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Couples Therapy: Can It Really Work?

Obviously, I think it can work. I'm a therapist. Duh. It can be super productive and beneficial. Couples who thought their relationship was doomed have been successfully able to heal their relationships and move forward with healthy communication and boundaries.

But when does couples therapy fail?

Here are three reasons why couples therapy sometimes doesn't work and how you can avoid these mistakes to make sure your couples therapy experience is successful.

Often times, people who contact me about couples therapy will say that they aren't so sure that their partner will participate or that they will even show up for the first appointment. In these cases, I will provide a word of caution to the person who has reached out to me. Most often, the client is a woman seeking therapy for her and her cisgender male partner. I will tell her that doing couples therapy with someone who doesn't want to do it almost certainly will result in failure. This is a fundamental truth about couples counseling. Both parties simply have to have faith. They have to have faith that couples therapy may help them and they have to have faith in each other. In other words, there has to be buy-in from both parties (or all parties if we're talking about a poly relationship).

One of the concepts that I often work with couples on in therapy is the concept of "presumptive goodwill". This is the assumption that your partner loves you and has good intentions. Often when there is no presumptive goodwill, you will find that your partner is suspicious, doesn't trust you, is overly defensive and reactive to minor unintentional slights. If lack of presumptive goodwill is a particular issue for your relationship, selling your partner on couple's therapy is tough because they may take the suggestion of therapy as an accusation that they are the problem in your relationship.

So how do you get someone to really get on board with trying couples therapy? Well, you don't. All you can do is speak from your own position. If you think that having a third party help you sort through some of your issues and learn better communication strategies, then say that. Avoid identifying your partner as the problem. Speak in "We" statements. For example, "I think that we could benefit from someone who can help us communicate better". If your partner agrees with you and is willing to give it an honest try, therapy can be very helpful for many relationship issues.

Issues that I often work with couples on include:

Empathic Listening

Improving Trust

Re-establishing a relationship after trust violations (affairs, etc).

Gender role disagreements

Distribution of emotional labor

Clear communication

Boundary setting

Sexual issues

In couples work, I often talk about intention versus impact. We have to be accountable for the impact of our actions on our partner even if we believe that our intentions were 100% honorable. The second most common reason that therapy might not work, aside from lack of buy-in, is avoidance of accountability. If you or your partner are not ready to really take accountability for how your partner has experienced your actions, therapy will not work. Couples therapy isn't easy. It can be emotionally draining and it can force you or your partner to take a good hard look at your own behaviors which can be difficult. It means dredging up the past sometimes to resolve past issues that have led to current resentments. It can mean that you have to really hear and feel how your partner has felt about your actions. Be ready to do some challenging work.

That is, if you can find an experienced couples therapist that is a good match for you. Much like individual therapists, every therapist is different and has a different style. I am not a listen-and-nod therapist but some therapists are. Think about what you want from your therapist. I am always clear with new couples therapy clients that I am a feminist therapist. And, no, that doesn't mean I always side with the woman. What that means is that I do not allow gender roles into my therapy session. I am not going to reinforce any sort of patriarchal structures that have led to inequality in the relationship. If division of emotional labor is part of the couple's presenting issue, you better believe we're going to talk about it and I'm not going to reinforce anything other than an equal distribution or whatever both parties feel completely comfortable with. I have worked with more queer couples than straight and so this hasn't been an issues that comes up with all of my clients. However, if you are a heterosexual couple seeking couples therapy, you're going to want to ask your potential therapist what their position is on gender roles. If your therapist has long held traditional beliefs about men and women's roles in relationships, that is definitely going to impact their practice. Make sure you find someone who is on the same page as you and your partner. If you're looking for someone with conservative or religious values that will filter into your therapy, look for that specifically because most therapists are more progressive than that.

The final reason why couples therapy sometimes doesn't work is that the couple doesn't do their homework. I always tell couples not to speak about our session until a few days later. It's better to let the session ruminate for a bit before talking about it. It's also exhausting to spend your whole day in therapy mode. If you have a session at 2pm and then talk about what happened during that session until midnight, you've just spent 10 hours living in that world and that is too much. So, give it a few days before you explore what happened in the session. Your therapist will likely ask you to do certain things in between sessions. This may simply be that your therapist asks you to think more about your wants and needs so you can talk about it in the next session. It may be literal homework like writing down all the ways that you appreciate your partner. It may be that you and your partner need to spend more alone time together without the kids so your homework is to go on a date. If you don't follow through with those things, it's likely that therapy won't work which leads me back to the first reason I gave you of why therapy won't work - buy in. You both have to be willing to do the sessions and then do everything else that's thrown at you and you have to do it with a willing and hopeful heart.

Fourth additional reason why couples therapy won't work: Abuse. I should point out that there is no amount of couples therapy in the world that will stop your partner from physically or mentally abusing you. If your partner is physically or sexually harming you, couples therapy is not the answer and can actually make you a greater target for more physical violence. If your partner is emotionally or verbally abusing you and you wish to remain in this relationship, your partner requires individual therapy. Couples therapy would not be indicated until the abusive behavior has discontinued. If you are being abused and want help, please consider calling the National Domestic Violence Hotline at 800-799-7233.

If you live in either Massachusetts or Florida, I am available for couples therapy. Send me an email to schedule a session.

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