Most of us want to meet and settle down with the “right” person, and most of us want such a relationship to last. All relationships will hit a rough patch at some point in life. And yes, research tells us that we all have conflict. We also know that couples therapy can make a significant difference in your relationship, improving your friendship, intimacy, and emotional connection.
Couples therapy can help couples improve their relationship in many ways. For instance, it helps couples resolve conflict, learn how to communicate effectively, better understand each other, enhance their emotional connection and strengthen their bond. However, there are times when couples therapy is not the right first choice. I’ve offered some considerations that should be addressed prior to therapy.
If couple therapy is not well timed, it can result in:
- Unnecessary expense and time being invested in care that could be more wisely spent at a different stage of recovery.
- Decreased focus on individual recovery goals if individual and couple therapy occur simultaneously. This is especially true for individuals who seek most of their identity from the relationship, or for individuals who have difficulty knowing what they need or want in their own right.
- Premature termination from couple therapy because “it isn’t working.”
- Increased risk of terminating the relationship because going to couple therapy “proved we have tried everything.”
- Frustration over negligible results.
A 2011 journal article in the Archives of Psychiatry and Psychotherapy2, outlined the following indications for engaging in couple therapy:
- Partners are mutually trying to improve the relationship.
- Partners want to undertake therapy for mutual support or help with problem-solving.
- Partners with negative past experiences or previous failed relationships want to prevent or solve problems in their current relationship.
- Partners want to prevent an accumulation of difficulties and strengthen their bond.
- Partners want to thoughtfully attempt to reach an agreement before making the final decision about separation or divorce.
- Partners have decided to divorce but mutually want to improve their relationship with improved co-parenting prospects.
In this list, there is a clear theme of equality, mutuality, safety, stability, prevention and thoughtfulness.
In contrast, the same peer-reviewed article summarized the contraindications for couple therapy:
- Active risk of abuse or violence between partners (can include emotional, physical or sexual abuse).
- Active or untreated mental illness or addiction with one (or both) partners.
- One or both parties are engaged in infidelity and lack the motivation to give those outside relationships up for the good of the primary relationship.
- One or both parties have undertaken the decision to separate or divorce.
Different Expectations, Different Goals
Through the assessment phase of our work, we will define a treatment plan made up of goals that we all commit to contributing to throughout the process.
Wanting the other partner to change.
“When clients come in for couple therapy they want a change,” said Mudita Rastogi, Ph.D, a licensed marriage and family therapist in Arlington Heights, Ill. “However, sometimes what they really want is for the therapy to change their partner’s behavior.”
For instance, they might want the therapist to change their partner’s spending habits. But they’d like to stay the same.
However, in couples therapy, “the target of change is the relationship,” Rastogi said. Both partners need to make changes in order to improve the relationship. Both need to change their perceptions and behaviors.
“For example, couples who want to change their fights over money will each need to examine their own patterns around money, and the role it plays in their relationship.”
Not acknowledging your role.
Another common — and related — obstacle is not taking responsibility for your role in your relationship problems. “Couples therapy can often feel like a courtroom for the therapist,” said Meredith Hansen, Psy.D, a clinical psychologist who specializes in couples, premarital and newlywed counseling. That’s because both partners are trying to communicate their side and hoping to receive validation and feedback from each other, she said.
They might focus on what their partner did wrong by saying, “You did this” or “I did this because you did this,” Hansen said.
However, in order for couples therapy to be effective, both partners must acknowledge how they’re contributing to the argument or problem, and work on changing their behavior, she said. She shared this example: “I’m sorry, I know I did not approach my complaint in the best way. I will try to phrase things differently in the future.”
Some partners start couples therapy with secrets — such as an affair or addiction — and they intend to keep those secrets, Rastogi said. However, “clients who continue to keep secrets from their spouse while engaging in couple therapy are fooling themselves and their loved ones, and creating barriers to achieve real change.”
If you’re keeping a secret from your spouse, consider its implications for your relationship, she said. “Secrets can sap trust and life out of marriages. They can morph into thick walls against interpersonal intimacy.”
(While you don’t have to share all your secrets, it’s best to reveal and work through any secrets that are currently affecting your relationship, Rastogi said.)
“Your therapist can assist you with this process, and your relationship will likely be stronger and have greater integrity due to this.”
Rastogi also noted that every clinician has a different way of handling secrets. She explains to couples before they start therapy that she won’t keep secrets. As such, if a partner reveals they’re having an affair, they either need to share it with their partner or they can’t continue therapy.
