Sue Johnson e Leslie Greenberg

How to distinguish between the two different psychotherapy approaches that share the same acronym “EFT”??

To learn the details of: Emotionally Focused Therapy versus Emotion-Focused Therapy: the differences, let’s start … yes, from the points of contact.

The acronym is the same: EFT for both.

The focus is the same: “emotions“.

For both founders of Emotionally Focused Therapy – Leslie Greenberg and Sue Johnson – that in psychology is not their first bachelor’s degree, but their second!

After beginnings that were almost polar opposites (which we will find out about in a moment), in the early 1980s, the two psychologists began working together, giving birth to Emotionally Focused Therapy. After a few years of working together, the two part ways:

  • Sue Johnson continues to develop Emotionally Focused Therapy;
  • Leslie Greenberg creates Emotion-Focused Therapy.

È un peccato che l’inizio comune di questi due approcci e le somiglianze esperienziali e di acronimo, lascino spesso i terapeuti e i pazienti confusi e disorientati. Per prendere consapevolezza dell’uno e dell’altro approccio, e quindi comprendere le loro particolarità e differenze, proviamo a conoscerli meglio

It is a pity that the common beginning of these two approaches, and the experiential and acronym similarities, often leave therapists and patients confused and disoriented. To become aware of either approach, and thus understand their particularities and differences, let us try to get to know them better.

Who is Sue Johnson?

Sue Johnson

Sue Johnson was born in Chatham, UK, two years after the end of World War II. Her education is deeply humanistic: in 1968, young Sue Johnson earned her first degree in English Literature from the University of Hull, the university in the small town of the same name in the East Riding of Yorkshire county.

As she likes to recall, her earliest observations about human relationships date back to when she was a child, observing the interactions between her father and pub patrons, and being struck by the emotional exchanges that took place between them.

Sue Johnson in those years was looking for an application of her humanistic knowledge and decided to embark on a new adventure by directing her studies toward clinical psychology.

She moved to Canada, and in 1984, in Vancouver, she earned an Ed.D. in Counseling Psychology from the University of British Columbia.

Following the development of Emotionally Focused Therapy, Sue has received a number of awards recognizing the formulation of the EFT model and her significant contributions to the field of couple and family therapy and adult attachment.

Most notably, in 2017, she was named a member of the Order of Canada, country’s highest civilian honor that recognizes outstanding achievement, dedication to community and service to Canada. In addition, in 2016 she was named Psychologist of the Year by the APA (American Psychological Association) and was honored by the AAMFT (American Association for Marriage and Family Therapy ) for her outstanding contributions to the field of marriage and family therapy.

Sue is founder of the Ottawa Couple and Family Institute (OCFI) and the International Centre for Emotionally Focused Therapy (ICEEFT).

Who is Leslie Greenberg?

Leslie Greenberg

Leslie Samuel Greenberg is a Canadian psychologist born in Johannesburg, South Africa, in 1945, and is among the main originators of Emotion-Focused Therapy.
Greenberg initially studied engineering, later beginning work in that field, until he decided to switch to the study of psychology, first graduating and then earning his doctorate by assisting Laura North Rice, a prominent student of Carl Rogers at the University of Chicago.

Around the mid-1970s, Greenberg began doing research in psychology, and as a former engineer, he devoted himself to the study of a mathematical model capable of defining the interaction between therapist and client.
Greenberg’s research revolves around:

  1. empathy;
  2. psychotherapeutic process;
  3. therapeutic alliance;
  4. emotions in human functioning.

His early career was influenced by Juan Pascual-Leone’s “neo-Piagetian constructivist model of the mind.” After an early client-centered therapeutic approach, Greenberg turned his interest to another humanistic approach, Gestalt Psychotherapy.

Gestalt therapy was developed by Fritz Perls in the 1950s in the United States as a therapy that integrates the experiences of the Freudian, Jungian, and Reichian psychodynamic traditions, as well as the principles of Zen philosophy, Lewin’s field theory, phenomenology, and Gestalt psychology from which it takes its name, which emphasizes that the whole is different from the sum of its parts.

Gestalt Psychotherapy assumes that in order to understand a behavior it is important to analyze it with the aim of having a field view of it, that is, to try to perceive it in the whole of the person’s global and environmental context.

Sue Johnson and Leslie Greenberg: common start, different paths

In the 1980s, Sue Johnson and Leslie Greenberg carried out a series of studies and researches, thus shaping Emotionally Focused Therapy, which in fact began as an approach for couples therapy.

So, although the two approaches shared a historic beginning, first integrating systemic and experiential approaches, they have since diverged considerably.

While Sue Johnson focuses on relational bonds, and expands the theory by integrating it with Minuchin’s systemic theory and Attachment Theory, starting precisely from couple relationships, Leslie Greenberg, on the other hand, takes a different route, that of intrapsychic work, in which attachment and systemic dynamics are not emphasized.
Greenberg’s approach, originally called “experiential process psychotherapy” (Greenberg, Rice and Elliott, 1993), develops as an experiential-humanistic therapy with an emotion-centered process of change.

