Couples Therapy: Treatment, Effect & Risks

In most long-term relationships, there are crises that a couple has to deal with. When you can’t solve problems on your own, it makes sense to get professional help in the form of couples therapy.

What is couples therapy?

Couples therapy refers to psychological work in which a couple is helped to work through and resolve their conflicts. Couples therapy is the term used to describe psychological work in which a couple is supported to work through and resolve their conflicts. In Germany, it is closely related to marriage counseling. Both belong to the non-therapeutic activities. In couple therapy or marriage counseling, mainly pastors, psychologists and social pedagogues work. Most often, work is done with both partners, but sometimes individually.

Function, effect and goals

Couples counseling is useful when a couple fails to satisfactorily resolve their problems together, but both partners want to work on their relationship. Partnership problems are stressful for both partners and, in the worst case, can make them ill and lead to depression. The goal of couples therapy does not always have to be the preservation of a relationship; sometimes it may also be indicated to guide the couple toward a separation that is acceptable to both. One of the most important conditions for the success of a couple therapy is the realization of both partners that not one of them is to blame for the crisis. In a couple therapy there are different application procedures:

In psychoanalytic procedures, it is assumed that one or both partners have neurotic predispositions. The psychotherapist Jürg Willi speaks of collusion, e.g. one partner is narcissistically predisposed and wants to be admired, the partner admires and idealizes him. Such fixations can always become problematic if a partner is reduced to this behavior and suffers from it. Among the humanistic methods, Michael Cöllen’s couple synthesis plays a particularly important role. The central thesis is that love and intimacy are created early in life and that an intimate and emotional bond forms an important foundation stone for personality development, especially with regard to the love and conflict dynamics of a couple. In therapy, narcissistic disturbances in couple dynamics are to be revealed and worked on, and intimacy in the various levels of body, feeling, soul, language and time is to be fostered and love is to be understood as an orientation to meaning and life. In multigenerational therapy, the cause of couple conflicts is believed to be in the families of origin. It is assumed that it is a recurring basic conflict over several generations that catches up with the couple. Central concepts in multigenerational therapy are loyalty, delegation, and conflicting orders from the families of origin. Systemic couples therapy is concerned with the question of which “circular processes” sustain the couple conflict, distinguishing the behavioral level, behavioral patterns, and construction of reality. Important concepts of systemic couple therapy are circularity, reframing, neutrality, solution and resource orientation, and positive connotation. Communication psychology therapy aims to improve communication between partners so that they understand each other better. John Gottman names 4 Apocalyptic Horsemen as typical communication traps of a relationship:

  • Criticism, blame, accusations.
  • Defense and justification
  • Contempt and disdain
  • Walls, retreat

Risks, dangers and special instructions

One risk of couples therapy is the possibility of a breakup at the end of therapy. Couples therapy can help expose conflicts and communication patterns, but it cannot mend a relationship. If there is not enough love between the partners, couples therapy cannot help either. Nor is couples therapy designed to fundamentally change one of the partners so that they become more “relationship-ready.” Psychotherapist Wolfgang Schmidbauer considers the bearing and endurance of differences between the two partners to be the most important qualities in a couple relationship. Couples therapy can be expensive, depending on the time involved, because couples therapy is not covered by health insurance. Side effects can be that both partners change in a couple therapy, which in turn can mean a new challenge for the relationship.