Barbara Wyer : : Book Abstract – Hold Me Tight by Sue Johnson
Johnson, Sue. Hold Me Tight. New York: Little, Brown and Company, 2008. 289 pgs.
EFT in the Paradigm of Marital Complexity
Sue Johnson, the author of Hold Me Tight, has been a driving force behind the development of Emotionally Focused Therapy (EFT) for couples. During her doctoral studies in counseling psychology at the University of British Columbia in the 1980s, she and thesis advisor Les Greenberg began developing a short term structured approach to couples therapy, calling it Emotionally Focused Therapy. Hold Me Tight is Johnson’s effort to distill her clinical research and therapy into a practical tool for all couples.
Taking over two decades of watching couples in distressed relationships recover and forge stronger, more loving bonds, Johnson extrapolates simple guidelines that explain how EFT can be leveraged by “real couples” to transform their relationships. Rooted firmly in her understanding of adult attachment issues, Johnson’s EFT for couples is both informed by and builds upon John Bowlby’s attachment theory, a “perspective [that] recognizes that our need for emotional connection with others is absolute” (p. 253). While all theories regarding marriage complexity share in common a belief that relationship patterns are impacted by love (or the lack thereof), Johnson points out “a key part of Bowlby’s attachment perspective is that we use the eyes of those we love to reflect back to us a sense of ourselves” (p. 91).
Johnson views adult attachment needs as the lynchpin of loving relationships. As she describes the Demon Dialogues (a sort of conflicted dance), EFT theory may be understood to fit best within the context of “Interactional” dynamics in the Paradigm of Marital Complexity. However, it can also be argued that a couple’s Family of Origin (“Individual”) issues play an equally important role in the influence of each partner’s attachment needs. Perhaps EFT is best described as an equal convergence of the Interactional and Individual dynamics present in a relationship.
EFT for couples is based on “encouraging a special kind of emotional responsiveness” (p. 49) and it asks three fundamental “A.R.E. Questions:” (1) Accessibility– Can I reach you when I need you? (2) Responsiveness– Can I rely on you for emotional support? (3) Engagement– Can I be sure you will value me and stay close? Johnson asserts all human beings need someone who will answer those questions with a resounding YES!
Achieving a Healthy Marriage Through EFT
According to Johnson, most marriage relationships break down not due to increasing conflict but as a result of disaffection and lack of emotional responsiveness. Her EFT for couples seeks to take partners beyond their outward emotional expression (fighting) to the inner distress about emotional disconnection.
In a healthy marriage relationship, says Johnson, securely attached partners become attuned to each other’s “core needs” and can express them coherently to their partner (p. 156). In Hold Me Tight she teaches couples about the Seven Conversations of EFT (pp. 50 ff): Recognizing the Demon Dialogues; Finding the Raw Spots; Revisiting a Rocky Mountain; Hold Me Tight; Forgiving Injuries; Bonding Through Sex and Touch; and Keeping Love Alive.
Interferences to Achieving a Healthy Marriage
As Dr. Johnson developed EFT for couples she sought to answer the question: Why did EFT work? She recognized EFT owed its success to the principles of attachment theory and that the great human need for attachment bonds did not end with childhood. She consistently identified three “Demon Dialogues” in distressed couples; an other-blaming “Find the Bad Guy,” the destructive, looping dance of the “Protest Polka,” and the deathly silence of a couple shut down in “Freeze and Flee.” While appearing different from each other, Johnson noted each served the same end; protecting self from further hurt and rejection from a spouse and in the end, further isolating partners from each other and any hope of achieving a healthier marriage.
Characteristics of a Healthy Marriage
The Boomers generation is the first to embrace the concept of therapy. Many self-help books on the shelves in the 1970s and 80s focused on lists of “how to’s” for achieving love and happiness by improving communication skills, among others. Sue Johnson proposed a radical new idea.
“Forget about…analyzing your early childhood, making grand romantic gestures, or experimenting with new sexual positions. Instead, recognize and admit that you are emotionally attached to and dependent on your partner in much the same way that a child is on a parent for nurturing, soothing, and protection.”
Marital health, according to Johnson, begins with the establishment of basic emotional safety. In order to sustain the secure bonds necessary for healthy adult attachment, couples must intentionally create “moments of engagement and connection” (p. 142). Johnson calls this the “Hold Me Tight” conversation, believing it to be “the ultimate bridge” and “tipping point encounter” in EFT. In the book she lays out a roadmap to assist couples in designing personal “bonding rituals” (p. 211) to deliberately and intentionally structure moments of connection.
Hold Me Tight is birthed from Johnson’s quarter-century of research and practice in the trenches of couples’ therapy. Her work has been published in The New York Times, a number of peer-reviewed journals (see References for a partial list of research by Johnson and her colleagues), and Time magazine, among others. From the early days of her studies in graduate school and continuing today at the Ottawa Couple and Family Institute and the International Centre for Excellence in Emotionally Focused Therapy, a breadth of empirical research by Johnson and her colleagues has proven EFT to have the highest success rate in achieving marital healing for couples. Outcome research studies have demonstrated EFT therapy to be successful for 70-75% of distressed couples and results appear to be lasting (Johnson, 1985 and 1999).
