The past couple of years have been tough on couples in many ways. With both working from home. Taking care of kids at home. Not having separate space and time to one’s self. Dealing with the unrelenting stress of the pandemic- and quite possibly being directly affected by it. These added pressures were put on top of tension in the relationship before the pandemic for many couples. For some, this has made for a crisis in the relationship- or even spelling its ending.
If you and your partner have found yourselves in distress, you are not alone. And if you’re considering couples therapy, please keep reading.
Couples therapy, like therapy in general, has been stigmatized in the past. Fortunately, that’s changing. The pandemic has increased focus on the importance of mental health, on par with the importance of physical health. Relationship health, in particular, is vital to our well-being.
So how can couples therapy help you? Let’s start with what couples therapy is, and isn’t.
What Is Couples Therapy?
Couples therapy is very different from individual therapy. A couple (or even some therapists) may think of couples therapy as ‘individual therapy plus one,’ but in fact, couples therapy brings with it complexities and considerations far beyond that. That’s because we human beings are complicated. The interactions between two people- the sum of all our thoughts, feelings, actions, and meanings we attribute to a given situation are complex and intertwined.
When you go to individual therapy, it’s all about you. You are the client, the focus of attention. It’s about what is stressing you the most, impeding your life, limiting possibility and your quality of life.
When two people are in couples therapy, neither is really the client. Instead, the relationship itself is the ‘client,’ the focus of attention. The focus is on what happens in the relationship that causes it to be stressful and the bond– the feeling of connection and commitment– to weaken. That, in turn, impacts each partner and can profoundly affect the quality of life for each.
In a nutshell, couples therapy is most often targeted towards helping with relationship distress (though it can also help a good relationship get even better). Let’s take a look at what relationship distress means.
What is relationship distress?
Each person has things in the relationship that they would like or need to have more of, and each has some things that they want or need to experience less of.
Let’s talk first about the ‘needs more of’ category. These are what I sometimes think of as ‘essential nutrients.’ If you were to see a plant barely surviving in a drought, you’d know that it needs water. It’s essential for that plant’s survival and well-being. If you looked at the ingredients list on, say, a cereal box, it would tell you the percent of essential nutrients we need in a day that it gives you in a portion.
We’re like that too. In relationships, we have nutrients vital to us, such as affection, caring touch, appreciation, respect, feeling understood, and feeling important to our partner. What they are, and how much is needed, depends on the person. When a couple comes in for therapy, one or both might feel like that parched plant. It’s not only not getting what you need, but often feeling isolated and alone to boot.
The second is the ‘needs less of’ category. These are the things that are damaging the relationship. These can cause direct damage and strip away those ‘essential nutrients’ a person is getting from the relationship. They strip away one’s ability or willingness to really share things with their partner. They erode confidence in the future or viability of the relationship. They can destroy trust. And they can transform a relationship from two people who have a life together to two people living in proximity, each in their own silo.
The ‘needs less’ category can include criticism, put-downs, anger, yelling, the need to be right, the cold shoulder, lack of cooperation and goodwill. It can also include lack of trust, broken trust, lack of reliability, blame, feeling uncared for, and feeling unsafe in any way.
There are often more of the second kind of interactions in a distressed relationship than the first kind. In fact, the ratio between them may become entirely out of balance. The thoughts, feelings, words, and actions of each partner, intentionally or unintentionally, can bring up feelings of distance, anger, disconnection, disappointment, frustration, sadness, and loneliness in the other. Repetitions of this pattern can bring a sense of despair, resignation, and questioning the relationship.
When there is a shortage of positive interactions, each partner’s ‘essential nutrients’ go unattended. And when there are few or no negative interactions and few positive ones, couples might feel a sense of emotional distance, drifting apart, or more like working partners. Over time, this reinforces feelings of unhappiness, disappointment, and loneliness.
This is where couples therapy comes in.
How couples therapy helps with relationship distress.
Now let’s get into how couples therapy deals with relationship distress. Keep in mind that this is an overview. There are lots of couples therapy models with different ways of thinking about and approaching this.
1. Have a good alliance with the therapist.
First, a therapist can’t help a couple if there is little trust or confidence in that person. It also wouldn’t work if one partner felt that the therapist was siding with the other. It may be obvious, but the therapist’s job is to demonstrate respect and understanding for each partner while focusing on the relationship. A couple also needs to feel that they are in good hands. Whatever approach or therapy model that therapist might use, it should be explained and make sense. The focus should be on those issues and dynamics that are causing the most distress. A couple should also feel that there is reasonable cause for optimism that things can, in fact, get better.
2. De-escalate.
How this happens will depend on the couple, the therapist, and their framework to approach this. But the target would be to open up room for dialogue and understanding. When things escalate, people tend to stay entrenched in their point of view. They are also more likely to feel that if only the other changed, everything would be fine. When we are angry, upset, frustrated, or resentful, our brains are literally working differently than when we are calmer or feel safer.
