In Treatment on HBO didn't leave us with much faith that couples therapy can actually work. Even the therapist's therapist, Dianne Wiest, finally gave in and told Gabriel Byrne to go ahead and sleep with his hot'n'horny 30-year-old patient, despite the fact that he was married to the most awesome woman ever. And studies of couples therapy aren't any cheerier: the research out there indicates that two years after ending counseling, 25 percent of couples are worse off than when they started, and after four years, 38 percent are divorced.

For a sunnier perspective, we thought we'd chat with Dr. Sue Johnson, director of the Ottawa Couple and Family Institute and author of the new book Hold Me Tight, about an approach she helped develop called emotionally focused therapy. Studies have shown that even years after this kind of counseling, almost three-quarters of the couples are doing better-- it's one of the few forms of couples therapy with empirical data showing that it helps. Johnson was recently recruited by the U.S. army for a pilot program to help army couples deal with Iraq war-induced marital stress...

Em & Lo: Why do you think so much couples therapy doesn't work?

Sue Johnson: Lots of couple therapy is off target. It's kind of a shotgun approach--an intervention here, another there, an insight into this, a technique for stopping a fight that works when the fight isn't really crucial. The kind of complex drama that is two people fighting out their most basic needs and fears in a love relationship is hard to work with if you don't have a compass or a map.

So give us the elevator pitch on how your approach differs.

In emotionally focused therapy (EFT) we have a scientific clear map to love--what it means to people, what are the moments that matter. And a 25-year scientific set of studies has taught us how to fix it. We know how to help folks with emotion, which is the music of the dance. Much of couple therapy tried to bypass emotion, but we honor it, we teach folks to listen to it and voice it to pull their partner closer. The rate of 7 out of 10 distressed couples recovering from distress and feeling satisfied after therapy is a very good result, and these results are stable.

How can EFT help a couple's sex life?

Let's just take 3 loops linking great sex and emotional safety:

 1. If you feel safe you can surrender to sensation--your brain is not wired to feel afraid or scan the environment for danger and get turned on at the same time, they are competing priorities.

 2. People who feel safe can communicate about sex. And trying to coordinate sexual responses without expressing what you need is like landing a 747 without the control tower input.

3. When we are safe we play, explore, take risks. Good sex is a safe adventure.

EFT is sometimes also called attachment therapy. How can couples know where emotional attachment ends and co-dependency begins?

This is a tricky question to answer in a simple way. Co-dependency is a confusing label; it was a word coined to persuade women that if they didn't confront and even get up and leave a man who was drinking. To try to protect themselves or their connection with him or his feelings, they were actively helping to create his addiction, unconsciously joining in with his addiction. This label is a big blame--a huge generalization and a general put-down of dependency! There is nothing wrong with our need to depend on others--being comfortable, being close, and being able to reach for and depend on another. We should accept our dependency needs in general; it's a strength, not a weakness. But when we get really scared of losing our partner we sometimes accept behaviors that need to be confronted.

When we know that our attachment is so uncertain and we are desperate about holding onto it--sometimes at a great price--we become pre-occupied with getting signs of being loved, and we become jealous. The fear of losing this person begins to run our life. Ironically, this leads naturally into arguments. When we are really unsure and insecure with a loved one, my approach would be to help a person express his or her fears and needs very clearly in a way that encourages their loved one to reassure them and listen to them.

So can the wrong kind of couples counseling ever cause a couple to split who might have stayed together otherwise? Or does it just hasten the process?

I think therapy can hasten the process of relationship breakdown. For one thing, the therapist can't give hope to a couple if he or she can't see a way through. "Cause" is usually a set of issues, and often people wait too long to attend to their issues.

Is part of your approach to teach couples to fight better, rather than fight less?

No, we don't teach couples to fight "better"--we show couples how the fight traps them both and help them listen to the hidden fears and longings in their fights so they can help each other and reach for each other. Once partners can create a loving bond, they can "fight" and have differences and disappoint each other sometimes and they are still in love and loving.

Can fighting be good for a relationship?

Everyone gets disconnected, everyone gets caught in Demon Dialogues, like stepping into a spin cycle in a machine. But happy couples understand what is going on and can see the spin and work as a team to show it down. And they can create a new positive spin that is full of emotional connection. We teach couples to see the emotional disconnection, the real bonding issues in their fights and their silences. And then we teach them to focus on their feelings in a positive way and use the language of bonding and connection to speak their needs to each other and help each other respond.

Well, that sounds like fighting better to us!

Fighting is good in that you are engaged with each other--silent disconnection and distance is more toxic than a good fight now and again. At least you are dancing and struggling to connect. It's hard to keep up the dance when everyone is sitting out.

If a couple comes to couples therapy together willingly, is there always hope for them?

Yes, I think that there is always hope, unless someone is insisting on doing something that actively destroys trust just as you are building it up. Deception, for example, does that.

So, we have to ask: What did you think about the couples therapy in In Treatment?

The only therapy I have ever seen on the silver screen that I could connect with was Judd Hersch in Ordinary People--but I must admit that I haven't seen In Treatment. I'll have to watch it and get back to you.

For more information on Dr. Sue Johnson, visit HoldMeTight.net.