The Core of Couples Therapy

Susan Johnson Explains the Root of Most Couples Conflict

Susan Johnson

On the first day of a clinical placement in my doctoral program during the early 1980s, I was assigned to a counseling center and told by the director that because of unexpected staffing problems, I'd be seeing 20 couples a week. I'd never done any couples therapy, but I did have considerable experience as a family and individual therapist with emotionally disturbed adolescents—a tough, challenging group of clients if ever there was one! So my first thought when given this new assignment was, "After what I've done, how hard can this be?"

I plunged in and almost immediately was appalled by how hard it actually could be! People who seemed perfectly sane and reasonable often became totally unglued with their partners—enraged and aggressive or almost catatonically mute. I was in way over my head, with no idea what to do with these couples.

I remember one wildly angry pair, whose fight escalated to the point that they threatened to kill each other in my office. What I didn't know at the time was that while I was trying to prevent a double homicide, the clinic's director and staff were poised on the other side of the door, debating about whether someone should come to the rescue. "Do you think she can handle it?" one whispered to another. At that moment, they all heard me break into the melee and shout at the top of my lungs, "Shut up, both of you!!" In the ensuing stunned silence, the director said to the worried assembly, "I think she'll be just fine."

In spite of my complete befuddlement and frustration, I found the dramatic, intricate, baffling dances these pairs did with each other enthralling, and wanted to understand better what was going on. Clearly though, I needed some tool in my toolkit other than "Shut up!" if I wanted to make any headway with them. The drama enacted in front of me by a couple was so powerful, so emotionally compelling, and yet so complex and ultimately confusing, that I felt chronically lost. I desperately needed some sort of map that would help me make sense of what I was seeing.

Feeling stuck, I went back to what I had learned from Carl Rogers—particularly his belief in the importance of empathically understanding a client's emotional experience and reflecting it back in a way that orders and distills it. I also reconsidered Salvador Minuchin's insights about how family members engage in patterned cycles of interactions. I took home session tapes and studied them over and over, focusing on the process rather than the content—keeping my eye on the game the couples were playing rather than following the ball, the particular subject they were arguing about. As I watched and listened to all these couples, it became stunningly clear that they'd sought therapy because they were in a state of anguish and terror.

Possibly the most important human relationship in their lives—with each other—was dying, and everything they did or tried to do just seemed to make it die faster.

When I quit trying to provide "insight" into my clients' problems or teach them skills, and, in good Rogerian fashion, just followed the emotional currents, reflecting back to them what I saw and heard, and helping them slow down enough to fully experience and explore their own feelings, I'd occasionally make progress. It seemed then that something shifted emotionally within the couple. New emotions would emerge; anger would give way to sadness or fear. For a moment, I could see and hear them tentatively begin to reconnect with each other, and sense the relationship quiver delicately back to life.

Once when I was still pondering these issues, I went to a conference and got into an after-hours bar conversation with an eminent researcher in the field, who argued that getting and staying married was like entering and sticking to a bargain. I disagreed, saying, "The only time marriages are like a bargain is when the relationship is already as good as dead and all hope of intimacy is gone." Then I heard myself adding, almost without conscious thought, "Marriages aren't bargains. They're emotional bonds."


Want to harness the power of emotion with the couples in your office? Check out this FREE CE seminar with Sue Johnson today!


At that moment, it felt as if a door had suddenly opened in my mind and I could begin to truly see what was happening with my couples. I realized what should have been the most obvious truth of all: marriages were primarily about the emotional responsiveness that we call love; about fundamental human attachment. These bonds reflected deep primal survival needs for secure, intimate connection to irreplaceable others. These needs went from the cradle to the grave. How had we ever decided that adults were somehow self-sufficient?

Relationships that Heal

Emotionally Focused Couple Therapy (EFT), the systemic, empirically supported model of therapy I've developed during the past 20 years, allows us to understand what happens at key moments of change and make these moments happen. We know how to bring about specific, highly emotional interactions between partners that predictably result in moments of deep bonding between them--bonding that lasts. This means that we can not only heal relationships: we can create relationships that heal. When we help forge new, loving connections between partners, we've found that the clinical depression or anxiety in one or both partners lifts.

Attachment Theory

After all these years of working with couples, I now understand that the heart of the matter, the central issue in the marriage, rarely concerns the content of a couple's arguments, but almost always concerns the strength and responsiveness of the attachment relationship they have. And the bottom-line test of that relationship is in the answer to a fundamental question each is, in essence, asking the other: Are you really there for me? Do I really matter to you enough that you'll put me first when it really countsbefore your job, before your friends, even before your family? Partners in troubled relationships feel that on some basic level the answer to these questions is "no," or at best "maybe." All couples fight, but the fights that really define a relationship are always about the same thing: whether the partners feel they have a safe, secure connection with the other.

