Why Most Couples Therapies Fail

First and foremost, couples therapy requires a well-trained and experienced clinician who can simultaneously assess, understand, and intervene upon several interlocking elements of the couple in distress; these include each partner’s relational history and psychological make-up, as well as the nature of the dynamics between them that they have mutually constructed.

Research indicates that, unfortunately, most couples therapies fail, often because the over-arching perspective mentioned above was not established or not maintained throughout treatment. This results in poor therapy outcomes due to the following reasons:

Each partner blames the other for the problems in the relationship.

This is so common that a variety of terms including “projection” and “externalizing accountability” are used to describe it; it refers to the refusal or denial to acknowledge one’s own contributions to problems in the relationship and, instead, a compulsion to find fault in, and point blame at, one’s partner.

The couples therapist fails to provide a conceptualization of what’s going on in the relationship to anchor and orient the therapeutic work.

A significant number of couples who enter my practice having had previous therapy experiences which were unsatisfying or ineffectual often indicate that they were never provided with a framework or conceptual understanding of what was not working in their relationship. “We don’t communicate well,” for example, is an insufficient depiction of what is going on, merely a description of an obvious symptom or manifestation of underlying, more insidious factors. In successful couples work, the couples therapist must provide a succinct, clear and usable framework or guiding metaphor for the couple that organizes their issues and captures what, exactly, hinders the couple’s potential.

The couples therapist assumes or is placed in the position of judge regarding who is “right” and who is “wrong” in the relationship.

At times, unfortunately, the therapist accepts this role and, by doing so, forms a coalition with one partner against the other; when this occurs, it erodes trust in the therapist and usually does not solve, but merely amplifies, the unresolved power dynamics in the couple’s relationship.

The partners and/or the couples therapist cannot tolerate the exploration, expression and resolution of difficult emotions that may come up.

The experience of rejection, disappointment, and hurt are often at the foundation of most couples’ problems, yet over time emotional pain tends to become covered over by frustration, anger, resentment, and rage. If couples therapy fails to dig below the surface level of anger and reach these underlying regions of emotional experience, little can be achieved.

The couples therapy session becomes nothing more than a scheduled time and place for the couple to fight, and the couples therapist fails to redirect the partners.

An unfortunate pattern frequently occurs in couples therapy in which each session begins with a description of the most significant issue or fight that has occurred since the last session; each partner provides his or her view of what happened, often in disagreement with the other partner’s portrayal, and a heated argument ensues in the session — relegating the couples therapist to the role of referee. Even more problematic at these times is the therapist’s hesitation or inability to de-escalate the partners’ intense conflict and reactivity in the sessions and failure to bring the couple back to a more calm and productive dialogue. Once this pattern to the therapy sessions is established, the couple understandably becomes demoralized and resistant to scheduling additional sessions because they feel, rightly so, that they are simply getting nowhere, just digging themselves into a deeper hole.

The partners do not see themselves as allies for each other, only enemies.

While partners have been hurt, angered, or disappointed by each other, often significantly so, something must occur in couples therapy that expands each partner’s view of the other as a benign source of goodwill and support who is committed to making the relationship better. If each partner sees the other as an ally, together they will be able to tolerate the difficult work of couples therapy and approach it collaboratively. Many couples therapies fail because the partners continue to experience each other as adversaries. Consequently, they remain locked in bitter struggles for dominance and persistently discredit each other’s point of view and emotional reactions.

The couples therapy gets bogged down by abstract ideas and psychological jargon; whatever insights are achieved do not translate into pragmatic changes in the relationship.

Couples want real-time positive change that improves the quality of their relationship and of their lives. Most couples I have worked with appreciate gaining an understanding of what went wrong in their relationship and how it went wrong, but what they want most is guidance on what to do about it. Linking new insights gained in the sessions to well-defined adjustments made outside of the sessions, and insuring that these new adjustments actually work and can be maintained long after couples therapy has ended, is a crucial determinant of the ultimate success of treatment.

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15615 Alton Parkway
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Tuesday: 8am - 8pm
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