SEX & ATTACHMENT IN THE PRACTICE OF EMOTIONALLY FOCUSED COUPLE THERAPY

Dr. Susan Johnson

Copyright: Sue Johnson 2009

www.iceeft.com

Six Favorite Quotes:

Sex is emotion in motion Mae West In sex, affect-regulated interactions predominate because of emphasis on desire, arousal and non-verbal communication. Judith Heiman, 2000 To the extent that we are emotionally responsive to someone, we are physiologically responsive to them. - H. M. Adler, 2002, Journal of Internal Medicine,17 And the light that shines above the heavenly vault . its actual manifestation is the warmth that is felt when the flesh is touched. Upanishads Sacred Hindu Scriptures Real pleasure in sex is about proximity, play and nurturance rather than orgasmic discharge - Jeremy Holmes in Attachment, Attachment Intimacy & Autonomy, 1996 Autonomy Cosmopolitan magazine, November 2006 says the hot new sexual positions are: in a doorway, while having a bath, on top of a running washing machine, on a kitchen counter. As a local journalist points out, once again in spite of this magazine being a great purveyor of such lists, this list is a letdown.
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Sex and Couple Interventions

Sex therapists are placing sexual responses in a relational context more Couple therapists are having to address sexual problems that impact relationship quality The nature of sex shapes a love relationship and the nature of an emotional love relationship shapes sexual responses. A feedback loop mutually defining But sexual interventions are often narrow, symptom focused This is: - inevitable unless we know what relationship factors are key in defining sexual behaviors - inevitable unless we have a broad tested theory of love relationships

Now we have such a theory

Adult Attachment
( John Bowlby, 1969, 1988; Mikulincer & Shaver, 2007 y, , ; , Attachment in Adulthood)

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Now we have a tested couple therapy approach based on this theory

Emotionally Focused Therapy

( Johnson, 2004 The Practice of EFCT)
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An attachment bond
Piglet sidled up to Pooh from behind. Pooh, he whispered. Yes, Piglet? Nothing, said Piglet, taking Poohs paw. I just wanted to be sure of you I you.

Attachment Theory: A Map to the Landscape of Love

1. Seeking and maintaining contact is a prime motivation. Isolation is traumatizing 2. A secure connection offers a safe haven and a secure base. Needs for connection, comfort and caring are key. (parallel findings re: soothing responses) 3. Accessibility and Responsiveness builds bonds. (parallel findings re: emotional engagement)

Attachment Theory: A Map To The Landscape of Love

4. Separation Distress A predictable process.
Protest Cling and Seek Depression and Despair Detachment (Parallel findings re: 4 horsemen)

5.

Emotion is the music of attachment dance.

Gives salience Colors events Cues organizes the dance Has control precedence

Key Features of Secure Attachment in Strange Situations

1. 2. 2 Child can regulate distress trusts relationship with mother. When tt h Wh attachment fi t figure returns, child gives clear unambiguous t hild i l bi cues. Re: Needs asks without defensiveness When attachment figure responds child trusts and takes in comfort reassurance is calmed and soothed. Child then turns attention to environment, climbs down from mothers lap plays with toys takes risks engages in tasks/activities with confidence confidence. Same process occurs in adult couple: e.g. After a bad day at work e.g. After an argument e.g. After sexual disconnect

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Attachment Theory: A Map To the Landscape of Love

6. Finite set of predictable attachment strategies in drama of distress.
Anxious up the anti Ill make you respond to me Avoidant Cool your jets I will care less Fearful Chaos Come here dont touch

Attachment Theory: A Map To the Landscape of Love

7. Position in the dance attachment strategies define sense of Self and Other Working Models. Defines pivotal moments of healing / of injury. Adult attachment is reciprocal, representational, sexual. p , p ,

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Attachment strategies sculpt the nature of engagement with loved ones. They h Th shape: The regulation and expression of emotion Cognitive models procedural scripts / expectations Response tendencies (in and out of bed)

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A sense of felt security with another leads to:

Happier relationships more closeness and trust, more satisfying relationships - less conflict Key responses - more ability to reach out for and give support -empathy More ability to communicate needs effectively - assertiveness More ability to be open to new information tolerate ambiguity Less verbal aggression or withdrawal during problem solving dialogues A more positive, articulated and coherent sense of self More ability to be separate and autonomous solve problems on our own. In general: More ability to connect at key moments and deal positively with inevitable disconnection - Effective dependency
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Research on Attachment and Sex

A.

