Demystifying Couples Therapy: What Really Goes On Behind Closed Doors?

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Demystifying Couples Therapy: What Really Goes On Behind Closed Doors?

Guest post by Sarah Christian, LCSW


Robert and Liz have been married for 37 years. With three grown children and four grandchildren, they take great pride in the appearance that all is well in their relationship. But Robert has seemed distant lately, leaving Liz feeling lonelier by the day. Not wanting to upset the apple cart, Liz is afraid to ask Robert what’s really going on. Part of her fears what the answer could be … so she maintains the status quo.

Andrew and Sherry were childhood sweethearts. While their relationship has been volatile from the start, neither can envision life without the other. Between Andrew’s new job, Sherry’s aging mother and raising two teenage sons, the couple is more stressed—and irritable—than ever. As a result, their fights are getting louder—and meaner. When their older son asked if they were going to get a divorce, Sherry was caught off guard by her inability to reassure him.

These are not real couples, but their struggles represent common themes in romantic partnerships: Disconnection ... Conflict ... Uncertainty … Pain. 

All relationships ebb and flow, changing over time. It’s normal—even healthy—for couples to argue from time to time. But a breakdown in attachment could be a relationship red flag, especially if it lasts longer than usual. Ignore it, and your relationship could be in serious danger.

A designated time and place to slow down, couples therapy is a safe place to explore these potential landmines. To reconnect. To gain a better understanding of yourselves—and each other.

Five Things You Might Not Know About Couples Therapy

What goes on behind the closed door of a therapist’s office? The perception of couples therapy is sometimes shrouded in mystery. Unless you’ve been in some sort of therapy before—whether on your own or with a partner—you may not know what to expect. Here are a few things you might not know about couples therapy:

1. The couple is the client.

Couples therapy isn’t aimed at treating one partner or the other; the couple (in therapy-speak, the dyad, which is a group of two people) is the client. As a couples therapist, I focus on learning about and respecting each partner—including their individual needs, styles and temperaments. I then work to help them understand one another. If conflict arises, I slow the process down, making sure each partner feels heard.

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2. Neutral doesn’t necessarily mean equal.

If I pick up on a specific pattern with one partner, I will call it to their attention. In Andrew and Sherry’s case, for instance, I might say something like, “Sherry, I’m not picking on you, but I notice that when Andrew talks about the kids, you tend to interrupt. Do you disagree with his parenting strategies?” 

Neutrality is very important, but it doesn’t always mean that the focus is equal in every session. One partner might be dealing with an undiagnosed depression—as in Liz’s example—that’s affecting the partnership. I might direct my attention a bit more to that partner in a given session, helping them sort through the variables that might be contributing to the depression, and offering appropriate support.

Even if their partner isn’t experiencing the same emotional challenge, their concern lends relevance to their treatment as a couple. Talking directly to either partner more than the other doesn’t mean that I’m any less neutral.

3. The process takes time.

The initial phase of couples therapy can feel like especially hard work because of the fears and anxieties people may have about the process. During this phase, there is a lot of diagnostic work taking place. What is the couple’s goal? Does each partner share this goal? How well is each partner able to self-observe?

This conversation, which takes place with both partners in the room, allows me to “take a temperature” of the couple’s situation. After this assessment, we can come up with a sort of verbal contract about the scope of our work together. This allows all parties to have a shared expectation.

In the course of couples therapy, all sorts of things may pop up; if it becomes apparent that one partner is suffering from a deep depression, or has anger management issues, I will recommend that they get individual therapy. (Because the couple is my client, I cannot treat either individual but will, instead, provide a referral for each to find their own therapist.)

Counseling might be “therapy-heavy” in the beginning, but usually lasts only through a period of time that allows for breakthroughs in understanding of themselves, each other and their partnership.

4. All three parties bring something to the table.

In order for therapy to be effective, each partner needs to be open to learning about themselves, their partner and their partnership. This openness requires a willingness to be vulnerable. Honesty is also essential. As awkward as it may be to share your deepest feelings, keeping them to yourself will not help move the needle on your relationship.

Obviously, the presence of a third party—the therapist—differentiates therapy from plowing through a difficult patch on your own. Part of my role is to advocate for both parties. Not only do I help couples observe their differences, but I also help them bridge any gaps and learn to interact in respectful, meaningful ways with one another.

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5. Seeing a couples therapist doesn’t necessarily mean that your marriage is in trouble. 

While seeing a couple’s therapist certainly makes sense when there’s been a significant or painful shift in your relationship, seeking counseling can be a way to strengthen a healthy partnership. It doesn’t always mean that something is “wrong” or that a breakup could be on the horizon.

Plenty of healthy individuals—who are in great shape—work with a personal trainer. They see their trainer once a week (or more!) to ensure that they stay strong and continue to improve their physical fitness.

In that same spirit, a couples therapist often works with emotionally mature couples whose relationships are basically sound, but need a bit of “coaching.” Perhaps one partner has been so caught up in work that they’re not connecting in the way that the other partner craves. An aging parent, a rebellious teen or the diagnosis of an illness are just a few examples of situations that can strain even the healthiest of relationships. A couples therapist can help you sort out—and face—these challenges as a team.


Therapy—whether individual or couples—can be a place to learn and grow. As a couples therapist, my goal is to provide my clients with the insights, support and tools to manage the inevitable ups and downs in their relationship.

Sarah Christian, LCSW, provides individual, family and couples counseling in her Lake Bluff and Glenview offices. Sarah can be contacted through her website or by calling 847-533-2287.

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