Personal Relevance and Agreement with the Theory of EFT
The author of this abstract has been asked to rate agreement with the material found in Hold Me Tight on a scale of 1-10. Given limited first hand experience with EFT it might be presumptuous to unequivocally give the book a 10, but Johnson’s statements about what makes couples “tick” deeply resonates with this 22-year married writer. The fact that outcome research continues to demonstrate EFT is effective for three-quarters of the couples who choose this form of therapy is astounding. The book, therefore, will get a “10.”
Several relationship issues discussed in Hold Me Tight stand out as particularly useful reminders in the context of this writer’s personal marriage dynamics. Johnson explains that when couples are trapped in their version of the Demon Dialogues and a safe connection between them is broken, the fight-or-flight mode that follows is not really the aggressive attack appearing on the surface. Instead, says Johnson, it is a desperate cry for reassurance and attachment, a cry that can “only be quieted by a lover moving emotionally close to hold and reassure” (p. 47).
Later, in a Play and Practice (where readers can act out the principles just taught, p. 139), Johnson describes a helpful process to de-escalate conflicts in a romantic relationship. She suggests reviewing memories of a somewhat unsettling (but not too upsetting) incident and talking about what feelings were involved for each partner, then writing a new ending to that story as a way to practice potential behavior reactions in the future. A number of insightful suggestions such as these combined to earn the book a “9” in helpfulness.
Numerous studies over the last several decades about EFT for couples have continued to inform therapists and scholars in clinical circles. While many academically oriented studies and books have been written on adult attachment and love the topic has never been presented in a format for the masses. Johnson states her goal was to offer a “streamlined version of EFT” and lay out a plan for readers to apply the principles of EFT in order to turn their relationships into a “glorious adventure.” She succeeds magnificently.
For Further Study: Selected Outcome Research
Retrieved online from http://www.iceeft.com/EFTResearch.pdf
Clothier, P., Manion, I., Gordon-Walker, J. & Johnson, S. M. (2002) Emotionally Focused Interventions for Couples with Chronically Ill Children: A two year follow-up. Journal of Marital and Family Therapy, 28, 391-399. Rev.5–August 2012 Page 3 of 5
Denton, W., Burleson, B., Clark, T., Rodriguez, C. & Hobbs, B. (2000) A Randomized Trial of Emotionally Focused Therapy for Couples in a Training Clinic. Journal of Marital and Family Therapy, 26, pp. 65-78.
Dessaulles, A., Johnson, S. M. & Denton, W. (2003) Emotion Focused Therapy for Couples in the Treatment of Depression: A Pilot Study. American Journal of Family Therapy, 31, 345-353.
Goldman, A. & Greenberg, L. (1992) Comparison of Integrated Systemic and Emotionally Focused Approaches to Couples Therapy. Journal of Consulting and Clinical Psychology, 60(6), 962-969.
Greenman, P.S., Faller, G., & Johnson, S.M. (2011). Finding the words: Working with men in Emotionally Focused Therapy (EFT) for couples. In D.S. Shepard & M. Harway (Eds.), Engaging men in couples therapy (pp. 91- 116). New York: Routledge.
Greenman, P.S., & Johnson, S.M. (2012). United We Stand: Emotionally Focused Therapy (EFT) for Couples in the treatment of post-traumatic stress disorder. Journal of Clinical Psychology: In Session, Vol.68 (5), 561-569.
Halchuk, R., Makinen, J. & Johnson, S. M. (2010) Resolving Attachment Injuries in Couples using Emotionally Focused Therapy: A 3 year follow-up. Journal of Couple and Relationship Therapy, 9, 31- 47.
Honarparvaran, N., Tabrizy, M., & Navabinejad, Sh. (2010) The efficacy of emotionally focused couple therapy (EFT-C) training with regard to reducing sexual dissatisfaction among couples. European Journal of Scientific Research, 43(4), 538-545.
Johnson, S. & Greenberg, L. (1985) Emotionally Focused Couples Therapy: An Outcome Study. Journal of Marital & Family Therapy, 11, 313-317.
Johnson, S. & Greenberg, L. (1985) The Differential Effectiveness of Experiential and Problem Solving Interventions in Resolving Marital Conflict. Journal of Consulting & Clinical Psychology, 53, 175-184. (EFT, CBT and controls tested.)
Johnson, S., Hunsley, J., Greenberg, L. & Schindler, D. (1999) Emotionally Focused Couples Therapy: Status & challenges (A meta-analysis). Journal of Clinical Psychology: Science and Practice, 6, 67-79.
MacIntosh, H.B. & Johnson, S. (2008) Emotionally focused therapy for couples and childhood sexual abuse survivors. Journal of Marital and Family Therapy, 34, 298-315.
Makinen, J. A. & Johnson, S. (2006) Resolving Attachment Injuries in Couples using EFT: Steps Toward Forgiveness and Reconciliation. Journal of Consulting and Clinical Psychology. 74(6), 1055-1064.