TREATMENT: Emotionally Focused Therapy (EFT)

[BPDFamily.com]

Greetings. 

So, my wife (uBPD) and I are separated.  We have been for about two months.  I had a health issue that required surgery and she was angry with me for always being tired.  I finally couldn't take it and moved out.  But I'm still on the undecided board because we're trying to work through it.  I love my kids too much not to try everything before resorting to the Big D(ivorce!).

We recently started marriage counseling with a therapist who is trained in Emotionally Focused Therapy.  The basis of EFT (not to be confused with Emotional Freedom Therapy--something I know nothing about) is that the two people in a couple are emotionally intertwined with each other and cannot be separated as individuals.  Traditional marriage counseling often takes the approach that you work on each individual in a relationship so that they're better for each other when they come together.  EFT looks at the attachment relationship of the couple, how the couple interacts with each other on a broad level, and how attachment issues and trust issues cause couples to fight.  The details of the fights (you didn't do the dishes!) are less important than the overall picture of how fights start and end.  There is a book called "Hold Me Tight" by Dr. Sue Johnson that explains EFT and how it works.  I'm about a third of the way through the book and have had two therapy sessions.  I'm actually optimistic about EFT's effect on my wife.  It gets to the root of the reasons that she rages.  That she feels attachment anxiety over different situations is completely normal.  With a Borderline, though, it's the severity of the reactions that are out of whack.

Here is my quesiton: does anyone have any experience with Emotionally Focused Therapy and a Borderline significant other?  I'm trying not to get my hopes up for a miracle fix to our marriage.  But I do have some guarded optimism.  Am I setting my expectations up for failure? 

I'm also hoping she can be officially diagnosed during this round of therapy.  This is the first time she has decided to do therapy since her diagnosis was first suggested to me two and a half years ago.  I told our therapist about my suspicions.  And the therapist did--in a very gentle way--get on my wife's case for not being in individual therapy for her diagnosed PTSD.  So we'll see.

Thanks!

[Giganticus]

Greetings. 

So, my wife (uBPD) and I are separated.  We have been for about two months.  I had a health issue that required surgery and she was angry with me for always being tired.  I finally couldn't take it and moved out.  But I'm still on the undecided board because we're trying to work through it.  I love my kids too much not to try everything before resorting to the Big D(ivorce!).

We recently started marriage counseling with a therapist who is trained in Emotionally Focused Therapy.  The basis of EFT (not to be confused with Emotional Freedom Therapy--something I know nothing about) is that the two people in a couple are emotionally intertwined with each other and cannot be separated as individuals.  Traditional marriage counseling often takes the approach that you work on each individual in a relationship so that they're better for each other when they come together.  EFT looks at the attachment relationship of the couple, how the couple interacts with each other on a broad level, and how attachment issues and trust issues cause couples to fight.  The details of the fights (you didn't do the dishes!) are less important than the overall picture of how fights start and end.  There is a book called "Hold Me Tight" by Dr. Sue Johnson that explains EFT and how it works.  I'm about a third of the way through the book and have had two therapy sessions.  I'm actually optimistic about EFT's effect on my wife.  It gets to the root of the reasons that she rages.  That she feels attachment anxiety over different situations is completely normal.  With a Borderline, though, it's the severity of the reactions that are out of whack.

Here is my quesiton: does anyone have any experience with Emotionally Focused Therapy and a Borderline significant other?  I'm trying not to get my hopes up for a miracle fix to our marriage.  But I do have some guarded optimism.  Am I setting my expectations up for failure? 

I'm also hoping she can be officially diagnosed during this round of therapy.  This is the first time she has decided to do therapy since her diagnosis was first suggested to me two and a half years ago.  I told our therapist about my suspicions.  And the therapist did--in a very gentle way--get on my wife's case for not being in individual therapy for her diagnosed PTSD.  So we'll see.

Thanks!

[1q2w3e]

Going to try marraige counseling again, and am reaching out to therapists familiar with BPD and DBT; I'm waiting on callbacks right now.

But in my search, I came across this therapist that utilizes EFT, Emotionally Focused Therapy, in her couples sessions.

www.psychpage.com/family/library/eft.htm

I see aspects of validating emotions/feelings in EFT, and am wondering if anyone else has experienced this type of therapy, or has any insight on its effectiveness with those struggling with personality disorders.

