Overview of Couples Therapy

Couples counseling is an option for couples seeking to improve aspects of their current marriage or relationship. Some areas of relationship focus may include the following:

  • Improving communication and conflict resolution skills
  • Improving maladaptive cycles of emotional distance and conflict
  • Improving emotional communication, closeness, and connection
  • Improving physical intimacy and enjoyment
  • Repairing a relationship disruption and trust (i.e. overcoming an affair)
  • Mediating difficult discussions and finding resolution
  • Discussing and resolving co-parenting issues

Healthy intimate relationships allow us to feel safe, connected, valued, and understood. A good relationship supports our individual growth and can enhance our life experience. If we feel safe with and trust in our romantic partners, we can allow ourselves to be vulnerable and to relate to one another in a sincere and meaningful way. In these healthy relationships, we can allow our true selves to be seen and feel that we will be loved and respected. All of these qualities help us to be open, flexible, and adaptive in how we relate to ourselves and others.

When a relationship is in trouble, it might be easy for us to identify what is not working from an individual perspective, but extremely difficult to understand why something is not working and to know what needs to happen for things to be resolved. For example, it might not be uncommon for one or both partners to say: "we do not have enough sex," "he/she ignores me as if I am invisible," "he/she is distant and unemotional," "he/she just complains and nags" or "we keep fighting about trivial things." In each of these examples there are clearly identified issues. However, relationship problems rarely exist in isolation. For example, one partner's defensiveness may be a symptom of something else yet to be identified. Another confounding issue is the fact that when we are in a relationship, we are emotionally invested and will be understandably biased in our perceptions of what happens in that relationship. For these reasons, it can be helpful to have a "third party" professional involved.


What to expect in Couples Therapy

During the first session my goal is to listen and to understand as completely as I can the problem, concern, or challenge that brings a couple to therapy. Each person will have a chance to express how they perceive the problem or concern. The goal is not to determine who is "right" or "wrong," but to understand the subjective experience of each partner in the relationship. At the end of the first session, I will sometimes make a few minor recommendations or things to try, which are not meant to resolve the issue, but may provide some short-term relief.

In general, I follow an Emotion Focused approach, which has been the most researched and validated approach to doing couples therapy. It is advised, though not required, that couples read Sue Johnson's book: "Hold Me Tight" (in the reference section below), which can either be read before or during the course of doing couples therapy. In my experience, couples who read parts of this book are both surprised and comforted by how many of the vignettes in the book explain their situation or how they feel in their relationship.

After the first session, I will ask to meet with each partner for one individual session. There are at least a couple reasons for doing so:

  • Each of us come into a relationship bringing certain expectations based on our family history, values, traumas, relationship experiences, and so on. It is important to understand a little bit about an individual's history, including any sensitive areas, "triggers," or "reflexes" to know how they might interact with their partner's background and fit within the relationship.
  • It also may be easier for an individual to express their concerns or their experience within the relationship without the pressure of anticipating their partner's immediate reaction. If an individual feels more comfortable being able to describe their experience one-on-one, we might also discuss ways to safely bring up the issues with their partner.

It is important to note that while these individual meetings can be treated as confidential, it is expected that an individual would permit discussions about their personal backgrounds and histories if it could be useful in understanding and exploring relationship dynamics in the joint sessions. If an individual would rather not discuss something from their past experiences in the joint sessions, it is important that they let me know. That said, I let my clients know that I do not support keeping big relationship secrets. If either discloses an affair that has recently ended or is ongoing, I will encourage them to disclose this information or otherwise suggest that we suspend therapy until they do.

These initial sessions are by far the most important in terms of building the foundations for a successful course of couples therapy. In the following joint sessions, we will work hard to explore the issues at hand and to understand and make sense of why aspects of the relationship might not be working for a couple, and what needs to happen to improve it. As the clinician mediating these joint sessions, I will help direct conversations and choose times to intervene when they begin to go astray or become unproductive. In the safe environment of the therapy room, couples will be encouraged to take emotional risks in communicating with their partner. While there might be some basic emphasis on "communication skills," a primary focus in the therapy session is on the "here and now" process of how couples relate to each other. The focus is not on blaming one another, but on identifying each person's needs, emotional experience, and triggers. It is often the case that a couple will get stuck in what becomes a predictable pattern or cycle of problematic communication. The process of therapy then involves identifying the maladaptive relationship pattern and finding ways to free the couple from it.

Often couples will ask if there is any hope for improving their troubled relationship. Some relationship issues seem so longstanding and problematic that hope seems to hang by a thread. I believe that all relationships take work, and from my perspective, there is always hope for change so long as each partner wants to improve the relationship and is willing to do some of the hard work it requires.

PDF Handouts

Recommended Reading for Couples


Hold Me Tight: Seven Conversations for a Lifetime of Love
(2008; Author: S. Johnson)


Sue Johnson is one of the pioneers of modern couple?s therapy and her version of Emotion Focused Therapy has quickly become one of the most empirically validated approaches to working with couples. From this perspective, and drawing from attachment theory, this book outlines some of the fundamental ingredients for relating to one another in an emotionally meaningful way. This book is an excellent adjunct to couples therapy. Couples who read parts of this book are often surprised and comforted by how many of the vignettes explain their situation or describe how they feel in their relationship.


Seven Principles for Making Marriage Work
(2000; Author: J. Gottman)


Most relationship books focus almost entirely on emotional communication as the key to a great marriage. Dr. Gottman takes a slightly different approach, drawing from clinical experience and research, to show that there is much more to a solid relationship than being able to openly share thoughts and feelings. This book outlines the 'not-so-obvious' signs of a relationship in trouble and explores important protective factors that can strengthen a relationship. Using in-depth relationship quizzes, checklists, and exercises, couples will develop new skills to help them find and maintain a happy and healthy marriage.