208: Emotionally Focused Therapy (EFT) with Dr. Sue Johnson

Welcome back to The Couples Therapist Couch! This podcast is about the practice of Couples Therapy. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.

This episode is dedicated to the incredible life of Dr. Sue Johnson. Listen to the episode on Apple Podcasts, Spotify, and your other favorite podcast spots, and watch it on YouTube – follow and leave a 5-star review.

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The Couples Therapist Couch 208: Emotionally Focused Therapy (EFT) with Dr. Sue Johnson

This episode is dedicated to the incredible life of Dr. Sue Johnson.

In this interview from nearly 5 years ago, Shane talks with Dr. Sue Johnson, the creator of Emotionally Focused Therapy (EFT). Hear how she came up with EFT, the patterns she noticed in her clients, how emotion organizes your inner world, the impact of working with someone in EFT, and the qualities of a good EFT therapist.

This episode covers everything from EFT to being an EFT therapist. Here’s a small sample of what you will hear in this episode:

  • What inspired Sue to become a therapist?
  • How can couples therapists use EFT?
  • What's an example of EFT in action?
  • Why do we put terrifying labels on things?
  • What is EFT?
  • How does the mammalian brain work?
  • What is Attachment Theory?
  • How does our prefrontal cortex work?

Learn more about the life of Dr. Sue Johnson at https://drsuejohnson.com/in-remembrance-of-dr-sue-johnson/

Check out the episode, show notes, and transcript below: 



 Show Notes


What is The Couples Therapist Couch?

This podcast is about the practice of Couples Therapy. Many of the episodes are interviews with leaders in the field of Relationships. The show is meant to help Therapists and Coaches learn how to help people to deepen their connection, but in the process it explores what is most needed for each of us to love, heal, and grow. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.



Please note: this transcript is not 100% accurate.

Dr. Sue Johnson 0:00
Your mammalian brain is wired to be totally lit up. By daunting conversations. They're full of survival significance. Your brain is just wired to go Oh wow. And to feel joy and to hold on to that experience. I mean, it's the epitomizes what we call the corrective emotional experience is to have a bonding experience with someone who's important to you in a session.

Intro VO 0:31
Welcome to The Couples Therapist Couch, the podcast for couples therapists, marriage counselors and relationship coaches to explore the practice of couples therapy. And now your host, Shane Birkel.

Shane Birkel 0:46
Everybody welcome back to The Couples Therapist Couch. This is your host, Shane Birkel. And this is the podcast that's all about the practice of couples therapy. Thank you so much for tuning in again, I have some really sad news, many of you have probably heard already, but the founder of Emotionally Focused Therapy, Dr. Sue Johnson has passed away. And she was truly a leader in the field and an inspiration for so many therapists. And I didn't have a personal relationship with her. She came on and did an interview about four and a half or five years ago, I'm actually going to share that with you today in her honor. But I know many of you had a personal relationship with her you did trainings directly with her. And I just I'm just so sorry. And to her family, I just want to send my regards. And I'll put some more details in the show notes, maybe post an article about the details of that. But I don't know if there's much else I can say about what a huge loss. This is for the world of couples therapy. in her honor. I'm going to keep this intro pretty brief. And just want to share with you this amazing interview that she and I did four and a half or five years ago. And so without further introduction, here is the amazing Dr. Sue Johnson. Hey, everyone. Welcome back to The Couples Therapist Couch. This is Shane Birkel, and today I'm very honored to be speaking with Dr. Sue Johnson, author, speaker, and the creator of Emotionally Focused Therapy. Hi, Sue, welcome to the show.

Dr. Sue Johnson 2:20
Hey, nice to be here.

Shane Birkel 2:23
I'm so excited to talk to you about everything EFT. You know, I really think it'd be nice for people to hear if they haven't already about your work as a couples therapist, when you were just starting off and what you were finding limiting about the models that were out there, and what sort of inspired you to start practicing in a different way.

Dr. Sue Johnson 2:44
I think the bottom line is that if I, if I'm really honest, you know, I don't every other kind of therapy I've done group and family and individual from a Raj Aryan point of view, and I work with a lot of different populations, violent men and really emotionally disturbed adolescents and care families. I mean, I, you know, and I thought I, you know, I was I was doing my, my doctorate, and I was sort of high, you know, I was high on the whole field. And I thought, I thought I was pretty hot as a therapist. Okay, I was pretty confident. And the bottom line is that I as my last sort of place that I went to, to do my clinical work, I had have a lot of experience, you know, compared to some of the other folks in the program. But the last place I went, the people said, well, so theoretically, you only have to see three clients over a period of months to fulfill your your requirements, but but actually, we've had a lot of terrible things happen in the clinic. And we're really strapped. And we would appreciate if you could see a couples on the hour, every hour for three days. And it was something like that, anyway, something pretty outrageous. And of course, I was in love with the field. And I was completely insane. In those days. I was just, I don't know what was wrong with me. When I look back at it. I was to say that I was on fire. I was I just was hurling myself at everything at 50 miles an hour. And you know, of course I said, Oh, sure, sure. And I thought, well, no problem. And then I started seeing these couples, my god. The bottom line is I felt completely uncut, incompetent. You know, I, first of all, there were two people in the room and they fought all the time in a different way than I'd experienced with families. I didn't know what the hell to do. And all my nice Raj Aryan approaches, they worked for a little bit. But basically, I felt incompetent. So I went, I was a graduate student. You know, this is what grad graduate students believe that every secret in the universe is in the library or they have to find it right You need the illusion When you're going to graduate school. So I went to the library, and I found all this analytic stuff on collusion and projective identification and insight. And it didn't help me at all. And then I went on, I found the most popular thing that was around, which was behavioral couples therapy alone, Neal Jacobson, who was just down from me, I was in Vancouver, he was down in, in Seattle. I read all his books, and I asked him, if I could go and sit in the back of his supervision, he said, no, go away. So I, you know, I read all his books. And he taught me to teach communication skills and during negotiations, and that didn't work with him either. And so I thought, Well, okay, then from my point of view, nobody knows what all this drama is about. And nobody knows how to do it. So what the hell am I going to do with it? Well, I'm an experiential therapist. So I'm going to take my clients, I'm going to watch them again and again and again and again, till I understand what the hell's going on. And I'm so glad I made that decision. And it's quite interesting because John Bowlby, the father of attachment theory, mean, he made the same decision, he said, with Mary Ainsworth, his, his researcher, he said, Well, if we really want to understand the ideas that I have, let's look at them in practice. Let's look at mothers and infants. And let's look at how they dance together. And we'll watch it and we'll see patterns. And I did the same thing. I said, I'm going to look at couples, until I see what's going on. And I would watch tapes, you know, 10-12 times, I'd watch it from their female clients point of view, I'd watch the male clients I watched, because only got heterosexual couples in those days. Okay, the gay folks weren't coming in, right. So, you know, I'd watch each client, I watched their reaction to me, I'd watch what I did, I watched what happened between them. I watch it and watch it and watch it. And of course, as I did that, I started to see patterns. And I started to see what I totally believe now, which is emotion organizes your inner world, and it organizes the way you dance with others, your emotional signals. So you know, I'm a rather intense person. So my natural thing is to grab the most powerful thing

