What Really Goes On in Couples Therapy—From 5 Women Who’ve Been There
It's not as scary as you might think.
What’s it like to go to couples counseling? Sessions can be explosive, with raised voices and lots of tears. But you might also spend a calm hour comparing responses to workbook exercises with your partner, or talking through an issue in modulated tones while your therapist guides the conversation.
Counseling can benefit long-term couples and help them remember what bonded them in the first place. It can also highlight issues newer couples are facing, giving them a stronger foundation. And while it's possible your sessions could make it clear that you and your partner might be better off going your separate ways, the outcome might also strengthen your connection and forge a happier relationship future.
If you're considering couples therapy but are hesitant to schedule a visit, knowing what goes on in the therapist's office can get you comfortable with the idea. Health spoke with five women about what happened when they and their partners sought a pro's help. Each had a different reason for making that initial appointment—and different experiences in their sessions.
“We needed a third party to help us communicate”
Marie H., 42,* first went for counseling with her fiance to discuss big-picture concerns before tying the knot. A few years later, the now-married twosome returned for what she describes as a “tune up.”
"We did five or six [premarital] sessions, and it's a good thing we did, because we uncovered a lot of things we thought we'd talked about. The therapist met with each of us separately and then both of us together. We did workbooks with pre-set questions about our values, priorities, and goals. We also talked free form about things that were bothering us.
The tune-up session was inspired by a bad apartment situation that turned into a larger crisis concerning where to live. We needed a third party to help us communicate. One upside to couples therapy is finding out that your problems might be an outgrowth of things you like about yourselves as a couple. For instance, my husband and I never shout at each other or call each other names. I really love that about us. But in our caution to be kind, we had trouble communicating. Therapy helped us learn how do that in a way that worked for us."
“Our therapist reflected to us our own truth”
After almost a decade together, Kathleen, 39, and her partner, Dan, had grown in different directions, and their once-harmonious relationship no longer felt familiar.
"Therapy felt like the most obvious way to handle our discord. We both wondered, what’s going to happen to us if we don’t get some help? We went to a few therapists. One practiced traditional talk therapy. Dan felt comfortable with him, while I felt ready for an accelerated pace, so he became Dan's private therapist. Our second therapist gave us readings and quizzes. Dan felt like it was me and that therapist against him, so we only saw him twice.
The third guy, we both felt really good about; we felt heard. He guided the conversation, but he wasn’t directive. He held our points of view in equal regard. By now, the process had taken a long time, and we'd decided time apart might be our next best step. I'd chosen to leave the country for a few months, but we still wanted to work on our relationship. The therapist asked us, 'If you’re not going to be here, how can you continue to work on the relationship?'
Neither of us had acknowledged that we might not be a couple anymore. In the room, our therapist was able to reflect to us our own truth. Then it became like grief counseling, as we realized we might be really ending it for good."
“A good therapist points to you and says ‘stop that'"
Sadie L., 37, and her husband began couples therapy after four years of marriage, two kids, a bankruptcy, a hospitalization, and a whole lot of resentment.
"Mike and I are on our fourth couples therapist. A few therapists would let us bring up whatever we wanted to hash over and then inevitably, one or both of us would feel picked on. The more successful ones spoke more than either of us, which seems counterproductive, but it's nice to turn off your errant judgment and listen to how someone perceives you. A good therapist points to you and says 'stop that.' Being able to recognize our go-to behaviors when we're feeling stressed or unloved has been critical, and we needed someone else to identify and name them for us.
For the most part, I've been the one pushing therapy. I've talked about my feelings in a cold room with a professional for most of my life. Mike, however, is not a fan, distrusts the format, and feels threatened, blamed, framed, shamed. So we've had best luck with therapists who recognize this and give him time, space, and a platform. Our current one spends a lot of time on childhood trauma. It has been helpful; I've learned things about Mike that help me understand his motivations for certain things, and his need for more affection than I am mostly incapable of providing, due to my own experiences."
“Couples therapy felt like it was driving us further apart”
Jane S., 36, married when she was 18. After 11 years her marriage had become unhappy. Sex was rare; sniping was frequent.
"We didn’t have a whole lot of of money, and lived in a small town, so we basically picked the closest inexpensive therapist. At first, I was really hopeful. He gave us both time to talk about what each of us were dealing with on a personal level and equal time to vent. But as sessions went on, we weren’t getting any real relief. In fact, things were getting worse at home. It was like wounds were being opened up, and our therapist wasn’t giving us coping skills to work better together.
Our last session was explosive—I told my husband to move out and that I wanted a divorce. The therapist did nothing to mediate. My husband and I left the therapist's office in tears (both of us), and drove home where we broke down and admitted this wasn't what we wanted. We wanted to fix things, not to divorce. We made the decision that night not to return to couples therapy. It felt like it was driving us further apart instead of bringing us together. That was almost seven years ago. We're now going on 18 years of marriage, and while we're not perfect, we are much happier and stronger today.
The thing I would say to any couple thinking about therapy is not to go with the first person they find. Investigate. Look up their background. Ask questions. Just because someone is a therapist doesn't mean they're especially good at it!"
“Therapy normalized our situation”
For Michaela C., 31, and her husband, Kevin, the impetus for therapy came from outside their relationship—Kevin’s family was convinced marriage changed him negatively. Going to a therapist helped them realize his family's reaction was a normal, if frustrating, reaction to Kevin setting basic boundaries.
"We were navigating a turbulent family situation, and couples therapy helped us get through it. Had we not been on the same page, communicating constructively about our feelings, it would have been challenging. Therapy normalized our situation. Hearing a trained professional say “This is really common” helped me realize it wasn’t me—this would have happened with anyone.
Our therapist used a technique called Imago Relationship Therapy, which focuses on making sure you’re actively listening to your partner. It’s more disciplined than traditional therapy. Some of it is repeating back something your partner said to you and making sure what they’re saying is being understood. I’m a therapy veteran, but I’d never done anything that was quite so structured. Couples therapy cemented our marriage and helped us realize that you need to put your partnership first."
*All names have been changed for privacy. Stories have been condensed and lightly edited.