GoodTherapy | How Emotion-Focused Therapy is Used in Couple CounselingThere is no one-size-fits-all approach when it comes to couples counseling, as each relationship comprises different challenges and experiences. But some therapeutic strategies have proven to be particularly effective when untangling stressful, tense partner dynamics.  

Emotion-focused therapy, in particular, is one of the most commonly used tactics that relationship counselors use to help couples establish more secure attachments with their partners. One analysis from the New York Center for Emotion-Focused Therapy showed that 90% of couples showed significant improvement after EFT sessions compared to the control group who did not receive such therapy.  

Let’s examine how it differs from other strategies and whether it can benefit your relationship as well. 

What is Emotion-Focused Therapy 

Popularized throughout the 1980s, the therapeutic practice helps clients better identify, explore, accept, and even alter their own emotions. The essence of EFT is rooted in our awareness and relationship to our own emotions, both positive and negative, subsequently boosting emotional intelligence and improving our reactions to events and external behaviors.  

According to an American Psychological Report: 

“Emotions are seen as crucial in motivating behavior. People generally do what they feel like doing rather than what reason or logic dictates. It follows that to achieve behavioral change, people need to change the emotions motivating their behavior.” 

EFT is used in a variety of therapeutic settings, such as individual counseling, and family or group therapy as well.  

How is emotion-focused therapy used in couples therapy 

Benefits of EFT in relationship settings 

Every successful relationship relies on healthy emotional dynamics, wherein each partner is not only aware of their own emotions but has the tools to regulate them and is also comfortable being vulnerable with the other person. 

In the words of Dr. Sue Johnson, one of the founders of emotion-focused therapy:

“To foster connection we need not just to spend time together as companions, but to also risk sharing softer, deeper emotions. We must learn to hold each other’s feelings in a way that calms our nervous systems and gives us a deeply-felt sense of safe connection.” 

That makes EFT a particularly useful approach in couples therapy. Let’s take an example of an exchange where such an approach could be valuable: 

Person A: Would you like to go out somewhere this Friday?
Person B: I don’t know, you probably don’t want to go anywhere anyway. 
Person A: [Shrugs, rolls eyes, walks away] 

In EFT, Person B’s dismissive response to the question would warrant further exploration if re-enacted or described in an EFT session. Upon further examination, it may reveal that they are feeling frustrated that Person A doesn’t take the initiative to make plans to do enjoyable activities together, something that Person B may find important as part of a fulfilling relationship. Conversely, Person B’s emotional response – as evidenced by rolling their eyes and ignoring their partner – may derive from feeling like, no matter how much effort they make, it’s never enough.  

Though brief, these emotional reactions can teach therapists and their clients a lot about not only the root of recurring arguments but what can be done to address them. 

Stages of EFT Couples Counseling  

EFT is typically administered over a finite number of sessions – often ranging from eight to twenty – with a few key phases demarcating the level of progress achieved: 

Stage 1: De-escalation 

Oftentimes, when a couple first begins counseling, there is a common communication cycle, where one person may lob a criticism – intentional or not – at their partner, who subsequently responds defensively (intentional or not). These exchanges often escalate to the point where it’s hard to resolve the original discussion that surfaced, to begin with.  

In the de-escalation phase, each couple should become aware of how they each play a role in perpetuating emotional distress in such exchanges. 

Stage 2: Restructuring 

Once couples have an understanding of how their actions impact the other person, therapists will start introducing guidance on alternative ways of responding, all with the intention that these prompts or questions will help each partner become more curious and empathetic to the other’s feelings.

The main goal of this stage is that each person in the relationship feels more comfortable being emotionally vulnerable and accepting their partner’s emotional and attachment needs.

Stage 3: Consolidation

Once deeper trust is established in the second stage, therapists will help couples navigate ways to more effectively communicate, which includes ways to better express their needs. Some level of conflict will always be a part of every relationship, but enhancing our ways of discussing old problems and disagreeing in the future is the key to reducing tension and building trust.  

Things to Consider 

While this applies to various therapeutic approaches, couples therapy can bring negative emotions to the forefront, particularly those that individuals have suppressed or been loath to confront for a long period of time.  

Emotion-focused therapy, especially during relationship counseling, requires us to address difficult feelings, behaviors, and thought patterns head on. While this may feel vulnerable and at times even painful, it’s also best to do so in the presence of a trained mental health professional who can help process raw, emotional wounds in a healthy way.  

GoodTherapy | Getting the Help You Want: Neurodiverse Couples Therapy

by Sarah Swenson, Licensed Clinical Mental Health Counselor in Seattle, WA

Don’t Give Up on Couples Counseling! Find a Therapist Who Understands Neurodiversity Instead  

In my work with neurodiverse couples around the world, the most common and the saddest comments I hear relate to their previous attempts to seek counseling. Instead of providing support and insight into their experience, counseling seemed at best ineffective or at worst (and not infrequently) downright harmful. Naturally, these negative encounters create a strong disinclination toward further attempts to seek help. If this describes your views of couples counseling, and if you fear it would be hopeless for you and your partner, please mull over these comments and consider giving it another try. 

Understanding Neurodiversity 

First, let’s make sure we’re talking about the same thing when we speak of neurodiversity. It’s a term that has only been around since a graduate student coined it in her master’s thesis in 1997 to describe individuals who felt they didn’t fit comfortably into the larger social patterns of expectations. She included those with ADHD, dyslexia, and autism under this umbrella.  

Her efforts were based in her concept that these are variations, not deficits, in the normal spectrum of human brain development. When I say neurodiverse couple, therefore, I am specifically referring to a couple in which one partner is what we call neurotypical (that describes roughly 97% of the global human population) and the other is neurodivergent with the traits of autism, whether diagnosed or undiagnosed. I often see ADHD accompanying autism as well, since it is frequently a diagnosis given to individuals whose autism was not diagnosed at the time of evaluation. 

Treating Neurodiverse Couples 

Remember that autism is a result of differences in the structure of the brain, when compared to what we call the neurotypical brain, and these differences affect an individual’s perception of the world as well as their responses to it and, therefore, social interactions. The key word is differences. These differences need to be identified, accommodated, and supported within the counseling framework in order for both partners to feel heard and understood by themselves, by their partners, and by their therapists. 

Faulty Assumptions Lead to Frustrating Sessions 

Besides the normal range of relationship complications faced by all couples, neurodiverse couples experience unique challenges that set them apart from the neurotypical couples that licensed therapists are trained to treat. Traditional couples therapy modalities are generally emotion-focused and insight-based, often embedded in a cognitive-behavioral frame, and they can offer profound help to struggling neurotypical couples. However, these treatment modalities present two great challenges for an autistic individual. For various reasons, the autistic partner is likely to shut down completely in the counseling environment, where presumptions are based in the neurotypical experience and where departures from those expectations are misconstrued to be resistance, reluctance, or manipulation.  

This likelihood needs to be identified and embraced with compassion toward both partners, but what often happens instead is that the autistic partner is pushed in ways that don’t make sense to them, while the neurotypical partner may feel slightly vindicated in the moment but ultimately frustrated when they sense that “there is no follow-through by my partner after counseling sessions,” as it is often described to me. 

Ignorance Leads to Misunderstanding 

A key point is this: graduate counseling education and post-graduate internships across the country lack deep emphasis and training in the concept of neurodiversity as it applies to couples. The best and most competent therapists, therefore, often miss signs of autism and proceed as if a couple were neurotypical and difficult or intransigent.  