I can see and go with it. So you know, I used to ride bloody great riding horses, right? Really, I should have died on some of those horses. So you know, that's kind of my personality. So I started listening to people's emotions and helping them change the signals they sent to each other. And something started to happen. And I just got so I don't know what the word is really. I was just on fire. I was so fascinated and enthralled. And to the point where when my advisor who'd given me who was les Greenberg, who had given me a nice little manageable thesis, you know, looking at tapes, I said to him, I don't want to do it. He's What do you want to do? And I said, Well, I want to, I want to write a little manual for this. And then we'll, we'll see if it works. And he said, you want to do a psychotherapy outcome study for your dissertation. I said, Sure. Why not? I said, That is insane. And he was right. He was right. So I did that. And when I look back on it now, you know, we did what was for the field of very rigorous, very quite substantial outcome study with Neal Jacobson, who thought the whole thing was a joke. He thought I was a joke. And who helped me actually, because he just thought it was so funny that I would even try and do this. And with some therapists for the clinical psych department, doing behavioral approaches, teaching people negotiation skills and communication skills. me during this weird thing that I got from nine sheets of paper called, either let's call it EFT, and then a waitlist. So it was very good. And I, I was very idealistic. And so I went to all this research books, and I made this thing as vigorous, rigorous as I could. And then we got these amazing results. And I was blown away. I ran them three times, because I thought, No, this is impossible. And indeed, you know, we always get great results, but we've never got results like that. I think it was, I don't know what it was. Everybody was on fire doing it. So, you know, I couldn't believe these results. And neither could Neal Jacobson, by the way he nearly died. I'm sure I'm sure. He wasn't terribly pleased actually. But But You know, and then I was totally hooked. But what I realized, and I always say this is I knew I had something I was onto something, I knew I started to understand relationships and this dance between people, and how emotion was the thing that was organizing the dance. But I did not understand really why we were getting those results. And it was a little while after we, I'd already got the job in Ottawa, I think I'd already sent the article off. And I just had this moment, when I realized that we were creating bonding conversations. And that's why and bonding conversations, your mammalian brain is wired to be totally lit up by bonding conversations. They're full of survival significance, your brain is just wired to go Oh, wow. And to feel joy and to hold on to that experience. I mean, it's the epitomizes what we call the corrective emotional experience is to have a bonding experience with someone who's important to you in a session, and I realized that was what was happening. And that's why we were getting these results. And by the way, I still believe that that's why EFT is the only approach to couples therapy, that gets the kind of results we do. And that gets results that last over time, our the follow ups that we've done, admittedly, they're only about three years long, because it's very hard to get people to fill in questionnaires. After three years, they just won't do it. Okay, it's not relevant to them anymore. But you know, over a three year follow up in the chaos, of relationships and why things change, we're the only approach I think that gets the kind of follow up results, we people even continue to improve after therapy is ended. And don't forget what we did, there was a very short therapy, because we didn't know what we were doing. So it was a short therapy. Now we do longer approach it longer. But we now do therapy with, you know, we have people, we've done studies with depressed folks and folks that have got all kinds of problems besides relationship distress. So we learned a lot and I was hooked for life. And I got a professor, you know, I got a job on the on that. And then I got all these wonderful people called graduate students who come and give you their time and their energy and their enthusiasm and, and it sort of took off. But in the last 20 years, two decades, it's taken off in a different way. Because adult attachment went from being something that everybody laughed at, to something that people are starting to recognize as amazingly important. And as attachment is simply the best, most rigorous, broadest, most significant theory developmental theory of personality that we have ever developed in psychology. And the point is, it's a relational theory, it's not a theory about what happens inside your brain or your head, or by yourself. It's a theory that puts the fish in the water, we are like fish and the water we swimming is our relationships, especially with significant others. When you don't pay attention to that you're looking at a fish out of water, if you take a fish and water the fish looks weird. You're I often think a lot of our all our labels in the DSM. I mean, they're all they're all focused on what what is going on inside somebody's head, they all take the fish out of the water. Right? And and what attachment does is it puts the fish back in the water, and looks at people in context, that context of their most intimate relationships. So that's taken off in the last 20 years. And as far as I'm concerned, it offers this amazing map that can integrate the whole field of psychotherapy, not just couples. It offers us an amazing map to people's inner world, their misery, their motivation, and two people's relationships and how those two things those two things come you know, attach was about biology in the end. But it's it's about how social interaction is a biological variable. It impacts your biology, your your relationships are not the icing on the cake. You're I'm watching the queen on Netflix. Which is silly because I'm actually violently anti monarchy, but I still find it intriguing as a story. And you know, the whole thing I pick it up from the royal family is how distant they were. Oh my god. You know, they're also you know, they speak in this incredibly correct English and You know, they're all incredibly correct. And they all you get this feeling of distance. And what I see is a whole bunch of people trying to survive alone. Oh, my goodness, that's hard. Yeah.

