Manual Emotionally Focused Individual Therapy Efit Level 1 Certificate Course

PARTICIPANT’S GUIDE
Emotionally Focused
INDIVIDUAL
Therapy (EFIT)
Level 1
with
Dr. Sue Johnson &
Dr. Leanne Campbell
Copyright Notice
The material in this document is copywritten to Dr. Susan M. Johnson and Dr. T. Leanne Campbell. No
part of this manual may be distributed or reprinted or reproduced without permission in writing from the
authors. This material may only be copied for non commercial use with appropriate referencing.
Transcripts included in this manual are from the Primer for Emotionally Focused Individual Therapy (EFIT),
Johnson & Campbell, Routledge, 2022. In the interest of client confideniality, the name of clients have been
changed. Sessions are edited somewhat for brevity and clarity.
Please protect clinical material/client confideniality.
© 2022 Susan M. Johnson and T. Leanne Campbell

EFIT: An Attachment-Based Humanistic Experiential Therapy
TABLE OF CONTENTS
Copyright Notice............................................................................................................................................................. 2
Table of Contents............................................................................................................................................................. 3
INTRODUCTION......................................................................................................................................... 5
EFIT — Emotionally Focused Individual Therapy: Shaping a Secure Sense of Self.............................................. 5
PRESENTATION SLIDES............................................................................................................................. 7
HANDOUTS................................................................................................................................................ 61
HANDOUT 1: EFIT — Tuning In, Finding Focus & Charting the Course in Stage 1........................................ 62
Tuning in and Finding Focus with EFIT: Key Principles.................................................................................... 63
Developmental Narrative........................................................................................................................................ 64
Relationship History................................................................................................................................................ 65
Risk & Protective Factors........................................................................................................................................ 66
Case Conceptualization and Treatment Planning............................................................................................... 67
History of Trauma? Type and Intensity of Trauma Endured? Level of Processing to Date?.......................... 68
Structuring the Process............................................................................................................................................ 69
HANDOUT 2: The CARE Model............................................................................................................................... 70
Tuning In with CARE — Intro............................................................................................................................... 71
Tuning In with CARE.............................................................................................................................................. 72
EXERCISES.................................................................................................................................................. 75
Day 2 Exercise 1: Affect Assembly Exercise (Yezda)................................................................................................ 76
Exercise...................................................................................................................................................................... 77
Transcript.................................................................................................................................................................. 78
Day 2 Exercise 2: EFIT Tango Transcript Review Exercise (Kat)........................................................................... 80
Introduction & Transcript....................................................................................................................................... 81
Day 2 Exercise 3: Moving Through the Tango (Yezda)............................................................................................ 85
Transcript.................................................................................................................................................................. 86
Day 3 Exercise 1: EFIT Stage 2 Transcript Review Exercise (Henny).................................................................... 91
Introduction.............................................................................................................................................................. 92
Transcript.................................................................................................................................................................. 93
For Reflection............................................................................................................................................................ 96
ANSWER KEY.............................................................................................................................................. 97
Answer Key: Affect Assembly Exercise (Yezda)........................................................................................................ 98
Answer Key: Moving Through the Tango Exercise (Yezda).................................................................................. 101
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Emotionally Focused Individual Therapy (EFIT) — Level 1
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EFIT — Emotionally Focused Individual Therapy:

Shaping a Secure Sense of Self
This workshop introduces EFIT, Emotionally Focused Individual Therapy, the individual therapy version of
the famous EFT couple model. This attachment based, experiential model allows the therapist to confident-
ly restructure the client’s habitual way of constructing moment to moment experience and regulating their
most difficult emotions. EFIT focuses on helping clients shape a coherent, resilient, secure sense of self, able
to explore and resolve the deeper emotional pain underlying depression, anxiety and the echoes of traumas.
As in EFT for couples, attachment science offers the EFIT therapist a map that clarifies the nature of client
problems and symptoms, specifying the steps in the journey towards emotional balance and the corrective
emotional epiphanies that are the essence of significant and lasting change in psychotherapy.
EFIT offers the therapist an empirically based, on target, deeply meaningful pathway to growth and the de-
velopment of aliveness, showing the therapist how to systematically attune to, and move the client into new
models of self and other – into a sense of belonging and becoming.
Participants will:
ӹ Discover the key elements of the attachment perspective on the development of a resilient self, and its
significance for clinical intervention.
ӹ Identify the 5 macro-intervention moves of the EFIT Tango and experiential micro- interventions.
ӹ Describe an on-target map for the creation of transformative moments where vulnerabilities can be
faced with balance and competence.
ӹ Outline the path to shaping corrective emotional experiences which restructure negative ways of de-
fining the self, organizing inner experience, and engaging with others.
ӹ Outline how to apply EFIT to clients suffering from a range of symptoms and post-traumatic issues.
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PRESENTATION SLIDES
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HANDOUTS
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HANDOUT 1
Emotionally Focused
Individual Therapy (EFIT):
Tuning In, Finding Focus
& Charting the Course
in Stage 1
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Tuning In & Finding Focus with EFIT:

Key Principles
X Be open, curious, attuned, present. NOT a checklist. Process of Discovery and Exploration.
X Maintain a stance of cultural humility and cultural awareness (cultural attunement.)
X Focus on process and content.
X Begin with open-ended questions (e.g., What was your childhood like?) and then move to more
specific inquiries based on the response(s) of the individual.
X Focus on the developmental narrative of the individual with attention to pivotal events/developmen-
tal transitions that have shaped working models of self and other.
X Attend to ‘window of tolerance’ of the individual (affect regulation capacity, broad or narrow/re-
stricted and reflexive). Attend to both verbal and nonverbal cues, and the manner in which individu-
al presents (e.g., flat affect?) and interacts.
X Attend to attachment strategy. Insecure attachment associated with numbing/avoidance, high reac-
tivity, or mixed (combination of both).
X Attend to key elements of particular problems, as well as the manner in which individual copes with
such experiences, thereby blocking revision of working models of self and other (“Protection be-
comes Prison.”)
X Focus on ‘within/between’ cycle, and listen for ‘emotional handles’ (e.g., evocative words, images,
metaphors that represent/capture person’s experience and that will open the door to what Bowlby
described as “frightening, alien and unacceptable emotions.”)
X Focus on safety and capacity (and, related to this, any contraindications and/or protective factors.)
X Establish the goals and an agenda for therapy in collaboration with the client.
See pages 71 and 72 for full details on Tuning In with CARE.
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Developmental Narrative
X What was your childhood and adolescence like? What was it like to grow up in your neighbourhood?
What did it look and feel like at your dinner table? What were mornings like?
X What did it look like before and after key developmental transitions / events? (e.g., Regarding a divorce or
loss… what was the before and after picture in your family?)
X Did you spend time with friends? What did friendships look like? (e.g., Was your social network broad or
narrow and deep?)
X Were you involved in sports or other activities? What was school like?
X Was there support outside the family? (e.g., Neighbours, church, clubs, organizations?)
X Who did you turn to for comfort when you were young? Could you always count on this person / these
people for comfort? When were you most likely to be comforted by this person / these people? How did
you let this person / these people know you needed connection and comfort? Did this person / these
people ever betray you? Were they available or unavailable at critical times or key times of need? (Explore
consistency and reliability.)
X If no one was safe, how did you comfort yourself? How did you learn that people were unsafe? Did you
ever turn to alcohol, drugs, sex, or food for comfort?
X Were there times you needed someone and had no one to turn to? What did that look like? What did you
do?
X How were feelings dealt with in your family during your childhood? Did it feel safe to share your feel-
ings? Did you have a “safe” person to help you with your emotions?
X Who did you turn to when you were sad, anxious, scared, or in pain? What comforted you during such
times?
X Any history of abuse, loss, or trauma? (Either a direct or indirect experience, e.g., witnessing parental
violence; intergenerational trauma; racial stress/trauma, both implicit and explicit; military trauma; first
responder trauma; etc.)
X How was loss, trauma, abuse, discrimination, or racism handled? Who did you turn to? Was that person
supportive? (e.g., Accessible, Responsive, Engaged?) What did that person say or do that was helpful or
not helpful? How did you comfort or soothe yourself?
X How would you describe yourself? How do you self-identify? How might others describe you? (View of
self / proximity to self — Tango can be used if/as appropriate.)
X What was it like for you during key moments of transition? (e.g., Developmentally, with regard to identi-
ty, growth... such as “coming out,” becoming sober, withdrawal from drug abuse, relationship dissolution,
birth of a child, immigration, or return from deployment.) Were you supported? How did key others
react? Who was there for you / helped guide you? What was this period of time like for you? How did you
cope and / or celebrate? What did that look like?
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Relationship History
X Current and previous relationship history? (e.g., stability vs. instability in past relationships, current rela-
tionship; breadth and depth of social support.)
X Previous loss, abuse, trauma? When? For how long? (Query through an attachment lens and with regard
to development and key developmental tasks and transitions.)
X If in a relationship, have there been any particularly traumatic incidents in current relationship and/or in
previous romantic relationships? (Assess for attachment injuries, i.e., betrayals of trust.)
X Have there been any affairs/significant painful events, i.e., attachment injuries? How were they handled?
(e.g., Have they been resolved?) Any violations of trust in current or other key relationships?
X Who did you lean on in childhood / adolescence during times of stress, anxiety, fear? Who do you lean
on now?
X When you are in need, do you reach to others? If no, are you aware of what gets in the way of reaching to
others? Have you ever reached to others? Has anyone ever been there for you?
X Have there been times when you have been able to be vulnerable and find comfort with a partner? What
does that look like? What does that feel like? Does it still occur? If not, when did it stop? (Assess history
of relationship(s); assess capacity to take in / be nurtured by love from others; if client is in a relationship,
assess whether partner might be a resource in the therapeutic process.)
Be curious ...get to know your client and the “characters that live
in your client’s mind” (Irvin Yalom, 1989)...
— that is, the key attachment figures who have impacted and
shaped model of self, as well as your client’s capacity to trust
(and reach and receive) and to maintain/regain emotional
balance under conditions of stress...
— as well as the ‘characters’ who might be resources in the
therapeutic process.
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Risk & Protective Factors
X Ask about potential risk factors, such as substance use/abuse, legal, medical and psychiatric/ mental
health personal and family history. (e.g., Have specific diagnoses been applied? If yes, when? Age of on-
set? Recurrent?)
X Ask about suicidal ideation / risk, self-harm behaviors (e.g., cutting).
X Assess potential strengths / known resiliency factors. (Pay attention to model of self, as well as indications
of hope, optimism, coherence of narrative, indications of capacity to regain balance / bounce back at
times of stress. What helped you thrive? Where did you get your resilience?)
X Ask about cultural, religious, and / or spiritual practices that might be a resource for the client.
X Ask about work history and work relationships. (e.g., Has work been a resource or a risk factor?)
X Ask about educational history and what school was like. (e.g., What was school like during childhood?
Adolescence? What was most painful / positive? Did you have friends? Lots? A few? Were they reliable
and supportive? Did you have a sense of belonging? Any history of bullying or teasing? If yes, what did
they say / do? What happened? How did you cope?)
X Ask about extracurricular activities. (e.g., Were you involved in sports or other activities? Was the sport /
activity a reprieve / a safe haven / an area of competence and confidence?)
Assessment and treatment merge

