Itziar Arana: "In couples an attachment bond is also created".

Psychologist Itziar Arana talks to us about Emotionally Focused Couple Therapy.

There are many ways of interpreting and perceiving the problems that arise in couple relationships. For some people, what does not work has to do with expectations; for others, what fails is related to the expression of emotions; in some cases, it is concluded that the couple's crisis has no solution.

It is normal that there are several interpretations of apparently similar phenomena, because human relationships are always very complex, and even more so if love is involved. Depending on the facet of that relationship on which we look, we will obtain different conclusions.

In the world of couples therapy there is something similar: there is no single way of intervening in marriages and engagements that need a "tune-up", since we can start from markedly different work philosophies. In this case we will get to know one of these working models in couple therapy, Emotionally Focused Couples Therapy.. The psychologist Itziar Arana, who has been using it for many years, will explain its keys.

Interview with Itziar Arana: Emotionally Focused Couple's Therapy

Itziar Arana Rivero is a psychologist expert in couple therapy, a field from which she helps people involved in marriages and engagements in her office located in Madrid. In this interview he explains his conception of psychotherapeutic assistance services for couples, and tells us about Emotion Focused Therapy applied to this kind of cohabitation and communication crisis.

How would you summarize the main idea on which couple therapy is based?

Human beings are social beings, and more than that, we are emotionally attached beings. From our earliest childhood, and even before we were born, we need each other in order to survive, we need bonds with significant people, as John Bowlby said in his Attachment Theory.

This attachment bond is also established in couples. It is no longer unequal as in childhood where parents mainly give and children essentially receive, but attachment after all. Adult attachment. Couple relationships are a type of relationship in which we feel seen, loved, valued... secure.

From the perspective of Emotion Focused Therapy EFT, created by Sue Johnson, we understand the conflicts that bring couples to therapy as a protest to the disconnection of this adult attachment. When we feel that our bond is in danger, that our need for connection is not being met, that is when fights and disagreements appear, because we need to know that we can tune in again with our partner.

From your professional experience, what do you do when couples therapy patients see the problem as something "encapsulated" in the other or in oneself, and not so much as a relational problem based on the interaction between two people?

My experience is that most couples who come to therapy do so from very opposing positions, in which they certainly feel that the problem is the other, or perhaps they are themselves, but yes, in general they do not experience it as a relational problem, although perhaps as a communication problem.

When so many emotions are at play, as in any couple's conflict, it is difficult to be able to get a clear picture of what is going on. Generally patients know their anger quite well, that which leads them to tell their partner everything that is wrong, and also that desire to disappear so that the conflict will end, but they know very little of all the emotions that lie beneath. Most of them can talk about a rather "amorphous" discomfort, if I may say so, and little else.

With the help of therapy, they are discovering, naming, accepting and experiencing the emotions underneath. And it is from this knowledge and recognition of our emotional world from where we can understand that the problem is not my partner, or me, but how sometimes we feel insecure in our bond and react trying to regain the connection with the other, although paradoxically we achieve the opposite.

Your work with couples is based on Emotionally Focused Couples Therapy, what exactly does it consist of and why do you think it is more useful than other types of therapy?

In EFT we do experiential work, within the session itself, which leads the couple to get to know each other in a deeper way, to be able to get involved with their own emotional world and that of their partner. We understand that emotions are the goal of therapy and at the same time the agent of change, so we put all our attention on them.

Generally, in my case, in the sessions the couples go into their emotional world, session by session, and discover what emotions are awakened in them that generate certain thoughts and behaviors. This is done as carefully as possible, respecting the time of each member of the couple, taking care that each of them feels safe in the process.

As to why I think it is more useful, I would say that today because I see it with the couples who consult me. But at the beginning, when I started my training in this model with Sam Jinich in Zaragoza, and I had not yet put it into practice in consultation, simply because he tuned in with me. At that time I had been with my partner for more than 15 years and everything, absolutely everything I was told in the training, resonated in me, in my emotions and in my own couple bond. I felt acknowledged in the bond and in the protest of disconnection, and I think we would all feel that way, because attachment is universal.