Without de-escalation, when one expresses criticism or complaint, the other usually sees it as an attack and therefore defends. That defense can come in the form of a counter-offense or a withdrawal, ending the conversation. In any case, it leaves both feeling more isolated and more unhappy. In this sense, de-escalation refers to both winding down ‘hot’ escalation- the kind where people just wind up yelling at each other, and ‘cold’ escalation, the ‘I’m not talking to you yet’ kind of outcome. So, de-escalation, when it’s called for, is essential.
3. Look for patterns.
If you’ve been together long enough, you’ve probably noticed patterns in the relationship. For example, there may be a pattern of fighting, making up, and resumed fighting later. There may be a pattern where one of you gives in, with resentments quietly building up in the background until a trigger sets it off. Or you might ‘sweep things under the rug’ until the next time. There may be a pattern in which one or both of you feel like you’re walking on eggshells around the other- until inevitably, something happens to upset that delicate balance. And there are different patterns.
In couples therapy, you identify the patterns that are causing distress and map them out. The goal is to understand the pattern and have ways to disrupt and change it. This sets up a realistic optimism that things can get better, even when both partners have tried to change the outcome before without success.
Note: If there is a pattern of abuse, your safety comes first. Please contact an advocacy organization your supports, and the proper authority where needed. You can also get a therapist (on your own). No one should tolerate physical or sexual abuse. This is a separate topic and beyond the scope of this article.
4. Enhance mutual understanding.
Most people think of this as ‘communicating better.’ But underneath that ‘umbrella’ description, there’s a lot more. It also means feeling understood by your partner- and not only that, feeling that they want to understand.
It’s feeling heard, listened to, and cared about. It can include communicating wants and needs- and why you want and need what you do and why it matters to you. There’s an exchange of values, opinions, and preferences. And there can be a sharing of aspirations, hopes, and fears.
There has to be room for vulnerability- the fuel for satisfying emotional connection. The bottom line is that it must be safe for authentic communication to have a chance. That means safety to express thoughts and vulnerable feelings such as worry, fear, longing, sadness, or hope. Both need to feel that those thoughts and feelings are received in a caring, respectful way and never used as ‘ammunition’ later.
Depending on the therapist’s orientation, this may be more prescriptive or organic. A more prescriptive approach would include guidelines for discussing a given topic, reconciling after a disagreement, or joint problem-solving. This approach can be constructive. However, a therapist can also promote a couple’s unique way of discussing things and creating understanding. With some gentle help, a couple can make their own path to a deeper understanding of each other. They can also make their own way to discuss decisions, sensitive topics, or problem-solve (as the old saying goes, …give someone a fish, vs. teaching them to fish…).
5. Think in relational terms.
Many people, especially those in a distressed relationship, see things primarily or exclusively from their point of view. So when needs go ignored or unmet, it makes sense to focus on getting what we need. It’s natural to want to stop emotional pain and want to avoid it. Ironically, the more intense the relationship’s discomfort, tension, or distress, the more we tend to focus inward on how we feel- and how we want to stop feeling that way. And we focus more outwardly on our partners to get them to change. We try to change our partners to give us more of what we need. And we try to stop them from behaving in those ways that add to our distress. And who wouldn’t want that?
But this doesn’t work. The relationship is more like a weather system between two people that they are continuously creating. One partner’s thoughts, feelings, words, and actions affect the other, often in ways that are not predicted or noticed. We take what our partner said or did and make sense of it in our own way. A human trait is to want to make sense of things, especially why something has happened. So, when our partner says something that doesn’t feel good, we also tend to ‘fill in the blank’ with our interpretation of their intent.
Relational thinking involves shifting perspective from ‘I’ and ‘the other’ in isolation. Instead, it incorporates the viewpoint of ‘we.’ Using the weather system metaphor, it focuses not only on the fact that it’s raining today but also the interactions between, say, a cold front and a warm front that made that rain happen. As a result, relational thinking helps couples see how they got to wherever they are more profoundly and clearly. It’s seeing the full context in which things happen between them.
6. Learn to repair.
This can be a critical skill. Some may think of this as ‘making up,’ but often, that doesn’t include an actual, satisfactory conclusion to an unpleasant or hurtful interaction. It’s the idea of ‘let’s just put this behind us.’ Instead, learning to repair allows for each misunderstanding, disagreement, or hurtful event to be an opportunity for deeper connection and understanding.
It underscores the resilience of the relationship, like a tree with a deeper and deeper root system that can resist the storms. So, learning to repair is the increasing ability to look at what happened in relational terms while also sharing its impact for each of you individually. At its best, it’s a way to elicit more compassion and empathy between you. And when that happens, goodwill tends to flow naturally, in both directions.