Shane Birkel 15:13
Fantastic. Yeah. Thank you. I'm wondering, I'm curious. You're talking about the change that happens. When you work with someone in EFT? Yes. And how that's much more lasting. And I'm curious if you could say more about what happens or why that is? Well,

Dr. Sue Johnson 15:31
one of the most referred to theories of change in therapy has been the whole idea of a corrective emotional experience. A lot of that came out of psycho psychodynamic, and, you know, you could see EFT as a version of experiential, humanistic therapy is certainly closer to psychodynamic than it is to traditional analytic or behavioral approaches, you know, and, and but then the tricky part is, what exactly is a corrective emotional experience? Well, what we found in EFT is what you have in couples therapy is an amazing arena for change, when you change your relationship in very significant ways, in ways that impact your nervous system, and right, and when you change your relationship, the partners start to change each other, because they start to create a safe connection. And that's the natural place people grow. And so I think in EFT what we do is recreate corrective emotional experiences where people can deal with their emotions in a different way, get their emotional balance, and then dance with their partner in a different way, a more open, responsive way. We know from attachment theory, what defines the quality of a bond? Yeah, what I just said. I mean, that's lightyears away from even what couples therapists were talking about 20 years ago. That's like, if I say to you, I know the basic variables that define the quality of any attachment bond, and I can create them in therapy. What I just said to you is, well, I wouldn't have been able to say that I certainly would have been able to say that to you. When I was a graduate student, it was like a Yuki, and it's emotional accessibility and responsiveness. And we add an E on their engagement. You know, the big question in relationships is, are you there for me? You know, and are you there for me? Are you accessible, responsive and engaged? And that is, what's the basic drama that's going on somebody else that question, and the answer is yes, on is no, or maybe. And that doesn't work. And what we do in therapy is create a corrective emotional experience where the answer is yes. Or not always, of course, even if the answer is no, it's better for people to understand that and grieve the relationship and come into some sort of balance. Right? And when what we see is that what attachment theory says is that when people feel securely connected to a significant other, their sense of self expands, their behavioral repertoire expands. Just like, you know, you take an animal and you give it safety, it starts to explore, it starts to play, it starts to open up, it starts to open up to its own inner experience, it starts to open up to its experience with others, right. It's your idols tango, and Argentine Tango, and it's all about attunement, okay? People don't not the silly stuff on the stage, that's just baloney. That's just theater. Okay. But the real Tango is all about attunement. And, you know, I'm a totally different dancer when I dance with somebody who I feel safe with. And I can pick up that safety in five seconds. That's why people who dance tango stand in front of each other and look at each other, and tune into each other. Right? And I know in the first few steps, if I'm safe with this person, if I can play with this person, if I can explore if I, if I should be careful about making mistakes with this person. Or if I if it doesn't matter, if we're just doing this amazing thing to music, and I dance. If you saw me, you'd say, oh, you know, that's weird. She dances totally different. Yes, I dance totally differently. And I have a totally different sense of myself as a dancer. You know, when I'm dancing. I was thinking one person I danced with last night. He just plays and I can play and we tune into each other. And when I dance with him, I know that I'm, I'm a pretty good tango dancer. But if you saw me On Friday night, when I was dancing with a few folks that I didn't feel that with, you would have said, Oh, she's kind of a, you know, she's alright. But she's just a boring conventional, you know, uptight dancer. So this is fascinating. So we create a corrective emotional experience of accessibility and responsiveness, where people can talk about their basic fears and get support from the other person. And their basic needs. You know, and, and, of course, you can do this in what we call a fit now Emotionally Focused individual therapy, which is in my book that came out in January, you can do it with an individual as well. I am working with a, an older, rather depressed Christian lady at the moment. Yesterday, she was telling me all, all the things that were wrong with her, and all the reasons why she didn't really deserve what she wanted was, she came to therapy to become more fully alive, which is not not something that I think and not a problem that you can do little coping techniques with, or little behavioral approaches, right. She wants to be fully alive, but she doesn't feel entitled to be fully alive, right? And so she was telling me all the things, reasons why she, she can't take in something good when I give it to her. And I said, Well, let's close your eyes. And let's have a conversation with Jesus about that. Why don't you can you see him you do say you talk to him every morning? Can you see him? Tell me what he looks like, what's his expression on his face? And I create a conversational dialogue. The same as I do in couples therapy, I created an individual therapy and you see him and tell him tell him, I don't maybe I don't deserve it. Maybe there's something wrong with me, maybe no, I can't listen to sue. When she tells me I'm brave. And you know, and, and what is Jesus say? See, this is so powerful, it's more powerful than me telling her you know, that she's brave, or, and of course, she tells me what Jesus says, or a version of Jesus. And she weeps. Because, of course, Jesus says, what he's what he says in lots of the Gospels, you know, he says, Jesus, by the way, I wrote it, I am not a practicing Christian. But it is fascinating to me that if you actually look at what happens in the Bible, not the rules or the church stuff. Jesus is Ara. He's accessible, responsive and engaged with everybody. And that's very interesting. You know, and so is the Dalai Lama, actually, the Dalai if you listen to the dial, these big spiritual figures, you know, they come across as open and accessible and engaged with people. You know, Dalai Lama is always giggling. He says things like, Well, what somebody said, Well, what do you do when you're afraid? I loved his answer. He said, he didn't say I go and you know, meditation. Oh, I feel my mother does love. I feel my mother's love. Because she loved me to see. And I still feel that and I tell my monks when you are afraid or angry yell mother. And I thought, Hey, man, you know all about EFT and attachment?

