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What is couples therapy?

Couples therapy is a form of counseling that focuses on improving the relationship between partners. In this way couples therapy differs from individual psychotherapy as the relationship and not the individuals within the relationship is the primary focus of attention. When working with couples I focus on relationship dynamics, the impact that family of origin and past relationships may contribute to the presenting concern, patterns of communication, and how the relationship manages trust and intimacy. This process involves tracking how partners relate, understand, respond, and interact with one another. Improving how couples understand and interact with themselves and one another is a common theme from which to work through conflict in an empathic manner. Couples therapy is a complex model of intervention and that requires specialized training and skill development. Before meeting with a clinician to begin couples therapy, ask about their training, the models they draw from, the length of time they have been practicing couples therapy, and their familiarity with couples’ issues and the areas that they tend to focus on.

My approach to couples’ therapy

I started working with families and couples in the 1990’s, and my approach to relational therapy has been evolving ever-since. My initial areas of interest and training in family and couples’ therapy focused on an integrated, structural, strategic, Bowenian, existentialist, object relations, solution focused, collaborative language systems, narrative and postmodern approach to intervention. I have trained in Emotionally Focused Couples Therapy, and am currently enrolled in The Couples Institute Developmental Model of Couples Therapy. At this time, I draw from a variety of perspectives and interventions frames and tailor each clinical encounter to the couples that I work with.

Couples therapy for all relationships

Much of the research and literature published to date on couples’ therapy has focused primarily on monogamous and heterosexual couples. Clearly, the information obtained from these resources contains important data and is, in many cases, transferable to therapy with same sex couples and couples that have varied relationship agreements concerning monogamy. While heterosexual, same sex, and non-traditional couples share many of the same relationship issues, attachment needs, and struggles, there are challenges faced by same sex couples and non-traditional relationships that differ from their heterosexual and monogamously pair bonded cohort. In addition, there are also strengths and communication strategies utilized by same sex couples and self-defined relationships that can greatly benefit heterosexual and monogamously pair bonded relationships. Recognizing the strengths and challenges of relational diversity can also serve to improve the lives of all people and relationships. Having extensive clinical experience working with a couples, sexual orientations, and configurations of intimate relationships, I make it a point to state that all couples and relationship styles are welcomed, honored, and respected in my practice.

What is expected from my partner and I in couples’ therapy?

Couples therapy requires a commitment to work on your relationship, share compatible goals, and a willingness to risk intimacy and growth. This also includes learning to be more present with yourself and your partner and moving past your comfort zone to experience one another in new and potentially life altering ways. Couples therapy requires that all parties be willing explore and share their needs, consider what they have contributed to the relationship strengths and liabilities, and develop new more emotionally attuned patterns of interacting and experiencing one another.

Preparing for couples’ therapy.

Many clinicians will discuss the couples that they are interested in treating. This is important as it allows the couple to consider the fit between their presenting issues and the expertise of the couple’s therapist. However, therapists tend not to discuss those situations and struggles that can undermine the effectiveness of couples’ therapy. To provide couples with a clear, open and honest line of communication, it's important to provide folks with a framework of issues that may indicate the couple is not ready for therapy.

If you are seeking couples therapy to get him/her/them to change, but remain unwilling to look at what you contribute to the current discord in your relationship, you may not be ready for couples’ therapy. If, on the other hand, you are ambivalent and questioning the viability of your relationship, that's A-Okay! One of the reasons couples come to therapy is to try and salvage their relationship! Not being sure of the outcome of therapy and being open to this conversation in a non-reactive, albeit emotionally challenging manner, is a central tenet of couples’ therapy.

During the process of therapy old injuries and expectations, sometimes from our family of origin or past relationship experiences, get re-activated and projected onto one another. This is not to say that relationships do not have "here and now" struggles; they do! However, being able to discuss these challenges while finding the strength to let your partner bear witness to and help heal old wounds can change how you experience one another.

If you are looking to convince me that your partner is “always” wrong and you are “always” right, you may not be ready for couples’ therapy. If, on the other hand, you are looking to share with your partner how you do not feel heard and you are willing to entertain the idea that your partner may also have similar feelings and complaints; I may be able to help!

Learning to hear and have compassion for one another can create an environment where you learn to experience moments of connection while also learning to trust that your partners’ intent is not to harm but to air and resolve unspoken needs, albeit, in a sometimes unclear and defended way.

If you are involved in non-consensual non-monogamy, and have no interest in working with your partner to understand where these choices and behaviors come from, how to change them, and how to heal these injuries prior to discussing the possibility of exploring an open relationship, you may not be ready for couples’ therapy. If you have been the partner of someone who has engaged in non-consensual non-monogamy, and you are unwilling to risk sharing with your partner how their choices injured you, preferring instead to shame them, you may not be ready for couple therapy.

I am NOT advocating a stance of forgive and forget, that is un-empathic and lacks compassion. However, remaining in a relationship where one’s pain hardens into unspoken resentment is more damaging, in the long run, than the original betrayal. It takes a great deal of courage to share how a loved one’s behavior and choices have hurt you and how that individual will need to assist you in re-establishing trust. This process also requires the ability to bear witness to the struggles that lead to your partner’s choice to be sexual outside of the relationship.

