Couples Counseling

Do You Need Couples Therapy?

Any relationship has rough spots, but it’s not hard to tell when it needs help. This page discusses issues that may require couples therapy and my couples therapy style. (Please check with your insurer for coverage of couples therapy.) Although experienced with emergencies, that is not my practice focus. As an outpatient therapist I work with people who can reliably cope, are not at risk or in crisis, do not have thoughts of self-harm, and are seeking to grow.

Issues That May Require Couples Therapy

Any one of these situations probably requires couples or marital therapy. Here’s a partial list:

Commitment

  • Thinking about leaving
  • Refusing or hesitating to commit
  • Infidelity or suspicion of an affair

Life Stresses on Relationship

  • Financial difficulties
  • Cultural differences
  • Different expectations learned when growing up
  • Difficulty coping with a partner’s problems, including mental or physical illness, addictions, stress or legal trouble
  • Conflicts with children or other family members
  • Life transitions, grief, loss or trauma

Something’s Missing

Painful Feelings

  • Tense atmosphere
  • Feeling lonely or scared in your relationship
  • Unresolved resentments
  • Feeling betrayed, wounded or disrespected
  • Damaged trust

Troubled Communications

  • Frequent, painful arguments
  • Conflict in front of kids or friends
  • Inability to resolve differences
  • Power struggles
  • Feeling misunderstood (words taken out of context, partner misses positive intent)
  • Feeling ignored (one or both partners ignore requests, stonewalls or defends)
  • Trouble balancing both partners’ needs
  • Silent treatment, passive aggression
  • Double messages

Urgent Issues and Emergencies

  • Violence, intimidation, stalking, criminal acts or abuse (with domestic violence, couples therapy is contra-indicated because it can stir up feelings that trigger violent behavior)
  • Major loss or trauma
  • Overwhelming mental or physical health issues

Some of these issues require immediate help. Others can worsen if not addressed.

My Couples Therapy Methods

Many couples come to therapy because they can’t talk things through. I facilitate discussions and train them in communication by watching their process in my office. I may use several methods, including:

  • Reducing Tension
    • Taking breakup off the table to allow time for therapy
    • Establishing time-outs to build emotional safety
    • Cognitive distancing from problems
    • Negotiating agreements
    • Prescribing enjoyable, shared activities to rebuild rapport
    • Acknowledging positive feelings toward each other
    • Bridging my rapport with both partners to each other
  • Interrupting arguments
    • To create an atmosphere of emotional safety I usually stop arguments. We explore how the conflict started and I offer tools to prevent such disruptions.
    • I might have each partner talk to me instead of each other
    • I may split the session, seeing each partner individually, hearing their concerns where they won’t activate each other, and reconvening
  • Education
    • Communication training—includes teaching time-outs (time-out, think about it, talk about it), signaling needs if emotionally flooded, limiting conflict duration, etc. Communication techniques are “training wheels” for establishing new patterns.
    • Presenting research findings and suggesting reading
    • Reflecting back the pattern of conflicts (see below)
    • Interpreting differing needs for togetherness and individuality
  • Guided issue resolution
    • Using questionnaires to identify issues
    • Homework assignments that respect personal style and time limits
    • Pre-scheduled extended sessions
    • When the time is right, discussion of issues where strong feelings are involved — I always give a respectful and fair hearing to each partner, even if we may focus temporarily on one of you.
    • Brief, non-conjoint treatment of individual issues
  • Changing patterns of arguing: Couples often get stuck in a pattern of arguing. They often express frustration about conflicts over trivial issues. Resolving the pattern, itself, is essential to achieving resolution. Such stuck patterns can include:
    • Arguing to win
    • 50/50 accounting – I’ll do my part only if you do yours
    • Trading accusations
    • Diagnosing your partner
    • Repeating old complaints
    • Unloading many issues at once, which muddies the waters (aka “kitchen sink” arguments)
    • Pushing toward resolution when partners are emotionally flooded
    • Getting tongue-tied under pressure
    • Saying hurtful things, name-calling
    • Emotional blackmail
    • Continuing discussion despite getting nowhere
    • Making agreements to avoid guilt
    • Insisting on resolving every single complaint (not letting some things go)
    • Substance abuse or process addictions that make either overly emotional, irrational or oblivious
    • Building tensions by sweeping things under the rug

    I could add many other instances. By interrupting arguments and recognizing their pattern, many couples reach resolution. Some relationship difficulties seem like emotional emergencies but quickly resolve. In our first meeting, I’ll give you feedback about whether your issue is likely to be easily repaired. Other situations may seem straightforward but can reflect deeper, longstanding difficulties.

    Situations That May Require Other Resources

    Some situations may need referral to another individual therapist to supplement our work or to a specialist who’s better suited to your needs. Some cases need more intensive treatment or a coordinated response of a treatment team or medical, psychiatric or law enforcement interventions. As noted earlier, couples therapy is contra-indicated when there’s domestic violence.

To schedule a first appointment please select this link.