Shane Birkel 23:27
Yeah, so wait. So you can create a an attachment bond, even if you don't have a partner, or, you know, drop.

Dr. Sue Johnson 23:36
You can have this conversation. Like Irving, yell on, who's one of my favorite psychotherapist says, a good therapist gets to know the cast of characters inside their individual clients head. Because we're always having these conversations with people that were bonded with or attachment figures. And there are huge, they're a drama that's going on inside our head all the time. And they're where we decide who we are, and how to deal with our emotions, how to deal with our vulnerabilities. A lot of EFT goes to an existential level, where you're really working at the basic question of how do you as a human being deal with your vulnerabilities. And the essential issue with an attachment orientated therapist is that we believe the most functional way to deal with your vulnerabilities is to take it to another safe person and share the load and get the support because your nervous system is not wired to deal with your vulnerability all by yourself. It's just not wired for that. You can do it. But it costs you and it's difficult. And you know this is if you want to know someone who I did a brain scan study with Jim Kohn, who's my wonderful colleague from the University of Virginia, and he talks about this all the time, he says, we believe in our society that the most functional way to deal with your emotions is to self soothe, to be able to take care of them by yourself. He says, that's nonsense. We're social bonding beings. We're not, we can't do that. And in fact, the irony is if we, if we know how to turn to other people, and make and use that to make coherent sense of what's happening with us and deal with our vulnerabilities, we're better than at dealing with it by ourselves when we have to write, but that's not the theory we've had all these years, we still have a society that actually believes that you're supposed to be self sufficient, and you're supposed to look even feminism, you know, which is all I understand, it's about women standing strong, but they have all these things about like, you're supposed to look in the mirror every day and tell yourself, you're fantastic, you're great. You're worth it. Well, this is nonsense. The only people that do this are psychopaths. Right? So. So, you know, we look into other people's eyes. And and of course, if you're a feminist, you're allergic to the idea that women are supposed to look into man's eyes and find their own worth there. And I understand that. But there is a basic human truth that we defined, we aren't define ourselves all through our lives in this intimate in these intimate relationships, right? It would, otherwise we're cut off from context. So but you didn't, you asked me? No, you said, how do you understand it or something? I mean, what we do is we create these corrective emotional experiences by in a very specific way. It's not the irony is we are flexible, attuned experiential therapists, who are also directive on target, focused and scientific, right? Well, we go in and we assemble emotion, people's emotion in a very particular way, we deepen it in a very particular way. And we shift them into their vulnerabilities in a safe environment. And then we help them take those vulnerabilities into their personal dramas with me with the therapist. So I'll say to an individual, you're talking about this right now you are ashamed? Could you look at me? What do you see in my face? And the person says, I don't know. I want you to look again, what do you see in my face? And the processes you look sad? To Yes. I feel so sad for you that you feel this pain. It's not fair, is it that you feel this pain, I feel so sad, it makes so much sense to me in the person weeks, I'm creating an a dialogue or interpersonal drama, right, that starts to shift their reality. And then I do it with with people in their lives. So we're always creating a new way of dealing with your emotions and your vulnerability. And then you're taking that out into the dramas that people live in, in their heads and in their lives. And you're creating new, more positive dramas. And that, for me, is the definition of a corrective emotional experience. And it's one that your nervous system is wired to zing to, to hold on to your Neal Jacobson always used to say, the change happens when people do homework. And the trouble is, people won't do it. And by the time I was sitting in the back of his is supervision, because eventually he left me interested. And he'd say, you don't believe that? Do Su, you know, silly little student from Canada, you know, who sort of intrigues me but you know? And I would say, No, you're wrong. The change doesn't happen in the stuff we do in, in, in homework, and we don't have to make people do their homework. Change happens in session in new emotional experiences. And those experiences are so powerful. They don't have to practice them. They take them home. They they do them, they hold on to them, like you hold on to oxygen. When you get a hit of oxygen, your body goes, yeah, a lot will take me home. Yeah, I can breathe. So when people start doing these hold me tight conversations, as we call them in our couples therapy. They keep doing them. I mean, they don't get right. It's like they found the way home. They found a way to go through the inevitable miscommunication and missing each other and disconnection that you come into with a bond. They found a way to recur. come back together and create that synchrony that all bonding mammals are drawn to and longed for, and want whether you're a swan meanwhile, if you look at birds, you can see bonding or even look at people or babies. You look at birds, birds do these amazing mating dances. I show and our four day externship, which is all over the world. Now, I always show this little clip of Greaves doing this mating dance. And you watch it blows your mind. They do what we do in tango, they go into synchrony, they look at each other, they tune into each other, they start moving in synchrony, they start doing all these, but what are they doing? What Why bother? They're saying, are you there? Will you respond? Are you predictable? Am I safe with you? Will you come with me? Will you dance with me? Are you there? And then when the answer is yes, they stand up on the on the water, these birds, these grapes? Where are they? They're in Oregon, and they're on these lakes. They stand up and they literally move across the water together beating the water together. And it's saying This is nature's saying, Can you guys really young, vulnerable young? Can you guys share intentions and pick up on each other's communications? Can you are you guys going to be a team to connect and real vulnerable young together? When you will one of you come to the defense of the other? Will one of you feed the other of the nest? If not, it doesn't work. And so this is nature's way of this bonding dances are nature's way of saying are you going to you're good at this survival game, you're going to manage this. And of course, in adults, one of the main ways people get into synchrony is sex. But that's a big topic. We can have another discussion about that if you'd like. Yeah,

Shane Birkel 32:03
yeah. But that's fantastic. I love you're such a great speaker. As you describe this. I'm wondering if you could give an example of you know, a couple who's sitting in front of us in the office, taking some of these concepts that you're talking about? And how are we and obviously, you could probably talk for hours about this too. But the 10 minute version of how are you guiding them into that? synchronicity?