In general, secure attachment facilitates relaxed and confidant engagement in sex ( Mikulincer & Shaver, 2007). Secure sex is better. Insecurity anxiety and avoidance leads to less enjoyment of/positive experience of sex: Fewer positive / more negative feelings during sex Lower rate of orgasms in women, sexual satisfaction in men and women (anxious noted emotional factors, avoidant physical factors) Less frequency of intercourse (when single and in relationships) and more solitary masturbation ( Av) Also More positive attitudes to casual emotionless sex one night stands ( Av) Force and coercive strategies more likely - ( Av & Anx)

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B:

Motives in sex: Secures identify closeness as motive Anxious report having sex to please, avoid rejection, gain reassurance Avoidant use sex for self-enhancement fit in, brag. Efficacy in sex insecurity linked to: Lower sexual self-esteem physical attractiveness of self More perceptions that sex is controlled by other, situation More problems in sexual communication (less coco ordination of responses?) Stronger concerns about sexual performance Less willingness to experiment sexually within a relationship 14

C:

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Security and the role sexual encounters play in defining a relationship

Anxiously attached partners are more sensitive to cues/changes more vigilant re: daily events - Sex more impacts appraisals of the relationship more Anxious men just having sex improved the relationship Anxious women had to feel good about sex for this to occur Sexual failures inevitable and trigger abandonment failures & rejection in anxious partners
Anxious partners put attachment / affection aspects first (not sex per se) - one dimensional Avoidant partners put sensation / performance aspects first dislike cuddling / affection one dimensional
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What is healthy sex ? (sets goal of therapy)

Both partners accessible, responsive and engaged emotionally and physically Bowlbys three behavioral systems attachment, attachment sex and caregiving integrated in four components of sex desire, arousal, orgasm, satisfaction Best aphrodisiac / technique is secure attachment between partners. Good sex is intimate play A safe adventure t f d t tension, excitement plus i it t l comfort, surrender to sensation. Touch arouses and comforts, oxytocin cuddle hormone released in orgasm. Synchrony sex resonance
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Versus concept that passion and attachment are antithetical predictability kills thrill, novelty. Passionate l P i t love provides a hi h lik id high, like drugs, and you cant stay high forever Hatfield In integrated sexual response: Practice and emotional presence makes Practice perfect Risk discovery of moment to moment presence ever new.
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Emotional attunement and responsiveness creates safety tender touch and erotic exploration / play creates physical pleasure Spiral of Synchrony - exquisitely coordinated signals Resonance (physics)

Parallel mother and child attune, sense each others arousal, inner state and intention, surrender to full engagement in moment to moment process.
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Emotionally Focused Couples Therapy

Looks within at how partners construct their emotional experience of relatedness.

(Using Rogerian Interventions)

Looks between at how partners engage each other

(using Systemic Interventions and tasks)

In Order To:
Reprocess / expand emotional responses Create new kinds of interactions / change the dance Foster secure bonding between partners

WEBSITE: www.eft.ca

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Emotionally Focused Therapy

70 75% recovery rate in 10 12 sessions Significant improvement rate - 86-90% Results are stable even under high stress Depression significantly reduced Variety of populations and settings Best predictor of success: female faith in partners caring not initial distress level. Alliance accounts for 20% of variance in outcome-the task relevance aspect of this alliance.

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EFT Core Assumptions

1.

