Functional and Structural Neural Effects of Emotionally Focused Therapy for Couples

Abstract

There is increasing acknowledgement that problematic interpersonal relationships and negative emotions are key factors in the development and maintenance of various forms of psychopathology. Emotionally Focused Therapy (EFT) for couples centers on changing attachment behaviours as a means to improve distressed relationships by helping partners access underlying emotions and foster positive interactions that promote accessibility and trust. EFT is a highly effective therapeutic approach that encourages the development of adaptive emotion regulation observed in secure attachment. The development and emergence of non-invasive neuroimaging techniques, in particular functional magnetic resonance imaging (fMRI), provides a unique opportunity to investigate neural adaptations underlying successful psychotherapeutic change. Eighteen distressed couples received an average of 23 sessions of EFT, and the resulting functional and structural differences in the neural processing of threat were investigated before and after therapy using MRI methods. Female participants engaged in a stressful task in which they were confronted with the threat of electric shock, while they held their partner’s hand, a stranger’s hand, or were alone in the scanner. Results offered preliminary evidence that EFT can significantly impact emotional dysregulation, promote attenuation of neural threat by their partner, and result in structural change in a key region of emotion circuitry. Moreover, physiological data demonstrated that following EFT for couples, female partners were effectively soothed by their male partners, as demonstrated by decreased cortisol levels.