Dr. Sue Johnson 32:29
Oh, talk about simple couple because because we want to get the simple and this is on a tape. This is on a training tape. We've got lots of training tapes on the ICEEFT site, right www.ICEEFT.com. And we got lots of little videos on on my site too, but it's mostly me talking about things. DrSuejohnson.com. But I'll talk about a South African couple that are one one of our videos. I can't remember which one. It gets called shaping secure connection, but I'm not sure. So this is a relatively simple couple. They come in the therapist brings them in for a live because we always do lives in our externship live sessions. The therapist comes in and says, I want you to see this couple of because they're they're lovely couple, they love each other, it's obviously love each other. They're immigrants, they've gone through immigration, which is amazingly stressful, okay, they've left all the all their families behind in another country, right, they have to depend on each other in a whole new way. And when they emigrated, he had a lot of skills that were recognized. And the Canadian I can't remember, I think they were and and so he immediately gets a job. He immediately gets embraced by the society because he has skills that everyone wants, her qualifications are not accepted. And she cannot get a job. And then she falls and she, she I think she broke her wrist or some way there's a reason why she's in a lot of chronic pain. She's in her apartment, she's away from other people, she lives he's away creating a new job. She's in chronic pain. And, you know, she needs his support, and he's preoccupied with creating their new life in Canada and you can just see it as a recipe for everything going wrong. So she starts to get clinically depressed. As she gets depressed she gets more and more sensitive to his cues she feels more and more alone. The aloneness she feels is key to the depression as always, okay, that's what happens to us we get depressed when we're facing our vulnerability alone and everything starts to go wrong but there are soft couple your she's not an aggressive she's a pursuer. You know, she's demanding. But she's she's a lovely lady. But she's she's saying I'm getting angry and I don't want to be angry but I am angry. So she's it Soft, they're a soft couple. And when she says I'm angry, he looks at me with these big eyes like me. Right? So I said to the therapist will actually serve instead of only seeing them a few times, I don't know what to do with him. Because she's, I can see her your she'll talk about her emotions, and obviously she's missing him and she wants support, he has no idea how to give a he's completely in his head. He's completely into his male sort of role of coping. And he, he, when she tries to talk to him, he just gives her advice and coping, tells her how to cope, or totally shuts down and goes away. And, and she's getting angrier and angrier, and I don't want to deal with him. So she says, I want you to go in and work with him. You know, when we do lives, externships therapists bring a case in and they give us they tell us what they want us to do we try, right? So I go into my work with them. And I work and I see the cycle, I stay and I see the cycle. I check it out. Yep, cycle is, as the therapist described, the woman is agitated, upset, teary, telling him you don't listen to me, you know, da, da, da, you know, I feel like you're not with me, you know, and, and maybe I'm, maybe there's something wrong with me, I'm getting depressed. So she's kind of started to go down that rabbit hole, and she's pushing on him. And indeed, he sits and stays gives her logic and tries to reason with her and tell us she shouldn't be depressed and, you know, changes the subject and then goes silent. And he they do it right there. What is lovely about couples therapy is you see the drama right in front of you. You have to hear it in a narrative in individual therapy, or you have to let the client do it with you. But you see it, that's all in front of you. So and if you're confident, that's wonderful. If you've just started couples therapy, that's horrible, because you say, oh my god, what am I going to do with this drama? But you know, you get used to it, and then you know, the way through. So I I listened look at this cycle. Yes. She's pushing and demanding. Yes, he's turning away. And as he turns away, she demands more. And they're stuck in there. That's right. And can they repair this know? What happens at home? They have these arguments now. And he goes silent, as she gets more and more depressed and thinks she shouldn't have come to Canada and right, so Alright, so then I work a little bit with her. Because the therapist has told me she's quite open. And she's coming into stage one of EFT, which is, you know, she's starting to get her emotional balance and be able to talk about the emotions that are going on underneath her demanding behavior. Yep, she's doing great. So therapist wants me to work with him. So I go in and work with him. And he isn't very emotional. I say what's happening for you and your lady gets angry with you. And the only word he will come up with is unsettling. So I say this is hard for you. No, no, it's, it's just a little bit unsettling. I say so. And I try again, I say, and he says, yes, it's, as I said, it's unsettling. And then he'll change the subject and go off into his his head. So what I do is classic EFT, I stay with him. And I listen to him, and I pick up a few emotional handles. I can't remember what they are now. But I think one was something like, there's a moment of doom. Right. The therapist has said he uses this right. So I pick up what we call emotional handles, I start using them. And I say, so. But there's something in here where it's almost like there's some Doom happening. And he starts to look at me and his eyes get big. And he says, well, it's unsettling. And this, there's something here that sort of dangerous, and like doomed and I keep going. The point is a good EFT therapist knows where they're going. They've got a map. So they just stay on the path. And it's, they're almost irresistible. If you see a good EFT therapist working, they know where they're going, they know what's happening. And they the client starts to come with them. So then I start saying, There's something in that's hard for you and I go in and I assemble his emotion. I say so, when your lady turns to you and you see this what is what is the what is difficult. This is what it's like look on her face. So when you see that look on your face trigger. What happens for you? Well, it is something bad here. Yes, she says yes. It's unsettling something unsettling and bad here. Right? Yes. Basic perception. What happens inside your body? And he comes he says, Oh, I get tight here. I say, Oh, you could feel it in his body. We're getting somewhere. Oh, you get tight. Get a I get. So you get this tightness. And what do you say to yourself? He says, Well, I don't know how this is gonna work. very vague, right? Ah ha. You say to yourself, something's going wrong here and you don't know how to fix it. He says, Yes. I don't know how to fix it. And I must fix it. And I don't know how to fix it. Oh, that's so difficult for you. And then what do you do action tendency says, Well, I just go quiet. I go quiet, because nothing else works as it are. And then of course, you go quiet, and then she can't find you. And she feels even more alone. And she gets more upset with you. And I put it into the cycle. And I blame the cycle as we do any of Jessie and you're caught in this dance. And you're both alone in this dance. This is so hard for you. Basically, I work into I keep doing this. And I work into him being able to say that there's something here unsettling is there's something here that's almost scary. And he looks at me and he looks at me. And he says, yes.

