"The Commitment of a Lifetime": The Role of Emotionally Focused Couple Therapy in Strengthening Attachment Bonds and Improving Relationship Health in Later-Life Couples—The Teletherapy Case of "Alice" and "Steve"

Abstract

A healthy marriage is a crucial protective factor for adapting to the challenges of late life. Emotionally Focused Couple Therapy (EFCT) is an attachment-based model of psychotherapy that emphasizes here-and-now processing of emotion in a safe holding environment; enhanced understanding of the patterned interactions between self and other; and a non-pathologizing, growth-oriented approach toward couples’ difficulties. This case study examines the benefits of EFCT for addressing issues specific to late life, including existential concerns such as aging, illness, and mortality; caregiving burdens and stress; cumulative relational trauma over the lifespan; and forgiveness and healing from emotional injuries.

The case study involved a 20-session, teletherapy treatment of a couple named "Alice" and "Steve," aged 74 and 75, respectively, with Steve suffering from advanced Parkinson’s Disease. The couple presented with hopelessness and resentment about their caregiving situation, unresolved traumas from early childhood fueling their relationship’s sore spots, and unprocessed grief and fears concerning losses at the end stage of life. The EFCT-guided treatment focused on promoting transformational and corrective experiences of secure attachment bonding. Throughout therapy, Alice and Steve cultivated coherent, positive perspectives of their marriage and related hardships by engaging in reminiscence; embraced their longings for each other by relinquishing their defenses against loss and mourning; and strengthened the legacy of their marriage by exploring their shared values and vision of family life.

At the end of therapy, the clients retrospectively completed several standardized, quantitative measures assessing aspects of emotional and relational health. Their responses evidenced their heightened emotional awareness and acceptance, increased marital adjustment and satisfaction, and improved attachment security over the course of the therapy. This case study highlights EFCT as a potent therapeutic intervention for fostering relationship health in later-life individuals to reduce the public health risks associated with social disconnection and loneliness in the aging population.