Couples Therapy: 7 Myths and What Really Happens in Sessions

What Couples Therapy Is

Couples therapy is a form of psychotherapy in which the client is the relationship between two people. The partners come together, and the specialist works with what happens between them: how they argue, how they express love and dissatisfaction, how they cope with stress, and which expectations and fears they bring from their past relationships and families. The goal is not to change one person but to change the nature of the interaction so that both feel better.

There are different approaches: emotionally focused therapy, integrative behavioral couple therapy, cognitive behavioral methods and systemic family therapy. What they have in common is attention to recurring patterns — the “dances” a couple performs again and again. For example, one partner demands attention while the other withdraws, and the harder the first one pushes, the further the second one retreats. Therapy helps the couple see this cycle and break out of it.

The Main Myths About Couples Therapy

Many couples put off seeing a specialist because of ideas that don't match reality. Some fear the therapist will declare them to be at fault; others believe that if help is needed, the relationship is doomed. Let's look at the most common myths — understanding how the work is structured helps you take the first step and come to a session without unnecessary fear and tension.

Myth 1: The Therapist Will Decide Who Is Right

A couples psychotherapist is not a judge or a referee. They don't hand down verdicts or take one partner's side. Their client is the relationship, and the task is to help each person express their position and hear the other's. If a therapist clearly takes sides, that is a reason to discuss it with them or choose another specialist.

Myth 2: Couples Only Go to a Therapist Right Before Divorce

Many couples really do come when the relationship is on the brink. But the longer resentment builds up, the harder the work becomes. Seeking help at an early stage — when conflicts have only just started to recur, after the birth of a child, a move or another crisis — usually takes less time and gives better results.

Myth 3: Therapy Will Definitely Save the Marriage

The goal of couples therapy is to help the couple clarify what each person wants and find a solution. Often this means rebuilding the relationship, but sometimes the outcome is a conscious separation. Therapy helps people part respectfully, without a war, especially when there are children and it is important to keep the parents cooperating.

Myth 4: If You Need Help, the Relationship Is Bad

Difficulties arise in any relationship. Seeking help says not that the couple is weak but that the partners value their relationship and are ready to work on it. Just as people see a doctor without waiting for complications, couples see a therapist to prevent the relationship from falling apart.

Myth 5: The Therapist Will Tell My Partner My Secrets

Confidentiality rules are discussed at the start of the work. Many therapists agree in advance on how to handle information that one partner shares in an individual session. The specialist will not disclose what you have told them without your consent, but they can help you prepare for an important conversation yourself.

What Happens in Couples Therapy Sessions

The first session is about getting acquainted. The therapist asks each partner what brought the couple in, how long the difficulties have existed, what they have already tried and what they want to achieve. They may ask about the history of the relationship: how the couple met, what was good, when the problems began. Sometimes the specialist suggests one or two individual sessions with each partner to better understand their point of view and assess safety.

After that, the work is built around specific situations. The couple describes a recent argument, and the therapist helps them break it down step by step: what each person felt, what they were thinking, what they really wanted. It often turns out that behind the reproach “you never listen to me” lies a fear of not being needed, and behind silence, a wish to avoid pain. The partners learn to talk about their feelings and needs directly and to hear each other.

• Working through recent conflicts step by step, without looking for someone to blame.
• Exercises in active listening and expressing feelings without blame.
• Rebuilding trust after infidelity, lies or other crises.
• Discussing the division of responsibilities, money and plans for the future.
• Restoring intimacy and time spent together.
• Homework — for example, a regular calm conversation once a week.

When a Couple Should See a Therapist

Reasons can include recurring arguments over the same topics, a feeling of estrangement and loneliness next to your partner, loss of intimacy, constant criticism, contempt or cold silence. Therapy also helps in crises: after infidelity, with the birth of a child, during one partner's illness, after emigration or job loss — when the usual ways of coping stop working.

A separate situation is when one partner has depression, an anxiety disorder or an addiction. Illness strongly affects relationships, and a strained relationship, in turn, gets in the way of recovery. In such cases, couples therapy complements but does not replace treatment by a psychiatrist or an addiction specialist (narcologist). Working together helps the other partner understand what is happening and offer support without losing themselves.

If Your Partner Doesn't Want to Go

You can start with individual therapy. Changes in your behavior will affect the relationship, and sometimes the partner joins later. Suggest one trial session and explain that it is not a trial but an attempt to understand together what is going on. Pressure and ultimatums usually provoke resistance.

When Couples Therapy Is Not Appropriate

Joint therapy is not safe if the relationship involves physical, sexual or severe psychological abuse, threats, control or stalking. In such a situation, an honest conversation in the presence of the abuser can lead to new danger for the victim at home. The first step is safety — contacting the police on 102 or 112, a protection plan, support from crisis services, and individual help.

Joint sessions are also of little use when one partner has an untreated severe addiction, acute psychosis or marked depression with suicidal thoughts. First, help from an addiction specialist or psychiatrist is needed. A qualified couples therapist assesses these risks in the first sessions and, if necessary, suggests a different form of help, with joint work resuming later.

Couples Therapy Online

The online format works well for couples. Partners can join together from one device or from separate ones if they are in different places — for example, on a business trip or during a period of living apart. This saves travel time and makes it possible to choose a specialist regardless of the city. It is important to find a private place and a time when you won't be interrupted by children or other family members.

Psychiatry Online psychotherapists provide couples therapy online, anonymously and at a convenient time, including in the evening when both partners are free. If it turns out during the work that one partner needs help from a psychiatrist or addiction specialist — for depression, an anxiety disorder or addiction — a consultation is available at the same clinic, without having to start searching all over again.

When to see a doctor

• Arguments keep following the same script and end in shouting, contempt or long silences.
• You feel lonely next to your partner and don't know how to bring back intimacy.
• There has been infidelity, lies or another crisis after which trust is hard to restore.
• The birth of a child, a move or a job loss has sharply intensified conflicts.
• One partner suffers from depression, anxiety or addiction, and it is affecting the relationship.
• You are discussing separation and want to make the decision consciously and with care.

Questions and answers

Reviewed by

Madina AbdrakhmanovaAddiction psychologist

Motivation for treatment, relapse prevention, codependency and work with families.