• Model of self
• Model of other
• Affect regulation
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Case Conceptualization and Treatement Planning
CONTRAINDICATIONS
X Active substance abuse?
X Suicidal ideation/risk?
X Self-harm behaviors?
X Potential for violence in current relationship?
X Significant personal (and potentially family) history of recurrent and severe depression, psychotic
features?
Will the individual be vulnerable to resort to maladaptive coping strategies (e.g., substance abuse, self-harm
behaviors, suicidal ideation or behaviors, anger/violence) under conditions of stress following a session that
might challenge the individual’s current window of tolerance for difficult affect?
Specifically, will the individual be unable to manage what the EFIT clinician is likely to ask of the individual
given the individual’s current personal and relational resources? Are additional supports required?
IF YES...
...consider other supports, either prior to (e.g., in-patient treatment for addictive behaviors) or concurrent
to (e.g., psychiatric consultation to consider medication and/or EFCT or EFFT) a course of Emotionally
Focused Individual Therapy (EFIT).
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History of Trauma?
Type and Intensity of Trauma Indured?
Level of Processing to Date?
X What type of trauma was endured (e.g., natural disaster? interpersonal? and, if interpersonal, at what
age? for how long? Was the perpetrator a family member/a trusted other?) Was there someone to
turn to for support? Was the abuse reported and was support provided? Any history of racial trauma,
intergenerational trauma?
X Has the client engaged in therapy? and, to what degree has the trauma been resolved?
X Exposure to trauma (e.g., single versus multiple exposures)?
X Proximity to the event (e.g., temporally, geographically, and relationally)?
X Duration of the trauma (in the case of childhood abuse for example)? Age of onset of the abuse (again,
in the case of childhood trauma)? Chronic racial stress? Racial trauma?
X Any resiliency factors present? (e.g., social support; positive self-concept, potentially not globally but
in specific areas; optimism and hope; security of attachment, including that of an intimate partner)
IF LOW CAPACITY...
...consider whether other resources are required to shore up the client’s resources (e.g., psychiatric referral,
medication).
...anticipate a longer and potentially more arduous Stage 1 process.
...anticipate the need for ongoing monitoring (e.g., risk / vulnerability factors; propensity to dissociate;
window of tolerance).
“Over the lifespan, the need for connection with others shapes
our neural architecture, our responses to stress, our everyday
emotional lives, and the interpersonal dramas and dilemmas
that are at the heart of those lives.”
— Attachment Theory in Practice, Sue Johnson, 2019, p. 5
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Structuring the Process
WITH ATTENTION TO:

X Building a therapeutic alliance and the key impact of trust, especially in case of trauma, low capacity,
and/or limited resources.
X Boundaries.
X Safety planning, as needed.
X The capacity of the client with respect to, for example, financial resources, child care, ‘emotional
capacity’ and related safety considerations as highlighted above.
X Goals for therapy, as established collaboratively between client and therapist.
X Building and capitalizing on the momentum of therapy with attention to the individual’s personal
and relational resources.
X The pacing of sessions — In some cases, weekly sessions will be too frequent, and in other cases,
weekly sessions are necessary to build and use momentum.
X Timing of interventions — In some cases, depending on the individual’s personal and relational
resources/capacity, the pacing will need to be slow. In other cases, once the focus has been
established, momentum builds quickly, along with therapeutic gains.
X Attachment theory and key guiding principles.
X The perspective of attachment theory, a developmental theory and theory of personality — It would
be anticipated that if key aspects of development, i.e., self, social and emotional development, are
thwarted by trauma early on, then the reshaping and revision of models of self and other will take
time, and will often require periods of intervention followed by consolidation, either in couple or
individual therapy, or in some cases, a combination of both.
X The fact that clients will often engage in an important piece of work, leave therapy for a period to
consolidate those gains, and then return again to build on and continue the therapeutic work they
started.
X The fact that clients will often re-initiate treatment at key developmental transitions or anniversaries
(e.g., marriage; birth of a baby; loss of a parent; anniversary of a traumatic event or loss), or in the
case of new trauma and symptom aggravation.
“When one is suffering or worried, it is useful to seek comfort from

others; when suffering is alleviated, it is possible to engage in other
activities and entertain other priorities. When attachment relationships
function well, a person learns that distance and autonomy are completely
compatible with closeness and reliance on others.”
— Mikulincer & Shaver, 2016, p. 143
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HANDOUT 2
The CARE Model
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Tuning In... with CARE
The overarching goal of initial sessions in EFIT is to join with the client and get a felt sense of and
as-complete-as-possible picture / understanding of the client in CONTEXT. As the EFT therapist moves
fluidly between assessment and intervention, attention is given to the four CARE dimensions:
■ Context;
■ Attachment;
■ Relationship/Therapeutic Alliance;
■ Emotion.
With this in mind, it is helpful at the outset of treatment to map the client’s story, chapter by chapter,
developmentally, with attention to key moments / scenes and transitions. What stands out for you as you
review your client’s overall narrative? To cite Irvin Yalom, who are the key characters that live in your client’s
mind? What pivotal experiences have been instrumental in shaping models of self and other? How were
these pivotal moments, either positive or negative, managed emotionally and interpersonally?
The CARE model is outlined and is followed by a template that can be used for note taking.
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Tuning In with CARE
C — CONTEXT
Experiential therapist seeks to enter the phenomenological world of the client. Therapist immerses self in
contexts in which clients live and have lived, with attention to:
X Identity (e.g., race, ethnic, spiritual, religious, gender, sexuality)
X Environmental factors (e.g., socioeconomic, work/organizational, neighbourhood)
X Experiences (e.g., racism, colorism, discrimination, sexism).
A — ATTACHMENT
Therapist explores attachment and relationship history, with attention to:
X Pivotal experiences/key moments that have shaped models of self and other;
X Coherence of narrative;
X Current relationship resources; relationship security/insecurity; potential intergenerational impacts;
risk/vulnerability and resiliency/protective factors.
R — RELATIONSHIP / THERAPEUTIC ALLIANCE

Therapist as temporary attachment figure establishes a secure base characterized by A.R.E. at the outset of
therapy.
X Therapist monitors the therapeutic alliance throughout the process of therapy.
X Therapist attunes to potential ruptures; contextual factors, including key differences.
X Therapist joins with the client in discovering and exploring painful material.
E — EMOTION
Therapist attends to expression of emotion, affect regulation strategies and capacity (e.g., window of toler-
ance), with attention to:
X Core features of emotional disorders, e.g., self-criticism, numbing, detachment, nightmares, flash-
backs, hypervigilance, heightened anxiety;
X Process elements, e.g., body language, facial cues; automaticity and/or rigidity of strategy; capacity
(on a continuum from wide to narrow); emotional handles, e.g., poignant words, images, phrases.
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NOTES — Tuning In with CARE

