Couples Therapy 101: What is it, who should go, what’s it like, and more questions that ordinary folks ask a couples therapist.
When I tell people that I am a couples therapist, they have all sorts of questions. In this series of posts, I thought I would write about the questions I’m asked most frequently about couples therapy and share how I answer them.
What is couples therapy exactly?
There are many different forms of couples therapy, but two of the most popular evidence-based modalities, both of which are practiced by clinicians at the Heart of the Matter Counseling, are the Gottman Method and Emotionally Focused Therapy (“evidence-based” means that researchers have demonstrated scientifically the effectiveness of a given technique). While there are differences in the two approaches, both focus upon implementing the parallel processes of de-escalating conflict while rebuilding positivity and connection in the romantic bond. This means that the therapist will help the two of you to slow down, to lower the temperature when you discuss difficult issues, and to find ways for the two of you to re-engage feelings of mutual respect, affection, and care.
Who should go to couples therapy?
There are many reasons why a couple might want to go to therapy:
- You might be in a relationship where you feel that you and your partner are stuck in an endless round of conflict.
- You might feel that your needs are unmet and you are at a lost as to how to meet them,
- You feel unheard, unseen, and unappreciated no matter what you do, and don’t know how to change this.
- You might feel that some hurt from the past simply is not healing in your relationship and you now need help in “getting past your past.”
- You might be preparing for a commitment like moving in together, getting married, or having a child, but want first to talk through all the related issues with a third party facilitating the conversation.
What’s the beginning of therapy like?
First you must make the appointment, preferably at a time and on a day that both of you will be able to commit to on a regular basis. In your first appointment, your therapist will introduce themselves and their method of working. The first session is the beginning of an assessment period that will last for two more sessions. The assessment is done to make sure that the therapist has a strong grasp of all the issues that the couple is struggling with as well as to ensure that couples therapy is the appropriate course of treatment at this time. The second and third appointments will usually be made with each of you individually, to give you an opportunity to speak openly to the therapist and to feel that your point of view is understood and validated. In the fourth session, the therapist will then bring the couple back together and recommend a course of action based upon all the needs and challenges that were assessed. This plan, which will be the focus of treatment going forward, usually consists of facilitated discussions in session and various tasks to be completed outside of session, both of which aim to de-escalate and work through conflict while building positivity and connection in your relationship.
What does the couples therapist do?
The therapist’s job throughout is to serve as a neutral third party who works for the good of the relationship, a facilitator of difficult discussions, a mentor and model of secure attachment and communication skills, and a source of reflection and validation. The therapist is especially responsible for making sure that both members of the relationship feel heard, seen, validated, and understood in their feelings.
How long does it take?
The modality of Emotionally Focused Couples Therapy is a nine-step process that occurs in three stages. When I am asked to estimate the length of time that therapy will take, I let couples know that the length of therapy depends upon several factors that are specific to each partner. However, I can at any time let the couple know which phase and step we are working on so they can understand where we are in the process.
What are some of the factors that can affect the length of therapy?
There are several factors that can come into play. The following is not exhaustive but can suggest to you some of the more important issues that can come into play. How well do both partners tolerate difficult emotions in themselves and in others? How much trust is currently in the relationship? How much warmth and/or contempt are currently expressed in the relationship? How willing is each partner to look at their own behavior and take responsibility for changing it? How much relational trauma has each partner experienced in their life? How comfortable is each partner with accepting other points of view? Have there been any significant betrayals that need to be attended to? All of these factors can affect a person’s motivation and ability to navigate the many tasks associated with therapy. Of course, part of the therapist’s job is to assess for these issues and to work with the client compassionately to learn the skills needed to address them.
What keeps people from trying couples therapy?
It is common for people to express to me a desire to try couples therapy, but they have concerns that get in the way. I think these fears are perfectly normal and useful to express so that your therapist is aware of them and will know to address them early in the therapeutic process. Here are some of the concerns that people have mentioned to me over the years, as well as how I address them as a therapist:
- I’m ashamed about the issue that is causing so much conflict and I don’t want my therapist to judge me or both of us.
Your therapist has special training and experience in not only how relationships can go right, but in all the difficult ways that they can go wrong. A therapist leaves judgment at the door because judgment only gets in the way of understanding how the difficult issue came to be and how to help you deal with it. You can expect your therapist to treat you with respect and compassion as you struggle with your particular issue.
