A very large part of the kind of work I do revolves around couples therapy. Being trained in this very powerful form of psychotherapy, I have witnessed the magic firsthand of a long-term relationship or marriage evolving from a dark place to a place of safety, compassion, understanding, and ease. It is an honor to be able to sit with a couple as they do the work to heal their relationship. This is a sect of counseling that I notice a lot of therapists are hesitant to touch. From a therapist’s perspective, couples counseling requires a lot of focus, presence, and training that some other forms of counseling do not necessarily require. I personally get excited when I sit down with a new couple–I become curious about the couple’s backstory, their wounds, their needs, and their overall goals for therapy. For this article, I hope to inform my readers about beginning the couples therapy journey as well as lay the groundwork for what couples therapy should feel like. Beginning a therapeutic journey with your life partner can feel very terrifying and vulnerable, and having as many resources and tools at the start of such a precarious process is key. No one, couple or otherwise, should begin looking for a therapist without being informed and knowledgeable. When is it time to begin couples counseling? A very popular, and yet VERY incorrect, view of couples counseling is that it is a last resort for a relationship. I have also heard uninformed people say that if someone begins counseling on their relationship that they have failed. I want to take a moment and debunk these rumors about couples therapy–Receiving counseling with your spouse is not a moment of weakness, and it certainly is not a move in failure. If anything, it takes an extreme amount of courage to sit down with both a clinician and your partner at the same time. I am also here to tell everyone that couples therapy can be a resource for both couples in a healthy, peaceful place just as much as for couples who are in an unhealthy, turbulent phase of their relationship. It always warms my heart when couples reach out to me wanting to do “maintenance” work on their relationship. Just the same, I am always happy to help a couple who are gridlocked, escalated, or unable to cope with the stressors of everyday life as a team. Below are some of the indicators that it may be time for relationship work with your spouse or partner: 1) Trouble communicating: If you have trouble expressing to your partner that you feel hurt, that you need their help, or you are unsure as far as where they stand regarding the relationship, it might be time to have an unbiased third party. 2) Lack of sex: If you notice that the sexual compatibility is not as strong as it used to be, this might be an indicator that something deeper in the relationship needs healing and processing. 3) Feeling trapped in a cycle or pattern: In my training, I learned to refer to this as a “crazy dance”. It basically means that each time a couple argues, they are caught in some kind of dyadic pattern that they feel they are unable to get out of by themselves. This is where couples therapy comes in. 4) Difficulty completing tasks together: Each couple is united in the beginning of their relationship because they have similar goals and life dreams. But if their relationship is characterized by pain, arguing, or sadness, achieving the simplest tasks can feel like climbing a mountain together.
5) An overall feeling of “disconnect”: This is a very common reason as to why couples reach out to me! If you feel that you and your partner are like two ships passing in the night, we definitely have some work to do together!
Therapist competence
As previously mentioned, not every therapist is as motivated to treat couples as I am. What sets me apart from many therapists is that there are very few couples I turn away. Since I can safely say relationship work is my specialty, this is not true for all therapists. Therapists who tend to shy away from couples work typically have said that couples are “too difficult”. But I can safely say that we can chalk this up to the training that the therapist has received. Not every therapist had the privilege of learning about Emotion-Focused Couples Therapy as soon as they started their internship like I did. This is perhaps why I feel so comfortable working with highly escalated couples, couples going through medical illnesses, couples experiencing infidelity, and couples who are navigating non-monogamy. The consumer is absolutely in charge when looking for a couples therapist. I encourage every couple to feel comfortable asking their therapist during the first phone consultation or the first session what kind of couples therapy experience they have had. Seeing couples should absolutely be something in which a therapist has had adequate training. Some tell-tale signs that the therapist is competent enough to see couples would be receiving training in Emotionally Focused Couples Therapy, Gottman Levels I and 2, Imago Couples Therapy, Solution-Focused Therapy, and Cognitive-Behavioral Couples Therapy to name only a few modalities. If there is one thing to take away from this article it is this: Therapist competence is one of the most important factors in creating a safe and productive couples therapy experience. I cannot stress this enough that therapists need to receive adequate training when handling a complex, vulnerable, and fragile case like counseling an entire relationship. Aside from the training in the different couples therapy modalities, some appropriate and necessary questions to ask a couples therapist on the first point of contact are below. 1) How long have you been practicing couples therapy? 2) What kinds of couples are you trained in when counseling them? 3) How many couples overall have you seen as a therapist? 4) Do you have training in working with (insert particular issue that you and your partner are struggling with)? 