How to Know When to Go to Couples Therapy?

You are probably here because you have been thinking about going to couples therapy, but you have spiraled into all the thoughts and questions. I’ve got you. Keep reading. And feel free to reach out! I would love to chat and point you in the right direction.

It can be overwhelming when you are not sure when to reach out for support in couples counseling. Maybe you keep wondering to yourself *things are that bad, we don’t really need couples therapy* or maybe you have been considering couples counseling for a long time but are just not sure about how to get started or what to expect?
Maybe you are aware of some deeper attachment wounds and you want to take your healing to the next level or address things before you get more serious. But you thought couples therapy is only for those couples who are like really bad at solving their issues, not necessarily true. **There lots of reasons why people go to couples therapy.**
Keep on reading, as a couples therapist who has served hundreds of couples in both the San Diego greater area and the Phoenix greater area, I will share with you the most common reasons people seek out couples therapy, how to find and choose a couples therapist, and what to expect in a couples therapy session. This is a long article, but I hope you find answers. Hopefully this will take out some of the mystery and overwhelmed that can come from deciding if couples therapy is for you and seeking out a couples therapist.

So what are the most common reasons people seek out couples therapy?

People seek out couples therapy for all sorts of reasons. Some couples come to couples therapy because, yes they are at a complete loss and really need the help and support from a therapist, trained professional who can help them navigate conflict in their relationship, but there are so many other reasons why people reach out to a couples therapist. This isn’t always the case. Not all people who go to couples therapy are on the verge of divorce, not all people who go to couples counseling are recovering from a big betrayal, and not all people who go to couples counseling hate their partner. Some come for pre marital struggles and wanting to heal deep things before they get out of hand. This is very common for younger generations wanting to be proactive in healing childhood traumas when they are still manageable issues.

Below are some of the most common reasons that people will seek out couples therapy in not only San Diego, California but also in Phoenix, Arizona (which I know from experience!)

Common issues addressed in couples therapy

Feeling distant and feeling like the person you share a bed with is a stranger
Feeling like you are having the same argument over and over again
Struggling with “me-ness” and “we-ness” with in your relationship
Lack of joy, fun, and play with your partner, spouse, girlfriend, or boyfriend. Here is how to increase joy in your relationship.
Worried about how to approach any topic with your partner, spouse, girlfriend, or boyfriend, for fear that it will turn into an argument.
Feeling like you are struggling with the four horsemen as discussed in Gottman Couples Therapy : criticism, contempt, defensiveness, and stone walling
Feeling like you are struggling with Emotionally Focused Therapy Demon Dialogues: Freeze and Flee, the Protest Polka, and Find the Bad Guy
Feeling like conflicts always end in shutting down, tears, a holding grudges
Having a feeling like this reminds you about your childhood home or a relationship that you have with your mother or father
Wondering if culture, ethnicity, race, religion, sexual identity and orientation, micro and macro aggression or traumas, might be impacting your relationship with your partner, spouse, girlfriend, or boyfriend
Feeling like a past toxic relationship continues to impact how you show up in your current relationship with your partner, spouse, girlfriend, or boyfriend
Inability or difficulty with being able to feel calm and emotionally safe around your partner, spouse, girlfriend, or boyfriend
Struggling with feelings of co-dependency or too much independence from you partner, spouse, girlfriend, or boyfriend
Difficulty with communicating with your partner, spouse, girlfriend, or boyfriend
Feeling anxious, overwhelmed, depressed, or avoidant when needing to talk with your partner, spouse, girlfriend, or boyfriend
Trouble with sex and intimacy, not being able to have conversations about sex and intimacy with your partner, spouse, girlfriend, or boyfriend
Wanting to talk with your partner, spouse, girlfriend, or boyfriend about uncoupling, divorcing, or breaking up

How to find and choose a couples therapist? (this applies to both California couples and Arizona couples).

Finding a therapist, the right therapist, can feel like an endless task. I know from my own experience and also from people who I have worked with as their therapist. Some people find that they have to “try out” a few different therapists. And that is okay!
Therapy is a kinda weirdly deep thing and you want to make sure that you connect well with a therapist. Connecting well with the right therapist has been shown to be the number one factor in whether a person will experience improved symptoms.
This is why it is so important to do your research, have that free consultation call, and connect with the right therapist. Here are some important things to consider when trying to find a couples therapist in not only San Diego, California but also in Phoenix, Arizona.

Here is a checklist of things to consider that will help you choose the right couples therapist:

Are you using insurance to pay for couples therapy? Can you?

Using insurance can be cost effective, since therapy can get expensive. But some caution, therapists who take insurance often have LONG waitlists, have restrictions about who they can and cannot see (couples are not always covered, and only certain issues and diagnosis are covered). Plus it might be harder finding a therapist who specializes in what you need.

Are you able to dedicate a few hours a week to couples therapy?

This is especially important to think about as going to see a couples therapist will require you to plan a few hours into your week for therapy. Drive time, finding a sitter, getting time off of work.
Seeing an online couples therapist can help save you time. So it is important to identify how much time you have to dedicate and if you have a preference for in person or online.
If you travel often, online therapy might be a better choice for you. As long as your therapist is licensed in the state that you are in.

What are important qualifications for your couples therapist?