Finally, you have to move. You have to tune into people and allow them to take the steps the size they want. Right? And, and he says it's scary. And then he changes it and says something like, it's I can't fix it. I can't fix it. And it's terrified. And then it's terrifying. Aha. So then we get his emotional experience tangible in the room. He's in it. He's feeling it. He's not talking about it. He's in it. He's feeling it. Right. I say good. So I summarize it. For him. I distill it. I say, could you try to tell your lady, please? What you're trying to tell your lady, I do shut down. I didn't know I was shutting you out. But I do shut down. Because I don't know how to fix it. And that's scary. And I don't know what to do with that. And he tells me, he looks at me. And he looks at me. And then he turns and he tells her. And you know, and it's fascinating. You see the whole thing shift. It's like watching a building shift on its access into a new shape. You see the whole thing shift, she comes towards him, her eyes filled with tears. She says, I didn't know that. I that helps me. It helps me so much to know that you're afraid that you're not just turning away from me. Because you think that I'm a bad wife or that I'm you know, there's something wrong with me, or you don't want to be with me. It helps so much know your thank you for doing that. And he looks at me. And he goes.

Shane Birkel 42:48
Yeah, because basically he's doing more of what he wants, he

Dr. Sue Johnson 42:52
finds a new way to fix it. Yeah, the way to fix it is to become more emotionally accessible and engaged. So that's the way to fix it. The way to fix it is to change how you dance with your partner. But people get hung up on. You know, I love John Gottman. He's wonderful. And we argue when we get together and he says, you know, people fight about parenting sex and finances. I say no, they don't. But that's just the content. That's just the first level of communication. If you listen, people always fight and only fight about disconnection. The others are just slight disagreements or nibble chronic differences. You know, my husband wants me to go hiking up mountains. I've been married to him for 31 years. I don't want to hike up mountains. It hurts my legs. I don't like it. But that's a difference. Right? We we've dealt with that 1000 times and it'll always be there. Right? He always says things like, well, of course, if you would come. What if you would go for so long? Well, if you would come, right, but it's no big deal. But a real fight is always about disconnection. It's about where are you? Where are you? So this is what I say to John, and bless his heart. We have great when we talk together we have great dialogues. And so from our point of view, the issue is always disconnection and distance. And the lack of this attunement. And the solution is always about bringing people together, we're stronger together. Once people come together and can support each other in their vulnerability, then the world changes. They change the problem changes, apparently, in solvable problems become solvable, because you're not facing them alone.

Shane Birkel 44:47
Yeah, I love that. And I think people use those things like parenting money, sex, to distract themselves from the vulnerability of what would happen if they thrust themselves into that emotional conversation. Shouldn't the fear that you got that guy to talk about? Is is terrifying for for some people to to put themselves out there like that, I think. Yeah,

Dr. Sue Johnson 45:10
and I, you know, we have lots of from my point of view of pathologizing labels to put on that sort of thing. But the way I see it is, for many people that is just foreign territory they've never seen, they don't even know it's possible. They see sort of versions of it on Hollywood movies, but it's all sort of tinged with whatever, Hollywood, you know, the message from Hollywood, it's all sort of superficial. They've never seen their parents or they've never done it with their parents, their parents never did it with them. They're in a culture where you just don't do that. You know, we've always worked with lots of military folks, for example, they've never seen this conversation, how would they move into it? Their nervous system isn't even wired to be open to it, and then they start doing it and their nervous system goes, Ah, you know, this is a bonding mammal making connection. My God, this feels good. And everything shifts. It's still fascinates me after all these years. I mean, I I'm still practicing, you know, a right now I'm doing effect emotionally individual therapy, because we're doing a big study on it. Because we haven't paid enough attention to doing EFT with individuals, right. So we're doing a big study, the first big study right now. But the whole thing still fascinates me. I mean, I'm no less fascinated than I was 30 years ago, because it seems to me that attachment science and the stuff that EFT has contributed and all the research now on emotion, you know, I have 70 trainers who go all over the world and take this stuff into Egypt, Iran, Finland, the slums of South Africa. You know, we have educational programs based on this for people who've had hardware, if somebody were a couple, one person's had a heart attack. I mean, this keeps growing. And I think it's because it's the first time that any approach to couples has been based on a real science of understanding romantic love. And it's bloody exciting. Yeah,