Thanks,

1q

[zulumama]

My uBPDh has agreed to counselling with an experienced EFT therapist. I am interested to know if anyone has any information or experience with EFT therapy?

Just to clarify Emotional Freedom Therapy is not the same as Emotion Focussed Therapy which is a form of integrative counselling that has attachment therapy as it's underpinning. It is quite different from DBT but could possibly be used as an adjunct. I just have not seen much around about using it with BPD. Emotion Focussed Therapy is an evidence based therapy often used in couple therapy.

[Skip]

Here is some information on Emotionally Focused Therapy for couples... .

www.youtube.com/watch?v=dsYntOvTmlA

[amazingcharis]

A former marriage counselor of ours has advised that my uBPDh and I look into Emotionally Focused Therapy through a colleague of his who has recently had training in EFT.  I don't recall reading anything on this board about EFT.  Have any of you gone through this therapy with your pwBPD and was it successful?  How does it compare to DBT? 

The fact that this person's training has been recent and therefore probably doesn't have a lot of experience using the therapy makes me feel a bit cautious.

[MaybeSo]

I think EFT is great but I suspect it would be tuff for a pwBPD. Unless they had some skills or training first. The book Hold Me Tight goes through the process, written by Sue Johnsen, who developed this technique. It revolves around attachment so it actually could be very on target for BPD. It requires each partner taking turns deeply listening to and attending to each other emotionally. A very experienced practitioner would be best suited.

[newworld]

I agree that's why it would be tough on a pwBPD.

first- their emotions are labile, so what we see at home (Jekyll and hide) would likely happen in therapy

Secondly - their emotions are very painful/overwhelming/unsafe feeling to them, so I imagine it would be like asking a burn victim to pick at his burns - and then be happy about it and feel connected to the person ordering them to pick ... .

[MaybeSo]

It would be hard for both the pwBPD and their partner. The partner would be asked to listen deeply for the underlying emotional message from the pwBPD, and vice versa. This is akin to the technique of emotional validation taught on this forum. Probably one of the hardest things to do, because our partners routinely say things that we find hurtful and then react to what was said  without getting underneath to the emotional message, which is usually fear based. The pwBPD would likewise be asked to listen and attend to their partners pain, which would be hard for untreated clients as they would likely feel triggered/attacked. Of course a very skilled T would know how to prepare, pace, and when to quit. It actually is one of the best couples therapies targeted toward healing attachment wounds, and in theory would be excellent for BPD. I've looked in the past for studies to see if they have looked at EFT specifically with BPD and couldn't find anything. I looked quite a while ago, there may be something out there now.

[newworld]

My T is a Christain counselor. her specialty is intervention and then EFT. She works out of a center that uses only the EFT model.

I am going to ask her what she thinks about this question- it's a really good one -

[amazingcharis]

Thanks for your input, Newworld and MaybeSo. You've made some really good points that need to be considered. 

After going through two sets of professional counselors and a set of pastoral counselors (none were experienced with pwBPD but one set told me that they suspected BPD), my husband vowed never to have professional individual or marriage counseling again.  The fact that he was the one who recently sought our former marraige counselor's advice on a matter was encouraging to me.

I'd be very interested in what your T says about it, Newworld.  The person who recommended it to us is a Christian counselor, but it looks like that form of therapy is new to the association of counselors with which he works since only one person has been recently trained in it.

[newworld]

k

I am waiting to hear when my next appt is this week- so it will be a few days - I will definately reply though... .

[amazingcharis]

EFT (Emotion Focused Therapy) has been suggested to my uBPDh and I would love to read the article mentioned in the abstract below.  I've looked all over the web but can only find where it was published in the Journal of Psychiatric Practice and it would cost $49 for me to obtain a copy of the article from them which is much too steep for my budget. Does anyone know where else I might be able to obtain a copy of the article to read?

Emotion-focused principles for working with borderline personality disorder.