CONTEXT
ATTACHMENT
RELATIONSHIP / THERAPEUTIC ALLIANCE
EMOTION
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EXERCISES
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DAY 2 — EXERCISE 1
Affect Assembly Exercise
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Please note that the transcript is an excerpt of the Session 5 video shown in Day 2 — Part 2 of EFIT Level 1.
In the interest of client confideniality, the name of the client has been changed and is consistent with tran-
scripts and related materials in the Primer for Emotionally Focused Individual Therapy (EFIT) (Johnson &
Campbell, Routledge, 2022).
Please protect clinical material/client confideniality. Do not distribute or copy. Store appropriately or shred
once finished exercise.
EXERCISE
Using the following transcript:
1. Describe the process of affect assembly.
2. Identify the trigger, basic perception, body response, meaning and action tendency.
3. Summarize / mirror / reflect the client’s experience — write out what you would say.
“This discovery and assembly process regulates

emotion at the same time as it elicits and distills it.”
— Johnson, 2019, p. 60
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TRANSCRIPT
Therapist: So Yezda, in terms of this process, so many big things have happened, sold a house, bought a
house, marriage. Where do you feel that you are with the two of us and this process?
Yezda: What do you mean?
Therapist: Do you feel like there’s been any change? If so, what do you notice? What might [your fiancé] say
he notices is different?
Yezda: My sister — I talked to her a couple Fridays ago, before the wedding. She said I sound more
relaxed. That was kind of at the beginning of when everything was shifting. I wouldn’t necessarily
say that I sound more relaxed if you talk to me now but I think I’m more patient. I know that. I’ll
have certain memories, lately, of things that have happened and I actually get pretty angry, more
so than I did in the past and so I’m trying to work through that.
Therapist: Yeah maybe that’s a place to start today, Yezda. If you feel like you have the space and are
comfortable.
Yezda: Yes I can.
Therapist: Okay, memories of childhood in your family or other memories?
Yezda: Yeah, they’re memories of childhood. I’m trying to remember. It happened the other day and I
was trying to remember what the situation was — they’re often to do with my parents.
Therapist: Both of them or your mom?
Yezda: Both of them. I think more so with those feelings — they’re definitely around memories of my
mom. I don’t have anger towards my dad. I don’t feel angry when I remember things, I feel more
sad. I think I always assumed that my mom knew better and so when I have memories of things
that have happened, I can tell that she knew what she was doing was wrong and that’s how I’m
seeing it now and that’s probably where the anger is coming from.
Therapist: Yezda is there a specific memory that comes to mind for you in this moment as you share with
me?
Yezda: Yeah, things like making up excuses. I really loved dance and I worked really hard at it. I have this
recurring memory that happens of auditioning to get into this performing arts school and the
whole time my mom would encourage me to audition. There was a lot of prep involved with
auditioning for the school. I actually auditioned for both, like the drama and the dance program,
and I spent a lot of time outside of school learning lines and taking extra classes in dance to get
ready for that. I think I was in grade 10 and I auditioned and I got in! I had had the conversation
with my mom before about about wanting to go, and she was aware and she encouraged me. But
when I got in, she ended up saying that it was too far for her to drive me there so I didn’t end
up going that time. Then it was either the next year or the year after, my grade 12 year, I decided
I wanted to try again to get in and do at least a year or two. I went through same thing — a lot
of extra prep, had the conversation with my mom. This was around the same time when I was
also trying to get my license for driving; I was planning on driving myself to the school. Again I
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got in and then I was told by my mom that she didn’t want me driving. My memory is that I
actually found out, not long after that, it wasn’t very far from my house. It was only a 10 minute
drive and it wasn’t a hard 10 minute drive. My regular high school was, maybe, less than 5
minutes away. I have a lot of resentment still from that experience and when I think about having
children and what they may go on to do, I have a hard time digesting how I could just be that
controlling with them.
Therapist: Hmm…Yezda what do you feel as you share that? ...in your throat and your voice right now.
Yezda: Disappointment... it’s still there, it feels like it happened yesterday, it feels so recent... and this is
the anger coming up in my chest, the feeling of almost being manipulated, actually.
Therapist: Right, yeah, and Yezda, as you feel that in your chest, is it near the top?
Yezda: Yeah, I feel it here... [Touches her chest.] ...and then a tightness in my throat.
Therapist: Yeah, and as you focus on those experiences Yezda, what happens inside of you, as you focus in
on that bodily felt sense?
Yezda: A feeling of helplessness.
Therapist: “I feel helpless.”. And what’s the natural propensity for you, Yezda? What would you normally do?
When you feel helpless and you feel that tightness in your chest, what would you normally do?
Yezda: I actually try to run away from that feeling. I try to dismiss it. I don’t really give it a lot of space. I
try to think of something else and chalk it up to, “That was out of my control,” so I don’t have to
take responsibility. But that’s where the anger comes in so it’s hard because I really want to not feel
badly about that anymore.
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Tango Exercise
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EFIT Tango Transcript Review Exercise

Please note that the transcript is an excerpt of Sessions 4 & 6. In the interest of client confideniality, the
name of the client has been changed and is consistent with transcripts and related materials in the Primer for
Emotionally Focused Individual Therapy (EFIT) (Johnson & Campbell, Routledge, 2022). Sessions are edited
somewhat for brevity and clarity.
INTRODUCTION
A Primal Scene
The client is Kathy (Kat) a soft spoken, nervous, intelligent young woman. First part is from Session 4. Kat is
25, working in a restaurant and presented with an eating disorder – anorexia and anxiety issues. The eating
disorder is contained at point of entry into EFIT. She stated that a clinic had coached her eating behavior and
she had put on weight but no-one seemed to help her with the anxiety that she knew was the core of the eating
problem, so she wanted help with this. Being with Kat constantly reminded me of Bowlby’s formulation that at
the heart of clinical problems, we always find, “frightening, alien and unacceptable” emotion.
The EFIT Tango