Shane Birkel 47:22
I agree. And now I'm all of the skills that a behavioral therapist might want to teach a couple. I imagine when you the way you describe working with that couple, when you start working with people in that way, and they have those aha moments in the session in their emotional connection, that they're going to start using those skills without needing to be taught them from the top down. Yeah,

Dr. Sue Johnson 47:46
all the research says that teaching people communication skills doesn't work, right. I think it's the wrong level. The point is, they can practice them in your office, but they're not going to do them when the bell rings in their relationship. And they suddenly hear that there's something going wrong. And the whole nervous system wraps up, you know, and they're looking to how to fix it a way out of this, you know, they do not go to their prefrontal cortex and access all these nice, clear communication skills they don't. So the only people that use those communication sequences, are the securely attached people who probably don't need them, do them anyway. So it doesn't work, you know, but what does work is for people to have this prototype in their head, or this blueprint of this powerful, emotional conversation that makes them feel better and connects them. And so they'll they'll move, they'll move into that. They'll say, I'm getting scared right now we're getting as people do they tell you, you know, I didn't go away from her and turn away and slammed the door. I turned around, and I said, we're doing that thing again. That thing we talked about in Sue's office, I'm getting scared. I don't know how to connect with you, I'm gonna lose you. And, and his wife is blown away and says, right, right. We are we are doing that thing. And this is where I start to feel like you don't care and I'm all alone. And then he says, Can we not do this? And she says, I don't know. What do you think? He says, Well, I love you. Let's go and have coffee. And she says, All right. So you know, this is an emotional learning. This is put down into your nervous system. And your brain says this is survival level stuff. This is oxygen stuff. And once you have this experience, you don't forget it. Just like you know, I was working with an individual lady. And I was saying to her you've gone through so much trauma in your life. I don't understand how you couldn't be so strong. You've got a loving man at home, you're, you're bringing up your children in a way that you were never brought up. I don't understand how you've done it. And I know in my head, I say, where did you feel seen and held? And she said, Oh my god, I know where did you feel seen a hell? Oh, well, I haven't told you about my grandmother to grandmother. She's, Oh, yeah. Oh, and then she tells me that in summers, she leave her appallingly traumatic homelife, and she'd be shipped off to her grandmother. And her she'd stayed with her grandmother all summer. And her grandmother, help comforted her and held her and gave her safety. Well, that grandmother is still alive, right. And what we do is we access the grandmother, and she's got the grandmother, and she tunes into that, that's a natural thing for us to do as human beings. And when couples can do that, they tune into each other, and know that the other person is there, when they're needed, the relationship just starts to bloom. And the wonderful thing is, so do that people. So do a good couples therapist, changes individuals, couple relationships, and families, or good couples therapist changes the whole caboodle, because they change the emotional music, emotional music that's defining the drama, on all those three levels. Once you start to change that everything's in play, people mean, Rogers said, If you give people safety, they'll grow. That's right. You know, and we pathologize the hell out of people put labels on in psychotherapy and in mental health, with we don't look at them in their context. What about Rogers and Bowlby basically said, that I can only remember the Sue Johnson version, basically, in, in, in mental health, what you have to do certain things to get you through the night when that connection with other people isn't possible. And often, what happens is this, those things are perfectly rational, shutting down and numbing out can save your life as a child in a dangerous environment. It's perfectly rational, it makes sense. There's nothing wrong with it, you shouldn't label it, it's an adaptive response. Trouble is people get stuck in it. And the protection that they create for themselves becomes a prison. Or they get stuck in this one way of dealing with their vulnerability, one way of dealing with their emotion. And then as adults, it doesn't work, it cuts them off from it constrains their world, it doesn't protect them, it becomes a prison. And then they, they they fall in love. And they don't know how to connect, and they don't even believe in connection. And at which the minute everything starts to go wrong, they numb out, well, this saved their life in another context. But now it keeps them trapped. So why do we label them? What's the point of labeling? You have to look at this drama, you have to look at the context, you have to look at the fish and the water, you know, and to say to the other guys got bipolar? Because occasionally he gets agitated and then in arms out so well, whatever. Nevermind, the label doesn't help me much. Let's look at the process. How's this guy dance with his own emotions and with his lady? Oh, how he dances with his he knows out? And what's that about? Oh, he already learned that he learned that in his terrible childhood. When he needed it. And I'm not going to pathologize it. I'm going to say yes, you numbed out that's brilliant. That's good. And now it cuts you away from your life. It shuts your lady out. So you, you leave him with his his way of dealing with that, that you add to it. Right and you help him learn to do something new. And, and then yeah, occasionally he gets agitated when he thinks he's gonna lose it. That's right. That the label bipolar is like, you know, all it tells me well, I turned it into process in my head. I say show me. Right, right. People say I can't dance. I can't dance. I can't dance tango. Show me. Well, no, you can't because you're, you're holding yourself completely rigid on the top of your body. And when your your partner sends you a cue, you gotta reach it. You don't you don't bend your body into your partner's Oh. So you know that's a process way of doing things instead of staying in labels and content. The FT People change through new emotional experiences, not through new explanations or cognitive labels. You can reframe things for sure. But it has to have emotional impact the reframes that matter to you have the emotional impact they've done in an emotional context. Well,

Shane Birkel 55:17
I am just so grateful for your voice and all this. I agree with what you're saying before, I think this is just such an exciting time that we're moving forward in a way that, like you were saying, we wouldn't have been able to have some of these conversations 20 years ago, even. And so I just so appreciative of how much of a trailblazer that you have been in bringing these things to the forefront. And I agree I see it with my own couples, about it being life changing, not just for their relationship, but for them as individuals for their families. I'm interested in this EFIT. I also think it was Gail Palmer I talked about talk to about EFT Emotional Focused Family Therapy. Another thing it's exciting to hear all these things branching branching out, but tell tell us more. You mentioned the website tell us more about where we can find more information about all these things. And, and your new book, who you know who would be who would that be good for to read? Well, my new

Dr. Sue Johnson 56:19
book was written for all psychotherapists who are interested in it. So attachment. I'm framing EFT as an experiential attachment orientated approach. It doesn't matter who you got in the room with you've got an individual a couple of our family. So my new book says, EFT is an attachment orientated approach. And attachment science is the way forward for psychotherapy period. It gives us some order and some way of integrating the field. Right. So you know, but and you can find all that on that book is with Guilford. It came out in January, it's sold amazingly well.

