What to expect in couples therapy

Couples therapy can be overwhelming to think about starting. Most of the time couples enter my office already on edge. While it can be a daunting process leading up to your first appointment, it can be worth it in the long run. Here is what to expect in couples therapy.

1. Getting to know the therapist and process

The first initial session both members of the couple are just getting to know the therapist. The therapist might ask relational questions like “How long have you been together?”. Therapist’s also go over the informed consent and other logistical matters during the initial session. This includes the counseling process, confidentiality, and also the boundaries of couples counseling. It’s important to note that some logistical information can be different depending on the therapist you see.

For example some therapists have a “no secrets policy” which means if one member of the couple tells the therapist something without the other member of the couple being present, the therapist will ask that the secret be disclosed during the next session, aka no secrets. The therapist will go over all the paperwork and logistical information with you the first session so that you can know what to expect in couples therapy. It’s our job to make sure both members of the couple agree to this process and fully understand it before moving forward. Questions are absolutely welcome at any point in the couples counseling process!

2. What brings you into therapy?

Once you have completed the intake, and understand what to expect in couples therapy, we now get into the main reason why you wanted to come into couples therapy. This is an opportunity for each member of the couple to speak about what seems to be troubling each of you in the relationship. It’s important to note that you both don’t have to agree with what the issue is, often couples don’t agree and have very different perspectives on what is going wrong in the relationship. Here’s an example of a dialogue between a couple that could occur.

• Partner A- “Well we haven’t been having sex as often and I feel like it’s because he’s too stressed at work, so I get angry at him.”

• Partner B- “I am stressed at work, but she doesn’t understand that when I get home the last thing I want to be is stressed at home too, her anger just makes things so much worse so I don’t want to talk to her.”

It’s during these interactions that the couples counselor listens to each perspective and gathers information about the dynamic between the couple. As a couples counselor we aren’t supposed to take sides per se but more so help the couple understand what is keeping them in gridlock and help guide them.

3. Changing the dynamic- Gottman 4 Horseman

As I mentioned previously, couples often come in complaining about each other. Why is this? Well a lot of it is out of frustration when the other person won’t change. The average couple waits 6 years before seeking help for marital problems (Gottman, J.M. 1994). See we often believe it’s the other person who is at fault for what’s going on. We tend to neglect how much we contribute to the dynamic.

It’s at this stage of the therapy treatment that we work on communicating our wants and needs effectively without criticism. The Gottman four horseman talks about how criticism, contempt, defensiveness, and stonewalling are accurate predictors of divorce. Therefore in couples counseling we try to change the criticism with the help of the counselor in speaking to each other. The counselor may act as a hypothetical coach by pausing the interaction between the two of you, if it seems to be getting too critical, and shifting it to a more effective way of communicating wants and needs. We want to prevent criticism, further wounding, and the other 4 horseman of the apocalypse Gottman refers to.

4. Getting to underlying feelings

Our goal is to communicate effectively without criticism and the other Gottman four horseman. Once we do that we can then address the underlying feelings each member of the couple has. This stage of couples therapy is often when we get to the core emotions that are underneath the presenting problem. Here’s an example of a dialogue between the therapist and a member of the couple that allows for underlying feelings to surface.

Susan- “I’m so angry that Jim didn’t even consider me when I called him. (Directed at Jim) You ignored me.”

Therapist- “I hear that you are really angry at Jim, and I understand that, but I also want you to be able to speak for this anger in a way Jim can hear it, would you be open to that?”

Susan-”I guess…I just wish he would change.”

Therapist-” Can we stick with that? Can you notice what comes up for you when you think about Jim not calling you?

Susan-”Alone…I feel alone.”

Therapist-”Ah ok so when he doesn’t text back you get this feeling of being alone."

Notice here how underneath Susan’s anger was this sense of feeling alone. In couples therapy we work to communicate these feelings and also help them.

5. Help underlying feelings and engage in repair

Once we’ve gotten to the underlying feelings we can then work towards helping them ourselves while our partner witnesses and also helps if needed. Like the previous example Susan may work with the therapist to help the part of her that feels alone while Jim watches and observes his own feeling.

This intrapsychic dance between the two of them often leads to each other feeling more open heartedness once those underlying feelings are resolved. Once both parties of the couple have worked with their underlying feelings they can engage in communication that often leads to repair.

This may look like apologizing from a warm hearted space or also communicating about needs and how you would like things to be in the future.

Working with me

You and your partner both deserve a love that works for everyone involved. It doesn’t mean you won’t have differences but you will be able to handle them better and through the process hold onto yourself. If you are interested in couples therapy, or have further questions about what to expect in couples therapy you can learn about my offerings as an Florida couples therapist here.