How to Get the Most Out of Couples Therapy: Straight Talk from an Experienced Couples Therapist

Inspired by the work of several couples therapy mentors: Martha Kauppi, Johannes Kieding, Marty Klein, Ellyn Bader and Peter Pearson

Let's Start with the Obvious

If what you were already doing in your relationship was working, you wouldn't be looking for a couples therapist. So let's take that as a given and use it as a starting point for what good couples therapy actually asks of you.

Expect to Feel Challenged, both Individually and as a Couple

My job isn't to mediate your fights or offer soothing words. It's to directly confront the behaviors that are getting in the way of the goals you came in for. To hold up a mirror and help you see what you might not be seeing.

There will likely be moments when the focus lands more heavily on one of you than the other. That’s to be expected. I’m always looking for what is creating a barrier to authentic, emotionally open connection– whether that’s one of you being defensive, withdrawing, blaming, shutting down or both of you not truly listening to each other. Many of the behaviors we employ in relationship are unconscious ways of protecting ourselves. While those behaviors may have served a purpose in the past, they often are what create challenges to having the kind of fulfilling intimate partnerships we want. So it’s my job – not to criticize or embarrass you– but to help you see what you might not see that’s harmful to you and your relationship. 

You’re always free to have your own perspective or disagree with me - however, if you want to get something valuable from the couples therapy, my suggestion is to see if there’s any truth to the feedback I’m giving, even if it may be difficult to hear. 

Being in the ‘hot seat’ and having the light temporarily shone on your behaviors can be uncomfortable– I get that. Know that if the focus is more on you in one session, it’s very likely your partner will be taking the heat in another.  As my mentor, Stan Tatkin likes to say– no one is solely an angel or a demon in a relationship. We’re all a pain in the butt sometimes and we all have the capacity to act out under pressure and when strong feelings get stirred up in us. 

What’s real is that if you want to make the most out of couples therapy and truly turn around long-standing, unsatisfying, disconnecting dynamics– you’ll need to exchange short-term pain for long-term gain. 

If You're Expecting to Feel Better After Every Session, You're Better Off Going to a Spa

Seriously. If feeling soothed is the goal, a massage or a feel-good comedy will do it better and cheaper.

Couples therapy is about facing the difficult aspects of your relationship that you may have been avoiding for months or years. That means there will be sessions that are hard– where you finally talk about a difficult topic that’s been unresolved for years or where you leave feeling more stirred up than when you arrived. That's not a sign something is wrong or that you’re regressing as a couple– it’s often a sign something important is finally being looked at.

A more useful question than "am I feeling better?" is "am I growing?" Am I becoming less reactive? Am I able to hang in there longer and stay open and curious when my partner shares something hard? Am I being more transparent and vulnerable in sharing what’s on my heart and mind? Those are the metrics that matter and are worth tracking over time.

There Is No Long-Term Gain Without Short-Term Discomfort

You may have heard this sentiment before in other contexts, but I’ll say it again here: growth doesn't happen from inside your comfort zone. Couples therapy may bring up intense feelings, anxiety and tense moments with your partner. You can take it as a given that if you’re doing real work in therapy and not just skating on the surface, you’re bound to feel uncomfortable in moments. I'm here to make sure that discomfort is well-utilized and not just pain for the sake of pain. Although your avoidance may have felt emotionally easier, it’s also been what’s kept you stuck.  While my job isn’t to soothe you or pretend that you’re not facing something hard, I will be there by your side as you explore fraught terrains of your relationship and psyche. You willget my undivided support and attention in dealing with the feelings and anxiety that arise from peering under the rug. 

One thing to note is that while anxiety in therapy is to be expected, I never want either of you to get so anxious that you can’t think clearly, feel sick, have ringing in your ears or exhibit other signs of being outside what we call your ‘window of tolerance.’ The window of tolerance is that optimal zone of nervous system arousal where you can handle stress and manage your emotions without going into overwhelm or shut down. Couples therapy should be pushing you toward growth without pushing you into dysregulation. We’ll work together as a team to make sure that you’re each in your optimal learning zones and feel supported as you dive into the hard stuff. 

You're the Driver of Your Own Success

If you can make room for some discomfort, you're already most of the way in. What happens next depends entirely on you.

Therapy isn't like going to the dentist, where you lie back and get worked on. It requires you to be a highly active participant in your own growth — not just showing up physically, but being available and present in your heart and mind.

Your ongoing engagement is what makes the work work. Bringing in what’s important to you– what you want to be learning about yourself and where you want to develop more effective relational skills, being open to looking in the mirror, practicing what you’re learning outside of session — that's what moves things forward. Just bringing your body to therapy isn't going to get you results.