Seeking Help, Finding Frustration 

Sometimes, therapists do consider autism, and suggest to a couple that they work with a neurodiversity specialist or consider pursuing an evaluation to rule out autism or to diagnose it. This suggestion can be met with resistance by an undiagnosed autistic partner, who feels blindsided and labeled abruptly. The couple leaves in tatters and often never returns to a counseling room because the therapist did not adequately explain their reasons for making the suggestion nor describe the benefits to the individual and to the couple seeking an evaluation. 

The more common reason couples leave counseling and don’t return is that they feel they are getting nowhere. The therapist’s ideas may sound good, but the couple senses they don’t address the root of their challenges, which they often struggle to express in a way that the therapist understands. They leave in great frustration, and often aggravation, especially if one partner inadvertently feels blamed for the other’s distress or feels identified as responsible for the dysfunction in their relationship. An autistic partner, for example, is often primed by life experience to feel blame where there is no intention to blame. This fact also needs to be understood and normalized for a couple, both to help them understand where they’ve been and preventively for the future. 

Getting What Neurodiverse Couples Experience 

Getting Neurotypical Partners 

In my years of work with neurodiverse couples, I have heard absolute horror stories. Not a small number of women, for example, have been misdiagnosed with Borderline Personality Disorder by therapists who interpreted their frustration inaccurately. I often hear about vague mentions of dependent personality or co-dependency on the part of the neurotypical partner whose legitimate struggles are misinterpreted. It is often suggested to the neurotypical partner that they stop viewing themselves as a victim in the relationship when they try to describe their inability to communicate clearly to their partner, no matter how they try. 

Getting Autistic Partners 

The autistic partner, on the other hand, is seen as aloof, disinterested, even intentionally cruel. A common misconception, and one that makes me seethe inside, is that autistic persons lack empathy. Pushing an autistic partner to express their thoughts or feelings in session can intensify the baseline anxiety already present in most autistic individuals. The experience is overwhelmingly unpleasant. 

Getting the Neurodiverse Couple’s Sexual Relationship 

A couple’s challenges in their sexual relationship are also frequently misunderstood. If the suggested antidotes to their problems don’t make sense to the autistic partner for reasons that make perfectly good sense to someone who understands autism, there is no follow-through. Use of porn, affairs, flirtation, alcohol use, struggles related to holding a job, and legal problems are all misattributed, and therefore suggested solutions by a well-meaning therapist most often do not align with the root issues. 

Finding Couples Therapy That Can Help 

The miracle is that so many couples do take a deep breath and are still willing to give counseling another chance.  

If you believe that either you or your partner might be autistic, and you are struggling to feel understood and supported by your therapist, please don’t give up. Instead, seek a specialist who understands the neurodiverse relationship and the implications for both partners. It truly is possible to feel embraced in a therapeutic relationship. 

The therapist directory here at GoodTherapy.org is a good place to start. You can search by location and clinical specialty. Many therapists work online now; thus, your choices regarding therapists are not so location-dependent. 

Find someone who can help you both understand what neurodiversity is and what it means, who can work as an interpreter between you and your partner, so that you understand yourself and your partner in ways that help you develop successful communication strategies. In this way, you can identify and explore the differences between you in good faith, with hope and compassion, and, in doing so, develop deeper connection and intimacy.  

Isn’t that why you sought therapy in the first place? 

GoodTherapy | Attachment Styles and Hope for Your Relationship

By Dr. Jocelyn Markowicz, PhD, Psychologist

Attachment Hope for Couples: How to Improve Your Security Odds

You walk into the room and lock eyes with the most gorgeous human being you have ever seen. This individual locks eyes with you as well. You begin talking and realize that the chemistry between you is intense. You plan a date. You have several great dates. You fall in love and begin to talk about spending the rest of your lives together. You have the wedding. You go on the honeymoon. You begin to live your day-to-day lives together. (Perhaps not quite in that order.) But then, as you settle into shared lives, you notice that something is changing. The arguments are more frequent. The emotions are not all positive. Why does your partner leave when there is conflict? Why does your partner walk away when you need soothing? Why are they sometimes exhaustingly clingy and other times too independent? John Bowlby and Mary Ainsworth offered an answer rooted in attachment styles to these questions. Several researchers after them offered solutions. I’d like to share them with you. 

The Evolution of a Relationship

It is important to acknowledge that it takes time for interpersonal patterns to emerge within a romantic relationship. A perception bias occurs when you first fall in love that naturally heightens your connection to your partner’s strengths and limits your awareness of their weaknesses. Thus, it is in day-to-day living that you develop more accurate perceptions of patterns that are problematic. 

Why You Relate the Way You Do

In the 1960s, John Bowlby asserted that we learn positive and negative ways of relating based on our parent-child experiences. Our ways of relating are designed to strengthen our bond with our attachment figures (parents/caregivers) growing up. They help us survive. An attachment behavioral system gradually emerges wherein we attempt to regulate our emotions and behaviors toward an attachment figure. To do this, Bowlby (1980) asserted that the attachment system essentially asks the following fundamental question: Is the attachment figure nearby, accessible, and attentive? According to Bowlby (1980), an individual who has experienced a secure attachment is likely to view attachment figures as available, responsive, and helpful. An insecurely attached individual would view attachment figures as inaccessible, untrustworthy, and unreliable.

Different Attachment Styles

Ainsworth expanded on Bowlby’s attachment behavioral system and introduced specific attachment styles that explain our attachment behaviors. She outlined three specific attachment styles: (1) secure attachment and two insecure attachment styles: (1) anxious-resistant, and (2) avoidant (Ainsworth, 1979). In adult romantic relationships, the insecurely attached adult who is anxious-resistant would be dependent on their partner and yet reject their soothing attempts. The insecurely attached adult who is avoidant would not seek emotional or physical comfort from their partner when experiencing emotional distress. 

Bowlby and Ainsworth helped us to understand that our way of relating to others is guided by our early attachment experiences, but do we indeed exhibit the same attachment behaviors in our adult romantic relationships?

Further Research into Attachment Styles 

Hazen and Shaver (1987) evaluated Bowlby’s theoretical premise that early attachment behaviors extend to adulthood and are relatively stable. They conducted research and found that adults also reported the three attachment categories that Ainsworth determined (secure, anxious-resistant, and avoidant). Their research identified that romantic relationships are attachment bonds and share similar attachment behaviors that characterize parent-child interactions. In essence, Bowlby and Ainsworth were right to suggest that we can look at our adult relationships and evaluate our partner’s attachment behaviors based on their childhood attachment experiences. 

Are People Stuck Forever in Patterns from Childhood? 

What happens if you partner with someone with an insecure attachment style? Can their attachment style become secure? 

Researchers had the same questions about whether or not early attachment behaviors could be changed in adulthood. Findings across several studies did indicate that while early attachment style is relatively stable (Kim, Baek, & Park, 2021), attachment behaviors can change (Tmej, AMA et al., 2020; Sims, 2000; Rimane, Steil, Renneberg, & Rosner’s, 2020; Overall, Simpson, & Struthers, 2013; Gazder & Stranton, 2010; Park, Johnson, MacDonald, & Impett, 2019). Therein lies the hope for the couple. So, back to the question, what happens if you partner with an insecurely attached individual? How can you increase your secure attachment odds in your relationship?