Abstract
This paper discusses the function of emotion, its importance in the treatment of individuals with borderline personality disorder (BPD), and the integration of emotion-focused therapy (EFT) principles in the psychotherapeutic management of patients with BPD. EFT principles involve emotional assessment; a strong therapeutic alliance as a necessary context for treatment; the therapeutic relationship as a bond that regulates affect through empathy, emotional validation, and interpersonal soothing; emotion-regulation; psychoeducation about emotional processes; the therapist as an emotional coach; and transforming emotion schemes as primary mechanisms of change. The authors discuss how EFT principles can be viewed as primary intervention strategies in the treatment of patients with BPD and how they can be incorporated into various psychotherapy approaches. Based on our experience, the integration of EFT principles into the therapy of patients with BPD shows promise as it has been helpful in targeting BPD symptoms, and is feasible and acceptable to patients.

Warwar SH, Links PS, Greenberg L, et al.  
St. John's Rehab Hospital, Toronto, Ontario, Canada.
J Psychiatr Pract 2008 Mar; 14(2) :94-104.
March 2008 - Volume 14 - Issue 2 - pp 94-104
doi: 10.1097/01.pra.0000314316.02416.3e

[survivalmode27]

In the last month I have come to grips with the unhealthiness of my relationship with my BPDH. I have set boundaries. I have researched separation and taken away the fear of separating. I am ready for a happier healthier life either way. I have given my H two options, separation or therapy. He chose therapy.

Our therapist is taking us down the path of EFT. She thinks that this will help us tremendously to where we can actually repair our marriage. My H has so far broke down every session, admitting to things I have never heard him admit to. He actually told the T that when he gets mad he says whatever he can say that he knows will hurt me the most rather it is true or not and then regrets it immediately but does not know what to do about it. Not that it is good, but the fact that he admits his accusations are not real, more of a weapon is good to hear. Always before it seemed like it was his reality.

I am keeping an open mind and trying to let the therapy work, however I am not getting my hopes up and still have the end goal of healthy, happy life for me and the kids.

Does anybody have any experience with this type of therapy. Any tips, success, or failures?

[Zon]

In the last month I have come to grips with the unhealthiness of my relationship with my BPDH. I have set boundaries. I have researched separation and taken away the fear of separating. I am ready for a happier healthier life either way. I have given my H two options, separation or therapy. He chose therapy.

Our therapist is taking us down the path of EFT. She thinks that this will help us tremendously to where we can actually repair our marriage. My H has so far broke down every session, admitting to things I have never heard him admit to. He actually told the T that when he gets mad he says whatever he can say that he knows will hurt me the most rather it is true or not and then regrets it immediately but does not know what to do about it. Not that it is good, but the fact that he admits his accusations are not real, more of a weapon is good to hear. Always before it seemed like it was his reality.

I am keeping an open mind and trying to let the therapy work, however I am not getting my hopes up and still have the end goal of healthy, happy life for me and the kids.

Does anybody have any experience with this type of therapy. Any tips, success, or failures?

My wife and I have been in EFT MC for months now.  Except for the first session (maybe the second too), she has cried in each one and has told me that she is not sure she can handle it anymore since she is not one to normally cry.  She has not admitted much unknown to me already except a few item.  You can see some of my posts (via my profile) for some of the events in the MC.

Recently, she has admitted to using hate to strengthen herself and be more important in my eyes.

[survivalmode27]

So do you find that it is helping or not?

[Zon]

So do you find that it is helping or not?

I wish I knew the direction it is going.  I will note that it is prying her open a bit.  She still does not quite recognize that she is a big part of the relationship breakdown.  I acknowledge my issues and she acknowledges some of hers but keeps saying how I need to change.  It does seem to have done a better than I originally thought.

The other day, she said that I need to let go of my hate.  I told her that I do not hate her (nor people in general); I merely react like one of Pavlov's dogs and feel anxious about another fight from her.  She thought she had not done anything this year to which I showed how she had done something earlier in the week.  Later in the conversation, when I told her that there is love yet I feel she hates me on some counts, she actually listed several things she hates about me.  The word "hate" was used by her for each one listed.

To get back to your question, I do not know if it is truly helping, but I do not see it hurting.

[Dutched]

A few yrs. before exHFBPDw left we have been in couples therapy, namely Gestalt Therapy.

I compared Gestalt and EFT. The EFT success rate is claimed to be a 75%  (for “normal” couples”?)

As I remember point of EFT is the deep emotional level on which the partners must be willing to operate.

