Ask a Psychologist: Five Tips for Couples Counseling The Who, When, How, and Why of Therapy Together by Shara M. Brofman, Psy.D. Couples Therapy is for everyone As a culture, we seem to talk a lot about how marriage is hard work. When people get divorced, we shake our heads. If they’d just worked harder, or gone to therapy, maybe they could’ve worked it out? At the same time—possibly because we associate couples therapy with crisis or divorce—there can also be a lot of stigma about going to therapy as a duo. First things first: going to couples therapy does not have to mean that your relationship is headed for trouble. If you are married, it is not a sign that you are going to get divorced. In fact, the opposite may be true. Going to couples therapy before you get to crisis mode can strengthen your relationship tremendously and help to avoid future conflict. To help answer the smart questions you asked me on APW’s Facebook page, I spoke to another New York City psychologist and colleague, Eugenia Cherkasskaya, M.Phil, about when couples therapy can be helpful. She suggested that therapy is a good option “any time you want to discuss an issue together, at any point in your relationship.” In particular, “loaded issues,” says Cherkasskaya, can be much easier to discuss and explore with an objective professional. Remember the ten topics in Meg’s book that she suggests discussing before getting married? (A refresher: the questions are under the general headers of faith, money, goals, family, location, sex, household responsibilities, fighting, skeletons in the closet, and end of life.) As much as we might wish we could discuss these topics once and then move on, they continue to come up and evolve throughout marriage. Read: it is totally okay for any couple to go to couples therapy at any time. Good Reasons to try therapy New York City psychotherapist Traci Maynigo, M.Ed. considers any of the following scenarios good times to start couples therapy: You’re going through a big life transition (e.g. marriage!, a new job, moving, illness, infertility, birth, or adoption, death of a loved one, living with family members, or becoming a stepparent, to name a few). You keep having the same fight over and over again and it’s hard to understand why. You feel like you can’t effectively communicate with each other. No matter how you try to communicate, what you each have to say is somehow not getting through. No matter what you want to focus on, couples therapy is about learning how to communicate with each other in a safe, healthy way. A couples therapist can help you to understand: What is the pattern you keep falling into that gets you stuck? How can you fight together effectively? You’re going to fight. You’ve probably read elsewhere that it’s not that happy, healthy couples don’t fight—it’s how they fight. So, Maynigo points out, the emphasis in couples therapy is not on stopping the fighting, but rather: How can you learn to fight in a different way, and, importantly, repair the fight in a healthy way? A couples therapist works with you to break unhealthy patterns, maybe even practicing healthier patterns in session, and capitalizes on your strengths as a couple. 1. What if only one of us wants to try therapy? Maybe your current fight is about whether to go to couples therapy. Perhaps one of you has already been to therapy and has had a negative experience. Maybe one of you has heard that couples therapy could be helpful, but the other partner doesn’t want to go. Here’s a possible solution: Discuss attending an initial consultation with a therapist (or more than one—see below), just to learn about it. Agree to a test run, and see how it goes. Keep in mind that couples therapy is different from individual therapy. Going to therapy with a partner is different from going alone. Plus, therapists vary significantly in personality, style, age, and how those variables interact with you as a couple. So, don’t necessarily let a previous bad experience cloud your judgment this time around. If an initial couples therapy consult still doesn’t seem like an option for you, the partner more interested in therapy can begin individual therapy, which can be helpful with or without concurrent couples therapy. 2. Where do you find a couples therapist? Your primary care provider or OB/GYN can be a great resource. Or, start with Psychology Today’s comprehensive Find a Therapist directory. If you can’t find a therapist close to home, you can even search by which therapists work via Skype (or other confidential video platforms). Clarify with the therapist, however, that his/her license allows him/her to provide therapy to patients in your state (working with someone in-state often fixes this issue). And at the end of the day, word of mouth is often a great way to go. It can be hard to talk to friends and family about needing help, but you might be surprised, when you ask around, how many people have been to therapy or know of a good referral. As APW contributor Aly Windsor wrote in “Secrets of a Gay Marriage,” if you ask your happily married couple friends their secrets, “One or two of them may even be able to refer you to their secret, heroic therapists.” 3. How do you find a qualified therapist who is a good fit? Most importantly, both you and your partner need to like your couples therapist. Feel free to consult with more than one therapist before beginning therapy. There are also various types of therapists and therapies, and it’s absolutely your right to have a good understanding of a therapist’s training and approach. Discuss with your partner what’s important to you, and just ask the therapist directly if he/she can work with that in mind. It’s completely normal to be anxious before starting, so be honest about your concerns. Ask the therapist about his/her specialized training in couples therapy, professional organizations he/she belongs to, what proportion of his/her practice includes couples, or if he/she has helped people with your particular needs before. 4. What are the different kinds of credentials, a.k.a. all of those letters after therapists’ names? In general, master’s level therapists have focused their training (approximately two to three years) on therapy, while doctoral level therapists have training (approximately five to seven years) in therapy, as well as psychological assessment and research. Counselors who are clergy may not necessarily be trained therapists, but may still have significant counseling experience. Clergy may approach relationships through a religious lens (they don’t always!), which may or may not be a good fit for you and your partner. Some therapists’ styles are practical/skills-oriented, some are more interpersonally oriented, and some are more emotion-focused. Some therapists have been working for many years, and some are new to the field, but both can be great. Some might see you for several sessions or a few months, and some might work more long-term. Again, just ask. Also: for a more feasible way to schedule couples therapy into your busy life, or to just brush up on skills, consider attending a weekend couples workshop. 5. How do I afford this? See if your health insurance includes mental health benefits, or if it offers out-of-network mental health coverage. Because even if they don’t take your insurance, most therapists are happy to help you obtain out-of-network reimbursement. Many therapists also work on a sliding scale fee. Last, therapy training institutes, clinics, and graduate schools often provide terrific opportunities for affordable therapy, usually with a therapist who is pursuing advanced training under expert supervision. I hope that this information is helpful and that the future brings happy times for you and your partner—even with the inevitable, but with the right tools, survivable, bumps in the road. Disclaimer: The information provided in Ask a Psychologist is intended by Dr. Brofman and APW to serve as general advice and guidance for all readers. It does not constitute or serve in place of confidential clinical consultation with a mental health professional. Shara M. Brofman, Psy.D. Shara Marrero Brofman, Psy.D., is a psychologist who values all things practical. She studied Child Development at Tufts University and worked in case management and clinical research before earning her master's and doctoral degrees in Clinical Psychology from Rutgers University. Dr. Brofman practices in New York City and has special interests in women's and reproductive mental health. She can be contacted at drsharabrofman at gmail dot com. Photo by Smitten Chickens.