What can we expect in couples’ therapy?

There is no “one size fits all” when it comes to psychotherapy, as such treatment is always tailored to the unique needs of the couple. This means that each therapy is a unique experience for all parties involved. Entering any form of therapy can raise anxieties about the unknown. Yet, having a basic framework to draw from can make this journey more manageable. When you enter therapy with me you can expect the following;

•  A supportive environment where the relationship is respected;

•  An engaged assessment of your struggles and strengths;

•  Exploration of past issues & family dynamics that may impact the here & now;

•  An individual session where your perspective will be heard;

•  A plan help you and your partner reach your goals;

•  Skills in learning how to hear and re-discover one another;

•  Exploration of new ways to be in relationship with one another;

•  Respectful redirection of discussions as needed;

•  The development of a voice in your relationship;

•  Understanding how to discuss sexual needs and desires;

•  Skills in discussing, understanding and & resolving conflict;

•  Hard work.

How to Maximize your Couples Therapy Sessions 

An unproductive pattern in couple’s therapy is making the focus whatever the problem happens to be on someone’s mind at the moment. This is a reactive, and often, approach to working through relational struggles and, more often than not, only serves to foster greater resentment and movement away from healing and change. 

The second unproductive pattern is showing up to session and saying, “I don’t know what to talk about, do you?” While this blank-slate approach can, at times, open some interesting doors, it is a hit or miss process that creates a tenuous therapy encounter.

The third common unproductive pattern is discussing whatever fight you are currently having or have had since our last meeting. Discussing these fights/arguments without a larger context of what you wish to learn from the experience is often an exercise in futility and creates a sense of moving nowhere. 

Over time, repeating these patterns will lead to the plaintive question, “Are we getting anywhere?” 

A more powerful approach to couple’s therapy is for each person to do the following before each session:

1. Reflect on your objectives for being in therapy;
2. Think about your next step that supports or relates to your larger objectives for the kind of relationship you wish to create, or the partner you aspire to become;

3. Consider what you have contributed to the struggle;

4. Explore ways you would like to handle your feelings and emotional reactions more effectively. 

This reflection takes some serious effort and self-soothing. Few people would call an important meeting and then say, “Well, I don’t have anything to bring up, does anyone else have anything on their agenda?” Preparing for each session will save you time and money.

Recording therapy sessions

Video and digital recording of therapy sessions is commonly used to improve the delivery of psychotherapy services to couples and families. By recording couples therapy sessions and obtaining consultation from other therapists, I will be in a better position to improve the effectiveness of our work together. Prior to recording therapy sessions, I will need your written consent. Please note that you may decline to have your sessions recorded without fear of a reduced quality of treatment from your therapist. Video and digitally recorded sessions will not become part of your medical record and, unless otherwise agreed on, all recorded materials will be destroyed at the completion of therapy.


Please be aware that in consultation the strictest confidentiality and respect for your privacy will be maintained. Neither video or digital recording materials will be shared beyond the limits outlined in this document. Except for your first names, your voice and images on the recording, there will be no information that could identify you. Please note, that mental health professionals who may view these video or digital recordings are bound by law, as well as their professional disciplines code of ethics, to protect your confidentiality as if you were their own clients. 

In you are interested in discussing the possibility of our working together please feel free to contact me at (617) 461-8479 or send me an e-mail at josephwinnlicsw@josephwinnlicsw.com

Suggested Readings:

Gottman, J., Silver, N. (1999). The Seven Principles for Making Marriage Work: A Practical Guide from The Countries Foremost Relationship Expert. New York, NY: Random House, Inc.
Greenan, D. E., Tunnell, G. (2003). Couple Therapy with Gay Men. New York, NY: The Guilford Press.
Harper, G. W., Schneider, M. (2003). Oppression and Discrimination among Lesbian, Gay, Bisexual, and Transgendered People and Communities: A Challenge for Community Psychology American Journal of Community Psychology 31(3-4), 243-252.
Hendricks, H. (2007). Getting the love you want. New York, NY: Holt Publishers.

Johnson, S. M. (2004). The practice of emotionally focused couples therapy: Creating connection (2nd ed.). New York, NY: Brunner-Routledge.

Lev, A. I., Sennott, S. (2012). Understanding gender non-conformity and transgender identity. In, Kleinplatz, P. J. (Ed.), New directions in sex therapy: Innovations and alternatives (pp. 321-336). New York, NY: Routledge.
Perel, E. (2006). Mating in Captivity: Reconciling The Erotic and The Domestic. New York, NY: Harper Collins Publishers.
Schnarch, D. (1997). Passionate Marriage: Keeping Love and Intimacy Alive in Committed Relationships. New York, NY: W.W. Norton & Company, Inc.
Sycamore, M., B. (Ed.). (2006). Nobody Passes: Rejecting the Rules of Gender and Conformity. Emeryville, CA: Seal Press. 

Taormino, T. (2008). Opening up: A guide to creating and sustaining open relationships. San Francisco, CA: Cleis Press.

Veaux, F., Rickert, E. (2014). More than two: A practical guide to ethical polyamory. Portland, OR: Thorntree Press.