Effective repair replaces blame with understanding, restores trust, and softens the hurt. It creates a guidepost for the future when you find yourselves in a similar situation. This is different from creating a ‘rule’ or ‘policy’ in the relationship. Instead, it’s the actual desire to avoid or bypass some kind of pain for your partner. Repair reinforces the immune system of the relationship. If a couple says, ‘we always fight,’ that immune system is eroded, worn down. So is that of a couple who assert that ‘we never fight,’ where their immune system hasn’t been tested and is vulnerable to any exposure or stressor.
7. Enhance motivation to change and make positive changes last.
All of these factors fold into an increased motivation to change and to make those changes stable. While still in therapy, as things get better, the level of motivation to improve the relationship goes up. The feeling of being locked into an unsatisfactory situation that doesn’t change starts to free up. De-escalation brings more safety and less of a need to be on guard with each other. With that safety, there’s more room for vulnerability, more space for that kind of sharing to be received empathically and respectfully.
Unhappiness in a relationship is an unintentional, self-reinforcing pattern. By the same token, satisfaction and connection are the outcomes of an intentional, self-reinforcing system. Of course, like anything else, systems sometimes don’t work or break down. But with enhanced motivation and knowing how to repair, it just becomes a bump in the road together, not the end of the road.
When should you consider couples therapy?
Here’s when you might want to get into couples therapy:
1. One (and usually both) of you are experiencing distress that you see as directly linked to the relationship. This can be felt as hurt, anger, worry, or resentment. It can be the result of fights and conflict or the result of emotional distance and isolation. It can be a feeling of hopelessness or resignation to how things are or questioning if the relationship could (or should) continue.
2. When trust has been broken. This includes partner affairs (whether it is physical, emotional, or both). It can also include other types of rupture of trust between you, such as finding out about secrets or not trusting your partner with sensitive information. That broken or ruptured trust doesn’t have to be in the immediate past. It can be an issue that has been lingering for years, affecting the relationship.
3. There are hot button topics between you that never seem to go anywhere. There’s a pattern of arguing without a satisfactory result or one or both partners avoiding it if possible. Finances, division of responsibilities, and in-laws, among others, are frequent topics.
4. Another way to think of it is whether or not this is a ‘DIY’ project. If things haven’t worked despite your best efforts- whether those are efforts to change yourself, efforts to change your partner, or your partner’s efforts to change- then professional help can be the better choice.
5. There is some form of crisis. It may be a crisis in the relationship, with one partner contemplating separation or having separated. It can be due to be a transition or adjustment or the need to make a significant decision that is at an impasse And it can be about loss, changes in lifestyle, or changes in health.
6. There is no crisis. In fact, things are pretty good. But you both feel that a ‘tune up’ would be helpful, and a period to pick up some skills to make the relationship even better is a good idea. It’s an investment in your quality of life together.
7. One or both of you feels that there are ‘disconnects’ between you. It can be feeling not understood or ‘gotten’ or not feeling appreciated. There may be times when you notice some anger, frustration, or resentment cropping up for one or both of you. You might see the beginning of a pattern. It’s not a high level of distress, but you’d like to learn how to ‘nip it in the bud,’ taking a more proactive, preventative approach.
Does Couples Therapy Really Work?
Research shows that the answer to this is yes. However, not all of the approaches to couples therapy offered have been researched in depth in clinical trials. Still, a number of the leading methods have a body of evidence showing their effectiveness.
For example, In a comprehensive analysis encompassing different modalities of couples therapy, 84% of couples experienced significant improvement compared to those who did not receive treatment. Other research has shown up to 90% effectiveness for couples therapy, with gains holding up over time.
Relationship distress has also been shown to impact personal anxiety, mood, and substance use and impact us physically, for example, with increased stress hormones. This implies that couples therapy can help not only our relationships improve, but our individual mental health and bodies can benefit too.
What Does Couples Therapy Ask of You?
Here are six things to expect:
1. Effective couples therapy will ask you to be honest with yourself. That means being willing to take a deeper look inside and ask ourselves questions. It’s the intention to know what affects us and why. It’s also the intention to name to ourselves what we need and want most.
2. It should involve noticing your thoughts and reactions to interactions with your partner because they are essential to getting traction in the process of change.
3. It asks you to be open to new ways of listening to your partner. You may feel that you already do this, but the sure way to know is if your partner really feels heard and understood- both on the content and feeling level.
4. This may seem obvious, but it entails the willingness to do things differently. This is especially important when it comes to entrenched patterns in the relationship.
5. Couples therapy involves taking responsibility for what’s yours. We hurt each other intentionally or unintentionally, make mistakes or forget things. We’re human.
6. Last, effective couples therapy asks you to keep an ongoing intention for your relationship to be a good one. Couples therapy is not like pulling your car into a garage, waiting for it to be fixed by someone else, and then driving away. Instead, it’s ongoing cultivation and care. This quote (one of my favorites) says it all:
“Love doesn’t just sit there, like a stone,
it has to be made, like bread;
re-made all the time, made new.”
-Ursula K. Le Guin
When you and your partner are ready to start working on your relationship with a professional, consult with a therapist and find the right practitioner for you.
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