A Guide on How Couples Therapy Sessions Work

November 7, 2023

Alright, wild guess here. If you are the pursuer in the relationship you probably arrived at a blog post like this to try and see how you can convince your withdrawer partner to actually see a couples therapist. If you happen to be the withdrawer, you are probably here for yourself to see how you can either ease some discomfort about seeing a couples counselor or find some information to get out of having to go. Just a guess.

Answering the question of how marriage counseling works can be a tricky one. It obviously depends on what each couple is needing and specific problems and relationship issues even are. But since I hate it when blog posts just speak in generalities and tell you “it all depends” over and over again without ever giving any sort of specifics, I will do my best to refrain from doing that here.

Additionally, for the sake of this article we will use the terms marriage therapy, relationship counseling, couples counseling, etc all interchangeably.

There are a number of different modalities that mental health professionals work with in regards to relationship problems. And I also believe that any therapist worth their salt will know how to integrate a few different angles into the same clinical frame. I know few professional counselors who haven’t been influenced by the Gottman institute. For those unfamiliar, Julie Gottman and her husband Dr John Gottman run a clinic in Washington which has produced some of the leading research in family therapy. They’re famous for hooking up their clients to heart rate monitors and stopping the session if somebody’s heart rate happens to get too elevated, usually citing that arriving at such an elevated emotional state disrupts the ability to achieve positive change in the therapeutic environment. And if you're wondering if that is actually true, just notice next time you are in a fight with your partner if your heart rate has risen to the pace of a medium jog and if that extra energy is helping or hurting the argument.

I see a number of current problems with the psychology today pages I read of the average marriage counselor. I see professionals stating that they offer a safe space in order to work on romantic relationships and that by gaining some more problem-solving skills as well as healthy communication skills are going to help you to resolve the conflict that brings you in. Solution-focused therapy certainly has its place when it comes to any treatment plan, but I usually find it best for some sort of single incident that is creating some relationship distress. For example, an argument about a major purchase that is not exacerbated by previous disagreements on finances.

And while I always recommend that you work with a licensed therapist who you happen to connect with, I will say that my favorite form of therapy I have found for working with couples is Emotion Focused Therapy (EFT). Could you find a healthier relationship from working with somebody who doesn’t specialize in this? The answer is 100 percent yes! There are quite a few different approaches out there, but this is just our favorite at Thrive.

First Session

When working with an EFT therapist you are going to have your first session together. This first session is all about building some level of rapport between you and your therapist and the therapist will go through a couples intake, which allows the therapist to get a little but more history about what brings you in to therapy, what’s been working, and where the issues are.

Early on in the therapeutic process, each partner will have their individual sessions with the couples counselor. These sessions are designed to be different than an individual therapy session and can create the space for each person to speak a bit more uninhibited. It is also important for the therapist to get to know you outside of the relationship, as healthy individuation requires that you know who you are outside of the context of being in relationship to another person.

It is paramount to note that most therapists hold a “no secrets” policy. Meaning that anything that you disclose to your couples therapist must be communicated to your partner as well. Holding a secret between the therapist and one partner in the couple can create an alliance between the therapist and that partner. There are occasions where this policy might be foregone but those are for more extreme circumstances where one partner’s level of safety might be jeopardized by the information being shared.

Disrupt The Cycle

We have already stated that we are looking to do more than create better ways to communicate. There are only so many different skills and tools that one can implement in order to repair their relationship and so the most important thing that we can do in couples counseling is disrupt the cycle. Over and over again when couples come in for therapy we see that they have been in the same pattern for years. That every fight seems to stem back to the way that the interaction takes place, and while the content of the argument might change, the ways in which people communicate and pursue or withdraw from relationship remain the same, leading to the same unresolved conflicts.

In order to do this, we must first identify the different roles that we inhabit in the relationship which is influenced by our attachment style. We initially find our style of attachment through childhood experiences and the ways in which we interacted with different family members or caregivers. You’ve already seen me mention these words a few times in this blog, but ultimately what we are looking for is who is the pursuer and who is the withdrawer. Just based on reading those two words you can probably identify which one you are in the relationship.

The pursuer is often the one who is keeping a gauge on how the relationship is doing. It’s important to note that they are not always the best at it, but they are certainly thinking about it the most. On the outside, the pursuer is more likely to criticize their partner, complain, point out what is not going well, and drive for there to be change. From an outside perspective it can look like they are putting in more work in terms of the relationship, but their habits can be just as destructive.

On the other hand, withdrawers tend to shy away from what they deem to be uncomfortable feelings or problems. This often comes from the learned experience that having uncomfortable feelings or problems in general is not okay and is going to threaten safety in the relationship. They may have had a parent who was highly reactive to any sort of mistake and so they learned to withdraw when conflict arose.

Now, I am sure I will get some push back that surely not everybody can fit into one of these two roles. And I prefer to not speak in absolutes, so I will concede that this may not be the case in all circumstances. However, this is what we see a high percentage of the time and almost always does a pursuer attract a withdrawer and vice versa. Withdrawer/withdrawer relationships might survive for years but often are running on empty as there is nobody in the relationship who wants to address the lack of intimacy they are experiencing. Pursuer/pursuer relationships seem to have a bit more spark but tend to carry two reactive people and require that both people be very healthy in order for the relationship to have a chance. My time as a therapist has reveled that we usually show our most unhealthy parts to our romantic partners and so creating these sorts of working dynamics is a fantasy that few have the ability to realize.  

Process vs Content

If there is one major misconception that people have about couples therapy, it is that the therapist will act as a mediator to sort out the content of what is taking place. Couples therapy is all about the process, not the content. It does not matter if the argument is around intimacy issues, finances, spending time with family, or hobbies/interests. We are looking at the process in which the fights and disagreements occur.

In order to do this, our goal is to slow things down so that each person can understand the emotional experiences that are coming up for them in regards to the content of the situation. It's not about the fact that your partner is working too much and doesn't get home on time. It's about the feelings of loneliness that come from such an experience. But so often we immediately move to content, citing that if this one thing were to just change then the relationship difficulties would disappear. But this generally is not the case as the emotions will resurface in a new area as it was never addressed properly in the first place.  

The Ultimate Goal

The ultimate goal of couples therapy is to decrease the intensity and frequency of fights. If you are looking to find yourself in a relationship that never has any disagreements, well let me know when you've found it so I can learn a few things from you. And by the way, that relationship will need to go on for a few years before I listen too much. What we can successfully do thought is decrease how often we get into these verbal spats as well as decrease the intensity of these. If we are able to do this, the feelings of disconnection that we experience will not last as long nor hit as high of a thresh-hold. If you think back to one of the more difficult conversations you've had, the hardest part was probably when your significant other called you a colorful word rather than the initial critique they made.


If you are looking for some more resources or next step, Thrive has you covered. We love working with couples and so that's why we've got a variety of options. If you are looking for a couples counselor you can look here. We also offer weekend intensives, a quarterly couples workshop, and a monthly couples group. If you are wanting to continue some work right now, I would recommend our course on attachment which you can find here.

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