A therapist’s guide to emotionally focused individual therapy (EFIT)
Written bySue Johnson, EdD
Last updated: 02/12/2024
Emotionally focused individual therapy (EFIT) is based on emotionally focused therapy (EFT), a tried-and-true methodology used with couples. EFIT focuses on helping people grow into a sense of secure, positive connection with the self—a self that is fit and vibrantly alive.
The theoretical base of EFIT
EFIT is like a conversation between British psychologist John Bowlby, the founder of attachment theory; Carl Rogers, PhD, the father of humanistic experiential therapy; and a group of passionate EFT researchers who for decades have studied what works in therapy to create lasting transformation in people’s lives and relationships.1, 2
Attachment is a science of belonging. It speaks to how our primary survival strategy is being wired for emotional connection with valued others. EFIT is grounded first in attachment theory, arguably the most extensively researched science-based theory of personality, growth, and relationships. Attachment theory tells us who we are and gives us a clear map to our deepest human longings, needs, and fears. This attachment map helps the therapist understand where to focus, how to tune in to the client’s world, and how to lead the client through vulnerability to a safe haven of competence and confidence.
EFIT intervention is experiential in nature, reflecting Rogers’ work. The therapist sends a clear, intentional message that each client is seen and safe in session so they can go to the edge of familiar experience. Then, in stepping past numbing, denial, or reactivity, the client can explore what feels frightening, alien, or unacceptable. They explore with the therapist the “order” in their lives, discovering patterns in how their key inner experiences or interactions with others are constructed in ways that lead to either growth or dead ends.
Rogerian therapists are experts in relentless empathy. They accept, reflect, and put together core elements of the flow of experience in the present moment, then deepen awareness so that experience expands and becomes clearer. This has been compared to the process of mindfulness, as outlined by Jon Kabat-Zinn.
Bowlby, Rogers, and EFT/EFIT practitioners see emotion as the prime organizer of our inner world. To shape meaningful change means to engage the client on an emotional level and use the momentum of emotion to “move” them into change. This fits with psychotherapy research stating that, across models, emotional engagement predicts good outcomes.3
To achieve this movement, we need an emotional map that illustrates how to evoke and order difficult emotions such as shame, sadness, and fear. EFIT offers therapists this map. The therapist tracks, validates, evokes, and restructures the client’s emotions so they become manageable and can be befriended.
Many clients are caught in cycles of emotional suppression, avoidance, and reactive escalation. These tactics for regulating feelings in unsafe environments end up becoming prisons that maintain distress. As my client Sarah said, “I don’t want to feel—it’s too scary. But now I can’t live empty and numbed-out anymore. So I am stuck, desperate, and getting more depressed by the day.”
In EFIT, clients can find their emotional balance, step out of these cycles, and be guided into and through their most vulnerable moments.
The goal of EFIT
EFIT strives not only for symptom reduction, but for personality growth and greater connection with the self and others. This kind of therapy enables clients to be more open and engaged with their inner experience and with other people—to be more alive.
Growth is our natural way of being. The client’s dysfunctional behavior is a distortion of a potentially healthy way of dealing with intolerable experiences. The therapist joins the client where they are, clarifies their predicament, and trusts in their innate health and ability to grow if given a safe environment. The therapist guides the client in confronting blocks to growth—such as the terror of rejection, which drives shutdown in relationships and keeps clients perpetually lonely as their terror increases.
A more specific goal is to choreograph transformative identity dramas where models of self and other are revised. EFT practitioners believe in observing patterns and testing explanations and interventions. EFT and EFIT arose from watching hundreds of videos of therapy sessions and noting patterns that either blocked or created growth for clients.
We are forever constructing our model of self in the core emotional dramas we shape with key others. New dramas can create new models of the self and transform how we see others.
My client Kat can close her eyes and shape a new image of an interaction with her mother where she can speak her hurt and need, and accept that her mother can’t respond. She then tells her mother from a place of balance that this was “a Mummy problem, not a Kat problem. What I needed was legit. I am legit.”