Towards the end of Session 4, the therapist recaps Kat’s emotional handles from last session and the image of
her creeping carefully into her mother’s bed as a young child when she was scared of the dark — she was not
allowed to wake her mother up. And she still has trouble sleeping at night. I ask her how she feels regarding this
image which represents a primal attachment scene — a drama with deep existential significance. This kind of
drama shapes models of self and other and the nervous systems ability to regulate emotion, especially threat.
TRANSCRIPT
Session 4
Kat: Its so sad. There was no comfort really. Mum had her back to me. She never even turned and said,
“Are you okay?”
Therapist: Yes. Sad. Very sad. You had to be so careful. Not to wake her or “impose” on her in any way
when you felt alone and when it was dark. That little girl was so alone. [Recapping Tango Move 2
— Affect Assembly and Deepening of earlier session. Making emotion specific and granular.
Using soft slow voice.]
Kat: I am still careful in relationships. I never initiate physical contact. There is a barrier. I don’t know
how to give love or how to receive it. It’s kind of unnatural for me!
Therapist: Yes. You learned back then to be careful — so careful. To expect, to make do with little comfort.
Not to reach — to ask. It was too risky. Loneliness and fear were what was normal for you [She
nods and tears up.] And you have told me that this would make you feel literally sick to your
stomach, and when you felt sick you couldn’t eat. Then not eating made you thinner — more
acceptable and feeling more in control. So developing an eating disorder was just logical wasn’t it?
[She nods.]
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Kat: Yes. It makes sense. And the clinic helped me start eating again — change my habits but... no one
helped me with the feelings that were what it was all about. No one wanted to or seemed to know
how to talk to me about that.
Therapist: Right. But here you are so brilliant at talking with me. So brave and so able to put your finger on
the sadness and the anxiety — the loneliness of that little girl — little Kat. Let’s stay with her. Can
you tell me more? How old was she when she was scared of the dark and crept into her mother’s
bed at night?
Kat: About 6. I’d hear noises in my room, my mind racing. I would wait — wait until mum was asleep.
Work up the courage to go into her room — knock very lightly and whisper, “I can’t sleep, can I
stay?” She might say, “Don’t bother me. Don’t wake me up”. There was a pillow between us. I’d get
in but... but there was no warmth. I was still alone. But I’d finally fall asleep. A little relief but... no
sanctuary. [She tears.]
Therapist: [Reaches out and touches her knee.] Right. No safe place. No comfort. No sanctuary. The rule was
— mustn’t impose on mummy. If you push further you are walking a fine line — and if you do??
Kat: She will say, “Stop sleeping with me,” or grab my arm hard and take me back to my bed and tell
— me to stay there.
Therapist: HUM. You will be rejected and then totally alone, yes? [She nods and is teary.] Scared — so scared
and so alone. And if adult Kat was there with little Kat just before she knocks on her mum’s door
— oh so carefully — what would adult Kat say to her, the stronger wiser Kat who is here now
with me? Can you close your eyes and tell her... that you see her... you are with her? [Move 3 of
Tango — Choreographing Engaged Encounters.]
Kat: [Closes her eyes. Speaks very quietly.] I see you are afraid. You are not imposing. It’s okay to look
for comfort. [Opens her eyes and turns to the therapist.] But why is she so afraid?
Therapist: We are all afraid in the dark — especially when we are little. We need to know there is protection
— comfort. To not be alone. [Validation, Normalization, Attachment frame.]
Kat: Yes. She is all alone — she doesn’t have a word for that!
Therapist: Can you tell her...?
Kat: [Closes her eyes.] It makes sense how alone you feel. You should have someone! [She holds her
chest.] It’s sad, sad. I will comfort you.
Therapist: Yes, tell her again, “I will comfort you.” What do you do to comfort her?
Kat: I hold her to my chest — “I can comfort you.”
Therapist: How does she feel? Can she let the comfort in?
Kat: Yes — she can relax and let go. [She opens her eyes and turns to the therapist. She weeps.] It is so
sad. It’s such a simple thing. [Long silence.] I saw a kid yesterday. She jumped up and wrapped
herself around her Dad. Just like that — I crave that.
Therapist: We all crave that — need that Kat.
Session 6
Therapist: So, what happens when you think of our last session Kat? Think about little Kat going into mum’s
room...
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Kat: I get very emotional — it’s a sadness — a hurt. But I can look at it now. I can kind of accept it. Not
shut it down. Then it kind of comes to an end.
Therapist: Hum. You can go with the flow now and then it is kind of tolerable, almost complete? [Kat nods.]
And last time you said that in the past you would fight it and try to dismiss it and then it would
hijack you? [She nods.] Last time you used an image I would like to go back to — you used the
image “starvation diet” for how things were with your mum and that hits me, seems to echo
your eating disorder. If you had reached for caring — nourishment, just asked her to hold you...
[She looks horrified.] ...she would have pushed you away completely? So you were “careful” and
you stayed “careful” with people. Right here, right now it seems like touching this is so hard.
[Move 1 of Tango — Reflect Present Process.] What is happening in your body right now as we talk
about this? [Start of Move 2 — Affect Assembly and Deepening.]
Kat: [Very quietly.] If I melted down, she’d get angry and take me back to my room and I would lie there
ALL NIGHT. Couldn’t turn the light off till I was 19! [She is internally focused now — absorbed.]
Therapist: What is happening in our body Kat? Right now?
Kat: I’m in melt down.
Therapist: Help me feel that with you.
Kat: Spiralling panic — pure panic.
Therapist: Alone, in the dark, no comfort. Where do you feel it? [Body sensation — part of Affect Assembly.]
Kat: It’s here. [Sweeps her hand across her chest.] Like a cut on my chest, a singe, a burn. I cringe.
[Therapist reaches out and lays her hand on Kat’s knee and leaves it there. Kat weeps.]
Therapist: And what goes through your head? What do you say to yourself? [Meaning part of Affect
Assembly.]
Kat: [Very quietly.] I blame myself. “If you had done it differently, you would be in there with her.” I
have messed up — failed.
Therapist: You say, “I should have been quieter. I did it wrong. Mummy leaves me in the dark all by myself
and its my fault. I wasn’t quiet enough.”
Kat: Yes. [Looks up at the therapist.] I go into “what ifs.” I get anxious. How to do this? So I plan and
plan and plan about everything. It’s pressure. Need to find the perfect formula. I planned and I
didn’t get what I wanted anyway. [Action tendency triggered by panic.]
Therapist: Yes. That makes sense. All the carefulness, the planning and you were still alone in the dark! That
is kind of a helpless feeling, isn’t it? [Interpretation. Kat nods emphatically. Therapist then slowly
repeats all the elements of emotion above in a clear coherent way.] In this helplessness, we don’t
know what to do. There are not many alternatives, especially when we are little. Better, less risky,
to get angry at yourself than at Mum, right? [She nods again. Long silence. She looks up at the
therapist.] But now you are stronger. I wonder what you would say to her right now — if she were
here? [Entry into Move 3 of Tango — Choreographing Engaged Encounters: vulnerable child self
and adult wiser self.]
Kat: [Smiles, speaks calmly.] Hum... Hum... I might say, “It’s that she is not listening! I’m screaming and
she is not listening! Perhaps it’s not a kid deficit — perhaps it’s a mummy deficit!” Cause I
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remember my Dad holding me when I was sick. That was a small dose but not enough.
Therapist: Yes, starvation diet. Kat, can you close your eyes now. Can you see your mum sitting with us? See
what she is wearing, how she is sittng. Bring her into the room. Can you tell her, “I was — I am
screaming and screaming in panic and you don’t hear me. I try to find the right way to get you to
hold me but I’m frantic and can’t find the ‘right way’.”
Kat: “You don’t listen to me. You say you only married Dad to have me but you don’t listen to me! I
can’t find you!”
Therapist: “You leave me in the dark. Alone. NO matter how much I worry and plan...”
Kat: YES! Yes. “You leave me in the dark and afraid all the time. You tell me that it was Dad leaving
that sparked my mental health problems but... that wasn’t true.” [She weeps.]
Therapist: You are telling her what is true for you Kat and doing it so honestly, so brilliantly. Putting all
your emotions together and saying what you could never say. [Validate and exit from intensity so
as not to overwhelm Kat — titrate risk.] How are you feeling Kat? [Entry into more reflective mode:
Move 4 of Tango — Processing the Encounter.]
Kat: This is a lot to take in — this hurts. [Therapist nods and touches her arm.] She takes no
responsibility. She explains stuff and I end up comforting her! I am not that assertive. She is off in
her head in her stories.
Therapist: She doesn’t see you. It’s hard to find the courage to stand up and say, “You don’t see my pain. I got
so anxious I couldn’t eat and it wasn’t because of my Dad. You are still not there. You left me all
alone in the dark.”
Kat: YES. I never had anyone to hear me — even at the clinic. I tried to show her, tried to show them but...
Therapist: You are saying, “I have been all alone in the dark with my fear.” That is so hard. We are all afraid
of that. None of us can bear that — we do anything to not feel that. [Normalize, making her less
alien to herself.]
Kat: I wish I could say this to her for real. But it would be me out there... Too risky.
Therapist: Well, you were pretty real here. And maybe its good she isn’t here then. [She laughs.] You need to
get clear and sure of yourself first maybe.
Kat: This helps me get clearer. Helps me make sense of things. My older brother says, “Just go to the
clinic they will fix it.” But the clinic doesn’t fix all this — my anxiety.
Therapist: [Entry into Move 5 — Validation and Integration.] Right. You are so mature and wise to have
figured that out Kat. And you are so brave here with me. [Therapist then recaps the whole of the
above as a narrative, including key emotional handles and images.] You are really brilliant in
therapy, aren’t you? [Kat’s self is reflected as competent and worthy.] How are you feeling right now?
Kat: [Giggles.] I feel light and okay. Last time I sang in the car all the way home. It’s funny cause we
talk about hard things but... I used to dread talking to the counsellors at the clinic. It never
went anywhere. I write things down when I go home from these sessions. Coming here, well, it’s
kind of exhilarating.
Therapist: [Laughs.] Yes — for me too. You work so hard. It’s a pleasure to work with you.
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Moving Through the Tango
85
Moving Through the Tango Exercise

Please note that the transcript is an excerpt of a Session 6. In the interest of client confideniality, the name of
the client has been changed and is consistent with transcripts and related materials in the Primer for Emo-
tionally Focused Individual Therapy (EFIT) (Johnson & Campbell, Routledge, 2022). Sessions are edited
somewhat for brevity and clarity.
TRANSCRIPT
Therapist: Yezda when you think back to some of those childhood experiences, how old are you in those
scenes and what do you see? Is there something that comes to mind?
Yezda: I’m probably 11. I feel and I look helpless. I’m so choked up with emotion that I don’t have the
words to say anything...
Therapist: Where is she? That’s good Yezda, let yourself feel it as much as you’re able. Where is she in that
scene?
Yezda: I’m at school in the hallway watching my mom yell at someone else and kind of feeling embar-
rassed about it.
Therapist: Feeling helpless and alone, without words because you’re silenced or because you feel muted, you
feel paralyzed?
Yezda: Mhm, yeah, I think it’s the last thing. I’m overwhelmed with emotion and a bit tired that I don’t
feel I can say anything in the moment.
Therapist: Do you see her little face Yezda, that 11-year old’s face?
Yezda: Yes.
Therapist: What do you see?
Yezda: She’s been crying, her face is puffy, she’s watching, she’s trying to keep her distance, she’s trying to
not be there.
Therapist: Trying to shrink?
Yezda: Yeah, she’s doesn’t want to be visible.
Therapist: Right, yeah... her face, yeah... and do you see her eyes?
Yezda: I don’t see her eyes. It almost looks foggy where her eyes are. I see the rest of her face but I don’t
see her eyes.
Therapist: Yezda that was a beautiful moment, when you found her [she was] a little bit younger... on the
playground... If you join her in the hallway, is she able to see you, glance at you, or maybe just feel
your presence? Is that possible, or no?
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Yezda: Yeah, I’m standing behind her. I see from behind her head, looking at what’s happening.
Therapist: Okay, so you’re there behind her, what are you drawn to do,Yezda?
Yezda: Put my hands on her shoulders.
Therapist: Will she let you?
Yezda: Mhm...
Therapist: Then what happens?
Yezda: I get the sense that she doesn’t see me but she feels me... my presence.
Therapist: Does she have words for you? Even if they’re not spoken?
Yezda: I get the sense that she says, “It’s okay, this will pass.”
Therapist: Yeah?
Yezda: She’s more frustrated than sad.
Therapist: What do your hands want to say to her? What does your touch say?
Yezda: “I’m here if you need it.”
Therapist: Yeah, that’s nice Yezda. If you inhabit — if you’re able to, if you’re able to be in the body of that
little 11 year old — it feels most powerful in the hallway, doesn’t it?
Yezda: Mhm...
Therapist: At school... if her little body could speak, and of course it’s not real, but if in that moment, if
her little body could speak to your mom, what would she say? If she didn’t feel silenced and
paralyzed, and maybe you won’t be able to do this but we could just see, if you really stay in her
body and I can be there with you in that school hallway and that older you is behind her and if
she could stay really still in her little body, probably her chest and feel your cheeks, if her body
could speak what would she say to your mom?...and to that girl?
Yezda: I would say to the girl, Amber is her name, “I don’t need your acceptance, I just need you to leave
me alone.”
Therapist: That’s great, Yezda. Are you able to find your eyes and look at her, and say that to her?
Yezda: Mhm... I can feel the force in the words leaving my mouth when I say that to her... very strong.
Therapist: “I don’t need you to accept me, I need you to leave me alone” Yeah? Say it again, Yezda, say it to
her again.
Yezda: I don’t need your acceptance. I just need you to leave me alone.
Therapist: Are you able to say it again, Yezda?
Therapist: Yezda, what are you feeling as you share that?
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Yezda: I feel power.