Sue consistently places Attachment Theory at the center of her work, expands the model by also giving great importance to the systemic/interpersonal aspects of therapy, and thus revolutionizing the world of couples therapy.

Emotion-Focused Therapy: from the individual to the couple

Emotion-Focused Therapy has an intrapsychic connotation and, as we have said, it began first as individual therapy and then also codified modalities for working with the couple.

Emotionally Focused Therapy: from the couple to the individual

Sue Johnson’s Emotionally Focused Therapy, on the other hand, began primarily as couple therapy and then developed as family therapy and individual psychotherapy.

To this present day, it is defined as a Model-Three Modalities (we discussed it here, in the post “Why Couples Therapy Also Works for Singles”):

  • EFCT – Emotionally Focused Couple Therapy – di coppia
  • EFIT – Emotionally Focused Individual Therapy
  • EFFT – Emotionally Focused Therapy for Families.

Adaptive and maladaptive emotions!?!

While Emotion-Focused Therapy distinguishes emotions into: primary adaptive, primary maladaptive, secondary and instrumental emotions, for Sue Johnson every emotion is valid.
There are no maladaptive emotions!
Every emotion is a natural and consequential physiological response to attachment needs, whatever their extent.

Emotions are not irrational; they are the compass by which we orient ourselves and move through the world.

“Emotions are the Goal and the Agent of Change”
(Sue Johnson)

To clarify, there is a fundamental difference between how emotion is perceived and how the therapist works with it in these two models.

Greenberg’s approach is an individualistic approach supported by research on emotion theory. Johnson’s perspective is specifically a relational approach to attachment, in line with past and current research on Attachment Theory. Sue’s Emotionally Focused Therapy thus privileges primary emotions related to attachment (e.g., fear, hopelessness, distress), and attachment needs in their deepest form.

Emotion-Focused Therapy: identity

To simplify, we can say that Emotion-focused therapy focuses on identity. It is basically about what the client is feeling and what the feeling is telling him or her.

Emotionally Focused Therapy: attachment

Les invece lo focalizza sempre sull’identità declinandolo nell’ottica di “autosalvaguardia”, sottolineando che lo scopo della relazione interpersonale è quello di regolare le emozioni.

Compared to Greenberg’s EFT, which instead focuses on identity, the main focus of Emotionally Focused Therapy is instead structured around Attachment Theory.

Emotionally Focused Therapy includes a deep existentialist aspect, again-as with Irvin Yalom – the meaning is interpersonal.

Greenberg, on the other hand, always focuses it on identity by declining it from the perspective of “self-salvation,” emphasizing that the purpose of the interpersonal relationship is to regulate emotions.

Why attachment?

For Sue Johnson, as well as for our community – EFT Italia Community – which follows her studies and clinical results, attachment is the very essence of human life, the fundamental element for a person’s survival and psychophysical well-being. and is seen as “as a global perspective of personality development and emotion regulation” (Johnson 2019).

Conversely, for Greenberg, attachment is an additional component of identity.

Thus, the main difference between the two approaches is the person, or even better, the person’s primary role in the therapeutic process: Sue Johnson’s research takes a systemic view from the perspective of co-regulation, while Greenberg’s research speaks of self-regulation.

Self-regulation versus co-regulation

For Emotion-Focused Therapy, the person can learn to self-regulate on his or her own. “Clients learn to self-regulate their emotions through internalizing consoling interactions with the therapist and developing empathy toward the self” (Greenberg, Paivio, 2003).

Extremely exaggerated, self-regulation comes quite close to the concept of “do-it-yourself makes three!”

For Emotionally Focused Therapy, starting with the validity of attachment, the person does it together with someone else. “We are mammals with social bonds, and co-regulating emotions and connecting with others is our basic strategy for surviving and thriving.” (Johnson 2019)

Exactly as we said about “Homo Vinculum,” human beings have survived the millennia and evolved because of their ability to form bonds.

If you have made it, indeed, if we have made it as a species, it is because of the relationships we have been able to form, the secure bonds we have learned to build…. Meaningful relationships are thus the ecological niche within which we have evolved and developed.

No process of growth, no personal or social improvement, no invention and no work of the arts and/or ingenuity ever came about by itself. Each of our achievements, as people, as scientists, as therapists, and as living beings, is the child of the bonds that nurture us.

According to Greenberg, differentiation from the other and self-sufficiency are virtues to be valued first and foremost.

In a more expanded view of human functioning, according to Johnson, our need for effective dependence on others is inscribed in our mammalian DNA. And through the efficacious expression of this need, within an emotionally secure relationship with significant others, we can explore the world with the confidence that if, and when, we need to, we will reach out our hand in the dark, and know that someone will shake it to help us.

Giulia Altera e Andrea Pagani