Talking to Your Spouse About Couples Therapy

Lots of people – mostly women – give my Bethesda psychotherapy practice a call to begin couples therapy. Most of the time, both spouses are committed to seeking help and we’re able to get started right away. Unfortunately, sometimes one partner is desperately wanting couples therapy but needs guidance about how to ask their spouse to join.

It’s a tricky situation to be in: seeking couples therapy indicates some level of current conflict, which can make an important conversation that starts with “I think we need help” go bad in a hurry. Here are a few suggestions for how to talk to your spouse about couples therapy.

First, it’s important to be careful with when and how you bring up the subject of couples therapy. The best time to do so is when you’re getting along, rather than in the middle of a fight or when you’re feeling angry or frustrated. From an easy-going or playful encounter, you can share with your spouse how good it feels to have fun together again and tell him you want more times like this. A wish for the relationship to get better will feel less threatening to him when it’s expressed calmly and with loving hope.

Second, it’s important to focus on your role in the issues facing your relationship. Saying something like “I think that I yell at you too often and I want to learn how to communicate better. I think a couples therapist can help us do that” is likely to resonate with your partner. If instead you say “You are always criticizing me! I just can’t take it anymore!” you are likely to trigger defensiveness and another argument. Naming the goals that you want to achieve, rather than blaming your partner and focusing on the problems themselves, is another way to help your partner see the benefits of couples therapy. Good couples therapy often results in improvements such as:

• Feeling understood and appreciated
• Better and more frequent sex
• More confidence and decreased stress
• Ability to communicate effectively without fighting
• Feeling closer and more connected
• Better physical health, such as improved sleep
• Deeper sense of trust
• Parenting as a team

Third, problem-solve together what might be making your spouse uncomfortable about therapy. Listen carefully to his concerns and figure out solutions together. Would meeting with a therapist near your spouse’s work facilitate sessions, or would he prefer to meet with a therapist in the next town over? Would your spouse want to do the research to find a therapist he is comfortable with, or would your spouse appreciate talking to the therapist first before making an appointment?

You may also need to educate your partner about what couples therapy actually is. Trained couples therapists don’t take sides and they focus on solutions to problems. Good couples therapy doesn’t last forever; you should expect to feel better and achieve positive results within a few months. And if he says, “only crazy people need therapy!” Offer him a metaphor: even pro-athletes need coaches to help them improve and play their best game.

Once you and your spouse have decided to seek couples therapy together, the next challenge can be finding good help. Many couples looking for therapy are not aware that any mental health professional can practice couples therapy without any specialized experience, training, or coursework. Two good resources for seeking a trained couples therapist would be through the American Association for Marriage and Family Therapy (www.aamft.org) or Marriage Friendly Therapists (https://www.marriagefriendlytherapists.com/).

Here are some questions to ask a therapist about her expertise and training to work with couples in therapy:

What is your background and training in couples therapy?

Although some psychologists, psychiatrists, clinical social workers, and mental health counselors are well-prepared in couples therapy, most who say they work with couples are self-taught or only workshop/continuing education trained. You can be more confident that you’ll be working with someone specifically licensed to work with couples if the therapist holds a state license in clinical marriage and family therapy and is a member of the American Association for Marriage and Family Therapy.

What percentage of your practice is couples therapy?

Couples therapy is the most difficult form of therapy and you deserve to work with a counselor who has the background, training, and clinical experience to help you achieve positive results. Avoid therapists who see mostly individuals, as they are less likely to be skilled in working with couples.

Of the couples you treat in therapy, what percentage would you say work out enough of their problems to stay married and what percentage do not improve or end their relationship?

Studies on the effectiveness of couples therapy show a success rate of about 70% — that is, 70% of couples who are committed to therapy have success resolving their issues and stay together. A therapist who says she helps 100% of her couples sounds unrealistic. A therapist who says “it depends” may be quick to lose hope for couples in conflict and unskilled in the techniques demonstrated to help couples improve.

What is your experience working with couples in my situation?

It’s important to share about your unique situation, and the therapist should be willing to be candid about her experience and willingness to work with couples in your situation. The therapist should also be able to describe specifically how she has helped similar couples in the past, in a way that makes sense to you and avoids jargon or a canned sales-pitch.