Distress in romantic relationships is the leading cause for adults to seek psychological services (Bradbury, 1998). There are specific interventions that increase attachment security or reduce the negative impact of insecure attachment behaviors in romantic relationships. The following interventions are supported by empirical examination.

Transference-Focused Therapy

Transference-focused therapy (TFT) is a therapeutic intervention that aims to reduce impulsivity, stabilize mood, and improve interpersonal and occupational functioning. The intervention is specifically designed for individuals who struggle with borderline personality disorder. Trauma can impact the internalized representations of personality. It is not uncommon for individuals to develop maladaptive personality traits in response to trauma. Trauma impacts attachment bonds. TFT is a great choice for an individual partner in a couple dyad who may also struggle with borderline personality. A recent study found that individuals who participated in TFT moved towards securely attached with some preoccupied behaviors away from insecurely attached with preoccupied behaviors (Tmej, AMA et al., 2020)

Emotionally Focused Therapy

Emotionally focused therapy (EFT) for couples focuses on reshaping distressed couples’ structured, repetitive interactions and the emotional responses that evoke partners and foster the development of a secure emotional bond (Jonson, 1996; Jonson, 1999). The EFT model assumes that the negative emotions and interactional cycles typical of distressed couples represent a struggle for secure attachment (Bowlby, 1969). Sims (2000) randomized 26 couples in which at least one partner had been rated as insecurely attached to EFT or a waitlist control group. Couples in the EFT treatment condition increased their attachment security (and decreased attachment-related avoidance) more than the control couples. 

Trauma-Focused Cognitive Processing Therapy

Trauma-focused cognitive processing therapy (CPT) focuses on changing the dysfunctional beliefs associated with trauma. Trauma during our early attachment years impacts our attachment functioning, thereby shaping how we related to others in romantic relationships. CPT offers hope for couples in that an insecurely attached partner, who has been the victim of trauma, can participate in this mode of treatment to improve functioning. In Rimane, Steil, Renneberg, and Rosner’s (2020) study, individuals who participated in CPT experienced reduced avoidance attachment (insecure) behaviors when assessed post-treatment.

Dyadic Regulation Processes

Dyadic regulation processing occurs in couples therapy and is designed to improve attachment-relevant dyadic interactions between them. Applying the Dyadic Regulation Processing Model, researchers evaluated how partners can buffer the impact of their partner’s anxious resistant or avoidant behaviors due to their insecure attachments. Overall, Simpson and Struthers (2013) videotaped romantic couples discussing relationship problems identified by one partner who wanted changes in the other partner. Results indicated that insecurely attached partners whose partners displayed more softening exhibited less anger and withdrawal, and their discussions were more successful. These partners buffered their insecurely attached partner’s responses by learning to be sensitive to their autonomy needs, validating their viewpoint, and acknowledging their constructive efforts and good qualities.

Partner Relationship Mindfulness

General mindfulness is defined as the awareness of what is happening in the moment. In their study, Gazder and Stranton (2010) defined relationship mindfulness (RM) as open or receptive attention to and awareness of what is taking place internally and externally in a current relationship. They found that an individual’s own daily relationship mindfulness did not buffer the effects of their own insecure attachment on same-day relationship behaviors, but their partner’s daily relationship mindfulness did. In essence, you can buffer the impact of your partner’s insecure attachment behaviors by increasing your own relationship mindfulness. Therapy is a great place to learn how to practice relationship mindfulness techniques.

Partner with Someone with a Secure Attachment Style

As outlined, various treatment interventions can move an individual and couple towards more secure attachment relating. At this point, you may be thinking that hope is only achieved within a therapeutic setting. I have good news for you. If you are a securely attached individual, you play an important role in your relationship with an insecurely attached partner. Experiencing secure behaviors within romantic relationships can reduce representations of insecure attachment style (Park, Johnson, MacDonald, & Impett, 2019). How romantic! Your secure attachment behaviors can provide a secure base for your insecurely attached partner to grow. In the context of your relationship, you and your partner will experience many life events together. In their most recent study, Fraley, Gillath, and Deboek (2020) found that life events could change attachment style presentations in adulthood, with some changes yielding an enduring pattern.  

What Lies within Our Power?

We cannot go back to our childhood and choose caregivers that would prevent us from developing an insecure attachment style. We, therefore, cannot prevent the impact of any dysfunctional early childhood attachment experiences on who we are, interpersonally, as adults. However, there is hope. We can increase our secure attachment odds by choosing partners who are securely attached. We can participate in couples therapy interventions. We can also offer a secure attachment base for our insecurely attached partner. Attachment styles do not equate to fixed potential in your relationship – there is always room for growth. 

If you’re ready to explore how therapy can help you and your relationship, click through to find a couples therapist near you.

References

Ainsworth, M. D. S. (1979). Attachment as related to mother-infant interaction. In Advances in the study of behavior (Vol. 9, pp. 1-51). Academic Press.

Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. New York: Basic Books.

Bowlby, J. (1980). Loss: Sadness & depression. Attachment and Loss (vol. 3); (International psycho-analytical library no.109). London: Hogarth Press.

Bradbury, T. N. (1998). The developmental course of marital dysfunction. New York: Cambridge University Press.

Gazder, T. & Stanton, S. C.E (2020). Partners’ Relationship Mindfulness Promotes Better Daily Relationship Behaviors for Insecurely Attached Individuals. Int J Environ Res Public Health. 5;17(19):7267.

Hazen, C., & Shaver, P.R. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511-524.

Johnson, S. (1996). The practice of emotionally focused marital therapy: Creating connection. New York. Brunner/Mazel.

Johnson, S. (1999). Emotionally focused couples therapy: Straight to the heart. 

In J. Donovan (Ed.), Short term couple therapy (pp. 14-42). New York Guilford Press.

Fraley, R.C., Gillath, O. & Deboeck,P.R.(2020, August13).Do Life Events Lead to Changes in Adult Attachment Styles? A Naturalistic Longitudinal Investigation. Journal of Personality and Social Psychology. 

Kim, S.‐H., Baek, M., & Park, S. (2021). Association of parent–child experiences with insecure attachment in adulthood: A systematic review and meta‐analysis. Journal of Family Theory & Review.

Overall, N.C., & Simpson J. A.( 2013) Regulation processes in close relationships. In: Simpson JA, Campbell L, editors. The Oxford handbook of close relationships. New York: Oxford University Press; 2013. pp. 427–451.

Park, Y., Johnson, M. D., MacDonald, G., & Impett, E. A. (2019). Perceiving gratitude from a romantic partner predicts decreases in attachment anxiety. Developmental Psychology, 55(12), 2692–2700.

Rimane, E., Steil, R., Renneberg, B. & Rosner, R. (2020). Get secure soon: attachment in abused adolescents and young adults before and after trauma-focused cognitive processing therapy. European Child and Adolescent Psychiatry.

Sims A. Unpublished doctoral dissertation. University of Ottawa; Canada: 2000. Working models of attachment: The impact of emotionally focused marital therapy.

Tmej, A., Fischer-Kern, M., Doering, S., Hörz-Sagstetter, S., Rentrop, M., & Buchheim, A. (2021). Borderline patients before and after one year of transference-focused psychotherapy (TFP): A detailed analysis of change of attachment representations. Psychoanalytic Psychology, 38(1), 12–21.