Rigid interactions reflect / create emotional states and absorbing emotional states reflect/create rigid interactions (loop). Partners are not sick / developmentally delayed/unskilled they are stuck in habitual ways of dealing with emotions/engaging with others at key moments. Emotion is seen as target and agent of change. Change involves new experience and new relationship events. Effective marital therapy addresses the security of the bond, mutual accessibility and responsiveness.

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EMOTION
Cue- Rapid appraisal of environment Body arousal Meaning/Reappraisal Action Tendency (Arnold)
Source of information fit between environment cues and needs / goals Vital element in meaning Primes action response Communicates organizes social interactions Six core emotions (facial expressions) and adaptive actions. ANGER SADNESS SURPRISE / EXCITEMENT DISGUST / SHAME FEAR JOY Panksepps attachment panic
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Assert, defend self Seek support, withdraw Attend, Att d explore l Hide, expel, avoid Flee, freeze, give up goal Contact, engaging

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EFT STEPS AND STAGES (OVERVIEW

Stage 1. De-escalation of negative cycles that continually confirm insecurity Steps 1-4 : Outlining cycle e.g. demand withdraw. I poke, you go silent, the more you the more I . Anything to get a response from you. Having partners own their cycle how they pull each other inplacing underlying primary attachment feelings in cycle. Framing the cycle as the common enemy i.e. See the game not the ball Sexual cycle outlined can be reflection of general cycle or specific Primary attachment emotions linked to sexual cycle Sex placed in attachment context education.
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Stage 2: Restructuring - creation of positive cycle of responsiveness Steps 5-7 : Deepening engagement with attachment emotions for each partners ability to accept these emotions. Create powerful enactments where partners reach for each other. Bonding events. events New ARE conversations applied to sexual realm Blocks to healthy sexuality addressed

Stage 3: Consolidation Steps 8-9 : Creating C ti positive coherent narratives of problems/solutions, iti h t ti f bl / l ti attachment rituals Using safety to solve pragmatic problems. Sexual problems solved as team.

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The Problem:
Do you love me? (accusing tone) Of course I do. How many times have I told you? Well it doesnt feel like it (tears, looks down, turns away) (Sighs-exasperated) Well, maybe you have a problem then. I cant help it if you dont feel loved. (Set mouth, lecturing tone.) W: Right. Right So its my problem is it? Nothing to do with you right? it s you, Nothing to do with your ten feet thick walls. Youre an emotional cripple. Youve never felt a real emotion in your life. H: I refuse to talk to you when you get like this. So irrational. There is no point. W: Right. This is what always happens. You put up your wall. You go icy. Till I get tired and give up. Then, after a while, when you want sex you decide that I am not quite so bad after all. H: There is no point in talking to you. This is a shooting gallery. Youre so aggressive. Rigid pattern- blame/withdraw and absorbing states of negative emotion form feedback loop. No safe emotional connection-escalating danger and isolation. Negative cycles / insecurity create / perpetuate sexual problems. Sexual problems create / perpetuate insecurity and negative cycles. Low female desire and lack of erection or premature ejaculation are most common.
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W: H: W: H:

Principles of an attachment oriented approach to sexual issues in humanistic therapy such as EFT are:
Safety first - attachment has control precedence over caretaking and sex systems Validate emotional safety as foundation for good sex. Place sexual responses in main cycle of interactions. Unpack negative cycles of sexual response blocks to engagement in four elements of sex, desire, arousal, orgasm and satisfaction. Explore sexual accessibility and responsiveness to own needs and to partner in light of primary attachment emotions. As positive cycles of responsiveness occur, create new interactions focused on sexuality fears, needs. Promote the active integration of erotic and attachment responses if sex and attachment are disconnected / undermine each other. Frame sex as a safe adventure problem solve sex issues and problems. Consolidate sexual openness and responsiveness as part of emotional bond rituals, coherent story, problem solve.

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