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Does couples therapy really work?

I was meeting with a couple last week who are in the assessment phase of our work together in couples therapy. Towards the end of the session, one of the partners asked, “so, does couples therapy really work?” I asked him more about what he meant by “work” to which he replied, “Is it possible for us to be happy together again?” These are both incredibly poignant questions, and I think representative of questions many people have about the value of couples therapy. In order to contribute further to this conversation, I want to share a summary of the research in couples therapy, as well as my own observations from my experience as a couples therapist.

First of all, the research on couples therapy is somewhat limited because frankly, relationships are complicated, and the process of therapy difficult to operationalize for research. However, in general, couples therapy has been shown to to work well to increase relationship satisfaction in the short-term. We have limited data on the long-term impact on relationship satisfaction after couples therapy, and what exactly makes couples therapy “work” is still somewhat of a mystery. However, there are 5 key factors observed in couples who report higher levels of relationship satisfaction after couples therapy:

– One partner expressing their feelings leads to a change in the perception of the listening partner, – Learning to express needs, – Increasing understanding of one’s partner, – Taking responsibility for one’s own experience, and – Receiving validation from one’s partner

These are all consistent with the theory behind the type of couples therapy I practice called the Gottman method which is based on three decades worth of John Gottman’s observations of natural, couple’s communication in his “Love Lab”. He followed couples long-term, and over time noticed themes in the ways couples communicated when they were satisfied in their relationships, and the ways they communicated when they were unsatisfied (and these couples often later split up). Dr. Gottman translated his findings into a method of therapy that teaches couples strategies for communicating that mimic those of the satisfied couples he observed in his research. These strategies are summed up in the Sound Relationship House which serves as the road map for treatment and for setting goals in Gottman method couples therapy.

For more on Gottman’s research, click here:

For more on The Sounds Relationship House, click here:

In my experience, it is completely normal for couples to enter couples therapy with the fantasy or hope that their partner will change. However, the couples who end up getting the most from couples therapy are those that use the therapy as a place to learn more about themselves (why do I react this way to my partner?), who stay curious about who their partner is and what makes them “tick” (vs. thinking they already know everything about their partner), and last but not least, those that cultivate a willingness to change their own behavior.

Couples therapy also seems to work best when it is aimed at the prevention of problems in the relationship. I recommend that couples come to therapy anytime they are headed into a major life transition such as moving in together, getting married, preparing to become parents, before retirement, etc. It’s easier to prevent hurts and resentments from building up than it is to heal them once wounds have already been created. That doesn’t mean that couples therapy cannot help couples who have struggled for awhile with their issues, but in these cases, couples therapy will likely take much longer as each partner builds up a tolerance for being vulnerable again in a relationship where they have learned to protect themselves from further hurt.

I have not read her book yet (it’s on my list!), but Harriet Lerner (one of my favorite authors on the topic of mental health) just recently wrote a book called “Marriage Rules” and this link features a video of her discussing some of the ideas above and the inspiration behind her book.

I hope this helps answer some questions about couples therapy, and I’m sure I will write more on this topic in the future! As always, your questions and comments are welcome!

Thanks for reading!

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