When to Seek Couples Therapy

**  This post utilizes the terms marriage and couples counseling interchangeably and refers to the partners as spouses, but can also be applied to couples who are in long-term committed relationships without the legal contract. Or really to any couple who is identifying with what’s described on the list.  **


 They say marriage is hard.  They say marriage is work.  They say things will change when you get married, but they can’t say exactly how.  And they are right.

The terms “work” and “hard” generally have negative connotations.  So, let’s reframe this.  All quality relationships require attention, nurturance, effort, give and take, and a willingness to work through challenges.  Think about your long-term friendships that have survived the years and changes in life. They’ve survived because you built the solid foundation and have continued to put in the effort over the years. Marriage is no different.  It is also similar to having a plant.  You can’t get a plant and stick it in a corner and expect it to thrive.  Even a cactus needs sunlight and water once in a while.  Taking care of a plant means making sure it has the right amount of water and sunlight specific to its needs, fertilizing, trimming off dead leaves, replanting or repotting it at times, and general attention.  Think of your marriage as a living, breathing plant that needs to be looked after, checked on, and attended to in order for it to thrive.

If you give your marriage the nurturance and attention that it needs – that it deserves– then the payoff will be a more fulfilling, satisfying relationship.  This has to start early and continue throughout the relationship.

I hope you walk away from reading this post with two major takeaways:

1.    Seek counseling early and often throughout the marriage.  Don’t wait until you are on the brink of divorce for marriage counseling to “save” your marriage. That feels like climbing Mount Everest and most couples enter marriage counseling at that point feeling hopeless and skeptical that counseling is going to work.  Think about marriage counseling as going to your PCP for your annual check-ups.  The goal at that appointment is to identify any issues and approach things from a preventative perspective rather than a reactive one. If you go to marriage counseling early, establish a solid foundation of skills and understanding,  and become comfortable with marriage counseling, then when issues arise, it can be shorter-term counseling (e.g., 4-6 sessions) for a tune-up rather than long-term (6 months – 1 year or more) to undo years of hurts, bad patterns, and repair considerable disconnection from one another.  

2.    There is nothing wrong or shameful about seeking help to make your marriage stronger.  It doesn’t mean you are defective or “can’t” do this.  In fact, you are investing in your relationship and giving yourselves the gift of prioritizing your marriage and learning how to be the best partners you can be for each other.  There is an art and science to love and attachment.  There are specific skills you can learn to be healthier individuals and healthier together.  And until you learn this information, it is an unknown to you.  You can’t make any changes without awareness, introspection, and education.  Healthy relationship skills are not taught in school and unless you seek out the knowledge, then you will just be in the relationship operating off of what you know, what’s been modeled to you, and you are doing the best that you can.  But with a little understanding, knowledge, and practice, you can do differently and become better partners. That’s what marriage counseling can provide.  


So, when is it a good time to seek couples counseling? 


1.      Pre-marital counseling

 Most of the time couples don’t think they need pre-marital counseling or see the benefit of it.  Or they are just doing it to get a discount on their marriage license.  After all, this is one of the best times in a relationship.  Both people are happy and excited to have found “the one,” wedding planning starts, and they are off to the races to have a glorious celebration.  The focus becomes the marital ceremony rather than the relationship itself.  Most people in this stage think “Yeah, marriage is work, but we’ve got a great relationship. This doesn’t apply to us.”  Or, “We’re practically married anyways, nothing is going to change.” Except it does.  And this is not something that you can fully be prepared for or predict until it actually happens.  

Pre-marital counseling can lay a foundation for the relationship to help couples identify strengths and challenges about their relationship.  Exploring each person’s beliefs and values around topics such as money, religion, sex, and children/family planning can help a couple ensure they are aligned and facilitate ways to communicate about these topics openly in a safe environment.  Identifying hurts from past relationships and childhood experiences will help you understand how those will impact the current relationship, and how to have healthy emotional responses around those topics.  Learning healthy communication skills to navigate and resolve conflict is tremendously beneficial as a preventative tool for when the going gets tough.  Conflict will happen, it is necessary in marriage.  It does not have to mean screaming, fighting, and hatred, but just “how are we going to resolve issues?” You can learn the skills you need to work through the issues, especially if you are uncomfortable with conflict.  

Pre-marital counseling can also give couples the experience of counseling itself so when other issues arise in the future, you are more comfortable with seeking help and will hopefully not wait until the relationship is at a crisis point to reach out. 

