:09)
Credits: Understanding Emotion-Focused Therapy
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