So, my overriding goal in therapy with couples became to help them regain (and sometimes gain for the first time) a secure attachment bond with each other. But how would I go about this? I'd already tried conventional means—exploring their individual childhoods for clues about their attitudes toward love, teaching them what to expect in marriage, and trying to improve their communication skills—to little effect. Then I realized that if the basis of attachment was emotional cues and responses, then emotion would have to be the royal road to better, more secure marital attachment. Any successful approach would have to focus on helping clients experience, develop, and differentiate their own emotions in the here and now with their partners.

EFT in Action

Elvera and Samuel, a couple in their late thirties with two young children, came into therapy with me because both partners had been diagnosed with depression and, after years of individual psychoanalytic psychotherapy, had come to believe that perhaps their rather distant marriage might have something to do with it. Though they considered themselves "good friends," they'd begun to wonder if this "friendship" was enough to sustain a marriage. Beneath their obvious decorum and restraint, I saw the anxiety and sadness in their eyes.


Want to harness the power of emotion with the couples in your office? Check out this FREE CE seminar with Sue Johnson today!


When I inquired more closely about why they'd come to see me, Elvera dropped her bombshell: this couple was quite literally "out of touch" with each other—they hadn't held hands, hugged, placed a companionable hand on the other's arm, kissed, or had sex in more than four years. It was only after a good friend had told Elvera that it was really quite odd for a couple not to display any physical affection for each other that they'd come to see me.

When I began talking about touch and emotion, both partners became quiet and attentive. I've found almost invariably that if I can connect with people emotionally in the process of asking about their feelings, they're fascinated and eager. They may find it scary, but they also love the fact that they're being truly seen and felt. So I asked Elvera, as I was trying to evoke with each in turn the fundamental reality of his or her emotional experience, "Could you please help me understand? Could you tell me how you're feeling as you say these things about your marriage?"

She answered flatly, "I don't know what you mean."

I replied, "When I listen to your voice, you sound calm, reasonable, and detached, but when I look into your face, I'm absolutely blown away by the sadness in your eyes."

At this point, she burst into tears. As it turned out, she'd originally been the "pursuer," demanding more affection from Samuel. When he wouldn't respond, she'd shut down and become increasingly distant and cool. Finally, she'd given up in despair.

After helping them reveal to me, one at a time over several sessions, the feelings beneath their carefully maintained detachment and begin to take small risks with each other, they were ready to turn to each other and, with some guidance from me, begin to talk directly about their deepest emotions. Having gradually put together, made sense of, and expressed their desperate loneliness and neediness to me, they could begin to reveal these feelings to each other.

I asked Samuel whether he could see his wife's desperation, and whether he could help her with her fear. He then looked into her eyes as she wept, put his hand out to her, and said, his voice full, "I've spent four years longing to touch you, and I, too, have been so afraid. If you come to me, I'll be there. I want you so much. I don't want you to be afraid and alone." He then stood up and she reached for him.

We call this type of event, which is the culmination of a hundred little realizations, risks, and new perceptions, a softening. Once this occurs, both partners are accessible and responsive to each other. They can stay with their emotions, tolerate the other's protests and upsets, and formulate their own needs and put them out in an attuned way with their partner—a way that helps their partner respond. Once this occurs, a new safety and a new connection begin to blossom. The couple can do what securely attached partners and children can do in relationships: they can accept and articulate their attachment vulnerabilities; they can ask clearly for their needs to be met, rather than attack or withdraw; and they can take in another's love and comfort, and translate that love into a sense of confidence in themselves and in others.

When Samuel and Elvera left my office that day, I noticed from my window that they were walking to their car hand in hand. This is what I expected. These bonding moments are exquisitely reparative because they home in on the most painful and wounding issues in the marriage and, in doing so, heal them by creating new bonding events. Each partner emerges from such an event getting from the other precisely what he or she yearns for and needs most. What we see is that each partner is personally strengthened and empowered by this process, not only in his or her relationship, but in life in general.


Susan Johnson, EdD, the developer of Emotionally Focused Therapy for Couples and Families, is the director of The International Center for Excellence in EFT and the author of Love Sense: The Revolutionary New Science of Romantic Relationships.

This blog is excerpted from "Are You There for Me?" by Susan Johnson. The full version is available in the September/October 2006 issue, Couples Adrift: What Science is Telling Us About Helping Troubled Relationships.

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Topic: Couples

Tags: arguing | couples | Couples & Family | couples conflict | couples counseling | couples therapy research | fighting | love | love and relationships | Sue Johnson | Susan Johnson

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1 Comment

Wednesday, September 6, 2017 3:01:54 AM | posted by Iris Black
An extremely well written piece and very useful not just for professionals but also for people seeking help with their relationship issues. When one is looking for couples therapy, it is important not just to be able to relate to the therapeutic techniques and theory that the psychotherapist follows but first be comfortable with the professional to talk about difficult issues. This is where a resource center can help. When you can read more about what you are going through, see testimonials of others who have faced similar issues and get recommendations for therapists, it really helps build confidence to deal with the relationship issue at hand.