Ten More Ways to Get the Most out of Couples Therapy

  1. Don’t Minimize Your Partners’ Negative Feelings

This often happens with people who are good at making decisions and taking control at work. What your partner feels is what they feel. You can disagree about whether they “should” feel that way, but if they are unhappy, they can leave you regardless of whether you believe they should be happy with you. You aren’t the judge of your partner’s relationship satisfaction. I’ve seen many people talk about how much money they make, how big their house is, and how strong their work ethic is, while their partner wants to spend more time with them. Sometimes these discussions get heated, with the unhappy partner saying their marriage is hanging on by a thread, and the other partner saying they are just ungrateful for all the material things they have. Your partner may not care about the material things if you don’t both have quality time. Unless it’s part of an unhealthy manipulative pattern where your partner tells you they are about to leave (and doesn’t mean it) all the time as a means to get you to bow down to all of their needs, it’s usually best to listen and start by trying to make them happy. Neither of you gets to decide the others conditions to be satisfied, so you should ask them and listen closely.

  1. Discuss and Agree Upon Appropriate Behavior with the Opposite or Attracted Sex(es)

I have written many blogs about this and won’t go into too much detail repeating myself here. Long story short, more people are working outside the home, and the internet has opened the door to temptation and questionable opportunities. What one person sees and believes to be completely innocent (e.g., going to lunch with a particular co-worker) could be viewed as a date and infidelity by the partner. I probably see about an instance every week where one person believes there has been cheating, and the other either doesn’t or it happened without intent and slowly over time as a result of actions that the partner would have said are not okay.

  1. Discuss and Share or Compromise on Long-Term Life Goals

This is a big reason for divorce. Sometimes goals change with time, but they are not fully discussed just as often. For example, one person may leave if their mother-in-law needs care and moves into the house. One person may want to retire in Florida, and the other wants to move to Oregon. Hopefully, these items have been discussed, or there is an effort to compromise if possible.

  1. Have Friends Outside Your Relationships

The Gottman’s have determined that a strong friendship is a building block for a happy relationship. Some people may be strong introverts (fantastic) and prefer to be homebodies. Some people may have little time for outside friendships or few chances to meet people. But having healthy relationships outside your romantic relationship is essential for many reasons. One is determining if you have a general pattern. Have you been inside due to COVID and just lost contact with people, or do you generally hate people? Do you tend to rub people the wrong way? Do you come across too many others in a way that you don’t realize or perhaps they don’t appreciate? Do you call on others only when they need help, or do you go out of your way to help others without expecting anything in return?

Having other friendships is also important because if you and your partner rely almost exclusively on the other to make each other happy, you are putting too much pressure on your relationship. Your partner will have bad days. You will have bad days. But, most of the time, it will have nothing to do with you. If you need someone and your partner slips up, says the wrong thing, doesn’t have enough time to give you, or is otherwise not completely available, you open the door for putting unneeded strain on the relationship. If you have a friend or family member to turn to when your partner can’t, won’t, or doesn’t know how to support you, that takes a lot of pressure off each of you. Yes, a counselor can certainly help, but not necessarily when you need them, and we can’t be at your beck and call either.

  1. Make Your Best Attempt to be Open and Honest in Therapy

Remember that counselors are professionals who have probably heard everything. If you have problems with intimacy, it’s nothing to be embarrassed about and is very likely to be a problem I’ve worked with. It’s not entirely uncommon for couples or at least one person to open up more as time goes on. It’s not out of the question that couples lie at first about the most severe problems. These situations are not met with judgment, but you will fare better the sooner you are open to disclosing your status. Some couples want to make their therapist feel good or themselves sound better by saying things are better than they are (this is extremely common throughout the healthcare community). It’s never too late to come clean if you have hidden something, lied, or didn’t feel comfortable sharing something yet. Please don’t think you are being strong, macho, etc., by keeping things inside or private. It takes much more strength to be open and honest and to talk about your real feelings.