It made me decide not to choose EFT as a BPD (of course it is a spectrum disorder) can be very very hard triggered as some emotions will hit the core. Certainly I expected that knowing exw.

So it became Gestalt Therapy. Very short it is based on the here and now.  Making one more aware of each other.

Anyway, we went, but several meetings were abruptly stopped as exw could not handle some (for her) emotional issues. Exw totally blocked, cried and got very anxious.

As with all courses one must commit and agree to follow up matters learned and agreed.

That is the difficult part.

For example, making real Q-time daily (during cooking, etc.) in which just ordinary matters are exchanged. Well, that went OK.

Heavier subjects (what annoyed me or her) should be discussed later in the evening (in order to process long enough ones own emotions in order to have a healty/healtier discussion later). Well… THAT was the difficult part for exw!  Or exw couldn’t control it and an outburst followed, OR exw “was not in the mood”, “to tired to discuss anything now”, “didn’t have anything to discuss”, etc., despite clearly visible all her emotion/frustrations.

What I am trying to say is:

A BPD expect us to do what they can’t fulfil themselves.

We must fulfil as agreed, however when I reminded exw., she tried to find arguments as an “excuse”.

So did Gestalt Therapy was of any help? 

Well, except from that emotional blocking, it gave more insight into the dynamics from a different point of view.

Projection of a BPD will be still around but with boundaries (referring each time the words of the T) exw did follow the rules most of the time. 

Further these T’s aren’t equipped to deal with our kind of relationships.  The main part to overcome is the resistant of the BPD partner

Good luck 

[survivalmode27]

Update- We are continuing therapy weekly and basically focusing on attachment theory, Hold me tight book.  I don't see any major changes at home outside of therapy, but in therapy BPDH seems to be making some headway. He is able to identify emotions and fears, other things besides anger and blaming. He has also admitted that he is so scared of abandonment that he needs me to physically be in the house with him for him to feel OK. I am not saying that we are happy this is the way things are, but I feel for a BPD to be able to see this and admit this is a major step to trying to recover, at least a little.

[MissyM]

We have done some EFT and attachment work but are concentrating on DBT right now.  After we have finished with the DBT therapy, we are looking to do some more EFT and attachment work.  We did find the little that we did helpful.

[Zon]

Update- We are continuing therapy weekly and basically focusing on attachment theory, Hold me tight book.  I don't see any major changes at home outside of therapy, but in therapy BPDH seems to be making some headway. He is able to identify emotions and fears, other things besides anger and blaming. He has also admitted that he is so scared of abandonment that he needs me to physically be in the house with him for him to feel OK. I am not saying that we are happy this is the way things are, but I feel for a BPD to be able to see this and admit this is a major step to trying to recover, at least a little.

That sounds pretty good.  I am glad it is working for you.

Personally, I would not be surprised if my wife has a bit of abandonment fears mixed with fears of being too close.  She wants to do things with me such as shopping, travel and events but not be intimate.  At times, she would be but only when she initiates (very infrequently).

My wife is still focused on how I should change (back).

[lifechangingdecision]

My husband and I just started EFT. We just got back from a retreat from it. I wrnt in with an open heart and mind but I am not expecting miracles. My biggest concern is that he never opens up or communicates. Never apologizes or takes accountability for his actions. He has BPD. I keep thinking is this really going to work until he works on himself first. We fought everyday on the retreat. Anytime we try to talk about anything he gets so mad and ignores me usially for days and that just nakes me angrier. Sometimes I feel like after 10 years of nonstop hurt and pain we are beyond repair. So confused I dont know what to do. My head tells me leving I would be so much happier and so wuld our kids but im so scared. He told me he woykd make my life a living hell if I left or he would commit suicide.

