The Leading Edge in Emotionally Focused Therapy

Episode 134: Stage 2 Mini Series—Caregiver Nightmares: Being Ready for the Predictable Worst Case Scenarios
Hosts: Dr. James Hawkins and Dr. Ryan Rana
Released: December 23, 2025

Episode Overview

This episode resumes the “Caregiver Nightmares” mini-series, focusing on the predictable “red light” responses that therapists will face in Stage 2 of Emotionally Focused Therapy (EFT)—especially the challenges that arise in the caregiving system. Dr. Hawkins and Dr. Rana explore how therapists can anticipate, regulate, and attune to typical blocks, and guide both withdrawers and pursuers toward responsiveness and healing. The discussion is rich with practical wisdom, clinical examples, and heartfelt encouragement for therapists facing difficult sessions.

Key Discussion Points & Insights

1. Setting the Stage: The Realities of EFT

• Acknowledgment of Therapist Struggles:
  • Both hosts reflect on the emotional and mental demands of extensive EFT training, emphasizing gratitude for the therapists' dedication.
  • “I just want to say thank you for the investment, how hard people worked… The level of engagement and how much people care means a lot to me.” (Dr. Ryan Rana, 01:31)
• Therapist Community and Support:
  • Importance of continued conversation, community-building, and collective learning in the EFT world.

2. Caregiving “Red Lights”: Predictable Pitfalls

• The Cyclical Nature:
  • Predictable caregiving blocks happen almost anytime someone is in a caregiving spot, notably in Step 6 of Stage 2, but also after vulnerable enactments (05:16).
• Attachment Patterns Surface:
  • “People's attachment strategy patterns show up in predictable ways. And as a therapist, if you can predict what’s going to go wrong, it’s a whole different animal, this whole process.” (Dr. Ryan Rana, 05:39)

3. Withdrawer Caregiving Blocks

• The Form and Intention of Withdrawer Responses:
  • Withdrawers often “loan out” their own coping strategies (e.g., positivity, avoidance) as a form of caregiving, but this is easily misattuned.
  • Example: A withdrawer encourages their partner to “be more positive” as a means of help (08:16).
  • KEY QUOTE:
    • “It is a form of love. It is literally saying, ‘Hey, here’s what I do. Maybe you try this.’” (Dr. Ryan Rana, 07:10)
• Therapist’s Role in Validation:
  • Strong warning against bypassing the withdrawer’s protective strategy.
  • “You have to have the ability…to empathize, empathize, empathize.” (Dr. James Hawkins, 07:53)

4. Practical Steps for Working with Withdrawer Blocks

(Starting at 10:44)

• Therapist Self-Regulation:
  • “If you can’t get those first two—curiosity and compassion—the rest of your interventions are going to be off.” (James, 11:05)
• Pre-session Preparation:
  • Practice “layered regulation” before/during/after sessions—anticipate difficulty (Ryan, 11:14).
• Validation in Practice:
  • Move towards validate “three to five times”; balancing over/under-structuring (Ryan, 12:40).
  • “If someone says something like ‘be comfortable in your own skin,’ and the therapist stops them halfway through their first sentence, that doesn’t give enough oxygen to that withdrawer, even though they’re doing something that’s not so helpful.” (Ryan, 13:24)
• Attuned Interruption/Containment:
  • “Assertively but attuned” interruptions after several validations to keep the cycle in check.
• Reframing the Strategy:
  • Reframe the withdrawer’s action as a regulatory attempt that makes sense given their history (James, 14:10).

5. Debunking Quick Fixes: The Myth of “Hoping”

• Validation Over Agenda:
  • Avoid rushing validation because of personal agendas; “hoping” for a certain outcome is counterproductive (Ryan, 15:46).
  • “When people rush their validation, it’s because they’re hoping for an exact outcome… And that’s deadly because it functions like a yes-but, and a yes-but means no.” (Ryan, 15:49)
• Sue Johnson’s Advice:
  • “If you’re not willing to repeat yourself five times, pack your bags and go home.” (Quoted by James, 15:26)
• Therapist as container:
  • Circle back to the sender, affirm the attempt, regulate the room, and don’t move forward until both partners feel caught and supported (19:40).