And if you're not ready to give it your full effort right now — no problem, no judgment. Maybe this simply isn't the right time for you to engage in this work. Only you can know if your will is truly on board to be a full participant in meaningful couples therapy. 

Don't Get Caught In the Fantasy That Anyone Else Can Solve Your Issues for You

I can point you in the direction I think you need to go. I can name what I observe, offer direct feedback, create the conditions for real conversation, and suggest what might help. But I cannot do for you what only you can do for yourself. The effort, the will, the openness to change — that comes from you.

The more open and real you are with me and with your partner, the more I can help. The more you go through the motions or perform your way through sessions, the less the therapy will benefit you.

Anyone Promising You a Quick Fix or a Guaranteed Outcome Is Trying to Sell You Snake Oil 

Engaging in couples therapy doesn't come with guarantees about where it will lead. Some couples come to see me and leave with a stronger, more connected relationship than they've had in years. Others, through doing the hard work of looking honestly at themselves and each other, come to realize they're no longer a good fit — and that parting ways is the most truthful path forward.

Both outcomes are valid. Both can be the result of good therapy.

My only agenda is truth. I'm not here to save your marriage at all costs, and I'm not here to nudge you toward the door. I'm here to help you each get real — with yourselves and with each other — and to support whatever clarity emerges from that process. Sometimes it leads toward each other. Sometimes it leads somewhere else. Either way, I'll be with you in it.

Some Goals Are Ones I Can't Get Behind

I want to be upfront about this: some of the goals couples bring in are ones I genuinely can't support.

I cannot help you create a relationship where strong emotions are never triggered. I cannot help one partner become so attuned to the other that conflict disappears entirely. A conflict-free relationship isn't a deeply connected one — it's one where someone is quietly suppressing their needs to keep the peace. That's not something I'm willing to help you sustain.

What I can do is help you handle conflict in ways that bring you closer rather than further apart. Help you feel your emotions without being ruled by them. Help you stay in the room with each other when things get hard — which is where real intimacy actually lives.

If both of you share a genuine motivation to change, there's a lot we can do together. If that common ground isn't there, I'll name it directly — because pretending otherwise doesn't serve either of you.

Here's What You CAN Do to Get The Most Out of Couples Therapy

Set goals for yourself, not your partner. If you’re human, you likely have feelings about some of your partner's behaviors or characteristics. Perhaps your partner even hurt you in some significant, gut-wrenching way. It’s totally warranted to want your partner to make some real changes in how they show up with you. And there’s room for that to be discussed in the therapy. However, you'll be in the most empowered position if you focus on the ways you want to change for yourself. Neither I nor you can change your partner. You can influence them, but you cannot change them. The most efficient way to change a relationship is to become a more effective partner yourself– that includes how you deal with your feelings of hurt, anger, disappointment etc. 

For example, even if your partner cheated on you or otherwise substantively hurt you, how you deal with your  feelings toward them matters– and can either bring you closer to them or further away. Looking at how you deal with your feelings can be a really great place to start in understanding your own contributions to your relationship dynamics. 

A meaningful goal isn't "I want my partner to stop shutting down when we argue." It's "I want to learn how to raise difficult topics without going straight to blaming" — because that's something you have agency over. Good goals are internally focused, specific enough to be actionable, and reflect the kind of relational person you want to become — regardless of whether you stay in this relationship or not. 

Goals built around appeasing your partner are not ones I can get behind, because appeasement is usually a substitute for real emotional honesty. And emotional honesty is the business I'm in.

Before each session, ask yourself: what do I want to work on (for the sake of my growth and learning) and what kind of partner do I want to become? Those questions alone will change the quality of the work.

Be real about everything — with me and with your partner. That includes any reactions you're having to me or to the therapy itself. Everything that happens in the room is useful information.

Trade your ego for humility. Be willing to sit with the observations I'm offering and the feedback your partner is trying to give you. Ask yourself whether there might be some truth in it — even if it's uncomfortable to consider.

Don't just debrief the last fight. Relitigating Wednesday's argument blow by blow rarely leads anywhere without a larger context. The fight is usually a symptom. Bring the symptom, but be willing to look for what's underneath it– including your own contributions.

A Final Thought

Couples therapy is hard work. But so is staying stuck. So is the slow erosion of a relationship that could have been different. And so is divorce — emotionally, logistically, and financially.

The couples I've seen make the most progress aren't necessarily the ones with the least damage. They're the ones who decide, somewhere along the way, that the truth matters more than being right — and that the relationship they actually want is worth the discomfort of getting there.

If that's where you are, I'm ready to go there with you.

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Jen Joseph is an AASECT Certified Sex Therapist and licensed couples therapist serving individuals and couples online across California and Oregon. She specializes in sex therapy, couples therapy, and discernment counseling.