Couple doing online therapy on their couch.Romantic relationships demand a lot: each partner must find a way to support and nurture the other’s needs while identifying and asserting their own needs.

When one person in a couple experiences stress, that stress can affect their partner and the relationship. Factor in kids, jobs, and financial entanglement, and it’s easy to see why so many people struggle in their relationships.

There’s no right way to be part of a couple. No matter what challenges your relationship faces, therapy can help you identify your needs. In couples counseling, you’ll work with your therapist to manage relationship challenges and address your needs in a way that’s consistent with your values.

Sometimes face-to-face therapy is not available or easy to access. Online couples therapy offers similar benefits to in-person therapy, with the added convenience and privacy of getting support at home. Here’s what you can expect from online counseling.

What is Online Couples Counseling?

Online couples counseling offers the same benefits of in-person counseling, but over the internet. You’ll use a secure platform to talk with your therapist—by video, in most cases. Couples usually meet with their therapist together, from the same location. However, online counseling can also be a good option for couples who live apart, or who are separated by military deployment, long-term hospitalization, or other barriers.

People who choose online therapy report similar levels of satisfaction with their treatment to those who choose in-person counseling.People who choose online therapy report similar levels of satisfaction with their treatment to those who choose in-person counseling. For some couples, online therapy may even mean the difference between accessing therapy to heal the relationship and getting no help at all.

Telemental health may be especially beneficial for:

Does Online Couples Therapy Work?

Romantic relationships are a source of love and comfort. Many people rely on their partners to fill the role of best friend, mentor, financial partner, and co-parent. So when a relationship is struggling, many people feel as if their entire world has been upended. It’s easy to feel hopeless about couples therapy, especially if you feel like you’ve tried everything. But the research shows that couples therapy works. According to a 2015 analysis, couples therapy is most effective when therapists identify the goals of couples therapy; use standardized tools to assess progress; and systematically monitor both the progress of therapy and the quality of the therapeutic alliance.

Online therapy follows a similar model to traditional counseling. In fact, therapists can do nearly everything online that they can in person. It may take a little more time to get comfortable with one another, especially when there are technical difficulties. Quality online therapy on a good platform works well, and even allows the therapist to read subtle cues such as tone of voice and body language.

When to Avoid Online Couples Therapy

Online couples therapy is not for everyone. When there is domestic violence, most experts advise that the couple avoid joint therapy. That’s because therapy treats the partners as equals, each of whom has valid concerns. When there is violence, the partners do not contribute equally to the problems in the marriage, and the abusive partner may even use therapy to justify their violence. Moreover, traditional couples therapy aims to keep the couple together, and some therapists may even ask the couples to commit to a certain number of therapy sessions. This may cause a victim to remain in an abusive relationship longer, potentially endangering their life. The online context may make it easier to conceal abuse, intensifying the risk.

Some other signs online therapy may not be a good fit include:

Questions to Ask About Online Relationship Counseling

When searching for a couples therapist, it’s important to find someone who can offer specific details about their treatment philosophy. You can ask potential counselors the questions such as the following to see if they are a good fit for you:

What to Expect from Online Relationship Therapy

Most online counseling uses video so that you can talk, read one another’s body language, and create an experience similar to traditional counseling. During the first few sessions, you will work with your therapist to identify treatment goals, share the history of the relationship, and cultivate a sense of trust.

As therapy progresses, you’ll each talk about your issues in the relationship, then work to identify strategies to manage these issues. Your therapist may give you homework, ask you to notice specific feelings or behaviors in between therapy sessions, or encourage you to come to therapy prepared to talk about a recent dispute. In some cases, the therapist may recommend individual counseling to deal with issues such as depression, trauma, and anxiety.

Your therapist should gently challenge each of you. If therapy is going well, you’ll be encouraged to confront unhealthy thoughts and feelings. Your therapist should also validate your emotions, and should not take sides—though they might offer insight on various conflicts, or help you identify unreasonable expectations. You should feel comfortable giving your therapist feedback, and the therapist should regularly assess and revisit treatment goals.

Finding the right therapist is key to seeing improvements in your relationship. A good therapist listens to your goals, helps you identify practical solutions, and helps both partners feel safe. Begin your search for a licensed therapist here.

Are you a therapist? Join GoodTherapy’s community today! We offer a secure telehealth platform for therapists powered by iSalus. Members also get access to our wide range of continuing education webinars and are listed in our popular online therapist directory. 

References:

  1. Halford, W. K., Pepping, C. A., & Petch, J. (2015). The gap between couple therapy research efficacy and practice effectiveness. Journal of Marital and Family Therapy, 42(1), 32–44. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12120
  2. Huffine, C. (1999). 12 reasons why couples counseling is not recommended when domestic violence is present. [PDF]. Retrieved from https://www.dhs.state.or.us/caf/dv/desktools/couples_counseling_12_reaso.pdf
  3. Rickwood, D., Wallace, A., Kennedy, V., O’Sullivan, S., Telford, N., & Leicester, S. (2019). Young people’s satisfaction with the online mental health service eheadspace: development and implementation of a service satisfaction measure. JMIR Mental Health, 6(4). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492057/

Therapist working with neurotypical partner in therapyEditor’s note: Sarah Swenson, LMHC is a private practice psychotherapist in Seattle, Washington, where she specializes in working with neurodiverse couples. Her continuing education presentation for GoodTherapy, titled “When Your Partner is on the Autism Spectrum: Individual Therapy for the Neurotypical Partner,” will take place on February 21, 2020 and is eligible for two CE credits. This event is available at no additional cost to Premium and Pro GoodTherapy Members (Basic Members and mental health professionals without membership can view this event live for $29.95). Learn more and register here.

Author’s note: Sometimes, of course, the neurotypical partner in a neurodiverse relationship is a man. I also work with gay and lesbian couples, and couples who are polyamorous. This article describes the client I encounter most frequently, a neurotypical woman married to an autistic man. Also, please bear in mind this guiding principle: If you’ve met one autistic person, you’ve met one autistic person. Nothing in this article will apply to everyone.

In my clinical practice as a therapist and in my international work as a coach, my clients are neurodiverse couples in which one partner is autistic and the other is not. As a result, I have come to know well one of the most misdiagnosed clients you will likely encounter. I’m speaking of a woman married to an autistic man who may or may not be formally diagnosed with autism (ASD).

When this woman comes in for individual counseling, she may have a flat affect. Her presenting concerns might sound vague, including hints of depression or anxiety. She may be self-effacing and ready to blame herself. She may stop and start, not seeming to know how to explain herself. She may appear embarrassed to be taking up your time.

Or she may seem full of rage. Her language might sound pressured, disorganized. She may be close to tears. She is the victim here, and she is furious.

Or she may simply present as hopeless.

I am not describing three separate women. You are likely to see all of this in the same woman in one session. Would you know how to understand her and offer her the support she needs?

She will not fully understand that over time, she has learned to minimize her needs and desires because conflict avoidance has become her chief survival strategy.

Meeting the Neurotypical Partner in Therapy

Most often, these clients are experiencing complex trauma (C-PTSD). They won’t be able to identify a specific traumatic injury because they are in a relationship that inadvertently creates the conditions of ongoing trauma. And since in this relationship there in no intention to harm, no intention to abuse, she is confused. She loves–or did love–her husband. She will tell you he is a good man.

