Couples Therapy: What to Expect (and What you Might Wish to Avoid)
If you’re considering therapy to work on your relationship, I want to begin by saying that I’m glad you’re entertaining the possibility. I know this step can be difficult.
It’s common to worry that seeking couples therapy is somehow an indication that a relationship is bad or, worse, doomed! On the contrary, therapy is a great way to enhance your relationship and bring it to an optimal level. This is true regardless of where your relationship satisfaction currently stands!
As you’re getting started looking for a couples therapist in Cincinnati, you may encounter different terms that feel a bit confusing. Terms like marriage counselor or couples counselor (versus couples therapist or psychologist) may leave you wondering if there is much of a difference. Generally, these terms simply convey the type of credentials that a particular clinician has. A psychologist, like myself, holds a doctorate degree in psychology, whereas marriage counselors attend counseling programs. Therapist is an umbrella term that covers clinicians who have attended social work, psychology, or counseling programs.
Regardless of the letters after a clinician’s name, what’s important is that the therapy you’re seeking is a good fit for you and your partner and that it can help you reach your treatment goals. Below are some questions that you and your partner might have, or wish to consider, when getting started with this process. Hopefully these answers help you feel a bit more informed on what couples counseling can consist of (and what pitfalls to look out for).
Is all couples therapy the same?
Not surprisingly, the simple answer to this first question is no. As is the case with nearly all psychotherapy, some of it is rooted in evidence-based treatment and some is not. In other words, some forms of couples therapy (e.g., Cognitive-Behavioral Conjoint Therapy, Integrated Behavioral Couple Therapy) have clinical trials to back-up their effectiveness, with tried-and-true track records. They incorporate concrete skills and tools that couples can take away from the process and keep using for years to come. In contrast, other therapists may adopt a general supportive approach that provides less structure or tools. In some cases, couple therapists with less training in evidence-based techniques may inadvertently use approaches that can actually do more harm than good. Certainly, rehashing and re-arguing all the tense moments from the past week does not sound very productive. Similarly, it’s not a couple therapist’s job to play referee or decide who’s right. Rather, a therapist should possess the ability to impose structure in sessions, remain impartial, and keep partners from frequently interrupting each other.
What are issues that are commonly addressed in couples therapy?
Naturally, there are a wide variety of reasons to present for couples counseling, but some of the most common include: frequent arguing, feelings of mistrust (which may or may not stem from incidents of infidelity), dissatisfaction with emotional or physical intimacy, difficulty communicating effectively, and disagreements about finances, in-laws, parenting, and other “hot button” topics. Though not exhaustive, these are among the most common concerns that I see.
What if my partner is hesitant about seeing a therapist?
It’s not uncommon for one partner to be reluctant about seeing a therapist, or for someone to feel like they’re being dragged to therapy begrudgingly just to appease their partner. But, don’t worry, that’s not necessarily a deal breaker (believe it or not)! For one thing, this dynamic is one that your therapist has seen before and is used to handling. And although it’s important that both partners be willing to put their best foot forward in the process, it is certainly okay if you are unsure about therapy starting out (or even whether or not you want to stay in the relationship!). These are concerns that can actually be discussed directly and frankly in therapy. The proof is often in the pudding as they say (whatever that means), and as couples begin to notice benefits from therapy, their level of buy-in naturally increases.
What does it mean to “work on our communication?”
By far, the most common goal that my clients set in marriage counseling is to improve their communication (even if they’re not exactly sure what that might look like). In my view, communication skills are tools for strengthening areas such as active listening, empathy, better articulation of thoughts and feelings, expressing love in a “language” that is appreciated, and being on the same page when it comes to the purpose of a conversation (e.g., just to vent, to problem-solve, etc…). Also, “working on communication” can mean learning to disagree without arguing or being disrespectful – and “fighting fair” when spats do occur.
What makes couples therapy work? (“How is just talking with someone going to help?”)
This question gets at mechanisms of change, which are the active ingredients within treatments that drive real world progress. There are a number of mechanisms that can boost relationship satisfaction. Some of the most common ones are: (1) enhancing insight and awareness of repeating patterns; (2) deepening understanding and empathy for your partner’s perspective; (3) becoming more mindful of your own emotional reactions and learning to deescalate situations before they become problematic; (4) decreasing avoidance of vulnerable emotions and increasing one’s willingness to express them openly; (5) addressing past pains or betrayals and working to rebuild trust; (6) increasing acceptance of the personality differences between you and your partner (perhaps even celebrating these differences); (7) noticing and challenging unhelpful beliefs about yourself, your partner, and your relationship; (8) overcoming anxiety or concerns associated with physical intimacy; (9) acknowledging relationship strengths and expressing more appreciation to your partner; and (10) working through logistical barriers to quality time.
How will we know if marital counseling is working, and how long will it take?
Some useful ways of gauging treatment progress are tracking objective markers that you wish to see change (e.g., fewer arguments, more quality time spent together), periodically completing questionnaires that measure your level of relationship satisfaction, and considering whether specific disagreements are being resolved to each of your satisfaction. The length of therapy varies depending on a couples’ goals and needs. On average, I work with couples for 8-15 sessions (following a brief, initial assessment phase).
Will this help our sex life?
Couples therapy is definitely a useful avenue to pursue when it comes to enhancing physical intimacy, especially if a lack of emotional closeness is what’s causing the lack of physical closeness. Although I am not a sex therapist and do not specialize in treating sexual disorders (I’m happy to refer you to one if needed), there are specific techniques I can incorporate to enhance sexual functioning. Also, as an experienced trauma clinician, I’m able to assist couples when one or both partners have a history of sexual abuse or assault that is impeding their ability to relax, be present, and enjoy sex.
Will we argue a lot in sessions?
Although this may be difficult to believe, I usually spend more time laughing with my couples than breaking up arguments. Yes, couples therapy involves challenging, emotional work and can contain periods of tension and disagreement; however, I believe that it’s important for the therapist to ensure that sessions do not lose structure or descend into full blown arguments. Worst case scenario, any arguments that do occur provide good opportunities for the real world practice of deescalation and repair skills.
If you or your partner have any other questions that you wish answered, please call or schedule a free consultation. I would love to hear from you. Thanks for reading!