2.     After the first year of marriage

This is a good time for a check-in to review what has gone well over the past year and work on challenges that have occurred.  You can discuss how the different roles and responsibilities have played out and if both partners are satisfied with each other in these areas. You can review common conflicts that have started to pop up and work towards understanding and resolution – or learn healthy communication skills if you didn’t do pre-marital counseling. Even if you did pre-martial counseling, it may be a good time for a reminder of these skills because you now have conflict to apply them to when you didn’t before.  You can review or set future goals that you will be working towards together.  You can discuss if each person feels satisfied with their individual identities (e.g., does each person have their own interests, hobbies, and friends) as well as the time you spend together (quality and quantity), shared interests, and if there is room for improvement.  You can do a check-up on the quality of your emotional connection – do you feel as though you can be authentic, vulnerable, and trust that you partner is going to be emotionally responsive or does this need some attention? And reviewing satisfaction in the physical intimacy department is also key – are both people satisfied with the sexual relationship or is there need to facilitate discussion?  Maybe you’re not comfortable talking about your sex life and this is a good opportunity to be able to become comfortable with this topic. 


3.     During the pregnancy of your first child and during the first year of your child’s life

Most couples feel closer and more bonded during pregnancy, so why would that be a time to go to couples counseling?  Similar to getting married, people say having a baby changes everything.  “Yeah, yeah, so I won’t get as much sleep or I have some diapers to change.  But our marriage is strong and we’ll be fine.”  Again, having a baby changes your life in ways that you cannot be fully prepared for or know exactly how you’re going to be impacted until the baby is here. And it’s always easier to do counseling and work on difficult topics when things are going well.  (Counterintuitive, I know.) 

Research consistently shows that marital satisfaction declines after the birth of a child.  If you are married, you have at least one child, and you are reading this, I picture you nodding your head in agreement.  This makes sense.  Having a baby changes the roles, routines, responsibilities, and priorities in the family system.  Homeostasis has to be re-established in the new system.  And it is very easy for the focus to be on the baby and the marital relationship take a back seat.  Stress is increased, sleep decreases, and for the first few months everyone is in survival mode.  

Going to couples counseling prior to the birth gives you an opportunity to discuss role and responsibility expectations, how to be supportive of one another during an incredibly stressful time, and get on the same page about parenting approaches or decisions – or at least how to communicate about parenting decisions. Then continuing counseling after the baby is born allows you to a) prioritize the relationship and each other and b) receive support to ensure that needs are being met and challenges are being addressed before they have the opportunity to fester and build into resentment and distance.  Doing a once a month check-in for a period of time (e.g., 6 months) after the baby is born helps you both keep your relationship on track.  


4.     When you notice yourself distancing emotionally or physically from your spouse  

Have you stopped sharing things with your spouse or going to them to meet your emotional needs?  This may be because you’ve started getting entrenched in conflict cycles where you don’t feel heard, validated, or things are not getting resolved.  So, you’ve started to build a wall to protect yourself. Maybe it’s not even in conflict cycles, but you just notice you share everyday things with your spouse and they are not responsive in a way that meet your emotional needs, so you stop sharing. Are you withdrawing and not seeking them out for physical intimacy?  This could because of broken trust or the nature of the sexual relationship changed during pregnancy or after a child and you haven’t reconnected.  Or you’ve found yourself initiating sex and getting rejected so you stop initiating it.  You feel a sense of loneliness in the relationship.  There are lots of factors that contribute to distance with the emotional and physical aspects of a marriage and couples counseling can help you develop an understanding of why this has happened as well as facilitate the reconnection. 


5.     When you notice your spouse is distancing from you 

 Similar to #4 above, but just in reverse.  Are you noticing your spouse is seeking out their friends more than you to share news with or seek comfort from?  Are you noticing them being gone more or on their phones more?  Is there a decline in the frequency of sex or quality of sex?  Let your spouse know that you are noticing these changes and shifts in the relationship, that you are concerned about what is happening, and it may be a good time to seek support to reconnect. 


6.     When you notice that conflicts are not being resolved or arguments are increasing in frequency - or you often feel misunderstood in communication or conflict. 

Couples counseling can help people identify their conflict patterns and cycles, understand why they have the reactions that they do, and help people get out of those negative cycles.  Often times when couples get stuck on recurring themes or issues in their marriage, each person starts to create their own narrative about what is happening around what the other person is thinking and feeling and ascribes meaning to events that may or may not be accurate.  Counseling helps you unpack those narratives, learn how to clear up and clarify conversations – especially during conflict – and work towards understanding each other better.  It also helps people develop conflict resolution skills. 


7.     If you notice the level of respect for each other is decreasing, especially during conflict

When people say their wedding vows to each other, they usually include words such as love, cherish, honor, respect, and the like.  However, couples can quickly forget these vows and what living them out actually looks like.  Love is a verb, not a noun.  Enter in sarcasm, name-calling, insults, curse words, hitting below the belt, and contempt.  These communication habits contribute to decreased trust, increased distance, and less respect for your partner.  People talk to their spouses in ways that they would never talk to their best friend, their boss, or even a stranger on the street.  Gottman’s research shows that one of the most important ingredients to a long-lasting satisfying relationship is creating an environment of respect and appreciation.  It is possible to have productive conflict in a way that maintains respect and honor for each other.  