5) What modality of couples therapy do you primarily use? (It’s important to note that I have gotten asked all of these questions by couples, and not once did I flinch or hesitate in my answers to them!) Safety As mentioned in the above section about therapist competency, safety is another monumental factor in finding the right fit in a couples therapist. From the moment that the first email is sent, the first phone call is made, and the first appointment has been scheduled, both partners should ideally have been made to feel safe, welcome, and seen. This sense of safety should continue throughout the entire couples therapy process from beginning to end. I always make sure to say things to my couples reaching out like, “This probably felt very scary making the first phone call”, “I am an open book and will answer any questions to make you feel safer in this process”, or “Your partner is free to reach out to me if they would like some further information about starting couples therapy with me”. Making statements like this immediately sets the tone of "You and your partner are seen, heard, and safe". Safety is paramount with my couples who are going through some very unique circumstances together such as a partner transitioning, a relationship experiencing a sexual shutdown, an affair that was recently revealed, a queer couple who feel that they do not have any queer safe spaces, or a couple who are unsure how to open their relationship or marriage. Regardless of the particular issue any couple struggles through together, fostering a sense of safety should absolutely be the role of the couples therapist throughout the entire process. If either partner does not feel safe with their couples therapist, no significant work can get done. When is couples therapy counterproductive? This is such an important topic to consider when beginning couples therapy with your partner. My knee-jerk reaction whenever I get asked this question is--If there is physical or emotional abuse involved, couples therapy becomes counterintuitive. If a couple reaches out to me and says that there is ongoing physical abuse, my advice to them is for both partners to enter into individual counseling (with the abusive partner or partners having a heavy focus on anger management); Once the physical abuse has ceased completely, they are free to reach back out to me. Below are the primary reasons why couples therapy would not help a relationship but would actually hurt it long-term: 1) Physical abuse: if a partner is being physically abused within the relationship, neither person will feel safe enough to be open and vulnerable without the fear of physical retaliation after the session. If there is physical abuse going on, the therapist would let the couple know they would have to pause sessions or stop entirely as it would be unethical to continue on with couples counseling. 2) Emotional or verbal abuse: much like physical abuse, emotional or verbal abuse does not make for a safe environment. A partner who is being gaslit, manipulated, or harassed prior to couples therapy will not feel safe in the vulnerable environment of couples therapy. 3) Active addiction: If there is substance abuse going on, it is best to pause sessions or to mandate that the partner with out of control behavior enter into their own counseling or treatment center. Active addiction in couples therapy is so incredibly easy to miss, so the couples therapist should be assessing for this throughout. 4) When the couple is separating: Couples therapy is not always productive for a couple who are actively separating. Therapists who are trained to heal a broken relationship through couples counseling may have to refer to discernment counseling, a less emotionally intensive and more pragmatic form of therapy where the couple is allowed to navigate staying together, divorcing, not really knowing how they want to move forward. This is when I frequently make a referral to several discernment counselors in my community. Benefits of couples therapy.
All of the complexities and cautions aside, I can say firsthand that couples therapy works. I have sat with couples and helped them navigate being on the brink of divorce and have watched them mend their relationships over time. As a clinician, money cannot buy the moments that I have watched my couples go through. There is almost a physical difference I see in my couples who commit to the process–I notice improvements in physicality as well as their overall mental state. Both partners also tend to have an improved sense of self–They understand themselves better once they are able to more easily access their partners!
This helps me confirm the notion that if we are not in a good place with our partners, we are not in a good place period! How many of us have had an argument with our partner, and the rest of our days have felt muddled, agitating, or downright miserable? As attachment-oriented beings, we have a distinct need to be in healthy partnerships. And if we feel as though our partners are turning their backs on us, it can literally feel like we are in a fight-or-flight mode.
Below are some benefits for couples who stick with the couples therapy process:
1) Learning short-term and long-term coping strategies: Very often, many couples therapists like to send their couples off with resources that will be helpful in between sessions. Some of mine are the book Hold Me Tight by Dr. Sue Johnson, Dr. John Gottman’s “Four Horsemen of the Marital Apocalypse”, and drawing the pattern that the couple is stuck with on paper and giving it to them to have to refer to in between sessions.
2) Gaining a deeper understanding of partner perspective: Overwhelmingly, a huge benefit that many of my couples receive throughout the therapeutic process is learning a new perspective that their partner has. This in whole increases the sense of safety in the relationship. Who doesn’t want to be on the same page within their relationship or marriage?
3) Overall beneficial to the family unit: There have been so many couples who have come to me and struggled not only with their own relationship, but also with raising their children as a parental team. Once the relationship itself begins to heal, the entire family feels it. It is almost uncanny how a family unit can heal once the relationship between the parents has gained a sense of safety and deeper meaning.
4) Less medical problems: Studies show that people who are in healthy long-term relationships are much less likely to get heart disease, cancer, or any immunodeficiency. This explains why I notice improvements in some of my couples' physicality over time. Cool, right?
5) Increased sense of autonomy in both partners: Another huge difference I see is that both partners gain a further understanding of who they are as people. Once their relationship is no longer in an unsafe place, they gain more understanding of themselves. Over time, I often see career changes, a change of wardrobe, a reconnection of a long-forgotten hobby, or making a decision to g back to school. The benefits of couples therapy are BOUNDLESS.
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