She will not fully understand that over time, she has learned to minimize her needs and desires because conflict avoidance has become her chief survival strategy. She will tell you that she has changed. She will tell you she is not the woman she used to be. She feels less joy in life. She has let friendships fall away. She can’t muster interest in the things that used to give her pleasure. When asked, she is unlikely to be able to express her needs. She can’t remember what she needs. She knows this, however: she feels alone. And she may fear she’s losing her mind.

You’ve read her intake paperwork, so you will know that her husband is successful in his career, which may be in a highly competitive and well-respected field. When you talk to her, you’ll hear about his high intelligence and how well-regarded he is at work. As you get to know her better, she will tell you that everyone thinks that the two of them have the perfect marriage because that’s what it looks like from the outside. She realizes all marriages have problems. Her well-meaning friends certainly share enough of their stories that she feels a little guilty when inside she’s thinking, “Yes, but you don’t understand what it’s like for me…it’s different…I can’t explain it…”

She may sound petulant, self-involved, or impossible to please, due to the fact that she can express her pain but can’t put her finger on exactly what the problem is. She knows it has something to do with her husband and the way he treats her. Yet she has painted a picture of him that impresses you. You may think she is exhibiting narcissism as a result.

Another possibility is that he is a good man, but for some reason, he cannot seem to keep a job. He’s intelligent. He’s talented. But the financial strain of his chronic unemployment has pushed her to the brink. She is the sole earner. She manages the household. She supervises and provides for the children. She hides this internal familial dysfunction from her friends and her family. She has no one else to rely on. She is embarrassed. She is utterly exhausted. She can’t see a way out of her distress and she fears it may kill her. You may diagnose depression.

Sometimes, from session to session, you’ll see her condemn her husband and the way he cannot seem to do anything right, from loading the dishwasher (“I even made a little diagram and taped it to the counter!”) to listening to her when she’s upset (“He always wants to fix everything and doesn’t even notice I’m crying!”). Next session, she will be filled with compassion for him because he honestly seems to be doing the best he can. She’s just expecting perfection from him. He’s human. (“Why do I always have to be like this? Why can’t I just let him be himself?”) You may wonder if you’re seeing borderline personality.

And when she paints a complex picture of her experience with him that screams “Run for your life!” you may wonder why she can’t decide to leave. You consider codependency.

This is the woman married to an autistic man before she understands that he is autistic and before she understands what autism means in a relationship. I agree with you that it is difficult to identify her based on the information described above. Here are some important things to consider that may help you sort this all out.

Signs You’re Working with the Neurotypical Partner in a Neurodiverse Relationship

The primary area of conflict for many neurodiverse couples can be broken into two components: emotional connection and communication. Many of the women I work with identify the courtship phase of their relationship as short, comfortable, and consistent. More often than not, however, they can look back and identify what they call red flags: his quirky manners, his deeply focused conversations on things he’s interested in and silence when he’s not, his apparent discomfort at expressing emotion. At the time, they interpreted these things to be endearing eccentricity, intelligence and skill, and admirable reticence–the stiff upper lip.

For reasons of misinterpretation like this, they went forward to the commitment of marriage. Only with time did the veil slip away, and they realized they were habitually filling in with projections about what their partner’s behaviors and comments meant on the basis of what they would mean if they did these things themselves. In other words, they applied neurotypical standards and expectations to the behavior of an autistic individual. Slowly but surely, their sense of who their husband actually is erodes until they often become quite uncertain about who he actually is.

The primary area of conflict for many neurodiverse couples can be broken into two components: emotional connection and communication.

Over the course of the marriage, this woman will feel minimized and criticized. She will express her husband’s constant negativity and say that she’s begun to feel negative about everything, too. Her descriptions of their sex life will be particularly illuminating.

Generally, by the time these women come to therapy, their sex lives are completely ruptured. They have to think when you ask them about it. They’ll tell you they don’t remember precisely when or how, but at some point, things just stopped. For some, it has been months, but for most it’s been a matter of years. And, frankly, when their sex lives were more active, it wasn’t all that rewarding: it felt mechanical, always the same, with no foreplay and no sense of intimacy.

She doesn’t miss the specifics of sexual encounters with her husband, but she craves sexual intimacy. She craves intimacy, period. She wonders whether she should have an affair, though she doesn’t really want to go outside her marriage to have her needs met. She’ll just stifle them for a while, hoping they subside. Instead, she worries that they will continue to grow. She may not be able to look you in the eye at this point. She is desperate not to be viewed as promiscuous, and she fears you will judge her.

There are exceptions. Sometimes, a woman will tell you she feels like a sex doll to her husband’s routine and frequent sexual demands. She continues to participate. She hates herself for her inability to stand up for herself, but she has tried, and it just seems pointless. She continues to acquiesce. She is becoming numb to her own sexuality, to any physical sensations at all. She cannot afford to feel aroused because she knows she will be disappointed once again.

As you know, diminished sexual intimacy in a relationship is usually a sign of severed communication. In the neurodiverse relationship, this is most often the case. The woman needs emotional connection before she can feel sexually vulnerable. She is unlikely to feel this with her autistic husband. I often hear from these women that they don’t feel safe enough emotionally to present themselves sexually to their husbands. She does not feel seen or heard or known by her husband, whose sexual needs are often more physiological than emotional. He doesn’t understand her withdrawal any more than she understands the way he treats her.

Work with Neurodiverse Couples: Moving Forward

If you see enough of these signs in your client, I suggest asking whether she has considered that her husband might be autistic. In order to do this well, you’ll have to be certain she understands what you mean and why you’re asking. If she has not thought of this possibility herself, you’ll need to explain to her that autism is a result of neurological variance and not mental illness or personality disorder. You don’t want her to reject your suggestion on the basis of having misunderstood you.

Many times, though, women come in for counseling after having read articles of mine or other material on the internet and already suspect autism (some still call it Asperger’s) in their husbands. They want to know what to do. In this case, we discuss all the points mentioned above in terms of what it would mean if their husband were in fact autistic. I do not ever volunteer a diagnosis of autism without having met someone, but we do reality testing to rule it in or out as a differential. Then I suggest couple work. I help her with language for bringing this up to her husband, which is a sensitive task in itself.

Sometimes, after several sessions, we schedule a couple session, if the husband is willing to explore the possibility. It is often a watershed moment in a couple’s life to learn that there are reasons that explain their problems and that we can work together on psychoeducation and on communication strategies and skills that offer a path toward improved intimacy. The relationship will never be neurotypical or autistic, but it can become more rewarding for both partners.

Sometimes, the husband is unwilling to consider autism and will not come in for a couple session. He fears being judged. Labeled. Vilified. She cannot get through to him that this is a supportive process. He locks into his fears and there is nothing more to be done. In this case, I continue to work with the woman alone to help her understand her choices. They are not always binary. There are more options than staying married or getting divorced. We explore them all.

It is important never to minimize the experience and challenges faced by the autistic partner.

It is important never to minimize the experience and challenges faced by the autistic partner. This work is about identifying differences and creating more successful ways to communicate. There are good reasons why the autistic partner behaves the way he does and says the things he says. I have never met an autistic person who sets out intentionally to hurt his wife, and seldom have I encountered an autistic person who lies. Misrepresenting something has its own rational pathway for an autistic person, and I distinguish this from intentional lying. This is an example of the kind of subject we explore in couple sessions. Sometimes, the intense anger of the neurotypical partner can be diffused with education and compassion. Sometimes, the weight of this anger and feeling responsible for the relationship is too much for her.