Therapist: Yeah?
Yezda: My voice was quivering cause I’m pushing the words out too... and I want to say to my mom in
that moment, “I don’t need you to fight my battles for me.”
Therapist: Are you able to fight those words out?
Yezda: I can’t do it there, with Amber there.
Therapist: Right...
Yezda: I feel that she’d be really angry with me, that I would embarrass her by saying that.
Therapist: Just tell her that at home, I guess.
Yezda: Yeah, I feel like I can tell her there, that I can handle it.
Therapist: That’s good, Yezda.
Yezda: She’s angry with me for saying it though. She storms out, the doors are right next to her and she
walks outside.
Therapist: Then what do you do Yezda? As that 11-year-old, what happens next?
Yezda: I start crying a little bit but not like sobbing.. the crying after having a bad argument... kind of
sad... depleted.
Therapist: What do you feel in your chest?
Yezda: I feel like it’s heavy but I feel a little bit... a sense of relief.
Therapist: Are you able to name the relief? Where the relief comes from? What gives you relief?
Yezda: Yeah, because I was able to say what I wanted to say.
Therapist: Yeah, mhm, not be invisible... not shrink... yeah? Good for you, Yezda, that’s perfect, that’s
amazing! Are you in her body or are you watching?
Yezda: I am in her body now and I can feel her quivering... and pins and needles in the bottoms of my feet.
Therapist: Yeah, good for you Yezda, that’s good... stay as long as you can, to let yourself feel what wasn’t safe
to feel at that time... knowing that you have that big you, that older you. Try to let her feel... the
feeling in her feet and the quivering... and the touch... your touch. Maybe the hallway’s empty
now, right? And you can just be there alone with that older you... and I’m close by too, watching...
and it’s okay to let yourself feel whatever feelings... it’s okay to feel. Whatever feels okay to say, you
can say it... or you don’t have to say anything
Yezda: I hear nothing and I feel comfort in not hearing anything.
Therapist: That’s nice.
Yezda: I’m soothing myself. I’m taking deep breaths to try and calm myself so that I can go outside to the
car where my mom is.
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Therapist: Right, yeah, do you feel the presence of an older you or not so much right now?
Yezda: Not so much now.
Therapist: You feel alone, yeah?
Yezda: I feel like I’m trying to find confidence in being alone.
Therapist: That’s what’s familiar for you Yezda, that’s what you know. Yezda, what would it be like to just
barely tilt your little head and glance up at her... at you... at that older you? What might that be like?
Yezda: I can see her eyes now, when she looks over at me.
Therapist: Yeah?
Yezda: They look a little bit more clear and it’s almost like she’s saying, “You know I have this... you know
I can handle this.”
Therapist: And what does that big you say to her?
Yezda: I tell her that she doesn’t have to do it on her own.
Therapist: That’s great, that’s right, Yezda. T, tell her. Is she able to take that in? “You don’t have to be alone.”
Yezda: She says she doesn’t know how to be anything else but alone.
Therapist: How do you hear that Yezda?
Yezda: That she doesn’t want to burden anyone with her sadness... that everyone else’s feelings and
emotions are more important.
Therapist: Are you able to respond to her? Older, wiser you?
Yezda: I tell her that she’s important too.
Therapist: What do her little eyes do when you say that?
Yezda: She’s just looking over at me. She says, “Okay...” She says, “Okay, okay, I’ll try to remember that.”
Therapist: “I’ll try to take that in. I’ll try to remember and know that I don’t need to be alone and that I’m
important and valued and special.” Where are you now, as you breathe, Yezda?
Yezda: I am back here and I’m remembering that that is why I have trouble now with that.
Therapist: Yezda, you are so beautiful, do you see what you just did?
EXERCISE
Write out what you would say (Tango Move 5).
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“A secure connection shapes balanced, adjusted human beings who

then have better relationships with loved ones and friends, which then
foster ongoing mental health and adjustment and a greater ability to
relate to others.”
— Attachment Theory in Practice, Sue Johnson, 2019, p. 10
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EFIT Stage 2
91
EFIT Stage 2 Transcript Review Exercise