“I believe this helps me best serve the needs of both members of the couple while doing effective work.”
Not following through.
Couples may agree on what needs to change in a relationship in order for it to improve, Hansen said. But following through or applying helpful techniques during an argument can be difficult, she said.
“To overcome this obstacle, couples must learn to be patient with one another and work together as a team.” Hansen encourages her clients to identify “catchphrases” for times that an argument is getting out of control, such as: “we’re off track”; “we’re spiraling”; “we need to stop”; “break” or “pause”; or “something playful [or] anything to interrupt the fight.”
She also suggests learning to identify and then expressing when you’re becoming emotionally overwhelmed. One clue is when you “feel like you are too overwhelmed to listen or engage in a productive manner.”
And she encourages clients to take a 20-minute break to relax and refocus. “Both parties must use the time to calm themselves, and both must agree to return to the discussion after 20 minutes.”
Not trusting the process.
Couples might enter therapy wanting a quick fix or again wanting the clinician to tell their partner that they need to change, Hansen said. However, to improve your relationship, it’s important for couples to trust the therapy process, she said.
“…[T]o really get to the root of your marital conflict and begin the healing process, you and your spouse will have to invest your time and commit to learning how to be vulnerable with one another, expressing feelings rather than thoughts, acknowledging your role in the dance, and learning how to hear what you partner is truly saying.”
Not informing your therapist it is not working before dropping out.
Five Rules to Couples Therapy
SOBRIETY IS ESTABLISHED: When a sex addict accomplishes the hard work of establishing an initial level of sobriety from all forms of acting out (e.g., 90 days is a common working minimum), it sends a clear signal that he or she is: 1) choosing the relationship over the addiction, 2) breaking through denial, 3) no longer minimizing the seriousness of the issue, and 4) wanting to change. Such signals are not only incredibly validating and reassuring for a partner, but they also allow the partner to commence couple therapy in a setting that is more likely to be free of minimization, gaslighting or further betrayal.
EMPATHY IS PRESENT: Empathy is the ability to comprehend and share the feelings of another. When the addict can begin to lean into the pain his or her actions have caused and take appropriate responsibility for that pain, it provides a foundation for understanding, awareness, safety and the dismantling of narcissistic traits and objectification. Ideally, we want to ensure all blame shifting has stopped and the addict has enough tolerance of his or her own shame that he or she can begin to comprehend the impact of the betrayal from the perspective of the partner. Getting empathy ‘online’ in the addict’s brain and heart is an important step for launching effective couple’s work.
FULL DISCLOSURE HAS OCCURED: For couple therapy to be effective, it is vital both parties have a shared knowledge of the sexually addictive behaviors. When couple therapy commences with a power imbalance of secrets in place (pre-disclosure), it puts the partner at risk of experiencing betrayal in and through the couple therapy setting (“Why didn’t the therapist catch that he was withholding information about a whole category of acting out? Am I safe with a therapist who was also fooled and manipulated by my addicted spouse?” “How will this relationship work if my spouse is still lying while we are in couple therapy?”). Consequently, I highly recommend couple therapy commence after a full therapeutic disclosure and when the partner is able to trust in his or her gut that the truth is out in the open.
MENTAL ILLNESS, ADDICTION & TRAUMA ARE MANAGED: When mental illness, addictions or traumas have not been adequately diagnosed and treated, they can wreak havoc on repairing attachment bonds within a relationship. While few people would ever be ready for couple therapy if being ‘cured’ from all such issues was the standard, it is reasonable to expect that these issues be identified and be in the process of being stabilized prior to engaging in vulnerable, attachment-based couple therapy for sex addiction. I cannot count the number of partners I have met who have been in couple therapy for months or even years and it was not until a mood disorder or addiction (in one or both parties) was diagnosed and treated that things turned a corner for the better.
RECONCILIATION IS MUTUALLY DESIRED: Although it is common for SA couples to experience differences in their level of commitment to the relationship, it is helpful if the couple can share at least some degree of willingness to explore reconciliation prior to beginning couple therapy. If one party is determined to leave the relationship, then couple therapy which focuses on relational repair is likely to prove ineffective. On the other hand, differences in commitment do not negate the option to explore differences or work toward an agreed upon goal in couple therapy or meetings.
Wolska, M. (2011). Marital Therapy/Couples Therapy: Indications and Contraindications. Archives of Psychiatry & Psychotherapy; September 2011, Vol. 13 Issue 3, p. 57.