If you have any suspicion about autism in a client’s partner, please tread carefully to explore the possibility. But do take the chance: otherwise, you could be missing the core challenge your neurotypical client is facing, which is the hub from which all her other apparently confusing behaviors emanate. The challenges to communication in the neurodiverse relationship are not insurmountable, but to ameliorate them requires sensitive counseling support. Educating yourself on the nature of autism, how it creates the lens through which a person experiences and interacts with reality, and how to help a couple bring implicit expectations to explicit and comprehensible statements are essential in this work. For initial solid grounding in the field of autism, I refer therapists to the work of Tony Atwood, PhD, and Simon Baron-Cohen, PhD.

Woman sitting in the driver's seat of her car, crying

Loneliness can be one of the most painful experiences in a relationship—especially when the relationship is neurodiverse. If you love your partner but still feel unseen, unheard, or emotionally distant, you are not alone. Many couples face this challenge, and understanding its roots can be the first step toward healing.

While loneliness can occur in any partnership, the dynamics in neurodiverse relationships bring unique emotional and communication challenges that deserve special attention.

Understanding Loneliness in Neurodiverse Partnerships

Many people experience occasional loneliness in relationships, but the loneliness in a neurodiverse partnership often has unique characteristics. Friends may reassure you by saying “that’s life” or “marriage is hard,” but these responses can dismiss what makes your situation different.

A person in this situation may feel guilty or wonder if they are making too much of the problem. They might try to convince themselves that things are fine—until the longing for emotional connection grows too strong to ignore.

How Autism Can Impact Emotional Connection

For some in neurodiverse relationships, deep loneliness becomes a constant presence, not just an occasional feeling. It may wax and wane, but it’s always there—woven into daily life, much like a wedding ring on your hand.

Autistic and neurotypical partners can both feel lonely, but for different reasons. A neurotypical partner may crave affective empathy—emotional attunement and validation—while an autistic partner may respond with cognitive empathy, offering solutions rather than emotional comfort. Neither is wrong, but the mismatch can create feelings of being unseen or unsupported.

Over time, these differences can lead to frustration, hurt, or even withdrawal from the relationship. In some cases, both partners feel equally isolated. 

Common Causes of Loneliness for Both Partners

Strategies for Bridging the Understanding Gap

One of the most effective tools for working with neurodiverse couples is psychoeducation (learn more). This involves exploring both the autistic and neurotypical experiences—not to label one as “better” but to understand similarities and differences.

From there, couples can:

When to Seek Professional Support

If loneliness is leading to ongoing resentment, emotional withdrawal, or repeated conflict, it may be time to seek outside help. A therapist experienced in neurodiverse relationships can help partners:

You can find a qualified therapist who understands both autism and relationship challenges.

Questions to Ask Your Therapist

The Path Forward

Every relationship faces challenges, but in a neurodiverse partnership, understanding and acceptance are the keys to a deeper connection. A neurodiverse relationship will never be entirely neurotypical or autistic—it will always be uniquely yours. By learning to navigate your differences, you can deepen your connection and create a partnership that honors both individuals.

You don’t have to navigate this alone—working with a therapist experienced in neurodiverse relationships can help you and your partner build mutual understanding and emotional closeness. Find a qualified therapist on GoodTherapy today and take the next step toward a stronger, more connected partnership.

GoodTherapy | How to Talk About Relationship Problems with Your PartnerSomething touched off hard feelings between you and your partner. Maybe it was a simple mistake. Your loved one forgot to pick up the milk on the way home. Or maybe you wanted some sympathy after a bad day at work, only to hear your partner criticize you. Ouch.

Now you’re upset. You may wonder if your partner really understands or cares about you.

How do you fix a relationship problem? Many people dread conflict so much they say nothing. They hope the bad feelings will just go away.

How to Bring Up a Relationship Problem

You need to know how to talk about a relationship problem. The important thing is to learn how to allow the emotions involved.

Because avoiding emotional pain in your relationship works against you.

Hard feelings between you don’t go away on their own. You need to see them and soothe them as a couple, so they resolve. That’s one major function of a healthy relationship.

I worked with a couple I’ll call Bob and Amy. Amy wanted to keep just those things around the house they needed and used now. Bob preferred having stuff like extra boxes, umbrellas, and materials for projects. Bob tended not to tidy up unless pressed. And when Amy has pressed Bob, they had terrible fights.

Now Amy doesn’t feel free to speak up about the “clutter” issue, though it still bothers her. Meanwhile, Bob throws away more than he wants to, and resents it. And he worries Amy will never be satisfied, no matter how little he keeps or how neat he tries to be.

Do you see the trouble? On the surface, the disconnect is about stuff in the house. But as a therapist trained in emotionally focused therapy (EFT), my job is to help Bob and Amy see the unspoken thoughts and emotions at work. What’s under the anger and resentment? What do those thoughts mean to their sense of attachment as a couple?

Learning to See What Hurts

In therapy, Amy admitted feeling Bob’s stuff was more important than her peace of mind. She felt dismissed and hurt. She needed Bob to hear that his desire for “stuff” seemed to come first, and it made her feel unwanted. After Amy expressed her hurt in a vulnerable way, you could feel their tension soften.

Then Bob said he worried that even if he threw everything away, she’d still find fault with him. He felt rejected. Bob needed Amy to hear that her demand for “order” left him no room to be himself.

Before they can solve their lifestyle problem, the bigger problem needs tending: the underlying panic that neither of them saw or cared about each other. They took time to tend the hurts and put stress relief first.

After Bob and Amy connected emotionally, they could affirm their support for each other. They quickly found the energy to be co-creative. They agreed on “clean” zones for Amy and built a “man-shed” for Bob. But more important, they learned how to take each other’s distress to heart, find the source, and assure each other they matter.

Sometimes, tensions arose again. But now they could talk over what was happening without getting locked into battle or withdrawal.

Relationship Stress Needs a Response

Unsolved relationship issues trigger deeper worries about how safe and secure partners feel together. It’s hard to feel close when you’re worried. That’s why distress with a loved one needs to be resolved.

Deep down, relationship hurts trigger bigger questions: Do I matter to you? Are we okay?

Doubts about a connection can make a person feel threatened or in danger. That’s because we naturally seek safety in relationships. Deep down, relationship hurts trigger bigger questions: Do I matter to you? Are we okay?

If we’re not sure how to say “I care” to each other, it’s easier to get angry and strike out against what seems wrong.

When we speak out of anger, we’re headed for trouble. There’s actually nothing wrong with saying something is bothering you. But the key to fixing your relationship is to talk about what you need—not your partner’s faults.

What else can couples do besides struggle in silence?

Good (and Bad) Ways to Tell Your Partner Something Is Wrong

Let’s look at some of the damaging ways some people bring up relationship issues. Compare these to some healthier ways to fix a problem instead:

Don’t glare: Don’t glower, grumble, or go silent to get a reaction. It doesn’t help your loved one understand. More likely, angry looks will make your partner defensive.

Do be clear: Do tell your loved one that you are upset. Say what you are upset about without blame. “I didn’t like the way you spoke to me when you came home.”