Do you have a preference in license type? LMFT, LCSW, LPC so many acronyms. Let me break it down for you. Spelling it out: licensed marriage and family therapist, a licensed clinical social worker, or a licensed professional counselor, all therapist and counselors but not the same thing. There is a lot of overlap between the licenses but they all have different philosophies of thought.
For example, I am a licensed marriage and family therapist, I was taught to think in systems, treat units, treat families. I was taught to not just think as one person having the diagnosis. I am more likely to think the family is unhealthy rather than a person being unhealthy. Plus in order to get my specific license I had to receive certain training, and supervised hours working with couples, families, and children. I have a lot of experience working with couples.
A licensed clinical social worker or a licensed professional counselor can work with couples but it is important to ensure they have additional training and supervision as it is not necessarily required for them to obtain their license.
Important qualifications might be a therapist who has a specific training in a type of couples therapy. Like Emotionally Focused Therapy, Gottman Method, or some other type of therapy. This can help determine the feel of the couples therapy. I am trained mainly in EFT, meaning I am all about attachment and deep bounds. But I will use some Gottman stuff for homework assignments and explanations. Every couples therapist is a little bit different in their style and training.
Important niches or specialties. Couples therapists often specialize just like other health care providers. Couples therapists might specialize in working with first responder and military families, couples where a partner or both have ADHD, premarital or new marriages, adjustments to bringing home a baby (Perinatal Mental Health), infidelity, addictions, queer and non-monogamous couples. So important to make sure that the couples therapist has experience working with what you need support in. This will ensure that you are getting the treatment that you and your partner need so that you can actually reach your goals. Here is how to know if therapy is working.
Do you want your therapist to be part of your group? Is it important that your therapist be the same gender, ethnic background, or that they have lived experience in what your struggles are? This can help you feel safer opening up to a therapist. This helps both you and your partner feel like couples therapy will work.

It not always tears, sometimes we laugh in therapy.

Going to couples therapy can feel scary, overwhelming, and almost like you are doing a bad thing.
But going to therapy can help, going to therapy can help you create the life and relationship that you want.
Plus it not always that painful, some session can feel lighter and there is often plenty of humor and joy. Therapy is not always tears and painful conversations.

So what should you expect in a couples therapy session?

Here are some common things to expect in couples therapy not only in San Diego, California but also in Phoenix, Arizona.

The first few sessions are really about getting to know what the issues are, to get a feel for the attachment styles (if you are an EFT therapist like me), and how the couples have been attempting to solve issues. Then you and your therapist will make measurable goals and figure out how to get there.
Some therapists give out homework. That way you can continue to practice what you learn outside of sessions.

Be willing to take ownership of your own stuff in couples therapy.

This is so important, because often people go to couples therapy and really feel like their partner is the only one with issues. But odds are that both of you are adding to the dysfunction. That's why I named my company Mindfully Minding Me, because we have to first look inward before we can really look outward and ask for our needs to be met in a healthy way. Inner Child Wounds are very much real thing.
Going to couples therapy can feel scary, overwhelming, and almost like you are doing a bad thing. But going to therapy can help, going to therapy can help you create the life and relationship that you want.

You might have to take a trip down memory lane and revisit past stressors in your relationship, to heal them. Sometimes this means addressing childhood traumas as they can often affect having a secure attachment with your partner.
You will always have a choice and a good therapist will ask often if they explore something with you or unpack an issue. I constantly ask my couples for consent, and ask for them to let me know their limits. This is so healing as so many people did not have this growing up, let alone in their adult lives. The way I frame it to my couples and individual clients, is that I am trying to teach their nervous system healthy boundaries and how to build trust, how to look out for green flags. This is so important for healing deep nervous system issues. This is why I am a huge advocate that therapists receive extra training in trauma, as a rule I always assume the person in front of me has complex trauma. Just to ensure I am ruling that out. It really is the standard of care for quality therapy.

A typical couples session with me (after the initial sessions) looks like:

A quick 5-10 minute check in: highs and lows, how did managing conflict go?
Unpacking an area of concern: this could be the low of the week, a fight, or a memory from a past wound that they would like to unpack.
Tying it to a theme in the relationship. I make it a point with my couples to see if this is a theme or a pattern in their dysfunctional communication pattern. I work with couples to not keep things surface level but instead I want us to get deep, identifying that negative interaction. That is what we are targeting in couples therapy. Not the fact that so and so didn’t take out the trash again, but what that meant, the deeper conversation about emotional load and roles in the home. Couples therapy will teach you how to solve problems in a more effective way.
Then we work together to relax the anxious and avoidant parts of use ( I often blend in Internal Family Systems here) and work with the couples to ask for their needs to be met in a healthier way of communication.
Then we review how that felt, giving positive feedback to our partner.
If we have time we might do this again for another issue or we might reflect and process the session.
Then we come up with anything that the couple would like to commit to over the next week. This could be putting themselves first and not projecting onto their partner, this can be a date night, or practicing skills on another conflict they have.
How Long Does Couples Therapy Last?
Couples therapy can last anywhere between a few sessions(for people who come in for “check ups” to a few years. When seeing a couples therapist in San Diego, California or in Phoenix, Arizona, it really depends on the issues and the goals that the couples have. I tend to see most couples for about a year. This is because I often work with deeper struggles, tapping into childhood wounds, and addressing struggles of race, culture, and gender. My couples and individual clients often unpack some pretty tough things and it really is quite an honor to support them in doing so.

Again every couples therapist is a bit different. This is a little bit about what my process looks like when working with couples. This is why you should really research a therapist, ask for a consultation, and not feel too guilty about moving on to another therapist until you find the right one. I wish you luck and feel free to reach out and we can chat more about if I am the right couples therapist for you and your partner.

With Warmth,

Elisa Blair