Shane Birkel 57:00
That's attachment theory and practice. Yes, listeners, yes,

Dr. Sue Johnson 57:04
EFT with individuals, couples and families. And we've done the first two training tapes of E fit, we have one out and another one's coming out in a couple of weeks, with me working with a client and with me and my wonderful colleague, Dan Campbell working with clients or individually to show people how we do individual EFT. And we're always putting out new couples training tapes and doing new courses. We I do courses with Cassie, we do. You can go my website, which we're changing right now. But you could go on my website and look at me giving little talks and you can find a hold me tight educational program in your community probably, which is my book hold me tight. If you're if you have couples, if you have couples dealing with illness, there's a program now for couples where one person has had a heart attack, for example, healing hearts together, you can find all this stuff. Oh, and I always forget, we have hold me tight. We translated it into an online program. www.HoldMeTightOnline.com We tried to keep it relatively cheap. I think it's like $299 You can do a an online course with your partner. It's fun. It's interesting. It's got people like my son in law, who used to be a radio announcer saying nice things on it and music and little quizzes and me, I look a bit like the queen on it. I'm kind of boring, because we decided that I was supposed to look safe. So I looked so safe. But anyway, you know, you you can go into that. And you can recommend that to your clients too. It would feed into your practice, it wouldn't compete with your practice. Yeah,

Shane Birkel 59:03
could be really helpful. If someone's working with a couple to have them do that hold me tight video course to enhance the work that they're doing. Yeah. And,

Dr. Sue Johnson 59:13
you know, we put a lot of energy into making it accessible and interesting. So there's all kinds of things happening. We're all we're all over the world. So

Shane Birkel 59:24
what's that website where all the externships are listed out?

Dr. Sue Johnson 59:28
www.ICEEFT.com, International Centre for Excellence. Pretty much the focus therapy. We've got about 70 affiliated centers all over the world now. So there's probably one in your community if you're, if you're in a city, there's one in Boston, if you're if you're in a city in North America, or a capital in Europe, you know, there's an EFT group there, or, you know, it's starting now on Facebook. Egypt, which love is blowing my mind. But you know, attachment is a biological approach to who we are as human beings, and how we relate to others. And it is supposed to be universal. It is supposed to go across culture, across religion across everything, sexual orientation, we're all bonding mammals, no matter what our image of God is all about what our culture is, or our politics, are we are you we don't get to choose, we are bonding mammals. And our nervous system is wired the same way. And we need other people. And we're stuck with that. So what attachment does is, keep your map to all that. So you've probably look around your community. If you haven't got a center yet, you've got a group of EFT therapists somewhere who are all meeting and looking at tapes. And we very much believe in community and team in EFT we're attachment people. So everywhere we go, we create teams, communities, local leaders, everywhere we go, we create this connection. Right? We feel like, I mean, that's the only way for you if you're going to make a change in people's lives and in society in general, by the way is not gurus, the way is not fancy gurus who spent a lot of money on marketing and who spend most of their life in self promotion. North America is very good at that. It's it's not about anything, except making money in the end. And you know, that's not the way so we do teams everywhere, and we believe in people contributing, you know, which is why people can join ISEF as members as well, you know, and so far, it's really working, it's where we just seem to get more and more excited, and more and more creative, and more and more. In fact, you know, my staff say to me, I walked in, and I say things like, I've got an idea. And whether I walk into my big office in Ottawa, or whether I walk into the smaller one now with my wonderful colleagues in Victoria, everybody grows. Now, right, like, Paul lays like, enough. Yeah, because they know, this is gonna turn into a study or a big DVD in Europe as some sort of enormous amount typing for them, or, you know, some huge charts for them. So they all look at me and go, right? Yes. Well, you know, they say things to me, like, are you going to retire? Which is ridiculous. If you retire from life? This is my life. I say, Yeah, I'm gonna retire the day before I die. How about that? Is that you know, that that'll do? It, you're actually you could look at them sometimes taking like, roll on, you know, because this is too much work. But we're, we're still having fun. So yeah.

Shane Birkel 1:03:10
Well, I love that idea of you've, you've created a community. And it's the attachment theory. It's the relationships, right? That it's not about like that, like being a guru or self promotion. It's about creating these relationships with so many different people and just continuing to have that spread throughout the world. It's, it's wonderful. And it goes, it's right in line with all of the work that we do as couples therapists. Thank you so much. I'm so grateful for you taking the time with this. I'll put all of this information in the show notes so people can easily find it, they can easily find the book, find the website. Yeah, I hope that we can catch up again at some point in the future. All right, thank you so much to Dr. Sue Johnson. And not just for this interview, obviously, but all of her work that she's done over the last 30 years for the field of couples therapy, and I'm just so sorry and want to send my regards to her family. And to all of you who trained with her personally had personal relationships with her. I'm just so sorry for this loss. And I hope all of you have a great week. This is Shane Birkel. And this is The Couples Therapist Couch,the podcast all about the practice of couples therapy. Thank you so much.

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