Don’t assume: Don’t expect your partner knows how you feel or can figure out what you want to happen.

Do explain: Tell your partner what hurts you. Be clear about what you want and need.

Don’t get personal: Avoid put-downs or name-calling. Words such as “selfish,” “clueless,” or nasty names usually make problems worse.

Do speak from experience: Focus on what happened for you. Clean anger deals with behavior rather than character.

Why Repair Works So Well to Fix Relationships

Repair is one of the most powerful things you can do to build a stronger relationship.

You don’t need to be perfect for each other to be happy together. You can do a lot to restore goodwill by repairing hurts.

What separates many successful couples from less happy ones is the ability to make repairs. It allows you to keep getting better at responding to each other’s needs over time.

Repair is any gesture—a phrase, apology, hug, a friendly glance—that eases the negativity between you.

A lot depends on whether, beneath it all, you see each other as friends. Even if the repair attempt is awkward or clumsy, faith in your friendship will tips the scales toward healing after conflict.

Your kindness—and your partner’s ability to accept it—makes you both part of the solution instead of the problem for each other.

Emotional Connection: One of the Most Important Jobs in the World

It’s hard to admit we need each other. No one wants to invite ridicule or rejection by showing a tender need for love and acceptance. Yet it’s more terrible to feel cut off and alone.

“Do I matter to you?” That’s the question we need to hear “yes” to, especially when one of you is hurt.

Gently explaining your hurt is the first step to deepening your understanding together. Being able to hear when your partner is hurt is just as important to make things better.

This is much easier said than done. It’s tempting to avoid painful feelings rather than talk through relationship issues. That’s why a good therapist can be a powerful help to find a repair process that works for you.

Talking to your partner when you’re upset is a great chance to connect. You can learn to get your message through in a way that works with your need to connect, not against it.

Cropped view of couple in the park looking in different directions, one out of focus“Is couples therapy actually going to work?”

As a couples therapist, I hear this question a lot. And it’s a valid question. When couples come to therapy, they are usually in pain and in search of relief. If I had a painful illness and the doctor prescribed treatment, my first question would be, “Is this going to work?”

When I was introduced to emotionally focused couples therapy (EFT), I was relieved to learn of this established method, with a science behind helping couples. And it works. Research shows that EFT helps 70% of couples recover from marital distress. Ninety percent of couples report significant improvements. If I were sitting in a doctor’s office with an illness and was told treatment had a 90% success rate, I would feel relieved.

But despite the success rate of the approach, it is still normal to have some reservations about couples therapy. Before you knock it, though, I recommend learning more about the process. As a marriage counselor, these are some of my thoughts about three of the common reasons people are resistant to couples therapy.

1. People can’t change.

We are who we are, right? In couples therapy, I’m not seeking to change anyone. I’m not trying to help anyone change their personality or their partner. I’m seeking to change the dynamics of the relationship. An EFT therapist helps couples understand and meet each other’s needs in effective ways.

These needs, which EFT therapists call attachment needs, already exist in each person. We aren’t changing a person to create these needs, since they are already a part of each partner. But often these needs go unacknowledged. In other cases, partners attempt to get their needs met in ways that prove ineffective. In EFT therapy, therapists simply help each partner access their emotions and needs in a way that helps them bond. In other words, we are pulling out emotions and needs that already exist but are often covered up with reactivity. We are helping decode this reactivity in order to understand the feelings and needs underneath. By doing this, we can help both partners engage with each other in ways that help them both feel close and connected.

2. My partner won’t do the work.

EFT is not about going home and doing “homework.” In fact, change occurs in the session. Experts have studied the process of change and determined the specific change needed for events to occur. An EFT couples therapist knows these change events and can guide the sessions to help create them. These events help change the way partners view each other and the relationship, which can bring about organic change in the relationship.

In EFT therapy, therapists simply help each partner access their emotions and needs in a way that helps them bond. In other words, we are pulling out emotions and needs that already exist but are often covered up with reactivity. We are helping decode this reactivity in order to understand the feelings and needs underneath.

When these change events occur, couples can shift from feeling distant and disconnected to feeling safe, secure, and connected. When couples feel more connected, reactivity can naturally change and soften outside of the session. This doesn’t mean you shouldn’t go home and try new things, such as planning more date nights or learning new communication tools. It just means the success of therapy doesn’t depend on doing “homework.” In EFT couples therapy, doing the work simply means showing up to the session and engaging in the process.

3. There is too much hurt.

Couples who seek out therapy have often engaged in a series of hurtful behaviors. One or both partners may have felt hurt by the actions of the other. Sometimes, this pain can feel overwhelming. Couples may have engaged in such a negative cycle that they have been unsuccessful in repairing these hurts on their own. The hurt has happened, and the unsuccessful attempts to resolve the hurt often only exacerbate the pain.

EFT therapists work to help couples dismantle their negative cycle so hurts can finally be felt, shared, heard, and healed. Most importantly, the way EFT therapists guide the conversations in therapy allows the emotions from these hurts to be shared in a way that bonds and connects couples. So yes, hurts can actually help bond a couple—when they are dealt with properly.

How Does Change Occur in Couples Therapy?

Jill and Paul came into therapy after years of feeling disconnected. During sessions, Jill described to the couples therapist their nightly routine: Paul retreated to his home office after dinner, while she would watch TV alone in her bedroom. Jill explained that despite her getting upset and angry at Paul for how much he worked, the pattern of loneliness continued. “He doesn’t care about how I feel. He only cares about his work,” Jill concluded.

The therapist helped Paul and Jill unpack the dynamics that led to these familiar lonely nights. The therapist helped Jill shift out of her anger and talk about her sadness regarding their distance. From there, Jill was able to express her desire to feel close and connected to Paul. Jill shared, with sadness, her belief that Paul hid away in his office at night because he wanted to get away from her.

With the therapist’s help, Paul was able to talk about his experience. He shared how through the years, Jill’s angry comments made him feel rejected. As their cycle repeated over and over again, he came to the conclusion that he wasn’t able to give her what she needed. He also explained his feeling that anything he says when Jill is upset only makes things worse. He shared how he wished he knew what could make her happy and that he has started to worry that maybe he doesn’t make her happy anymore. So instead of doing or saying something that may make the situation worse, he goes into his office at night.

Paul’s explanation helped Jill see that Paul pulled away from her not because he didn’t care, but rather, because he cared so much about protecting their relationship that he didn’t want to make things worse.

Many change events that occurred in therapy ultimately helped Jill and Paul get out of their negative cycle and create a way to communicate their needs more clearly and feel more connected to each other.

Paul and Jill still found find themselves back in their familiar negative cycle at times. But as a result of the pivotal change events they experienced in therapy, they could more quickly identify the disconnecting cycle between them and find their way out.

When Does Couples Therapy Not Work?

With all of this said, there are some factors that can inhibit therapy success. I like to be realistic with couples about the prognosis of their relationship. If any of the following factors are present, success is less likely.

References:

  1. Johnson, S. (2004). The practice of emotionally focused couples therapy: Creating connection (2nd ed.). New York, NY: Brunner-Routledge.
  2. Johnson, S. (2008). Hold me tight: Seven conversations for a lifetime of love. New York, NY: Little, Brown, and Company.

