The Case for Couples Counseling

According to research, 70 percent of couples report that counseling helped improve their relationship.

Two people's hands touch on a couch.

Every relationship hits occasional potholes. Time can pave over some of them; others require more immediate attention. Whether to smooth out communication snafus or address deeper rifts, couples counseling can prevent those potholes from turning into sinkholes.

Research supports its efficacy. In a 2010 UCLA study, 134 “chronically, seriously distressed” couples engaged in 26 therapy sessions over a year followed by a maintenance session approximately every six months for another five years. After the first 26 sessions, about two-thirds of the couples reported significant improvements. Five years later, about half had maintained the momentum.

Success depends on timing: One reason counseling fails is that couples wait too long to seek help.

“There can be a stigma that a relationship is ‘broken’ if couples seek therapy,” explained couples and family therapist Trisha Hartmann, LMFT.

“Research shows that couples tend to feel unhappy for six years before they get help. Couples who enter therapy early on can work to ensure the relationship is progressing in a healthy and satisfying way, which helps to prevent emotional damage that can result from years of discord.”

Read on for ways to spot trouble before the situation gets too dire — as well as what to expect both in and outside of the therapist’s office.

When to Seek Help:

For some couples, an elephant-in-the-room issue such as an affair or addiction compels them to seek counseling. But problems also often arise within the daily routine of relationships.

To catch these types of issues early on, watch for what psychologist John Gottman, PhD, cofounder of the Gottman Institute and one of the leading researchers in couples therapy, calls the Four Horsemen of the Apocalypse:

  • Criticism
  • Defensiveness
  • Contempt
  • Stonewalling (or any gesture communicating withdrawal or disinterest, such as the silent treatment).

While each of these habits contributes to discord, contempt is the most pernicious. In fact, frequent expressions of contempt — when one partner regularly communicates disgust toward the other — are the single biggest predictor for divorce; this can be as simple as an eye roll or a disdainful comment.

Couples can also be mindful of the Magic Ratio. Gottman Institute research shows that, during times of conflict, healthy relationships need at least five positive interactions, such as moments of affection, joy, or laughter, for every negative interaction. If the ratio gets out of proportion, counseling may be necessary.

One important caveat for those considering couples counseling: Therapy only works when everyone feels safe being honest, both in and out of the session. Those who are suffering physical or emotional abuse from their partner are unlikely to enter therapy with that basic foundation of safety, which can make sharing their feelings difficult — or even dangerous. Individual therapy or support groups are a better fit in these situations.

What to Expect (and Not Expect):

Couples counselor Herb Grant, PhD, LMFT, says the crux of his work lies in “teaching couples to negotiate how to negotiate.” He considers healthy communication skills essential to this process and often gives clients assignments that require active listening or asking each other about their feelings and needs. But he and other therapists understand that many couples struggle with poor communication skills, which often are a symptom of more complex issues. That’s why counseling may require a deeper plunge into each partner’s past.

“We each come to the relationship with our own set of experiences, beliefs, and perceptions, and our own mostly subconscious narrative about the meaning of those experiences, beliefs, and perceptions,” explains couples and family therapist Lindsay Hildreth, LMFT. “If a person lacks awareness of their subconscious narrative, they tend to be susceptible to misattunements with their partner. These misattunements can, and often do, happen on a daily basis. For a lot of couples, the misattunements go unaddressed, which over time impacts how safe and connected they feel with their partner.”

Unpacking how past experiences play out in the present is essential to recognizing and resetting unhealthy patterns. But in order to change those detrimental dynamics, both partners need to pitch in.

“Two people traditionally create a relationship, and it takes two people to repair one,” says Hildreth.

“Many people assume the therapist will side with one partner,” adds Grant, who considers this one of the most problematic misconceptions about couples counseling. He emphasizes to clients that it’s not about determining which member of the couple is “right” but helping both partners feel heard and understood.

The real work happens outside of the therapist’s office. Actually applying new skills within the daily grind of coupledom ensures that they stick, which is why many couples therapists give clients assignments to practice between sessions. “Some couples really benefit from doing exercises with tangible goals, such as increasing physical or emotional intimacy at home, or renegotiating the division of labor,” says Hartmann.

The Path Forward

While traditional individual psychotherapy can last for years, couples counseling often runs a relatively short course. Most of Grant’s clients attend six to 15 sessions over the course of about three months.

Still, duration ultimately depends on the nature of the issue. Some couples see improvements in communication, intimacy, and daily positive interactions within a few months. Others require a longer course of treatment in order to excavate deep-seated patterns, rebuild trust after a major breach, or address secondary issues such as mental illness or substance abuse — in which case individual therapy for one or both partners may be needed. Still other couples realize during the course of the therapy that they’re better off apart (see below for more).

However treatment unfolds, good couples counseling — when initiated early on and with both partners willing to put in the work — helps each partner clarify and communicate how they feel, what they need, and what they can do to strengthen the relationship.

is a licensed professional clinical counselor based in St. Paul, Minn.

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