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The Most Effective Couples Therapy, by Far

No approach compares in research support to Emotionally Focused Therapy.

When we first start couples therapy, my clients are often skeptical. They want to know if it will do any good to talk about their fights and feelings. “Does couples therapy work?”

The truth is, it depends. Not all couples therapies are created equal.

No couples therapy has as much research support as Emotionally Focused Therapy (EFT). Ninety percent (90%) of couples who go through EFT significantly improve their relationship and 70-75% of couples no longer fit criteria for relationship distress following treatment (according to a metanalysis). Compare this to a 35% success rate for the next leading couples therapy.

So, if you go with an EFT couples therapist, yes, couples therapy really works.

What Is EFT?

Couples often find themselves stuck in repetitive patterns that leave them feeling misunderstood and alone. These patterns might involve feelings of being shut out, attacked, unwanted, not being heard, or craving greater closeness.

Such relationship cycles happen because we are hard-wired to seek connection with others. Because of your need for attachment, when you perceive a threat to your connection (or to your sense of self as worthy of connection) you experience a primary emotion such as fear, hurt, or sadness. However, experiencing such vulnerable emotions can be incredibly painful. So, usually, you have an almost immediate instinct to cope with such primary emotions by replacing them with reactive secondary emotions such as anger or numbness. This coping response can happen so quickly and unconsciously that you may not even be aware of the primary emotion underneath. For example, If your partner criticizes you, you might miss your own emotional hurt from feeling not good enough in your partner's eyes (primary emotion), only noticing your own irritation or a sense of going cold toward your partner (reactive secondary emotions).

You act out your reactive secondary emotions with protective responses such as withdrawing from the conversation (in an attempt to shield the relationship and the self from the pain of experiencing conflict) or pursuing your partner to change their behavior or give you answers (in an attempt to get a response from your partner and thus confirm that you and your relationship matter to your partner). Unfortunately, these protective responses often trigger further fear, hurt, or sadness in your partner, which become reactive secondary emotions and protective responses, which again trigger your primary emotions ... and thus the cycle repeats itself over and over again. The result is a lack of understanding, a sense of emotional distance, anger, or resentment.

I help couples to clearly see their typical pattern and learn how to relate in a deeper emotional way that fosters understanding and leads to real, authentic, intimate connection. EFT is all about “scuba diving” into the feelings of pain, hurt, sadness, or fear lurking underneath the surface of destructive cycles. Couples usually aren’t aware of the primary emotions that are driving their secondary emotions and protective responses. In therapy, we work to identify, investigate, and experience these vulnerable feelings and the important messages they convey. Uncovering these "softer" emotions and risking to share them directly with your partner is the secret to a deeper emotional bond because sharing vulnerability naturally pulls for compassion and is the foundation for intimacy. This is what EFT is all about.

How Will Your Relationship Be Different After EFT?

Many couples therapy methods coach you to change negative behaviors in your relationship to improve your communication. The problem is, you know what good communication looks like in the first place! You know you shouldn’t yell at your partner or shut them out, but your communication skills go out the window in the heat of your relationship patterns. And, trying to change your behaviors without addressing the unspoken issues that underlie your responses can feel forced. No wonder so many are skeptical about couples therapy.

The goal of EFT is not just better communication, but a secure attachment. One study demonstrates secure attachment beautifully. Women came into a lab and were electrically shocked while holding their husbands’ hands. Initially, these women were in unhappy marriages and experienced considerable pain from the electric shock. After a course of EFT, however, the women considered the pain only “uncomfortable” and the pain centers in their brains were considerably less active when holding their husbands’ hands. In other words, EFT can enhance the safety and security in your relationship to make your bond a refuge from the pain and stresses of the outside world. When your relationship serves as a source of comfort and soothing, you have a “safe haven” and a life-enhancing bond that can make the stresses of life seem less painful and more manageable. A more secure attachment will naturally make your communication better, but beyond this, it will promote your flourishing as a whole and healthy person.

Effective couples therapy will guide you in developing greater emotional awareness and having transformative conversations that will move you toward a more secure and satisfying bond. In nourishing a relationship in this way, you will build a secure base that can bring comfort and joy into your life and provide the strength to face life challenges. This powerful force, called love, is the most important thing in this life. And EFT can help.

For more on EFT, I recommend Sue Johnson's book, Hold Me Tight.


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.

Johnson, S. M., & Greenberg, L. S. (1985). Differential effects of experiential and problem-solving interventions in resolving marital conflict. Journal of Consulting and Clinical Psychology, 53(2), 175.

Newberg, A., & Waldman, M. R. (2013). Words can change your brain: 12 conversation strategies to build trust, resolve conflict, and increase intimacy. Penguin.

More from Tasha Seiter MS, PhD, LMFT
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