Attachment Theory in Practice: Emotionally Focused Therapy (EFT) with Individuals, Couples, and Families is written by Susan Johnson, the primary developer of Emotionally Focused Therapy (EFT). This book focuses on how to apply EFT and attachment theory to clinical practice.

Here are the core tenets of attachment theory, according to Sue Johnson:

Core tenets of attachment theory

1. Humans are hardwired to seek social contact

2. Predictable physical and/or emotional connection with an attachment figure calms the nervous system and shapes a safe haven where comfort and reassurance can be reliably obtained. Responsiveness from others tunes the nervous system to be less sensitive to threat

3. This emotional balance promotes the development of an integrated sense of self

4. A felt sense of being able to depend on a loved one creates a secure base

5. Key factors include perceived accessibility, responsiveness, and emotional engagement of attachment figures

6. Separation distress arises when an attachment bond is threatened, or a secure connection is lost. Emotional and physical isolation from an attachment figure is inherently traumatizing

7. Secure connection is based on how individuals encode patterns of interaction into mental models

8. Those who are securely attached are comfortable with closeness and their need for others

9. If others have been perceived as inaccessible when needed, secondary models emerge

10. Adult attachment is more reciprocal and not as dependent on physical proximity. Two other systems emerge: caretaking and sexuality

Here are some additional insights from the book

• Attachment security predicts almost every identified indicator of positive functioning, while insecurity is a risk factor for almost every identified indicator of dysfunction.

  • Emotional isolation is more disastrous for health than smoking, obesity, or lack of exercise

  • Isolation is the ultimate existential trauma

• Emotion is triggered most strongly by relationship issues, and coregulation with another is usually the most intuitive and efficient route to emotional equilibrium

• Simply teaching top-down containment and coping skills to try to control emotion is insufficient

  • Social self regulation is a relatively bottom up process, whereas self regulation is usually more costly effortful top down process involving extensive cognitive and attentional processes to inhibit somatic responses that are already triggered

• Emotions are adaptive behavioral and physiological response tendencies called forth directly by evolutionary significant situations. They communicate needs motives and priorities to the self and others.

  • Being tuned out of emotional experience is like navigating life without a compass.

  • Emotion orients and engages. It grabs our attention and guides perceptions

  • Emotions shape meaning, motivate us, and communicate with others and sets up their response

  • Anger is an approach emotion that sets up the assertion of needs and the removal of blocks to satisfaction

  • Sadness elicits support from others and withdrawal in service of letting go

  • Shame elicits hiding

  • Surprise elicits exploration and engagement

  • Joy provokes openness and engagement

  • Fear elicits fleeing, freezing, or fight