- I know that I have done/am doing something that has caused damage to the relationship, and I think the therapist will blame me for all of our problems.
Your therapist is interested in understanding the forces that drive the unhealthy dynamic in your relationship, not in assigning blame.
- The therapist is different from me and more like my partner (for example, I’m a man and my partner and my therapist are both women)- wouldn’t the therapist naturally side with my partner?
Your therapist has received special training on how to be a neutral third party who is aligned with the needs of your relationship and not with one or another member of that relationship.
- I’m afraid therapy will be all about fighting.
The beginning of therapy can be an emotional time because you are being asked to openly talk about thoughts and feelings that you maybe haven’t been able to fully discuss in front of your partner before. It can also be emotional and uncomfortable to listen to what your partner has to say. The therapist’s job is to slow the discussion down and keep the exchange respectful, so that you both are willing and able to listen. Over time, these exchanges can open up new perspectives and levels of understanding and compassion between partners. Eventually, couples start to apply the new skills that they have learned not only in session but during their everyday life so that they come to view conflict and misunderstandings not as a “Oh, no, here we go again- “scenario but as opportunities to learn new things about each other and to grow closer, not further apart.
- I’m so sick of talking about the past.
The only topics that your therapist wants to talk about in session are relevant to your present-day problems. Of course, sometimes present-day conflicts happen to be about the way that people feel about something that happened in the past. If this is the case, your therapist will want to talk about that, however, the difference is that your therapist will try to find a new way to understand the past so that the way that you and your partner feel about the issue is more peaceful.
- I’m not the one who’s unhappy. It’s my partner.
If one person is discontented in a relationship, then that is a relationship in trouble and threatened with instability. It can be uncomfortable to acknowledge that your partner isn’t as happy as you are in the relationship. Some people even can perceive this as a criticism of how or who they are. Or you can be grateful that your partner is open and honest with you about this and loves you and your relationship enough that they want to make it better.
What can I do to make couples therapy more successful?
There are a number of things that you can do to make your experience in couples therapy more productive and successful:
- Have an open mind.
Sometimes people get stuck in seeing issues from a particular point of view. Expect your therapist to introduce you to a new way of looking at the dynamics in your relationship. This new perspective is grounded in research and the information that you and your partner provide in session and has been shown to improve relationships.
- Give it a try, not a thought.
The kind of learning that occurs in therapy is emotional and experiential, not cognitive. This means that can’t imagine your way through a scenario and know how it will turn out- you have to do it. You will be asked to try behavioral changes in order to have specific experiences and to find out how you feel about them. Research shows that people are very poor at predicting their actual emotional response in a given circumstance. To learn something new, you must do something new. This involves going into a situation not knowing exactly how it’s going to turn out while being curious about the outcome and open to finding out. For some people this is truly daunting. And that’s okay, your therapist is more than willing to support you in learning to be moe confident with this kind of learning.
- Ask questions when you don’t understand, don’t agree, or just “don’t wanna.”
Therapy is rewarding and helpful, but it can be hard sometimes, and it can be demotivating to try something hard when you don’t understand the reason for doing it. Remember that your therapist is open to questions and is interested in knowing about any emotional obstacles that might be getting in the way of your participation.
- Be prepared to spend time outside of session working on a task.
Sometimes, your therapist will ask you and your partner to work on a specific task between sessions. These tasks are always optional, but they are given as a way to help you and your partner to practice the skills that you are learning in session. The more that you practice, the more quickly that you learn!
- Be prepared to talk about things that are uncomfortable and understand that you have some choice in the pace of the conversation.
Often, there are topics of conversation that have never or rarely been addressed in a relationship that come up in therapy. The reason for this is because one or both partners feel emotionally overwhelmed when the topic arises and so they avoid addressing it. Your therapist’s job is to help you to have these conversations. However, it is also your therapist’s job to make that conversation as comfortable as possible by slowing things down, giving you tools for self-soothing, and helping to facilitate a respectful pace and tenor to the exchange.
- Be prepared to focus on what you can do differently.
To be honest, most people come to couples therapy fully prepared to talk about what their partner is doing wrong and how they want them to change. That’s an important beginning, but that approach usually isn’t what is going to institute a real and lasting change for the better in your relationship. Your therapist will work to empower both of you to focus upon the part of the relationship within your control- your thoughts and actions- and will show you how making different choices about these can affect changes- sometimes profoundly- in the quality of your relationship.