Couples Therapy Final

EFT - Emotionally Focused Therapy

Focus: Attachment bond & emotional accessibility

Key concept: Negative cycle (pursue → withdraw)

Affair: Attachment injury — validate pain, rebuild bond

Depression/Trauma: Withdrawal = shutdown, not rejection

LGBTQ+: Minority stress = chronic attachment threat

Stages: De-escalate → restructure → consolidate

Gottman Method

Focus: Friendship, conflict, shared meaning

Key concept: The 4 Horsemen

Contempt (most destructive) → antidote: appreciation

Criticism → antidote: gentle startup

Defensiveness → antidote: responsibility

Stonewalling → antidote: self-soothing (20-min break)

Affair: Atonement phase — transparency + consistent behavior

Cultural couples: Build Shared Meaning (Level 7)

Love Languages (Gary Chapman)

5 love Languages: Words of Affirmation, actives of service, receiving gifts, quality time, physical touch

Affair: unmet love language created vulnerability

Depression: Symptoms silence love languages — not rejection

Trauma: Physical touch may be triggering — assess first

LGBTQ+: Affirmation especially powerful for those w/ rejection histories

CBT/CBCT (Beck, Epstein)

Focus: Distorted thoughts & maladaptive behaviors

Key techniques: Cognitive restructuring

Automatic thought → examine evidence → reframe

Subs use: Enabling = systemic pattern, not blame (BCT model)

Cultural couples: ‘They don’t respect my family’ = automatic thought to test

LSBTQ+: Internalized homophobia = self-critical thought → restructure

Emotional Disconnection/Distance

Lead Model - EFT

Why: attachment bond is the primary issue

High Conflict, contempt, criticism

Gottman

4 Horsemen framework targets this directly

Individual depression or anxiety

EFT + CBT

Attachment withdrawal + cognitive distortions both at play

Trauma/PTSD

EFT (+CBT for psychoeducation)

Safety and attachment are foundation to trauma work

Affair /Betrayal

EFT + Gottman

Injury model + Atonement phase complement each other Su

Substance Use / Recovery

CBT (BCT model)

Behavioral patterns and enabling cycles are the target

Cultural / racial differences

Gottman (shared meaning) + EFT

Build shared narrative; explore attachment to cultural identity

Attachment Injury

occurs when a significant attachment, including partner, figure does not meet your emotional needs at a critical moment

Flooding

High physiological arousal (fight-or-flight response) predicts relationship breakdown

Signs include rapid heartbeat, sweating, chest tightness, feeling overwhelmed

Causes defensiveness, stonewalling, and misinterpretation of intentions

Enabling (CBT/BCT)

Behaviors that help to maintain use - CBT helps partners identify behaviors that maintain use — not from blame, but from pattern recognition

Minority Stress

Stigma, prejudice, and discrimination create excess stress. Internalized homophobia, concealment, and vigilance erode relationship quality

Negative cycle (EFT)

a self-reinforcing, often destructive pattern of interaction that couples fall into when their emotional needs are unmet. A predictable loop of behaviors and emotions that escalate disconnection rather than repair it

4 Horsemen

Stonewalling - withdrawing to avoid conflict to convey disapproval, distance, and separation

Contempt - Attacking sense of self with intent to insult or assuming a position of moral superiority

Criticism - Verbally attacking personality or character

Defensiveness - Victimizing yourself to ward off perceived attack and reverse the blame

Cognitive Restructuring (CBT)

a core skill that helps you to identify, challenge, and replace unhelpful or distorted thoughts with more balanced, realistic ones

Cultural humility

A life-long process of self-reflection, self-critique, and respectful engagement with people from diverse cultural backgrounds. Not about mastering cultural knowledge, but about recognizing the limits of one’s own cultural lens and approaching others with openness, empathy, and a willingness to learn

Secure bond

Step 1: De-escalate negative patterns

Step 2: Express Attachment Needs

Step 3: Shape secure connection

Shared Meaning

The sense of purpose, connection, and cultural identity that couples build together over time

The ‘culture’ of your relationship

Automatic thoughts

rapid, reflexive mental reactions that occur in response to a trigger or event. They often happen so quickly that we don’t notice them, but they can strongly influence our emotions and behaviors

Atonement Phase

The first and most critical step toward healing after infidelity. It focuses on full accountability, transparency, and remorse from the partner who had the affair