Therapy Explained · EFT for Couples Emotion-Focused Therapy (EFT) for Couples: What It Is and How It Works Emotion-Focused Therapy is one of the most rigorously researched couples therapies available, built on a simple idea: most recurring fights aren’t really about the dishes or the schedule — they’re about whether we can still reach each other. Reading time: ~6 min · For couples · In-person in Lisbon & online What is EFT? Emotion-Focused Therapy (EFT) for couples was developed by Sue Johnson and Les Greenberg in the 1980s, grounded in attachment theory — the idea that adults, like children, have a basic need for a secure emotional bond with the people closest to them, and that most couple distress is really distress about that bond feeling shaky. Where many approaches focus on communication skills or problem-solving, EFT focuses on the emotions underneath the argument: the fear of not mattering, the hurt of feeling dismissed, the panic of feeling alone in the relationship. Change the emotional experience, EFT holds, and the interaction pattern built around it usually starts to shift too. The cycle EFT works with Most distressed couples get caught in a repeating pattern — often a version of pursue–withdraw: one partner presses for contact, reassurance, or resolution, and the harder they press, the more the other partner pulls back to avoid feeling overwhelmed or like a failure, which then confirms the first partner’s fear of being unimportant, and the cycle tightens. Both partners are usually reacting to the same underlying fear — disconnection — from opposite ends. Not about who’s right: EFT deliberately steps back from adjudicating the content of an argument (whose version of last Tuesday is accurate) and instead maps the emotional cycle both partners are stuck in together. How a course of EFT usually unfolds 1. De-escalation Naming the cycle itself as the shared enemy, and helping each partner recognise the softer, more vulnerable feeling — fear, loneliness, inadequacy — hiding underneath the anger or the withdrawal. 2. Restructuring Helping partners express that underlying vulnerability directly to each other, and respond to it with care rather than defensiveness — creating new, more secure moments of contact. 3. Consolidation Reviewing old conflicts in light of the new pattern, and building confidence that the couple can find their way back to each other when future ruptures inevitably happen. Who tends to benefit most EFT has a strong research base for couples stuck in a persistent negative cycle of conflict or distance, including couples working through a specific attachment injury — a moment one partner experienced as a betrayal of trust or abandonment that keeps resurfacing. It is also widely used, including by us, with expat couples navigating the added strain of relocation, distance from family support, and identity shifts that come with building a life abroad — see our related piece on couples and relocation. Where EFT is not the right starting point EFT assumes both partners are willing to be in the room and, eventually, emotionally honest with each other — it is not designed as a venue for actively ongoing violence, untreated addiction, or a decision one partner has already made to end the relationship. In those situations, individual work first, or a different kind of support, usually needs to come before couples work can be useful. Recognise the cycle? Sylwia Latacz offers English-speaking EFT couples therapy in Lisbon and online, and we’re happy to talk through whether it’s the right fit for what you’re both dealing with. Book a Consultation

