Sue Johnson Interview

Sue Johnson discusses EFT and Attachment Theory

In February 2014, Sue talked with Jim Thomas from the Colorado Association for Marriage and Family Therapy, where she discussed attachment theory, EFT and her book, Love Sense: The Revolutionary New Science of Romantic Relationships.  Our thanks to Jim for allowing us to use this interview.

Jim Thomas:  Hold Me Tight, your book for the public, was such a success.  It is still published only in hardback in the U.S. because of the steady sales.  Writing a book is no easy task.  What compelled you to write your second book for the public, Love Sense?

Sue Johnson: Writing Hold Me Tight was very satisfying.  It took the last 20 years of work in helping couples heal their relationships and put it in to a book for all couples to use and learn from.  What it did not do was articulate what I’m most passionate about.   Love Sense articulates the huge shift in understanding adult bonding and love.  Love Sense is a big idea book.  The core message is that it’s time to think about close relationships differently.  It’s time to think about adult love differently.  It’s time to think of us as a species differently.  Let’s recognize that we have a whole new understanding of romantic love, of partnership and of close relationships.  This is a paradigm changing book.  I want nothing less than to challenge old, harmful and limiting ways of viewing romantic love that exist in our culture, the media and in psychology.

JT: What is the core of this new paradigm about romantic adult love?

SJ: First, we must acknowledge that romantic relationships are bonds, not bargains or compromises.  Adult love is not a mystery or fleeting in its core nature. If we can see romantic love as an attachment bond, we can make sense of it.  If we can make sense of love, we can work with it and heal.  This is why I called the book Love Sense.  
As a trainer and proponent of Emotionally Focused Therapy and attachment theory, I would go home from training events with the feeling that even therapists were not getting the revolutionary new vision that attachment theory and science offers us about ourselves as bonding animals. This love sense, this way of seeing love as an attachment bond is revolutionary.  It changes everything for both couples and therapists.  Beyond that, it impacts the vision of what a human being is and what a human society is.

We need to be communicating to therapists and couples that attachment is the richest model and body of research we can use to integrate psychotherapy in general.

So Hold Me Tight was written for couples in distress.  Love Sense is written for everyone.  I would like policy makers to read this.  I want anyone who struggles to understand love to read this. I particularly want therapists to read it because they are the ones who can help us change the paradigm around love from a “fall in” endeavor to a “shape it and make it” endeavor. They are the front line of any revolution in our societies’ vision of love; in a sense, they are the people who make or break the scientific revolution because they are the ones who put our new knowledge into action and show people that love can work!

JT: You get at this on page 7 in the introduction to Love Sense, that you write this as “a revelation and a promise.”  Tell us more about that.

SJ: I was in Toronto a few days ago, tired after the 20th interview in 48 hours.  An interviewer asked me what I was trying to do in this book, and I found myself blurting out, “I am trying to change the culture of romantic love in this book.”  I think that I am trying to change a pessimistic culture that is amazingly dismissive of the power, hope and possibilities of romantic bonds. It almost denies caring and love and the significance of these bonds.

There is an urgency here. At times, I feel like I’m standing and watching couples, all of us, driving off a dark cliff while my colleagues and I are trying to hold up a sign post to a highway that leads straight home.  We don’t have to give up on lasting relationships. Emotionally Focused Therapy demonstrates in 16 outcome studies that we can shape loving bonds.  Attachment theory research shows us this straight road home again and again.

JT: What are some of these terrible things we are led or convinced ourselves to believe about relationships in these other paradigms?

SJ: Do we want to base our precious love relationships on a mystery?  This is not just benign misinformation.  It sculpts our moves in relationships.  If love is a mystery, then it simply comes and goes; we come to believe that there is little we can do. We simply fall in and fall out of love.

Second, there is the idea that “needing” a partner is some sign of mental instability and immaturity.  The idea is that you must become independent and have firm boundaries to stay separate and define yourself that way. And this becomes a rule for relating.  We still have psychologists who stand up and deny the thousands of studies on attachment.  They argue that the most functional way to be is to be essentially separate.  I would argue that we are wired to connect and the best way for us to live and live well is to be securely connected to a few precious others.

Third, concerning sexuality, there is the belief that the strongest drives are sex and aggression. Attachment science states that the need to connect is our strongest drive and puts sex into this relational context.  Sex is a key bonding experience for mammals.  Mammals that groom and protect each other and stay together to raise their young are flooded with bonding hormones when they mate.  Is that an accident?  Emotional intimacy and vulnerability fuels the best sex – synchrony sex, I call it.  This kind of sex then fosters closer bonding.  Sex and bonding are naturally entwined, but attachment is primary and defines much of how we are sexually. 