[GENERAL ANNOUNCEMENT]

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[Zon]

My husband and I just started EFT. We just got back from a retreat from it. I wrnt in with an open heart and mind but I am not expecting miracles. My biggest concern is that he never opens up or communicates. Never apologizes or takes accountability for his actions. He has BPD. I keep thinking is this really going to work until he works on himself first. We fought everyday on the retreat. Anytime we try to talk about anything he gets so mad and ignores me usially for days and that just nakes me angrier. Sometimes I feel like after 10 years of nonstop hurt and pain we are beyond repair. So confused I dont know what to do. My head tells me leving I would be so much happier and so wuld our kids but im so scared. He told me he woykd make my life a living hell if I left or he would commit suicide.

lifechangingdecision, I cannot say it will work or not.  It probably will not be obvious for quite sometime (many sessions).  I go, but I am not sure why.  She is acting more normal as of late.  She explains some of her actions.  Ironically, most of those actions seemed logical to me before she explained.  I did learn from the last session that when she gets really upset with me for no apparent (to me) reason is when she has read into what I have said or ask.  For example, when I asked her a question about a conflict between her and our D9, she stated that I "said" or implied something when all I did was ask a question about why she so upset at our daughter.

I wish you luck with the EFT.  More, I wish you luck with whichever outcome happens.

[survivalmode27]

So far it does seem to be helping. We have moments where he goes off and gets anger and tells me I am terrible. Usually when I am leaving the house. then later he will call or text and wish me a good evening, or tell me to have a good time. Where before he would not talk to me for days. It is as if he can now recognize rational thoughts and irrational ones.

[lifechangingdecision]

Zon thank you for your response. He hasnt gone to his therapy in 3 weeks and comes up with every excuse in the book. The doctor he gets his meds from is horrible. We have both read that there are alot of options and there are certain meds that people with BPD amd Bipolar have had huge great success with that his doc has never even mentioned. Ive suggested numerous times for him to try a new doctor but he always forgets to call. To me this says i really dont care and dont want to change. If there are alot of other options and you have the potential to feel alot better why in the world wouldnt u want too. I swear he likes to blame everything on his psych issues so he doesnt have to be as accountable for his actions.

[Kailin]

Hi, my SO pwBPD is seeing a psychiatrist. He seems to be recommending us to use Eft, emotionally focused therapy, for his treatment. He suggests that I speak from my deepest feelings (of fear or shame for example) while completely connected emotionally, in order to reach him and receive comfort from him. The theory is that this type of exercise can heal both of our trauma. I've read four of the main books suggested for family members of BPD and haven't seen anything recommending this type of treatment. Has anyone tried it?

[Tattered Heart]

I don't know anything about this type of therapy but I found a peer reviewed article on the subject of EFT and BPD. (or at least the abstract). You might be able to find the original article to see what the research has shown.

https://www.ncbi.nlm.nih.gov/pubmed/18360195

[Portent]

Well our marriage councilor was ETF and he felt that as a BPD she would respond better to DBT.

[Kailin]

I'm so glad that my post was added to this thread. It was informative reading other peoples experiences with Eft in a BPD relationship. My H and I went through a long faze of reading psych books ourselves and trying to figure out our individual issues as well as our problems as a couple this way. We read a few books about Eft and tried doing the exercises without the benefit of a T. This had disastrous results in two ways: 1: I tried to become securely attached and become a secure base for him by not complaining or becoming angry and providing every need or want that he had if it was in my ability to possibly do so. The result was that my BPDh became increasingly demanding and hard to please. The effect this had on me was that since he was becoming less and less reasonable and I wasn't allowing myself any anger or boundary's that I internalized all of that anger into shame and my chronic depression worsened to the point that I was very suicidal. 2: the second issue that happened was when we tried to do the exercise where you pour your heart out in a connected state about a wound or trauma that happened in the relationship in the past. When I did this (again without T supervision) He became the most emotionally disregulated that I have ever seen him. It was like a nervous breakdown. He is normally functional BPD but he became non-functional for a few months. He was crying often and would stare at me with eyes wide open like a terrified small child looking at a vicious dog. He would spiral and rock his body and cry hysterically. This is why I was worried to try eft again. I can see now though that working with a psychiatrist and taking it slow can possibly be good for us. He also has more emotional skills than he did before. Back then he was not able to tell what emotion he was feeling accept sometimes anger. Now he is starting to differentiate emotions and identify them, including shades of emotions like frustration vs anger. His T says that his progress is faster than his average patient which is promising. He is also sometimes able to see if he had unjustified anger in some circumstances, this is unprecedented in our 17yrs of marriage. I plan to use eft communication in moderation and not to address any deep anger or deep pain that he has caused me for the time being.