Is Couples Therapy for Me?

by Anna Glezer, MD

Authored by: Anna Glezer, MD

Is Couples Therapy for Me?

The pandemic has been challenging for many couples, with increased stress and anxiety, feeling trapped in close quarters, concerns about safety for front line workers, and more. Couples therapy can really help. There are a couple of questions that often come up in my practice when it comes to couples counseling. One is, "Can couples therapy help me?" And, more often, "How do I convince my partner to join me?" Let me answer these by dispelling several myths about couples counseling:

Myth 1: Couples counseling is for those whose relationship is struggling. 

You do not have to be on the brink of divorce or break up to choose couples counseling. Counseling can be a healthy choice for maintaining a strong relationship. I recommend thinking about it the way we think about preventative care in primary care. You visit the doctor for your annual check up to make sure you don't get sick or get your mammogram, and this is similar. Common goals for couples work include:

  • To strengthen communication

  • Improve intimacy

  • Prepare for an upcoming change, like a new baby. Many couples may have good equilibrium with but a change like a child can definitely shake things up. 

Some hear couples counseling and think their partner wants a divorce, but this can be far from the truth. Instead, it is a place to work through common disagreements. The most common reasons why couples disagree based on my experience include:

  • Finances

  • Communication styles are different

  • Parenting disagreements/child rearing. 


Myth 2: I've already decided I want a divorce. What's the point? 

Separation can be amicable or it can be fraught with challenges. For your own mental health, and, if you have kids for theirs, wouldn't you prefer a more cordial separation? Couples counseling can help resolve differences, resentments, and teach skills and tools to more effectively manage conflict. 


Myth 3: A counselor will choose a side and I don't want to hear what I'm doing wrong by another person. 

An experienced couples therapist's job is to be nonjudgmental. Their job is not to tell you how to be, but to help each person listen to the other and figure out how to communicate and work together. It's never 100% one person's fault. 

One caveat is that I do not recommend couples counseling if there is an abuse situation. 

Myth 4: Seeing a counselor means there's something wrong with me.

There can be the stigma of mental illness for the word therapist or counselor. However, you do not need any kind of diagnosis to seek therapy. 

Myth 5: "We should be able to figure this out on our own." 

When I hear this question, my first response is to genuinely ask why. We turn to experts for so many things. Without thinking, if our car breaks down, the majority of us turn to a mechanic for their expertise rather than tinkering ourselves. Similarly, the therapist can take the role of the guide. If you are traveling in a new city, you can use maps and try to figure out where you are going. But it could be much more effective to turn to a guide who will help you learn the streets and the maps. 

Myth 6: It takes too much time or money. 

This is a common obstacle I hear from my patients. This applies to individual therapy as well. I recommend thinking about this in the setting of your priorities and values. Re-examining those values and resetting priorities can make it such that taking an hour each week feels like a good investment. Think about the return on that investment. Effective couples work can defuse conflict and infuse positive sentiment into a relationship. 

If the issue is time, I often recommend couples to consider committing to a weekend workshop or retreat rather than Individual sessions. For example, there are workshops called Hold Me Tight. 


What to do if my partner doesn't want to come?

This is a common question. I recommend first thinking about when to approach the conversation. Do not bring it up in the middle of an argument, but rather at a time when you are both in a calm mindset. During that discussion, you can go over many of the myths noted above. 

Second, consider starting alone. An experienced couples counselor can help you troubleshoot how to engage a partner effectively. 

Finally, ask your partner if they would consider committing to just a few sessions. That can feel more manageable because some have the belief that engaging in therapy means a very long term commitment. 

Does couples therapy work?

Yes. There is data answering this question. A 2020 Meta-analysis published in the Journal of Consulting and Clinical Psychology found that it has a good effect on important relationship domains, including overall satisfaction, intimacy, and communication. It also found that there are both short and long term effects. 


What are the types of couples counseling styles?

There are many types of couples counseling styles, just as there are for individual therapy. Here are several of the most common: 

Gottman Method: This was developed decades ago by a psychologist couple. They focus on the Four Horsemen of the relationship (Criticism, Contempt, Defensiveness, Stonewalling). The goal is conflict management rather than resolution. A 2019 article demonstrated its effectiveness for marital satisfaction and intimacy. 

Emotionally Focused Therapy (EFT): This was developed in the 1980s by Dr. Susan Johnson and Les Greenberg. The focus is on figuring out what drives a person's emotional response. A study in 2019 reviewed the effectiveness of EFT over 2 decades and found it effective and sustained. 

Cognitive Behavioral Therapy (CBT): In this style, the therapist helps you identify thought patterns that are interfering with the relationship and communication. 

Narrative Therapy: In this style, the focus is on the stories you have about your world and provides a way to rewrite your story. 


Finally, I want to make note that for those struggling with intimacy issues, you can consider sex therapy with a clinical sexoligist. This is a specific type of therapy and you can find an expert through the American College of Sexologists (ACS). These clinicians are board certified by the American College of Sexologists, the American Board of Sexologists, or American Association of Sexuality Educators, Counselors and Therapists (AASECT).

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