Tell Me About Couples Counseling

Tell Me About Couples Counseling

The joint effort of finding a couples therapist seems daunting at best. But if you want to work things out, or at least try, counseling may be your best shot. Here’s how to get the ball rolling, push through the more awkward parts of the process, and make sure you’re getting the help you need.

When is a good time to go?

Ideally, you want to find a therapist when you’re not in a real crisis. But that’s kind of like how you’re supposed to establish a relationship with a great doctor before you get sick. It’s nice in theory, but we’re all busy, and good physicians are hard to find and even harder to schedule. Most of us aren’t going to bother doing that legwork if there’s nothing urgently wrong.

But you should at least consider it. “I wish more couples reached out for therapy before they had a catastrophic problem,” says Kiran Arora, a family therapist and vice-president of diversity, equity, and inclusion at the Ackerman Institute for the Family in New York. “Couples counseling can be a great resource while you’re going through a specific life event. But it can also just be about strengthening some piece of your relationship, or providing ongoing support as you move through life together.”

In that sense, couples counseling can be preventative. You and your partner will be in a much better position to nip larger issues in the bud if you’re not at each other’s throats. And you won’t have the added pressure of finding a therapist in a hurry, which is important, because it’ll probably take some time to choose someone who clicks with you both.

How should you find a therapist?

This may be the hardest part. Prepare to dedicate time — a couple of weeks, or even months — and see at least a couple of different people. And before you even start, talk to your partner about what kind of vibe they’re looking for, and other factors that may be important to you both. What are your location and scheduling requirements? Do you have a gender preference, or want someone from a certain cultural background?

Meanwhile, ask around. “I recommend getting a referral, if you can,” says Debra Roberts, the author of The Relationship Protocol: How to Talk, Defuse and Build Healthier Relationships. “See if any of your friends know of anybody. You could also ask a trusted medical professional, like your OB/GYN or primary care physician. Or, if you’ve ever been in individual therapy, you could ask that therapist if they can recommend someone.”

You can also look on websites like Psychology Today, where most therapists pay to be listed (it also allows you narrow down your search based on location, specialty, gender, language, and types of insurance they take). Some cities have local associations of therapists online that you can poke around. Don’t be weirded out if a therapist doesn’t have a big web presence; many good ones get enough business by word of mouth and are busy enough without having to advertise or even create a personal website.

And finally, keep an open mind. “You might have a mental checklist for what you think the right therapist looks like, but allow yourself to be surprised,” says Roberts. “You don’t really know how it feels to be in the room with someone until you’re there, talking to them. Both of you must feel comfortable and respected. It has to click.”

What are the most common types of couples’ therapies?

Many counselors are trained in different types of therapy and will tailor your treatment based on your needs. But three most common and established approaches to couples counseling, specifically, are the Gottman Method, Emotionally Focused Therapy (or EFT), and Imago Relationship Therapy. Of course, there are many nuances within these schools of thought, as well as tons of other types of therapy — including hypnosis, certain types of sex therapy, and so forth — that might be helpful.

You may be familiar with the Gottman Method from Dr. John Gottman’s famous book, The 7 Principles of Making Marriage Work; the basic idea is that unresolved conflicts are a given norm, and couples must learn to manage them through positive communication rather than “criticism, contempt, defensiveness, and stonewalling” — also known as “the four horsemen” (of your relationship’s apocalypse, in Gottman’s context). Sessions have a pretty specific framework, which you can learn more about here.

EFT was popularized by psychologist Dr. Sue Johnson, author of Hold Me Tight, and focuses on the idea that couples must establish an “attachment bond” — a feeling of emotional safety with each other. An EFT therapist will focus on helping you map out your specific emotional needs and how your partner can meet them. As you might imagine, this type of therapy can be pretty open-ended and a bit less structured, which may be helpful for people who find other formulas too rigid.

Imago Relationship Therapy was developed by doctors Harville Hendrix and Helen LaKelly Hunt, who also happen to be married to each other. Their philosophy is outlined in the book Getting the Love You Want, and hinges on the idea that most people pursue “familiar” relationships — a romantic partner who reminds us in some way of our early caregivers, for better or for worse. To me, the most compelling component of Imago Therapy is Imago Dialogue, a script-like method of engaging your partner in conversation during conflict by repeating what they’re saying back to them in a way that makes them feel understood.

Before you visit any therapist, ask if they have a specialty and, if so, why they chose it. You should also feel free to ask for recommended reading about their preferred methods.

How else should you prepare for the first session?

Before you see any therapist, you should get on the phone and ask about their fee, their background, whether they take insurance (most don’t, although some insurance plans will reimburse you for therapy costs, or at least count it towards your deductible). While you’re at it, make sure they are licensed! Don’t expect a free “trial”; most therapists will ask for you both to come in and do a proper first session, which you will be expected to pay for. Couples therapy is usually a bit more expensive than individual therapy, often ranging from $90 to $250 and up, depending on where you live and how experienced the therapist is.

What if one of you isn’t sold on therapy to begin with?

Hopefully you’re both invested in therapy, but chances are, one of you is going to be more into it than the other. “When one person wants to go more than the other, it’s very important that they let their partner know how much they appreciate their willingness to go,” says Roberts. “They should also make it clear that it’s an opportunity for the partner to say what’s on their mind and express how they’re feeling — it’s not just a one-way street.”

As for drawing out the less-enthusiastic party — remember, a good counselor is trained to do that. “At a certain point, it’s on the therapist,” says Roberts. “Your goal is to get them in the door, and then we take over.”

How can you tell if a therapist isn’t working?

If one of you isn’t feeling comfortable with the direction therapy is going, don’t quit yet — talk to your therapist about it first. “A lot of people think that they’re going to hurt their therapist’s feelings if they say they’re uncomfortable in the room, or upset about something the therapist said,” says Arora. “But a good therapist should welcome that information, and not get defensive. That kind of communication can actually lead to very fruitful conversations.”

Of course, some therapists just aren’t going to be the right fit, and that’s okay too — that’s why you should shop around a bit before settling down with one person.

What kinds of results should you expect to see?

Even the very best therapist can’t save certain relationships. And sometimes couples come to therapy not even sure that they want their relationship to be saved. “All I ask of my clients is their commitment to doing the work,” says Roberts. “They don’t have to know if they want to stay in the relationship. It’s nice if they’re committed to the other person, but the most important thing is that they’re committed to working to improve the relationship. Then it’s a win-win. Even if the relationship ultimately doesn’t work, you’re still learning something from the process.”

Also, be explicit about your goals. “I think it’s a good idea, in the first few sessions, to figure out one or two goals that you want to work on as a couple, and then do periodic checks along the way to see where you’re at,” says Arora. “Sometimes progress is hard to measure. It may just be that a feeling has shifted, or that there’s been a small change in behavior. But it’s important to pay attention. Even the slightest pieces of progress is progress.”