Please note that the transcript is an excerpt of an EFIT Stage 2 Session. In the interest of client confideniality,
the name of the client has been changed. Sessions are edited somewhat for brevity and clarity.
INTRODUCTION
Henny is 55 years old, has had a varied career as a specialized physiotherapist and as a teacher of gymnastics
and has two adolescent children, Vinnie and Veronica who now live with her since the breakup of her mar-
riage 9 months before coming for therapy. She asked her husband, Tom, a dentist who she met when she was
18, to leave because of his complete withdrawal into addiction to alcohol, cocaine and gambling. This was
the third time she had left him, “running away” to new cities, but this time was “final”. She told me that she
came for therapy because she had, “Always lived in survival mode, just focusing on taking the next breath,”
and now she was “tired out.” She stated, “I shut down and sleep for a whole day now.” She was diagnosed with
PTSD after the birth of her second child when Tom turned up high at the hospital and her parents, who live
on the other side of the country, paid her a surprise visit to see the new baby. She reported that she went into
a “trance” and was “catatonic” for a week in the hospital. Indeed, at the beginning of therapy, her scores on
Briere’s Trauma Symptom Inventory (TSI) were very high, scoring on average in the 97th percentile on all the
key factors on this test. For a while she was heavily medicated but currently takes a small dose of anti-anxiety
medication only. She said her symptoms had abated for a while but since asking Tom to leave, she reported
nightmares and feelings of hopelessness, panic attacks and flashbacks of her past trauma with her father, who
would drug his two girls and repeatedly rape them until they reached puberty. He would arrange where the
girls slept and if you were the one in the most isolated room, then you were “hunted.” Her mother witnessed
many of these incidents but would then deny they had occurred.
Henny presents as honest, vivacious, highly intelligent and eager to grow. She is resourceful, telling me, “I can
fix anything. I can rebuild a house if I have to”. She describes holding down three jobs at a time and teaching
gymnastics, stating that her skill at gymnastics saved her life. As a child she remembers moving a dresser in
front of her bedroom door to keep her father out and other “victories.” She said, “I want a life that feels safe. I
want to break the pattern but now it’s hard. Tom was the only person who ever loved me. Seemed to love me.
I don’t trust anyone.”
The goal of Stage 1 of EFIT is to build a positive alliance and stabilize the client, pinpointing sources of
strength and resilience, shaping coherence and emotional balance, and formulating core treatment themes,
dilemmas and goals with the client. Henny told me her life was a “whirlwind” and at first she spoke very fast,
moving from story to story and from childhood to recent events in an intellectualized haphazard way that
was difficult to make coherent sense of. We moved through assessment and stayed in Tango Move 1 for most
of the first 10 sessions. Then I was able to slow her down and help her deal with her grief and fear around
the breakup of her marriage so that she felt more grounded and able to do tasks like filling out the custody
agreement with Tom and setting limits on him seeing the girls when he was high. She was able to be more
emotionally present in sessions and begin to pinpoint key scenes in her childhood that continued to haunt
her in nightmares and flashbacks. She began to be able to enter and stay in deeper experiencing (levels 3-4
rather than levels 1-2), accessing dinner table scenes as a child when she was in her father’s “strike zone” and
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would get so scared she would gag and throw up. There was “no safety anywhere.” She was able to stay with
and explore memories that induced “total panic” such as walking in as her father was raping her younger
sister. Generally she began to be able to connect with her “frightening, alien and unacceptable emotions” and
to feel them rather than “numbing out and fighting to cope, to fix stuff all the time.” Fight-Fix-but-not-Feel
wasn’t working. She reflected that she wanted to save others and fix things in order to not feel so helpless
and alone and to “matter to someone, at least for a moment,” but then she would get hurt and numb out
and “escape” into a new place or activity. The Move 3 Tango encounters we worked with were short, such as
closing her eyes and telling Tom, “I can’t fix you. I have to give up on us.” After telling me a dream where she
was in a trap where she treads water out in the ocean and swims to people trying to save them all the time,
we also have an encounter where I ask her if she can be in the water and let me hold her up sometimes, and
she weeps and agrees she can.
TRANSCRIPT
From a beginning Stage 2 session — a third of the way through the session:
Henny comes into the session saying she is “bitter.” It is her birthday and she remembers, like watching a film,
a birthday party where her father stared beating on one of her friends at the party. The girl’s parents came to
the house to complain but, “As usual, NOBODY DID ANYTHING!” The other kids then ostracized her.
Henny: It was brutal. I can see it. He pummelled her. So I told Tom I didn’t want to go out for a celebration.
No more roller coaster where he is nice to me for an hour and then... gone.
Therapist: Yes. A kind of bitter helplessness comes up when you think of your Dad and when you think of
Tom.
Henny: It was all pretending. I remember Mum making cookies! Little morsels of caring. When Dad was
nice to you it was off, kind of scary. He was planning something. I’d refuse his gifts. Tom won’t
accept he is an addict. He says it’s me and my PTSD that is the problem, that I’m too needy. That
I can’t do regular things like close or lock doors. Always need an escape. Dad said I was crazy too
when I resisted him.
Therapist: Yeah. He robbed you of your reality — denied the brutal reality that you were all alone and helpless
and he was a predator — a terrifying abusive Dad. And Tom too... he let you down.
Henny: She — my mum — took me to the doctor once cause I was so sore and bleeding down there... but
nothing happened. She made some excuse. I always said I would escape but... feels like I am still
in prison. My sister says she doesn’t remember anything but she is a mess so...
Therapist: How are you feeling as you say this, Henny? You are telling me that you have had to deal with this,
what did you call it — life sentence of fear — with no-one to turn to, to see you and tell you your
pain is real — that it matters — no comfort — and you are heroically fighting for your life again
and again. All by yourself.
Henny: I don’t know. I’ve done pretty good — lots of jobs — I can speak languages.
Therapist: Yes. And we talked about how you are a fighter. An amazingly strong vibrant lady. Remember our
strong story? Where you are about 11 and you are up on the balance beam, feeling the beam under
your feet, strong, sure of yourself. You leap into the air and turn — feel the power — and touch
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the beam and turn again. You know where the beam is — and then land on the ground and see
your coach’s face smiling at you — at your skill and your courage and your fierce leaps, your risks.
Can you feel that in your body as we touch it? [She nods empathically.] Good. You knew where
the ground was — what was real — and you were in your body. It’s a good place to go when you
are scared and unsure. [She nods again.] And you were just a child, a child who couldn’t let go and
sleep for fear of your Father coming for you. But part of you was still strong and whole. [Resilient
image/experience evoked.]
Henny: [Her eyes fill with tears.] My child is broken. What did I do to deserve such horrible treatment?
Wasn’t good enough to be considered by my husband... I had a medical procedure last week and
Tom didn’t even ask me how it went, how I was doing. That was hard. [Trigger for emotion.]
Therapist: Yes. None of the people close to you in your life have seen you, have they? Seen your pain and
your fear and comforted you — showed you your pain mattered. That breaks us — that is so
terrifying... to be so vulnerable and abandoned. Unseen.
Henny: It’s difficult. [Perception.] And it’s sad. [Core emotion pinpointed.]
Therapist: Yes, where do you feel that right now?
Henny: In my chest — here. [Hits her chest.] And I tell myself I must fix it. Escape. [Body and Meaning
elements of emotion — she adds them herself.] So I go to the gym or work on something but...
[Action tendency.]
Therapist: [Softly and slowly.] Right, “I’ll fix it or I’ll run, but inside the sadness and the fear breaks me.”
[Proxy voice.] Inside I am broken and alone. [She nods.] What did I do wrong? How can no one
care about me and my pain? No one did anything to help me. Inside the vulnerable part of me is
always fighting to not be destroyed by this sadness and fear. [RISSSSC. Use of proxy voice. “Broken”
is an emotoonal handle.]
Henny: [Very softly and with lots of hesitations.] It’s a constant roller coster and my daughter Vinnie looks
just like my younger sister did when she was little. She has little breasts now. She got mad at me
the other day and Tom isn’t protecting her. He takes her to parties. [Goes very still and her eyes get
wide.] I just got triggered. I just shut down. For a whole day. Spaced out. I was a zombie.
Therapist: Yeah. [Softly. Slowly.] Can you stay with me right now, Henny? Can you feel your feet on the floor
[She nods.] Can you look at me? [Therapist reaches out and touches her arm. Her attention returns
to the therapist.] That was how you learned to escape, wasn’t it — to space out? To escape? That
was the only way to survive — to protect little Henny. And now your body just does it for you
And you worry about if Vinnie is safe? [Henny nods and weeps.] And you saw your little sister
being raped by your Dad, didn’t you? [She nods.] And there was nothing you could do — you
could not protect her. [She weeps.] You saw what was happening to you, happening to her — you
were a witness, a helpless witness. [She covers her face in her hands and weeps again. Long silence.]
That is unbearable, isn’t it? Like your dream of being in the sea holding everyone up. You were in
a sea of pain and fear and you had to watch it happen to her — in front of you. That is overwhelming.
Henny: [Very quietly.] Nobody did anything. [She holds herself — folds her arms around herself.]
Therapist: Yeah. Right. There was no safety — no protection — and you said last session that your goal was
to find a way to have a safe life. Yeah? You couldn’t protect your sister or you. You were broken
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and alone, hiding behind your mum’s curtains at night, yeah? No safety anywhere. And letting go
into sleep is still so hard for you. What is happening Henny? Are you with me? This is so hard.
Henny: [She looks up at the therapist.] Yes. Part of me is rigid, tense. I feel the fear.
Therapist: I can’t imagine how terrible this was for you — my heart breaks that little Henny had to go
through this all alone with no help anywhere. It is amazing that you made it through to be the you
that you are now. I hurt for you. [She weeps.] Can you take that in? Can you feel me feeling with
you — feeling your hurt? [Move 3 and Move 4 of Tango.] I see your terror and your pain. It’s
overwhelming!
Henny: Yes. [She laughs.] So different. A switch — to feel that. [Pause.] Helps. [Long pause.] I was thinking
that on Mother’s Day I felt triggered all day. I couldn’t call her. She denied it all.
Therapist: Yes — she left you – couldn’t stand with you — left you questioning your reality for so long. [This
is an emotional handle.] Left alone in the face of all this fear. No one to even help you know what
was happening. You didn’t even have words for what was happening. Just vague terror and pain.
So then, as you said, you doubt yourself all the time.
Henny: [Very softly.] She was THERE!! When he would bring out the booze, she would ask him, “What
are you doing?” She knew he was giving it to us to make us pass out. I thought I was crazy —
broken. She was just stoic — I don’t even remember her comforting me.
Therapist: Yeah. Do you remember a few sessions ago, you closed your eyes and talked to her? Can you do
that now? Tell her what is real for you — you have the words now.
Henny: [Closes her eyes.] You pretended. You left us alone with him — again and again. I wasn’t crazy. You
let it happen — again and again.
Therapist: How are you feeling right now Henny — in your body? Do you feel angry right now?
Henny: No, I feel huge huge sadness. That she could do that to us. Pretend. Leave us naked with him. She
was afraid, I think, but...
Therapist: So helpless. So sad to be left alone in the face of all this darkness. No one can stay strong in that —
no one can hold another up. It was all desperate survival struggle, wasn’t it? [She nods.]
Henny: [Closes her eyes again.] YES. And I did it with Tom — what you did. I denied his addiction again
and again. But I wouldn’t do that with my kids. I told him, “I have reported you to the police for
driving the kids inebriated. I don’t forgive you.” I won’t call you on Mother’s Day. You were not
a mother. [She weeps. The therapist puts her hand on Henny’s arm.] You let him do it. No protection.
I didn’t have a mum. I had no one.
Therapist: Yes. That is unbearable. No one can tolerate that. You had to numb out. You were small, so
vulnerable and you faced terror every day all by yourself. [Therapist felt like Henny was about to go
outside her window of tolerance so moved to Tango Move 5.] But you found a way through — you
are here — you are an amazing woman. You have faced so much in your life with so much courage.
Look at what you did here with me today! You said your truth. It was clear. You walked into it and
took a look at the “picture” you told me you could never bear to draw or see.
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Henny: [Smiles.] I made it through. You get it. I felt always naked as a child — but in my gym oufit, well
THAT was like body armour.
Therapist: Yes. You were not in prison there — you learned to fly into the air and to land on your feet,
strong.
And you still do that — in the gym. You show other kids how to fly. That’s amazing, isn’t it? [She
smiles.] Can you fly a little here — and land — get a little balance?
Henny: [Laughs.]
Therapist: Can the Henny who learned to fly — found her balance on the beam — landed strong — can the
Henny who is here right now talking to me, offer some comfort to that little broken girl, do you
think? Can you close your eyes and see her, hiding behind the curtains, afraid to go to sleep,
knowing she would be hunted? [Emotional handle from Henny. Henny closes her eyes.] Can you
see her — curled up in the curtains, so scared? Can you see her face? [Long pause.] What would
the Henny who knows she can fly and land strong like to say to her, right now?
Henny: [Very softly.] You are so small. I want to hold you — keep you safe. There is a way to be safe — you
will find it. You are strong — you know deep inside what is true for you. This pain and fear are not
all of you. You can fly. [She weeps.]
Therapist: Yes. Can she hear you? [Henny nods.] What happens now?
Henny: She sleeps — she lets go.
Therapist: Yes — that is beautiful Henny.
We then debrief this enactment and the session shifts to the same themes but regarding Henny’s relationship
with Tom — this is less overwhelming.
FOR REFLECTION
The following questions are meant as a reflection exercise to practice your EFIT skills. There are no “correct
answers” and none are included in this manual.
1. Can you find 3 deepening interventions the therapist used here (like repetition — images — evocative
language — adding meanings — using client’s handles — using soft, slow, music/non-verbals)?
2. What other experiential EFT micro intervention could the therapist have used here? Can you find a place
where the therapist could have used it.
3. Can you find one place where you might have gotten stuck or done something very differently? Reflect on
the EFT intervention. How difficult might this have been for you? What might have blocked you?
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ANSWER KEY
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ANSWER KEY
Below you will find the Affect Assembly Exercise transcript with aspects highlighted with a different font
colour for the purposes of drawing your attention to the elements of emotion. As well, you will find a sample
reflection. There are many ways to reflect Yezda’s experience. It is very likely your response will differ.
TRANSCRIPT
Therapist: So Yezda, in terms of this process, so many big things have happened, sold a house, bought a
house, marriage. Where do you feel that you are with the two of us and this process?
Yezda: What do you mean?
Therapist: Do you feel like there’s been any change? If so, what do you notice? What might [your fiancé] say
he notices is different?
Yezda: My sister — I talked to her a couple Fridays ago, before the wedding. She said I sound more
relaxed. That was kind of at the beginning of when everything was shifting. I wouldn’t necessarily
say that I sound more relaxed if you talk to me now but I think I’m more patient. I know that. I’ll
have certain memories, lately, of things that have happened and I actually get pretty angry, more
so than I did in the past and so I’m trying to work through that.
Therapist: Yeah maybe that’s a place to start today, Yezda. If you feel like you have the space and are
comfortable.
Yezda: Yes I can.
Therapist: Okay, memories of childhood in your family or other memories?
Yezda: Yeah, they’re memories of childhood. I’m trying to remember. It happened the other day and I
was trying to remember what the situation was — they’re often to do with my parents.
Therapist: Both of them or your mom?
Yezda: Both of them. I think more so with those feelings — they’re definitely around memories of my
mom. I don’t have anger towards my dad. I don’t feel angry when I remember things, I feel more
sad. I think I always assumed that my mom knew better and so when I have memories of things
that have happened, I can tell that she knew what she was doing was wrong and that’s how I’m
seeing it now and that’s probably where the anger is coming from.
Therapist: Yezda is there a specific memory that comes to mind for you in this moment as you share with
me?
Yezda: Yeah, things like making up excuses. I really loved dance and I worked really hard at it. I have this
recurring memory that happens of auditioning to get into this performing arts school and the
whole time my mom would encourage me to audition. There was a lot of prep involved with
auditioning for the school. I actually auditioned for both, like the drama and the dance program,
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and I spent a lot of time outside of school learning lines and taking extra classes in dance to get
ready for that. I think I was in grade 10 and I auditioned and I got in! I had had the conversation
with my mom before about about wanting to go, and she was aware and she encouraged me. But
when I got in, she ended up saying that it was too far for her to drive me there so I didn’t end
up going that time. Then it was either the next year or the year after, my grade 12 year, I decided
I wanted to try again to get in and do at least a year or two. I went through same thing — a lot
of extra prep, had the conversation with my mom. This was around the same time when I was
also trying to get my license for driving; I was planning on driving myself to the school. Again I
got in and then I was told by my mom that she didn’t want me driving. My memory is that I
actually found out, not long after that, it wasn’t very far from my house. It was only a 10 minute
drive and it wasn’t a hard 10 minute drive. My regular high school was, maybe, less than 5
minutes away. I have a lot of resentment still from that experience and when I think about having
children and what they may go on to do, I have a hard time digesting how I could just be that
controlling with them.
Therapist: Hmm…Yezda what do you feel as you share that? ...in your throat and your voice right now.
Yezda: Disappointment... it’s still there, it feels like it happened yesterday, it feels so recent... and this is
the anger coming up in my chest, the feeling of almost being manipulated, actually.
Therapist: Right, yeah, and Yezda, as you feel that in your chest, is it near the top?
Yezda: Yeah, I feel it here... [Touches her chest.] ...and then a tightness in my throat.
Therapist: Yeah, and as you focus on those experiences Yezda, what happens inside of you, as you focus in
on that bodily felt sense?
Yezda: A feeling of helplessness.
Therapist: “I feel helpless.”. And what’s the natural propensity for you, Yezda? [Therapist is asking, what is
the action tendency? the prototypical response?] What would you normally do? When you
feel helpless and you feel that tightness in your chest, what would you normally do?
Yezda: I actually try to run away from that feeling. I try to dismiss it. I don’t really give it a lot of
space. I try to think of something else and chalk it up to, “That was out of my control,” so I don’t
have to take responsibility. But that’s where the anger comes in so it’s hard because I really want to
not feel badly about that anymore.
The therapist tracks the process, with careful attention to the key elements of emotion as highlighted
above. The therapist then provides a reflection that helps the client order their experience/assemble
the emotion, putting the elements of emotion together into a coherent whole. One possible therapist
reflection follows.
THERAPIST REFLECTION
Okay, I hear you Yezda. You have said lots of important things. The thing I hear you saying is you have been
experiencing more memories of your childhood, [Trigger.] as you begin to share more and get closer to
those experiences. And the thing that comes up for you is anger... anger that you were not protected... cared
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for.. That instead you were the protector of your younger siblings and the confidante for your mother. What
I hear you saying is that these memories are triggering — trigger feelings of anger — and when we begin
to slow this down and put the pieces together, I hear you saying that the main perception is one of feeling
manipulated, controlled. No control. Trapped. Alone. Dismissed. Unimportant. [Perception.] “What I want
is not important... I’m not important... I don’t matter.” [Meaning/Attachment Significance.] The bodily feeling
that comes up is a tightness in your chest. [Bodily response.] And the meaning you make is, “I am helpless.”
[“Helpless and alone” = Meaning/Attachment Significance.] No control. Trapped and alone... and when I ask
you, “What would you normally do? How would you normally respond to all this?” You tell me you would
normally run away, take distance... [Action Tendency.] Is that right? Am I getting this right? [Pause, allow
Yezda to respond. Notice the difference it would make if this reflection was provided in a distant intellectual
manner, rather than loaded with RISSSSC and with the therapist being fully present and genuine, that is,
A.R.E.: accessible, responsive and engaged.]
The therapist then may (or may not) add the following reflective summary and provide a rationale for
the therapy process, as well as a celebratory commentary on gains to date.
And now, as we begin to explore some of this, get closer to your experience of all this, the thing I hear you
saying is you are beginning to feel some of the feelings you were unable to feel at earlier times. Of course
you could not feel them, you were alone and lonely, you were the protector, the care provider. You were not
protected and cared for, at least, not consistently in the ways that you needed. So, of course you developed a
way to manage all this, to run away, to take distance. [Validation.] But now, as you embark upon a marriage
— a significant transition — all of this is coming to the forefront and you are now in a space and place to
tune into yourself in new ways, in the comfort and in the arms of your fiancé, [Even more powerful to use his
name but we do not do so here to protect confidentiality.] to grow and to become all you can be. Your anger is
legitimate and you will be able to move through it to the other side. I will be with you — you are doing amaz-
ing Yezda, you are doing great. We are going to get there, you are gettilng there. The more you can revisit and
share some of these key experiences, these pivotal experiences that have shaped you, the more you can have
control of them rather than them controlling you. The more you can slow things down when you get trig-
gered and have more flexibility in your response, the more you will feel a sense of control, a sense of agency.
And that doesn’t mean you won’t be able to run away/take distance when you want to, when that is the safest
and best course of action, the best thing to do — you will, it just won’t be so automatic and reflexive. Does
this fit? Does this make sense to you?
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ANSWER KEY
Moving Through the Tango Exercise
Therapist: Yezda when you think back to some of those childhood experiences, how old are you in those
scenes and what do you see? Is there something that comes to mind? (Move 1)
Yezda: I’m probably 11. I feel and I look helpless. I’m so choked up with emotion that I don’t have the
words to say anything...
Therapist: Where is she? That’s good Yezda, let yourself feel it as much as you’re able. Where is she in that
scene?
Yezda: I’m at school in the hallway watching my mom yell at someone else and kind of feeling embar-
rassed about it.
Therapist: Feeling helpless and alone, without words because you’re silenced or because you feel muted, you
feel paralyzed?
Yezda: Mhm, yeah, I think it’s the last thing. I’m overwhelmed with emotion and a bit tired that I don’t
feel I can say anything in the moment.
Therapist: Do you see her little face Yezda, that 11-year old’s face?
Yezda: Yes.
Therapist: What do you see?
Yezda: She’s been crying, her face is puffy, she’s watching, she’s trying to keep her distance, she’s trying to
not be there.
Therapist: Trying to shrink?
Yezda: Yeah, she’s doesn’t want to be visible. (Reflection)
Therapist: Right, yeah... her face, yeah... and do you see her eyes?
(Increasing contact to move toward deepening engagement with experience.)
Yezda: I don’t see her eyes. It almost looks foggy where her eyes are. I see the rest of her face but I don’t
see her eyes.
Therapist: Yezda that was a beautiful moment, when you found her [she was] a little bit younger... on the
playground... If you join her in the hallway, is she able to see you, glance at you, or maybe just feel
your presence? Is that possible, or no? (Resourcing the client)
Yezda: Yeah, I’m standing behind her. I see from behind her head, looking at what’s happening.
Therapist: Okay, so you’re there behind her, what are you drawn to do,Yezda?
Yezda: Put my hands on her shoulders.
Therapist: Will she let you?
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Yezda: Mhm...
Therapist: Then what happens?
Yezda: I get the sense that she doesn’t see me but she feels me... my presence.
Therapist: Does she have words for you? Even if they’re not spoken?
Yezda: I get the sense that she says, “It’s okay, this will pass.”
Therapist: Yeah?
Yezda: She’s more frustrated than sad.
Therapist: What do your hands want to say to her? What does your touch say?
Yezda: “I’m here if you need it.”
Therapist: Yeah, that’s nice Yezda. If you inhabit — if you’re able to, if you’re able to be in the body of that
little 11 year old — it feels most powerful in the hallway, doesn’t it? (Move 2 — Deepening)
Yezda: Mhm...
Therapist: At school... if her little body could speak, and of course it’s not real, but if in that moment, if
her little body could speak to your mom, what would she say? If she didn’t feel silenced and
paralyzed, and maybe you won’t be able to do this but we could just see, if you really stay in her
body and I can be there with you in that school hallway and that older you is behind her and if
she could stay really still in her little body, probably her chest and feel your cheeks, if her body
could speak what would she say to your mom?...and to that girl? (Move 3)
Yezda: I would say to the girl, Amber is her name, “I don’t need your acceptance, I just need you to leave
me alone.”
Therapist: That’s great, Yezda. Are you able to find your eyes and look at her, and say that to her?
Yezda: Mhm... I can feel the force in the words leaving my mouth when I say that to her... very strong.
Therapist: “I don’t need you to accept me, I need you to leave me alone” Yeah? Say it again, Yezda, say it to
her again. (Repetition)
Therapist: Are you able to say it again, Yezda?
Therapist: Yezda, what are you feeling as you share that? (Move 4)
Yezda: I feel power.
Therapist: Yeah?
Yezda: My voice was quivering cause I’m pushing the words out too... and I want to say to my mom in
that moment, “I don’t need you to fight my battles for me.”
102
Therapist: Are you able to fight those words out?