Fourth, there is the classic argument that monogamy is impossible and unnatural and having a long term love relationship is impossible without denying your sexual and identity needs.  A reporter told me recently, “Ethan Hawk says we are not meant to be monogamous anyway.”  I asked him why he wanted to base his guiding ideas about his relationships on the comments of an actor!  But, if you don’t have a scientific map, how do you know what to believe?  Ideas shape our experience and how we respond to our partner.  These ideas shape our cultural conversation about adult love.  They shape our love stories.

We must acknowledge that romantic relationships are bonds, not bargains or compromises.

Such myths lead people and therapists in the wrong direction.  We teach “skills” like set sequences of active listening, or we dive into teaching problem solving and negotiation skills.  These things can help, but they usually operate at the wrong level to really help couples move out of emotional distress and attachment panic.

A huge advantage that comes with practicing EFT is that when a couple says to me, “Can we fix this and can you help us? Can we heal from this affair?”, I have a confident and positive reply to give. Based on my experience and the research on our interventions, I can say, “Yes, we see people heal and craft new loving responses and we can help you do this. I expect you to get better.”  That is the first step out of despair for many couples.  And as they delve into EFT couple therapy, I hear partners say, “This fits,” and “This gets us to the heart of the matter.”

I also have a secure base to lean on as a couple therapist in that attachment science gives me a key to love and loving.  Again and again, attachment frames and attachment focused interventions guide couples back from the brink of divorce or the chaos caused by an affair.  What would we want therapists to take from this attachment perspective that would change how they approach couples and families in therapy?  I want therapists to see that they are engaged in a massively important enterprise. 

When a therapist helps a couple or a family gain more secure relationships, they are helping to create a civilization.  They are creating the basis for happier and more stable families.  They are creating the conditions that foster increased mental health and physical health.

This new understanding of adult love and bonding allows us to offer what our clients so desperately need – a way to loving emotional connection and the resilience that comes from this connection. This is like gold for our field and it is desperately needed in our society.  I see our job as helping people to learn about this code and use it.  It is liberating as a couple therapist to work with the natural emotions and longings and the wired in ways that people naturally connect.

And I want to say, that the hunt for the simple magical intervention is the wrong way to go.  I think this is looking for light in the wrong place.  I think we need to tune in to the most powerful inherent force in us as a species and use this force to help people grow.  The evidence is that the most powerful unconditioned, instinctive response in our species is the need to connect emotionally with another human being who would be there for you.  Therapists recognize this when an individual client bonds with them and in doing so is able to access new resources and take new changes outside of therapy.  We can help partners be this secure base for each other. Knowing how things work in love relationships allows us to access the power that is there.

You don’t have to teach people how to bond – just provide a safe place for them to explore their pain of disconnection, their fears and longings together. It’s a matter of blocking the exits and helping them get out of their own way.  If we help them tune into themselves and their partners, people already know how to be responsive; they just don’t know that they already know how to do it.

JT: Why does E.F.T. get such powerful, robust and long-lasting results with couples?

SJ: We address people’s deepest, most significant emotional needs and longings, so our interventions are relevant to almost everyone. We do not get many drop-outs in EFT, in our studies or our clinical practice.  Couples and families tell us that we get to the heart of the matter; we are on target.  The experience, the emotional balance they gain and the closeness they achieve stay with them over time and deepen. Once they know how to meet each other’s attachment needs and longings, they keep doing this – it feels so good, and every challenge faced together strengthens their bond.

JT: How did writing Love Sense change or impact you? 

SJ: (Laughs heartily) Apart from exhausting me? Well, it focused my passion even more.  As with couples in our sessions, when you focus on and really articulate something, you order and organize it.  You get new clarity and integrate things deeply. And you grasp key meanings in a new way.  Love Sense pulled me more into my passion for attachment. It intensified this sense that we need to be communicating to therapists and couples that this is the richest model and body of research we can use to integrate psychotherapy in general.

JT: That is a bold statement.  You are saying that attachment theory, the new science of emotions and this research can integrate psychotherapy in general, how?

SJ: Attachment integrates developmental, personality, interpersonal and neural science in one theory. There is no other theory that is empirically based and has such depth and breadth and it is a relational theory. It puts human beings in their natural ecological niche – relationships with others. Our world desperately needs to know about attachment. 

So many of our day-to-day problems arise from emotional isolation. We have electronic devices everywhere to allow us to always be in contact but not connected.  Our mammalian brain, our hearts, our social selves long for deeper, secure attachments in our daily lives.  Love Sense draws attention to the already huge body of evidence that close connection is the best recipe for mental health and physical well-being.