Therapy Explained · TFP Transference-Focused Psychotherapy (TFP): What It Is and Who It Helps Most Transference-Focused Psychotherapy is a structured psychodynamic treatment built specifically for intense, unstable relationship patterns and identity difficulties — most rigorously tested for borderline personality organisation. Here is what it actually involves. Reading time: ~5 min · For adults · In-person in Lisbon & online What is TFP? Transference-Focused Psychotherapy (TFP) is a manualised, twice-weekly psychodynamic treatment developed by psychiatrist Otto Kernberg and colleagues at Weill Cornell Medical College, specifically for people whose relationships and sense of self swing between extremes — idealising someone one week and feeling devastated or furious with them the next, with a self-image that can feel just as unstable. The name comes from its central working tool: transference — the way a client’s core relationship patterns show up live, in the room, in how they relate to the therapist. TFP treats that live material not as a distraction from the “real” work, but as the most direct evidence available of how the client’s internal relationship patterns actually operate. How TFP works A clear contract Treatment begins with an explicit agreement — session structure, boundaries, and how crises will be handled — negotiated before the deeper work starts, to create a stable frame for intense material. Working in the here-and-now The therapist actively names what seems to be happening between client and therapist in the moment — a shift in tone, a sudden wave of anger or withdrawal — and explores it as it happens. Integrating “all-or-nothing” images A central goal is helping split, extreme images of self and others (“all good” or “all bad”) become more complex, realistic, and stable over time. Who TFP was built for TFP has one of the stronger evidence bases of any specialised approach for borderline personality disorder and related borderline personality organisation — patterns marked by unstable relationships, an unstable sense of self, intense and rapidly shifting emotions, and sometimes impulsive or self-damaging behaviour. Randomised trials have shown it can reduce suicidality, improve emotional regulation, and — a finding that sets it somewhat apart from other approaches for this population — increase what researchers call reflective functioning: the capacity to think clearly about one’s own and others’ mental states, especially under emotional pressure. Not only for crisis: while TFP was developed with severe presentations in mind, its focus on unstable self-image, intense relationship swings, and difficulty trusting one’s own read of a relationship can be relevant well beyond a formal diagnosis. What TFP asks of a client TFP is demanding: twice-weekly sessions, a clear contract, and a willingness to look directly at intense feelings as they arise between client and therapist rather than only discussing them in the abstract. It is not designed as a brief intervention, and it is not the natural first choice for a single, circumscribed problem like a specific phobia — for that, CBT or a shorter dynamic approach such as ISTDP is often a better starting point. A careful initial consultation is the best way to work out whether TFP’s structure and pace fit what’s actually going on. Wondering if TFP fits your situation? Both Piotr Szmyt and Sylwia Latacz offer English-speaking psychodynamic therapy in Lisbon and online, and we’re happy to talk through whether TFP or another approach makes the most sense for what you’re dealing with. Book a Consultation

Therapy Explained · Psychodynamic Psychodynamic Therapy: What It Is, How It Works, and Who It Helps Most Psychodynamic therapy is one of the oldest and most researched families of talking therapy — and one of the most misunderstood. Here is what it actually involves today, stripped of the couch-and-silence stereotype. Reading time: ~6 min · For adults · In-person in Lisbon & online What is psychodynamic therapy? Psychodynamic therapy works from a simple starting observation: patterns that cause trouble in the present — in relationships, at work, in how we handle conflict or closeness — usually didn’t start in the present. They were shaped earlier, often in relationships that mattered most, and they keep replaying because they were once the best available way to cope. Rather than only managing symptoms in the here and now, psychodynamic work aims to help a person recognise these recurring patterns as they show up — including inside the therapy relationship itself — and understand where they came from well enough that they stop running on autopilot. Three ideas that hold the approach together The unconscious is active Feelings we can’t quite name and don’t want to feel — grief, anger, longing, guilt — still shape behaviour even when we’re not aware of them. Therapy makes room for them to surface safely. The past organises the present Early relationships teach us what closeness, conflict, and dependence feel like. Those templates get applied to new relationships, often without anyone noticing it’s happening. The relationship is the lab Patterns tend to show up live, between therapist and client. Rather than only talking about a pattern, psychodynamic work uses the therapy relationship to notice and shift it directly. What a session actually looks like Modern psychodynamic therapy is not silent, and it is not primarily about childhood storytelling for its own sake. A session is a conversation — the client brings whatever feels most alive that week, and the therapist listens actively for patterns: recurring conflicts, feelings that get avoided, moments of disconnection between what’s being said and how it’s being said. Some psychodynamic approaches are longer-term and open-ended, giving patterns time to surface and shift gradually. Others are time-limited and considerably more active — the Intensive Short-Term Dynamic Psychotherapy (ISTDP) we practise at this clinic is one such approach, built to work directly and quickly with feeling and defence rather than waiting for insight to accumulate over years. A note on defences: in psychodynamic language, “defences” aren’t character flaws — they’re the coping strategies a person’s system built, usually in childhood, to manage feelings that once felt unbearable or unsafe to have. The goal is understanding and choice, not judgment. Who tends to benefit most Recurring relationship patterns Repeatedly choosing similar partners or friendships, or hitting the same wall in relationship after relationship, often points to a pattern worth understanding rather than a string of bad luck. Feelings that resist “logical” solutions Longstanding low mood, diffuse anxiety, or a sense of being stuck despite understanding the problem intellectually — the kind of difficulty that lives more in feeling than in thought. Where this approach is not the best fit Open-ended, insight-oriented psychodynamic therapy asks for patience — change tends to come gradually, and it’s not built for a single acute crisis needing a fast, structured protocol. For circumscribed problems like a specific phobia or compulsive rituals, more structured approaches such as CBT often work faster. We’ve written a full comparison here: ISTDP vs CBT — what’s the difference. Wondering if this approach fits you? Both Piotr Szmyt and Sylwia Latacz offer English-speaking psychodynamic and ISTDP therapy in Lisbon and online, and we’re happy to talk through what would suit what you’re dealing with. Book a Consultation