Yezda: I can’t do it there, with Amber there.
Therapist: Right...
Yezda: I feel that she’d be really angry with me, that I would embarrass her by saying that.
Therapist: Just tell her that at home, I guess.
Yezda: Yeah, I feel like I can tell her there, that I can handle it.
Therapist: That’s good, Yezda.
Yezda: She’s angry with me for saying it though. She storms out, the doors are right next to her and she
walks outside.
Therapist: Then what do you do Yezda? As that 11-year-old, what happens next? (Follow organic process)
Yezda: I start crying a little bit but not like sobbing.. the crying after having a bad argument... kind of
sad... depleted.
Therapist: What do you feel in your chest?
Yezda: I feel like it’s heavy but I feel a little bit... a sense of relief.
Therapist: Are you able to name the relief? Where the relief comes from? What gives you relief?
Yezda: Yeah, because I was able to say what I wanted to say.
Therapist: Yeah, mhm, not be invisible... not shrink... yeah? Good for you, Yezda, that’s perfect, that’s
amazing! Are you in her body or are you watching?
Yezda: I am in her body now and I can feel her quivering... and pins and needles in the bottoms of my feet.
Therapist: Yeah, good for you Yezda, that’s good... stay as long as you can, to let yourself feel what wasn’t safe
to feel at that time... knowing that you have that big you, that older you. Try to let her feel... the
feeling in her feet and the quivering... and the touch... your touch. Maybe the hallway’s empty
now, right? And you can just be there alone with that older you... and I’m close by too, watching...
and it’s okay to let yourself feel whatever feelings... it’s okay to feel. Whatever feels okay to say, you
can say it... or you don’t have to say anything. (Keep client in experience and continue to
propel process forward.)
Yezda: I hear nothing and I feel comfort in not hearing anything.
Therapist: That’s nice.
Yezda: I’m soothing myself. I’m taking deep breaths to try and calm myself so that I can go outside to the
car where my mom is.
Therapist: Right, yeah, do you feel the presence of an older you or not so much right now?
Yezda: Not so much now.
Therapist: You feel alone, yeah?
103
Yezda: I feel like I’m trying to find confidence in being alone.