6. Pursuer Caregiving Blocks

(Switches focus at 23:36)

• Pursuer Response Tendencies:
  • When their partner shows vulnerability, pursuers may “up the ante,” doubting the authenticity, or seeking more proof (“kicking the tires” analogy, 24:19).
  • First withdrawal vulnerabilities may trigger a paradoxical lack of receptivity in pursuers; they may protest, dismiss, or distrust the moment (Ryan, 24:34).
• Why It Happens:
  • Past experiences of unmet needs, protest after long deprivation, and fear of being dropped again underlie the block.
  • KEY QUOTE:
    • “It’s like I’ve been chasing this for 20 years…The safety of the therapist accesses emotion from that withdrawer, which is exactly what the pursuer is asking for. But then I get it…this feels like a trap.” (Ryan, 24:49)

7. Practical Steps for Pursuer Blocks

• Validate, then Slow Down:
  • The therapist should move towards the pursuer with multiple validations (“three to five”), appreciate their fight, and gradually slow down the process as speed is often a “survival” mechanism (James, 29:55).
• Highlighting the Longing Within Protest:
  • Be genuinely curious about the underlying hope and longing that drives the intensity: “They wouldn’t be doing [this] if there wasn’t some kind of—ready for this word, Ryan?—hope.” (James, 29:01)
• Staying Present:
  • Gently point out in-the-moment feelings or bodily responses, helping the pursuer bear witness to their own vulnerability and the partner’s effort.
• 1% Responsiveness:
  • “Can you give me 1% of a reach for comfort for that withdrawer’s pain?” (Ryan, 32:59)

8. Trusting the Caregiving System

• Leanne Campbell’s Leading Edge:
  • “I’m learning that trusting the process is actually learning to trust that the caregiver system is to trust the caregiving system.” (Leanne Campbell via James, 33:47)
• Natural Capacity for Care:
  • Caregiving responses are instinctual, often just blocked or paralyzed by the cycle. The work focuses on reactivating that innate drive.
  • “People do know how to respond. You’re born with these skills. These are survival instincts. They’ve just become latent.” (Ryan, 34:22)
• Experiential Pathways:
  • Attending to body responses helps reconnect clients to their “blocked” caregiving impulses—e.g., asking “what does your body want to do for your partner?” (James, 35:19; 35:41)

9. Begrudging Respect

• The Utility of Observed Effort:
  • Witnessing partners struggle against old cycles authentically builds respect and trust.
  • “Intimacy is often built by begrudging respect. Meaning, I am watching how hard my partner is fighting their old tendencies. I see them breaking through for me. So my respect for them just went way up.” (Ryan, 37:08)

Notable Quotes & Memorable Moments

• Validating Withdrawer Blocks:
  “If you can’t meet me where I’m struggling, why would I show you even more deep, vulnerable part of me?” (Ryan, 10:31)
• On Therapist Preparation:
  “If you see someone that maybe has trauma history or a difficult cycle, you need a few deep breaths before you go get them…they’re supposed to block me. Get ready to stay with the process.” (Ryan, 11:17)
• On Validation:
  “Sue even said, if you’re not willing to repeat yourself five times, pack your bags and go home.” (James, 15:26)
• On Therapist Mindset:
  “Knowing where you’re going is different than hoping.” (Ryan, 18:13)
• On Pursuer Protest:
  “It’s like, I don’t know, the way the analogy I’ve used is they’re kicking the tires to make sure that the car is really not going to just fall apart.” (James, 24:19)
• Begrudging Respect:
  “I am watching how hard my partner is fighting their old tendencies…So my respect for them just went way up.” (Ryan, 37:08)

Important Timestamps

• 05:16: Description of predictable blocks in caregiving roles (pursuer vs. withdrawer)
• 10:44: Practical steps for working with withdrawer blocks
• 12:40: The magic “three to five” validation rule
• 15:26: Quoting Sue Johnson on validation
• 23:36: Shift in focus to pursuer caregiving blocks
• 24:19: “Kicking the tires” analogy for pursuer skepticism
• 29:01: The role of “hope” in pursuer responses
• 32:59: 1% responsiveness meme
• 33:47: Leanne Campbell on trusting caregiving systems
• 37:08: “Begrudging respect” as an intimacy-builder

Key Takeaways

• Caregiving “red lights” are to be expected and predicted by the attachment system: being forewarned lets therapists stay present and compassionate.
• Self-regulation, layered preparation, and repeated validation are essential tools for therapists facing blocks.
• Both pursuer and withdrawer strategies are rooted in longing and care, even when they present as blocks.
• Validation must be both attuned and assertive; don’t rush for outcomes. Stay with the process, be patient, and contain the cycle.
• Trust that both clients’ caregiving systems are present and can be reawakened; the therapist’s job is to create safety and space for their emergence.
• Progress happens in small steps—seek “1%” bids for empathy, not perfection.
• Validating protective strategies as longings rather than judging them as resistance opens the door to healing and connection.

Final Thought:
The episode underscores the humility, patience, and perseverance required of EFT therapists, affirming that therapists are never alone in confronting these complex cycles. Dr. Hawkins and Dr. Rana leave therapists with encouragement to embrace the “leading edge” of learning, trusting both the EFT process and the innate caregiving instincts within every client.

For More:

• Follow the hosts and podcast via their socials and websites as mentioned in the outro.
• Upcoming in-person EFT community events (see timestamp 22:34 for details).