Late Phase of Therapy: Making Meaning and Supporting Changes
The late phase in EFT is focused on reflecting on painful, as well as newly emerging emotions and helping clients make sense of their emotional experience. In addition, to support the transformation of emotion schemes, the therapist validates and supports new feelings and responses and the client’s emerging sense of self. To support John in transforming the shame in relation to his father and his feeling of entitlement of his unmet need to be loved and cared for by his father, the therapist asks John to imagine how his deceased father would respond and helps him put words to his new internal experience of his remorseful father:
Therapist: How do you think your father would feel now, beyond his grave, if he were to hear how much you’ve suffered?
John: Hmmm. Sad and sorry.
Therapist: Can you be your dad and put words to how he would feel sad and sorry?
John: okay
Therapist: As your dad can you express it directly to John in the other chair?
John: [as father, says tearfully] It really wasn’t about you… I was sick… I wish I had been a better father…. I can understand if you don’t believe it. … You didn’t deserve the way I treated you… You were a good kid and I loved you. I know I didn’t show it, but I did…
Therapist: [to father part] Can you tell him what you love about him?
John: [as father] You are my son; I love you just for that. You don’t have to do anything more than to be my son. There was nothing wrong with you! I was defective!
Therapist: That sounds very important! Can you tell him again, I love you just because you are my son, there was nothing wrong with you! …
John: [as father says tearfully] It was my loss, I missed out on knowing you and your family. I missed out on all of these important events…. I’m so sorry…
Therapist: Tell him more about what you’re sorry for…
It surprises John that he feels forgiveness towards his father and following this significant change in feeling, he also has a shift in meaning regarding his father. His narrative of his dad starts to change from, “He would have treated me differently if I was lovable” to, “He was an alcoholic who was not mentally well and had an abusive childhood himself. He was not capable”. The therapist helps John accept and make sense of these important changes in both feeling and meaning. In addition, the therapist suggests that if it fits for John, it would be helpful to take some time to reflect on and write about what his current feelings are, and any other feelings that are coming up regarding the work they have been doing.
In the following session, John conveys that he has been reflecting a lot on things and feels like there has been a significant emotional shift:
John: It’s an acceptance of some kind, that this relationship will never be, and it is sad, letting go of the unmet needs. I accept the fact that I won’t ever have that, that parental child relationship and all the things that could have been. I accept the fact that he’s the cause of my suffering, directly and indirectly. I let go of that. … I am reflecting on the fact that it was such a long time this painful relationship has gone on. It always amazes me that I have been affected by his behavior this whole time. I am grieving, it’s sad to be in a position that I have to forgive my father for being a terrible father, but I have.
The therapist validates John’s healthy grief and sadness, as well as the meaning and importance of letting go of these unmet needs and helps John to reflect on what he needs from himself to move forward. In addition, John and his therapist make meaning of the impact of his abusive childhood on him, particularly feeling worthless and unlovable, and John reflects on the various ways in which shame has affected his life. For example, John talks about having difficulty opening up and getting close to family and friends for fear that others would see that he was “unlovable” and “worthless”. John expresses poignantly that this has contributed to his loneliness because it has been hard to feel comfortable being himself with others. Through the process of co-constructing new meaning with the therapist, John conveys that his narrative of “I am unlovable and worthless,” has now changed to, “Because my father was sick and abusive, I was scared of being myself with others and they couldn’t get close to me.” In addition, John makes sense of his past anger issues as he realizes that he has a sensitivity to feeling shame, originating from his early experiences in his relationship with his father. This unhealthy emotion scheme of shame triggered John to react with secondary anger or rage when he felt that people were rejecting him or looking down on him. Furthermore, John reflects on how his feelings of shame would worsen because of feeling embarrassed after getting angry with others. John shares that more recently he has been able to have better conversations with family because he is not feeling triggered as much, and when he is, he reports that he is able to regulate himself and come back to the conversation in a healthy way. Through encouragement, empathy, validation, and experiential teaching, the therapist supports John’s newly emerging healthy self-organization, and co-explores how John wants to carry forward these internal and external changes in his daily life.
John’s emerging need to be accepted unconditionally is now supported by a more compassionate part of self (formerly the self-protective critic). His therapist encourages John to engage in between-session activities to strengthen and carry forward these changes. To the end, therapist asks John, “What do you need from yourself to heal from a childhood where you felt so worthless, ashamed and unloved?” He replies assuredly, “I need to allow myself to get the care and love I deserve from others.” When asked to be more specific about what this might look like, John stated that he wanted to open up to his wife about some of the work he was doing in therapy. John was asked to imagine in what contexts he could do this over the week, and he noted a few opportunities and that he would like to try. The therapist helps him envision and specify the between-session task:
Therapist: This sounds like a wonderful idea. It’s a very important need and an important way to heal this loneliness you’ve been feeling. Do you have any ideas of what you would want to open up about?
John: Maybe to talk to her about the work we have been doing regarding my dad.
Therapist: That sounds great! Could you imagine doing that? What do you think her response would be?
John: I think she would be happy to hear anything personal from me….
Therapist: I know this is something that has been hard for you to do, so it’s okay to if it doesn’t go exactly as you want, but even trying to put yourself out there with her is so important. Perhaps you can tell her to be patient with you as it’s a work in progress?
John: [laughs] yes, she is already very patient.
Therapist: When we try new things, they can seem hard at first. Since this is new, I might suggest, that you make sure that you can protect a time with her where you know it’s a good time for her and that you have her attention and that she understands that you want to talk to her about something important.
In this example, having John visualize the task and provide specificity makes the task more feasible. Furthermore, the therapist’s expectation that the goal is to explore and see what happens, and to predict that it is expected and very okay that it may not go as planned, makes the task more approachable.