Therapy Explained · CBT CBT Therapy: What It Is, How It Works, and Who It Helps Most Cognitive Behavioural Therapy is one of the most widely used and extensively studied talking therapies in the world. Here is a clear, honest guide to what it actually involves — and where its strengths and limits lie. Reading time: ~6 min · For adults · In-person in Lisbon & online What is CBT? Cognitive Behavioural Therapy (CBT) is a structured, present-focused form of psychotherapy built on a simple premise: the way we think about a situation shapes how we feel about it, and how we feel shapes what we do. Change one part of that loop — usually the thinking — and the feeling and behaviour tend to shift too. It was developed from the 1960s onward by psychiatrists and researchers such as Aaron Beck, and it has since become one of the most rigorously tested approaches in psychology, with a large body of clinical trials behind it and endorsements from major clinical guidelines internationally. The CBT model: thoughts, feelings, behaviour CBT works with the relationship between three things that constantly influence one another: Thoughts interpretations, beliefs Feelings emotions, body sensations Behaviour actions, avoidance Situation the trigger The classic CBT model: a situation triggers thoughts, feelings and behaviour, each of which can reinforce the others in a loop. In therapy, this usually means learning to notice automatic thoughts as they happen (“I’m going to fail this,” “Everyone can see I’m anxious”), examine how accurate or helpful they really are, and practise responding differently — sometimes through changing the thought itself, sometimes by gradually changing the behaviour (such as approaching a feared situation instead of avoiding it) and observing what actually happens. What a CBT session actually looks like Structured and collaborative Sessions usually follow an agenda set together at the start: reviewing the week, checking in on homework, working on a specific problem, and agreeing on the next step. The therapist acts as a guide and teacher, not primarily as an interpreter of the past. Time-limited, with homework CBT is typically a defined course of treatment — often somewhere in the range of 8 to 20 sessions depending on the problem and protocol — with exercises to practise between sessions. Progress is usually tracked with simple measures so both therapist and client can see whether it is working. Who CBT tends to help most CBT has some of the strongest trial evidence of any psychotherapy for a specific group of presentations: OCD Especially with clear compulsive rituals, where exposure and response prevention (a CBT method) is considered a first-line, gold-standard treatment. Specific phobias Graduated exposure — approaching the feared object or situation step by step — is one of the most reliably effective interventions in all of psychotherapy. Panic & health anxiety Psychoeducation about the body’s alarm system, combined with breathing retraining and behavioural experiments, directly targets the cycle that keeps panic and health anxiety going. Where CBT reaches its limits CBT works primarily top-down — from thought to feeling. For many presentations, this is exactly the right lever. But some people arrive at the end of a CBT course able to name their cognitive distortions perfectly, and still feeling much the same underneath. They know the thought is irrational; the feeling hasn’t moved. This gap — insight without felt change — is common with longstanding depression, complex or diffuse anxiety, relationship patterns, and difficulties that seem to live more in the body than in belief. In these cases, approaches that work bottom-up, directly with feeling and the body, such as ISTDP, are often a better fit. We’ve written a full, honest side-by-side comparison here: ISTDP vs CBT — what’s the difference. In short: CBT is an excellent, well-evidenced choice for many problems — particularly OCD, phobias, panic and health anxiety. If you’ve tried it before and understood your thoughts perfectly without feeling different, that isn’t a failure on your part; it may simply mean a different kind of therapy is worth exploring. Wondering which approach fits you? Both Piotr Szmyt and Sylwia Latacz offer English-speaking therapy in Lisbon and online, and we’re happy to talk through whether CBT, ISTDP, or another approach makes the most sense for what you’re dealing with. Book a Consultation