Therapist: That’s what’s familiar for you Yezda, that’s what you know. Yezda, what would it be like to just
barely tilt your little head and glance up at her... at you... at that older you? What might that be like?
Yezda: I can see her eyes now, when she looks over at me.
Therapist: Yeah?
Yezda: They look a little bit more clear and it’s almost like she’s saying, “You know I have this... you know
I can handle this.”
Therapist: And what does that big you say to her?
Yezda: I tell her that she doesn’t have to do it on her own.
Therapist: That’s great, that’s right, Yezda. T, tell her. Is she able to take that in? “You don’t have to be alone.”
Yezda: She says she doesn’t know how to be anything else but alone.
Therapist: How do you hear that Yezda?
Yezda: That she doesn’t want to burden anyone with her sadness... that everyone else’s feelings and
emotions are more important.
Therapist: Are you able to respond to her? Older, wiser you?
Yezda: I tell her that she’s important too.
Therapist: What do her little eyes do when you say that?
Yezda: She’s just looking over at me. She says, “Okay...” She says, “Okay, okay, I’ll try to remember that.”
Therapist: “I’ll try to take that in. I’ll try to remember and know that I don’t need to be alone and that I’m
important and valued and special.” Where are you now, as you breathe, Yezda?
Yezda: I am back here and I’m remembering that that is why I have trouble now with that.
Therapist: Yezda, you are so beautiful, do you see what you just did?
Provided below is the next session of the transcript (EFIT Tango Move 5 — Reflection, loaded with
RISSSSC). Once again, we all have our own EFIT voice. This is a sample of what might be said. Your
reflective summary is likely to be different and reflect your voice. Note the elements that are included
and compare your summary with the summary below. Note also, the therapist starts with a more general
process summary, then moves to a reflective summary of the session. You might have simply reflected
what happened in the session. Regarding the session specifically, are you missing anything? Is there
something the therapist might have said/missed?
Yezda, you are beautiful, you are doing such beautiful work. Do you see what happened? So the thing that
happened, is that as you share about your childhood experience — feeling alone and not belonging. You talk-
ed about race and discrimination, about being bullied and there’s some sense of it being about the way you
104
look. It’s also, as you sort of unpackage it and reflect upon it, about that but it’s also about... well it’s so mixed,
isn’t it? On the one hand, your parents wanted to hide culture to somehow protect you, but on the other
hand, your mom restricted you in ways that didn’t allow you to fit in. Then when you didn’t and you were
bullied, she would come in to try to rescue you and assert for you, and somehow protect you. But that wasn’t
really protective either, although, in some ways it did feel protective, it was a time when you could hold her
hand, walk out of the school and not feel completely alone, and she would do kind things for you at home.
Again, it’s mixed because in some ways that is true but you also feel that it was her way of maintaining a sense
of dependency or having you maintain a sense of dependency on her. There’s all these things going on but
at the core of it is this tiny little being who does feel alone and doesn’t feel a sense of belonging or a sense
of true safety, really, anywhere. And the best recourse, the best way to manage that, is to transport yourself
somewhere else. And there’s some amazing, resilient part of you, Yezda, that would say things like, “It’s not
always going to be this way,” and “You are going to find your way out of here.” And in fact, you do and you
did and you have, or you would shrink, become invisible, silent, muted, paralyzed — your little body would
still be trembling and feel out of control and powerless, like you said. So the thing that just happened, Yezda,
is that you took the risk of actually allowing yourself to feel what [you thought] there was no way you could
feel — what would be so unsafe and so dangerous to feel as a little girl. Then you actually, in that moment,
you actually did allow yourself to be held by the older you, right? You allowed yourself to feel the touch and
then you risked glancing at her, at you. And when you did that, somehow it shifted things. You could see her
more clearly, her eyes became more visible. I don’t know what the right word is but it almost feels like she’s
a bit more alive, right? Not so numb, not so paralyzed, not so frozen. And then you beautifully said to her,
Yezda, you beautifully told her that she doesn’t have to be alone, that you can be there with her and that she
is important and valued and loved and lovable And that those things happened — it doesn’t mean that there
was anything that you did or didn’t do. It wasn’t your fault and a little tiny part of you took it in, I think, but
not fully. [Move 5. The therapist then makes space for Yezda to respond.]
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PARTICIPANT’S GUIDE

Please protect clinical material/client conﬁdeniality.

© 2022 Susan M. Johnson and T. Leanne Campbell

EFIT — Emotionally Focused Individual Therapy:

Tuning In & Finding Focus with EFIT:

X Maintain a stance of cultural humility and cultural awareness (cultural attunement.)

X Focus on process and content.

See pages 71 and 72 for full details on Tuning In with CARE.

Risk & Protective Factors

X Ask about suicidal ideation / risk, self-harm behaviors (e.g., cutting).

Assessment and treatment merge

Case Conceptualization and Treatement Planning

Structuring the Process

WITH ATTENTION TO:

“When one is suffering or worried, it is useful to seek comfort from

Tuning In... with CARE

Tuning In with CARE

R — RELATIONSHIP / THERAPEUTIC ALLIANCE

NOTES — Tuning In with CARE

RELATIONSHIP / THERAPEUTIC ALLIANCE

Affect Assembly Exercise

“This discovery and assembly process regulates

EFIT Tango Transcript Review Exercise

The EFIT Tango

Moving Through the Tango Exercise

Yezda: I feel power.

“A secure connection shapes balanced, adjusted human beings who

EFIT Stage 2 Transcript Review Exercise

Therapist: Are you able to ﬁght those words out?

Yezda: I feel like I’m trying to ﬁnd conﬁdence in being alone.

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