16. You Want Success for Yourself More Than I Want Success for You

It’s taught in grad school many times, but many counselors really want to help their clients and have a hard time letting them fail. The reality though, is that you will not have lasting success if you rely on a counselor as a crutch and can only work on your relationship when they are present over the long term. My goal is that your sessions are reasonable in number, with perhaps the exception of monthly maintenance check-ins once you are doing well and have met your goals. While I have spent hours and hours working harder for clients than they work for themselves, this doesn’t really help anyone in the long run. It’s like going to a personal trainer. They can teach you good workout techniques and push you, but if you want long-term and lasting health benefits, you have to learn to work out without them at some point. You have to be able to work on health goals without them there to force you. If you don’t do your homework, I’m not going to beat you up. I’ll remind you how important it is, but you’re adults and the reality is that I have no real authority to make you do anything. To paraphrase a line from the movie the breakup, I don’t just want you to do your homework, I want you to want to do your homework. If you don’t want to, then we can do all that work in therapy sessions, but it will take a lot longer, be a lot more expensive, and you are almost guaranteed to have sub-optimal outcomes.

17. You Don’t Primarily Want a Referee

Many clients come into couples counseling saying they want a referee to serve as a neutral party because they can’t have a conversation on their own. While this may be important in the beginning, it is not a good long-term solution. I’d rather teach clients how to communicate at home than be a crutch that they need to talk to one another. Many clients want a referee because they are competitive and want to win. These same clients often live the referee when the calls go their way and hate them when they don’t and get “bad calls.” If your counselor’s long-term role is referee, you are likely to always need them or relapse quickly.

18. You are Open to Talking About Sex

Sex is as normal and necessary for human survival as eating and elimination. Same people grow up with shame related to talking about sex. That is ok. The important thing is that you are open to talking about sex. You may be able to do all of this talking outside of therapy but just need some guidelines. You may need to talk about your sex life in therapy at first. Counselors are professionals and couples counselors in particular hear about sex and intimacy all the time. Would you hesitate to tell your OBGYN about an infection? Perhaps, but you know you need to. Would you not tell your primary care doctor about some sexual dysfunction if you want to get help? There is little chance that any issues with intimacy are unique to you.

19. You Show Up On Time

Life happens, traffic happens, and being on time is not always possible. Successful clients show up on time much more often than not. I am a stickler for ending on time to support my self-care, give me time to prepare for the next client, and make sure the next client doesn’t have to wait. You are allowed to be late, but you will likely just have a shorter session and hence get less value. Clients who are more than 20 minutes late should message or call. You may have to reschedule if more than twenty minutes late.

20. You Have Thought About Something you Want to Discuss

I almost always start sessions by asking clients if there is anything that has come up that they want to discuss. Many clients have not taken a moment to think about this. If the answer is truly no, that is fine. We can move on to working on your initial goals and items identified by an assessment you can choose to take. You will get the most out of therapy if you reflect on what has happened since the last session and bring anything up if you think it needs further discussion. The most difficult and awkward situation is when I haven’t seen you in a while, you don’t have any goals to talk about, and it’s been long enough that I don’t know what you need to discuss either.

BONUS

You Keep Regular Appointments

If you schedule appointments every month or longer, it is difficult to do much more than maintenance. Your schedule or budget may not allow for more than monthly appointments, just be aware that you will probably spend more on the long run as the counseling will be much less efficient. The most successful clients start with once a week for a month or so, move to every other week, and then move to once a month only after they have met their goals and just want maintenance (the schedule depends on the extent of client issues and urgency with meeting goals). Clients can also choose marathon therapy or front load a lot of sessions upfront to build off of momentum. Clients are also more likely to keep up the pace if they schedule the next appointment during their session. Clients who make a habit of waiting until they get home sometimes forget about it, get out of the habit, and find excuses that they are too busy. These clients typically relapse or go backwards if they haven’t yet met all of their therapy goals.

This list is far from exhaustive. Your particular issues may require different interventions. Better yet, if you are being preventative or coming in before things get too bad, that is perhaps the number one most important thing you can do. Fixing a scratch on an arm may just require a band-aid. Fixing an arm thats been broken for six years may mean surgery.

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