Adult couple sit at window table in cafe, facing each other and talkingRelationships can be a lot of fun, but they may also be challenging and require work at times. When we meet someone and fall in love, we tend to see only their endearing qualities. After the honeymoon phase is over, some of the things that may have drawn us to them may begin to irritate us instead. We may find ourselves venturing outside our relationship to get certain needs met.

Maintaining and growing a relationship is not easy. We need to continually invest time and energy to keep it going strong. Finding new ways to nurture the relationship or get it back on track can be difficult on our own. We can get stuck in unhelpful patterns or simply not know the best way forward.

Here are some ways couples counseling can help:

[fat_widget_right]

  1. Understanding your partner better. We all have different styles of interacting with others, and yours may differ from your partner’s. If you are operating on different wavelengths, getting your needs met in the relationship may be challenging. A counselor can work with you to recognize and overcome natural differences. Learning about how your partner engages with the world (and why they engage the way they do) can help you develop empathy for them. Empathy is key to relationship success.
  2. Improving your communication skills. One of the common misconceptions in relationships is when one partner believes the other should automatically know what they want or need from them. Learning to communicate openly and clearly in therapy about your emotional needs can help to enhance your connection.
  3. Discovering ways to have constructive (rather than destructive) arguments. There can be lasting damage when relationship conflict gets out of hand. If anger is not kept under control, it can lead to contempt, resentment, blaming, yelling, name-calling, even domestic violence in extreme cases. In counseling, you can become aware of more productive ways to listen to one another and be heard. Learning anger management skills, effective time-out techniques, and how to use I-statements to express feelings can lead to an increase in respect and satisfaction.
    In counseling, you can become aware of more productive ways to listen to one another and be heard.
  4. Addressing underlying issues that may be negatively impacting the relationship. If one person in the relationship has issues that are affecting their well-being, chances are their partner is experiencing tension and/or stress. Talking through these issues in couples counseling can be helpful. In some instances, the counselor may recommend individual therapy for one or both partners (with a different therapist).
  5. Finding new ways to connect and build intimacy. At times, relationships may become entrenched in routines and responsibilities. Couples with children may start to view one another only in their roles as parents, rather than as romantic partners. Others may begin to take things for granted and stop nurturing their relationship. A therapist can offer strategies for reconnecting on an emotional level and rekindling passion and intimacy.
  6. Rebuilding trust in the relationship. If there has been infidelity or betrayal but the couple is willing to work on the relationship, a counselor can help them to explore any underlying issues that may have led to the problem. Partners can safely express their fears and concerns, and they can work together with the nonjudgmental therapist to rebuild trust.
  7. Determining whether to stay in the relationship. Some challenges may simply be too daunting. Only you and your partner can decide that. If both partners are willing to work at it, a therapist will hold space for the promise of your relationship. If, however, one or both partners are determined to end the relationship, a counselor can help find an amicable way to handle the breakup or separation/divorce.

All relationships go through difficult times and can benefit from couples counseling. We all want to feel loved, appreciated, and understood by our partners. We all want to make a good thing better. If your relationship feels off course or could simply use some fine-tuning, give couples counseling a try.

Hikers help each other up mountain under setting sunAre you feeling hopeless about your relationship? Has your marriage devolved into a manipulative game of tit for tat? Or perhaps you’ve both withdrawn and haven’t had a meaningful exchange in years. In any case, if you’re reading this, you probably wish you could get back that lovin’ feeling.

You’re tired of marital frustration. You’ve suffered long enough. You could probably benefit from couples counseling.

Divorces sometimes happen when a couple hits a rough patch. Some are healthy, good, appropriate divorces. But many are unnecessary responses to temporary, treatable problems. Marriages go through different phases. If a couple splits too quickly or easily, they miss the growth opportunity that is built into conflict.

[fat_widget_right]

Marital distress can be excruciatingly painful. So can cranking up your old eHarmony subscription. And living separately from your children. And starting over with someone new only to find old patterns showing up.

An honest conversation is key to rebuilding your relationship. A qualified couples counselor can help you to have that conversation. You can maximize the benefits of therapy by being a wise consumer. Here are some suggestions:

  1. Search inside yourself first. Are you willing to do this work? Look at your motives. Do you want to make things better or do you want to check off the box that says, “We tried therapy and it didn’t work”? Make a conscious decision to be rigorously honest as you do the challenging work of relationship rebuilding.
  2. Tell your spouse that you want to work on your marriage. Show your own hand first. Share your vulnerability. Disclose your wish for your intimate connection to be stronger. Then ask your partner how they feel about the issue and if they are willing to participate in the therapy.
  3. Work collaboratively with your spouse regarding the selection of a therapist. I suggest you agree beforehand on a process of selecting a therapist. Do some research. Ask questions. One of you will make the phone calls, but it is important that you both agree that the person you work with is the right person. One “no” vote wins and you keep looking.
  4. Choose a well-trained couples therapy specialist with whom you both feel comfortable. Interview at least two or three. A competent couples therapist (1) is trained in specific interventions that will interrupt destructive patterns; (2) is directive, a strong leader who will intervene rather than watch you argue; and (3) won’t sugarcoat the truth, but will guide you to a new way of being relational.
  5. Be aware of the pitfalls of individual therapy for couples issues. When calling around, ask if the therapist is “marriage friendly” or if they are neutral about the institution. An individual therapist only hears one side; they need to understand the bigger picture of your relationship. Make sure your counselor’s biases line up with your own.
  6. Set limits with friends. In some situations, it is appropriate and necessary to work on boundaries with friends and family members. Ask them to support you in ways that are truly supportive. Tell them that you want to fight for your marriage. Teach them how they can help you at this difficult time. Tell them it’s not helpful to predict that your life will be better without your spouse. If you’ve badmouthed your spouse to friends and family, apologize to them for the inappropriate disclosures.
  7. Be honest. If you are certain you will end the relationship, tell your therapist. You will redefine successful therapy as ending the relationship well. Understand that if you are 99% sure that you wish to divorce, it is still valid to go to couples therapy. It is worth trying. Enter therapy with your heart soft and mind open.

There will be plenty of time to end things if divorce becomes inevitable. But as long as there is a tiny spark, you may be able to make your marriage healthy again.

Why should you fight for your marriage? Research shows happily married people are emotionally and physically healthier than their single counterparts. Married people are wealthier, less anxiety-prone, and less depressed. They have fewer suicides. Furthermore, people in a connected and cherishing partnership tend to have a stronger immune system, live longer, and have more sex. The mental and physical health benefits of being lovingly attached are well documented.

There will be plenty of time to end things if divorce becomes inevitable. But as long as there is a tiny spark, you may be able to make your marriage healthy again. If that’s difficult to imagine, give it a try. Find a therapist who can help you develop and hold a vision of how things could be. Remain open to the experience for at least 12 to 16 weeks.

[amazon_affiliate]

Think of it like this: Marriage is a little like climbing Mount Everest. You have to work hard for it. You have to prepare extensively for the experience of ascending the mountain. You’ll have trials throughout the endeavor. There will be legitimate reasons for some to end the climb before it’s over. But if you want to be among the finishers, you must find a way to stay with it even when it isn’t fun. If you want to stand triumphantly at the top, keep putting one foot in front of the other. Couples counseling might give you the courage to keep climbing.

Reference:

Waite, L., & Gallagher, M. (2000). The case for marriage: Why married people are happier, healthier, and better off financially. New York, NY: Broadway Books.

Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.