What are the main stages in which Emotion Focused Couples Therapy develops when, for example, a married couple comes to you for professional help?

This question would be very long to explain, because the EFT model is very clear for therapists and gives us a map of where the couple is and where they should go. But in short, summarizing it very much I would say that there are three fundamental stages.

In the first one we try to stabilize the conflict they bring to therapy. We promote the understanding of what is happening to them, why they argue so much, what reactions do the behaviors of the other provoke in each one, what thoughts appear in those moments, what emotions are put into play in these discussions,... and that they understand how this cycle of negative interactions traps them both.

In the second stage we promote a structural change in each of the partners that also restructures the bond between them, turning it into a secure bond for both of them.

And finally, in the third stage, we consolidate this change and talk about the most practical conversations about their daily lives.

What is known about the effectiveness of this therapeutic approach and what kind of problems or needs is it most helpful for?

There have been several studies on the effectiveness of Emotionally Focused Couples Therapy (ECT) in the United States and Canada that show that between 70% and 75% of couples who follow this model reduce their conflicts and feel more secure and happier in their relationship. And 90% report a significant improvement.

Not only this, because follow-up studies have also been done, years after the end of the therapy, and it has been found that the change generated by KET is particularly stable, it is maintained. Which, from my point of view, is an added value of this type of therapy.

In fact, the American Psychological Association has recognized Emotionally Focused Couples Therapy (EFT) as a clinical treatment of empirically proven efficacy because it has a clear formative process and there are several randomized clinical trials demonstrating its effectiveness.

This is in the USA and Canada, but EFT is a model in continuous advance, a living model, which is being refined day by day, and although it is based on something as universal as attachment, it is believed that the cultural factor may influence its refinement. For this reason, researcher Martiño Rodríguez-González of the University of Navarra, with the support of experts from the USA and Canada, is currently initiating the first randomized clinical trial in Spanish-speaking couples.

This study will be conducted in the countries of Argentina, Spain, Mexico and Guatemala. And I am fortunate to be one of the therapists selected to be part of it.

Could you give an example of how Emotion Focused Therapy helps to manage arguments or love conflicts?

In a first session the man says: "When he gets like this, telling me that I'm doing everything wrong, I can't take it anymore and I have to leave".

Later sessions: "Really, when I only hear everything I do wrong from her mouth, with all the efforts I make to do it right for her, I feel completely frustrated and I need to walk away".

Some more session: "It is very painful for me to try to do well, to do well for her, for her to be happy, for us to be happy, and to feel that I will never be able to reach the bar she sets. It hurts me deeply to feel that I am not and will not be able to, and I can't stand the look on her face in those moments, I have to go."

And if we follow....

Many times it is not easy to know if an argument or incident is part of the normality of the love relationship or if on the contrary it is a significant symptom that something is not going well. What would you recommend to learn to distinguish between these two types of situations?

The practical issues in life in which disagreements in a couple can appear are many and of all kinds: education, family, work, extended family, friends... in general any topic. Normally the partner is the person chosen to accompany us in almost all facets of life and that is why his or her opinion is important.

But, at the end of the day, we are talking about two different people, raised in different environments and with different ideas; and this often leads to a lot of differences of opinion on issues that we consider very important, such as the education of children.

Having said that, I think it is understood that all couples argue, I would say in a practical way, about what to do and what not to do, in each situation. And whenever a couple argues there is always some discomfort between the two, it is not a pleasant feeling for one, nor for the other.

But it is also true that there are discussions that go beyond this practical character of two opposing opinions looking for a solution and make us feel insecure about this bond I was talking about before.

When we feel that the discussions do not end, but are postponed to a new confrontation in which there will be more of the same, more insecurity and frustration.

When we do not argue and there is a certain calm, but we experience it as tense because we still feel insecure in our relationship.

When we choose not to argue and say what we really think for fear that it will totally destroy our relationship.

So when a couple finds themselves in the situation where the issue of disagreement is not what is at stake, but the security of the relationship, that is the time when I would recommend going to therapy to repair their bond.