8.     If the two of you have stopped having fun together and have lost the friendship aspect of your relationship

Has life become about the mundane and the routine?  Going to work, getting the kids to their after-school activities, dinner, homework, bath, bed, repeat?  Focusing on tasks and stressors?  Focusing on kids, the jobs, the chores, and fun events are child-centered?  When was the last time you and your spouse had a genuine laugh together over something one of you did or said?  When was the last time you went out and did something together and enjoyed the experience?  Noticing you’ve lost that sense of friendship that was present in the early stages of the relationship?  Time to get back to the connection and strengthen the friendship.  Your relationship is like the foundation of the house and if the foundation is not strong, the rest of the house can have cracks and issues. Friendship and knowing one another inside and out is the solid foundation of your relationship. 

9.     If you feel like your spouse is more of a roommate than a husband/wife

Have you lost the passion that once was in the relationship?  Yes, it is normal for sexual passion and desire to decrease over time in a marriage.  That is the nature of how love works as it evolves over time and in addition, many psychological components contribute to sex and the sexual relationship.  However, you don’t have to accept that things just change, sex becomes less frequent and stale, and that’s just part of being married. No, the desire and passion can be maintained.  Sex can be a place of connection, security, exploration, vulnerability, and satisfaction.  But, this does take effort, nurturance, open communication, and figuring out why the passion has dwindled.  Couples counseling can help you address this and get back on track with a healthy sexual connection.


10.  When trust has been broken 

The most common way that trust is broken is when infidelity occurs.  Each couple may have a different definition of what infidelity is (and it is helpful to have conversations about what each of you thinks infidelity is before it happens), but it may look like an emotional affair, pornography, or a physical relationship with someone else.  Ultimately, I think of it as you are going to someone else to meet one of the intimate needs you should be getting from your spouse – those being physical and emotional needs.  It is more about the betrayal of trust in the relationship than it is about the other person.  The discovery of these types of relationships often leads to a crisis in the marriage.  However, more couples stay together and work through these issues than divorce over them. You can use the crisis as wake-up call and an opportunity to strengthen the relationship if you choose to do so. 

Trust can also be broken in smaller ways such as lying, hiding information in the financial realm, and repeated patterns of not being reliable.  Couples counseling can guide you through rebuilding trust and hopefully making it stronger than it was before.  You may also seek the safe, trusting environment of a therapist’s office to share information that you’ve been wanting to tell your spouse, but have been unable to on your own.  Having someone help you facilitate the sharing of the news often results in it going much better than if you did it on your own or waiting until it is somehow discovered. 


 11.  When you’ve gone through a devastating event and it is changing how you relate to each other

Couples can face a number of hardships over the course of their marriage: infertility issues, financial challenges, major medical issues, losing a child, caretaking of parents or other family members, loss of employment, and turmoil in one person’s family of origin to name a few.  Each of these types of events takes a major toll on a relationship and can change how you see your spouse.  Couples counseling can help you process through these events, strengthen your bond, and help you learn how to weather storms.



12.  During or after major transitions (i.e., moving, empty nest, retirement)

Change can be difficult for people.  Moving requires a couple to start over with building friend groups and community and they only have each other to lean on at the beginning of a move.  Transitions such as children moving out of the house and retirement lead to a shift in identity as well as a shift in what you need from your spouse.  Doing a check-up on your marital connection can help facilitate these transitions and strengthen your marriage.  

 There continues to be an increase in divorce among people in their 40s, 50s, and on because as the children leave the house, they look at each other and realize they haven’t been connected in a long time and don’t feel the romantic connection anymore. Or they’ve been very dissatisfied with the relationship for a long time, chose to stay together to keep the family unit intact for the children and one person has secretly been planning to end it for years – without communicating this to their spouse or giving their relationship an opportunity to be healed prior to this time.  They’ve gone on co-existing as roommate, co-parents, and business partners without tending to the romantic attachment. This comes back to the original encouragement to tend to the relationship throughout the years and utilize counseling as a support so you don’t find yourself in this position 25 years into the marriage. 



Finding the right therapist for you is also an important component and it may take visits with different ones to find the correct match.  And then once you have that relationship established, it is then easier in the future to reach out and schedule those tune-up appointments.  You also have the benefit of working with someone who already knows your relationship history and you don’t have to start over each time with a new therapist. 

At Knoxville Counseling Services, Emily Heird and Connie Crossley provide couples counseling. We’d be honored to help you have a healthier and more satisfying romantic relationship.


Invest in your relationship.  It is worth it and so are you.