Therapy Explained · CBT CBT Therapy: What It Is, How It Works, and Who It Helps Most Cognitive Behavioural Therapy is one of the most widely used and extensively studied talking therapies in the world. Here is a clear, honest guide to what it actually involves — and where its strengths and limits lie. Reading time: ~6 min · For adults · In-person in Lisbon & online What is CBT? Cognitive Behavioural Therapy (CBT) is a structured, present-focused form of psychotherapy built on a simple premise: the way we think about a situation shapes how we feel about it, and how we feel shapes what we do. Change one part of that loop — usually the thinking — and the feeling and behaviour tend to shift too. It was developed from the 1960s onward by psychiatrists and researchers such as Aaron Beck, and it has since become one of the most rigorously tested approaches in psychology, with a large body of clinical trials behind it and endorsements from major clinical guidelines internationally. The CBT model: thoughts, feelings, behaviour CBT works with the relationship between three things that constantly influence one another: Thoughts interpretations, beliefs Feelings emotions, body sensations Behaviour actions, avoidance Situation the trigger The classic CBT model: a situation triggers thoughts, feelings and behaviour, each of which can reinforce the others in a loop. In therapy, this usually means learning to notice automatic thoughts as they happen (“I’m going to fail this,” “Everyone can see I’m anxious”), examine how accurate or helpful they really are, and practise responding differently — sometimes through changing the thought itself, sometimes by gradually changing the behaviour (such as approaching a feared situation instead of avoiding it) and observing what actually happens. What a CBT session actually looks like Structured and collaborative Sessions usually follow an agenda set together at the start: reviewing the week, checking in on homework, working on a specific problem, and agreeing on the next step. The therapist acts as a guide and teacher, not primarily as an interpreter of the past. Time-limited, with homework CBT is typically a defined course of treatment — often somewhere in the range of 8 to 20 sessions depending on the problem and protocol — with exercises to practise between sessions. Progress is usually tracked with simple measures so both therapist and client can see whether it is working. Who CBT tends to help most CBT has some of the strongest trial evidence of any psychotherapy for a specific group of presentations: OCD Especially with clear compulsive rituals, where exposure and response prevention (a CBT method) is considered a first-line, gold-standard treatment. Specific phobias Graduated exposure — approaching the feared object or situation step by step — is one of the most reliably effective interventions in all of psychotherapy. Panic & health anxiety Psychoeducation about the body’s alarm system, combined with breathing retraining and behavioural experiments, directly targets the cycle that keeps panic and health anxiety going. Where CBT reaches its limits CBT works primarily top-down — from thought to feeling. For many presentations, this is exactly the right lever. But some people arrive at the end of a CBT course able to name their cognitive distortions perfectly, and still feeling much the same underneath. They know the thought is irrational; the feeling hasn’t moved. This gap — insight without felt change — is common with longstanding depression, complex or diffuse anxiety, relationship patterns, and difficulties that seem to live more in the body than in belief. In these cases, approaches that work bottom-up, directly with feeling and the body, such as ISTDP, are often a better fit. We’ve written a full, honest side-by-side comparison here: ISTDP vs CBT — what’s the difference. In short: CBT is an excellent, well-evidenced choice for many problems — particularly OCD, phobias, panic and health anxiety. If you’ve tried it before and understood your thoughts perfectly without feeling different, that isn’t a failure on your part; it may simply mean a different kind of therapy is worth exploring. Wondering which approach fits you? We offer English-speaking therapy in Lisbon and online, and we’re happy to talk through whether CBT, ISTDP, or another approach makes the most sense for what you’re dealing with. Book a Consultation

A new Polish study co-authored by Peter Fonagy shows betrayal trauma affects adult mental health mainly through dissociation and hypomentalizing — and what that means for therapy.

Relocation is often described as a shared adventure. In practice, it is frequently an asymmetric experience — one that surfaces existing tensions in a relationship, creates new ones, and does so in a context where the usual support structures are unavailable.

The cultural adjustment curve — a gradual arc from disorientation through adaptation to integration — is one of the most widely cited models in expat psychology.

Dlaczego terapia w ojczystym języku ma znaczenie – bariery językowe w gabinecie psychoterapeuty.

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