The four P’s of EFT intervention
Emotionally focused therapy can be used with individuals (EFIT), couples (EFT), or families (EFFT). In all of these forms, the work is grounded in the four P’s:
- The presence of the therapist, who is accessible, responsive, and engaged. These three variables define a secure bond and generate a sense of safe haven where risks can be taken.
- Exploring and distilling the present moment: What is happening right now as you’re saying this?
- The process of shaping experience and interaction: emotion regulation, engaging with others, and how these form process patterns that become self-perpetuating. The key question is, for example, how does Joe end up alone and ashamed all the time? He arms himself with anger and acts with belligerence; then, when people turn away, he tells himself that they’re all against him, so rage and aloneness are his only options.
- The non-pathologizing perspective required for growth, wherein the client finds their own truth and names their own demon. The therapist’s job is to seek out the logic, the core emotional response underneath “dysfunction,” and to enhance the client’s natural tendency to grow. Labels can then expand, so “depression” becomes “heartbreak” for Amy, and heartbreak must be grieved. Rick’s posttraumatic agitation becomes a desperate need to prove himself and deal with his fear that he is defective.
Who is EFIT for?
The simple answer is that EFIT is for anyone who can begin to engage with their therapist using a short-term, focused method. That said, EFIT is most often used for depression, anxiety, and posttraumatic issues.
How does EFIT work?
EFIT has three stages:
- Stabilization: In this first stage, the goals are to pinpoint the problem in process terms and help the client find enough emotional balance to tolerate shame, reactive anger, deep grief, sadness, and fear.
- Restructuring: In stage two, the therapist leads the client deeper into their core negative emotions and identity dramas, then back out into a restructured emotional reality and identity.
- Consolidation: Stage three integrates all the changes made in therapy and prepares the client for future challenges.
The EFIT Tango
In all these stages, the therapist uses the experiential skills of focused reflection to hold the client’s experience up to the light, validating and normalizing it. The therapist asks evocative questions and uses images, slow pacing, and tone of voice to deepen engagement in the moment. To open the door into deeper emotion, the “music” the therapist plays must be slow, soft, simple, and specific, and it should also repeat the client’s images and emotional phrases.
These skills are then consolidated into a macro-intervention sequence called the EFT or EFIT Tango. This sequence is so named because the tango is a dance of exquisite, synchronized response and movement built on mutual attunement and structured by emotional music. Both therapy and the tango can result in total absorption and an intense, trancelike focus.
The EFIT Tango has five moves. They aren’t mechanical and need not be completed in a set sequence. The client’s emotional processing determines the pace and structure of the dance. The moves are as follows:
Reflecting both inner cycles of emotion regulation and cycles between the client and significant others that feed the client’s symptoms and distress.
Assembling and deepening awareness of emotions; identifying core emotions (normally disowned fear, sadness, and shame); and making these emotions less frightening and more acceptable. New emotions shape a new compass and a new way of seeing the self.
Choreographing engaged encounters with the self and others: Here, new dramas with new emotional engagement are enacted either with the therapist or on an imagined level. Engaging with the most vulnerable level of the self and being able to hold, listen to, befriend, and grow with that vulnerability is key.
Processing the encounter: The therapist reflects and summarizes the process of enactment, helping the client confront blocks and integrate new epiphanies.
Integrating and validating: The client’s ability to grow in the session is celebrated, and/or blocks are accepted and validated. The therapist recaps the session so the client can own it and process it further.
EFIT brings the precision of attachment science, an effective way of working with emotions, and a high level of empirically validated interventions together with genuine attunement to and connection with each client. Visit the International Centre for Excellence in Emotionally Focused Therapy (ICEEFT) for books, articles, studies, DVDs, trainings, and connections with EFT learning communities around the world.
About the author
Sue Johnson, EdD, is the primary developer of emotionally focused therapy (EFT), which has demonstrated its effectiveness in more than 35 years of peer-reviewed clinical research. Her best-selling book Hold Me Tight (2008) now has a companion workbook and has been developed into a relationship education program available in numerous languages. This program has also been adapted for specific groups such as families with teens and couples facing cardiac disease. Founding director of the International Centre for Excellence in Emotionally Focused Therapy (ICEEFT), she trains counselors in EFT worldwide and provides guidance to over 90 affiliated centers.
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