So attachment theory, with its clarity about health and optimal functioning, risk factors and how we become stuck in dysfunctional affect regulation and interactional patterns offers a natural platform for the integration of psychotherapy.  It gives a clear picture, for example, of how disconnection from others and insecure bonding may be fueling the rise in depression and anxiety rates in the United States.  It has allowed us to address these problems in a couple therapy context. A recent study by my colleague, Wayne Denton, shows good results using EFT with couples who also struggle with depression. Strong bonds build strong individuals.

Again and again, attachment frames and attachment focused interventions guide couples back from the brink of divorce or the chaos caused by an affair.

JT: How does the vision presented in Love Sense and in EFT differ from other approaches to couple relationships in therapy?

SJ: The first difference is that we do not focus on just intervention.  In general, couple therapy has been accused of being a grab bag of tools that addresses only the surface symptoms of relationship distress.  Salvador Minuchin, one of the great pioneers in family therapy, has said that our field made a crucial mistake when it moved away from trying to understand relationships into first trying to treat and change them.  I think this move came from a good intentions, from therapists wanting to help. But without a grounded theory of bonded relationships, we are left seeking magic interventions to address the apparent “mystery” of affectional bonds.

Attachment gives us an in-depth understanding of love and interdependence. This helps us understand how relationships work from the bottom up.  Attachment also helps us understand relationships and how they evolve throughout our lives. It does so in a way that other models cannot; simply because they are not based on a well- researched socio-biological model of what is means to be human.

You know, if you are an attachment oriented therapist, that teaching cognitive negotiation skills is most often not that effective in couples and families. It happens at the wrong level.  General research in psychotherapy outcome by researchers like Castonguay and by Coombs find that it is emotional engagement and connection with the therapist that predicts success in therapy, as well as a collaborative rather than a coaching approach to working with emotion.

Attachment also offers a very clear view of what goes wrong in close relationships and what is necessary to make them right.  A clear treatment protocol comes from a well-developed understanding of what the problem is and what is   necessary to create the best solution.  EFT is an attachment based approach to couple and family therapy.  With 16 positive outcome studies, we see that it works.  Numerous process studies of how change occurs have also helped us hone EFT interventions and training.

JT: What was the most compelling or intriguing piece of research you came upon in writing the book from outside of E.F.T. research that supports this understanding of adult love?

SJ: There are lots of them; it is tough to decide; I like three in particular.  Jim Gross has done great work on the suppression of emotion and how amazingly difficult and physiologically taxing this strategy is.  It’s so taxing; it stresses you out and it stresses the people around you because they tune into your tension. It also shuts them out!

Nancy Eisenberger’s work is also wonderful. She stresses that we are social and bonding animals.  Thus, social pain from rejection or being ignored are processes in the same way as physical pain. Both are danger cues, alerting us to survival imperatives. She finds this effect even in research tasks that involve strangers, imagine then the impact of rejection in our closest relationships. This kind of research helps us understand the huge impact that lovers and family members have on each other’s emotions, brain functioning and general physiology.

Jill Hooley also writes on the toxic effects of criticism from those we depend on. She suggests that such responses are equivalent to low grade punches to the brain.  These three stand out, but there were so many more that are outlined in the book.

JT: And there is an exciting, ground breaking study on EFT – one that showed changes in the brain, (Johnson, Coan, et. al., 2013, PLOS ONE), can you tell us about that?

SJ: For the first time, this study demonstrates that a relational intervention led to changes in how the brain responds to both contact comfort from a partner and an imminent perceived threat – in this case the threat of a painful electric shock to the ankles.  This study used fMRI imaging to show that, after EFT and key bonding conversations designed to create a more secure bond between partners, holding a husband’s hand modified the way women’s brains responded to threat and to the pain of shock. After therapy, but not before, these client’s brains were amazingly quiet and calm as they were given the cue that a shock might be coming, and they reported that the shock was simply uncomfortable rather than painful. Attachment theory predicts that a felt sense of secure bonding changes offers us a safe haven where threat can be tolerated and modified, and this is what we saw in this study.

This study was part of a larger study designed to show that EFT interventions can indeed change the security of a couple’s bond – the emotional responsiveness – the love they have for each other. It speaks to the enormous advances made in the social sciences that we can do a study like this – and it speaks to the enormous promise of our field. We talk lots about environmental sustainability but for me, human kind sustainability is all about whether we can learn to connect and co-operate to build loving partnerships and families that foster truly civilized societies.

When Ghandi was asked about western civilization he replied, “I think it would be a good idea!” It seems to me that professionals who know how to show others how to build loving relationships are a key part of this “good idea”. And we are moving to the place where we know how to help people build the kind of partnerships and families that to do just that – create an empathic and truly civilized society.

Thanks for your questions and for listening, Jim.