Couples Therapy Guide: How it Works

When Relationships Feel Harder Than They Used To

Every relationship goes through periods of strain. Sometimes these challenges are linked to a specific event, a betrayal, a major life transition, a growing disagreement. At other times, the distance builds slowly, through miscommunication, unresolved tension, or feeling emotionally unseen over time.

When this happens, it can be deeply unsettling. You may find yourselves having the same arguments repeatedly, feeling more disconnected than close, or unsure how to move forward together. Many couples wonder whether what they are experiencing is “normal,” or whether it means something is fundamentally wrong with their relationship.

Couples therapy exists to offer support during these moments, not to assign blame, but to help you understand what is happening between you, and to create space for greater clarity, connection, and growth.

Therapists are skilled at spotting negative relationship patterns and guiding couples through difficult conversations with clarity and care. They are trained to utilise tools like the Gottman method , Cognitive-Behavioural Therapy or Emotion-Focussed-Therapy to ensure that couples can have producive discussions regarding difficult conversations.

Seeking therapy is not a sign of failure. For many couples, it is an act of care, a way of tending to the relationship when it feels strained or uncertain. You can checkout our article on the success rate of couples therapy to have a better understanding of what couples therapy can or cannot achieve.

Alternatively, to further understand the true value of how a skilled therapist can help. Check out our guide on how to choose a therapist.

What Is Couples Therapy?

What is Couples Therapy? Couples therapy is a form of psychological support that focuses on the relationship itself, how two people interact, communicate, respond to one another emotionally, and navigate challenges together.

Rather than deciding who is “right” or “wrong,” couples therapy looks at patterns. These patterns include how conflict unfolds, how emotions are expressed or avoided, and how each partner’s needs and experiences influence the relationship dynamic. Often, couples find that they are not arguing about the surface issue at all, but about feeling unheard, unimportant, or unsafe in some way.

At its core, couples therapy is a collaborative process. The therapist works with both partners to understand the relationship from multiple perspectives, helping each person feel heard while also gently guiding the couple toward greater awareness and emotional understanding. Therapy is not about fixing one person or changing who you are, it is about creating conditions where connection, empathy, and healthier ways of relating can emerge.

Who Is Couples Therapy For?

Couples therapy is not only for relationships in crisis. In fact, many couples seek therapy at very different stages of their relationship journey.

Some couples come to therapy because they are:

• Experiencing frequent or escalating conflict

• Feeling emotionally distant or disconnected

• Struggling to communicate without arguments

• Navigating trust issues or betrayal

• Facing major life changes such as parenthood, illness, relocation, or career stress

Others seek couples therapy because they want to:

• Strengthen their emotional connection

• Develop healthier communication skills

• Prepare for marriage or a long-term commitment

• Gain clarity during a period of uncertainty

Couples therapy can support married couples, long-term partners, newly committed couples, and those considering whether to stay together. There is no “right time” to seek support. What matters is recognising that the relationship deserves care and attention.

We have an article outlining the common signs for couples that indicate couples therapy may be helpful.

What Brings Couples to Therapy?

While every relationship is unique, certain challenges commonly bring couples to therapy. These experiences often overlap and influence one another.

Communication Difficulties

Many couples struggle not because they do not care, but because they cannot communicate in ways that feel safe or productive. Conversations may quickly turn into arguments, or difficult topics may be avoided altogether. Over time, this can lead to frustration, resentment, or emotional withdrawal.

Emotional Distance

Feeling disconnected can be painful and confusing. Partners may still share daily routines, but feel less emotionally close, less understood, or less supported. This distance often develops gradually and can be difficult to address without guidance.

Trust and Betrayal

Experiences such as infidelity, secrecy, or broken promises can deeply affect a sense of safety in the relationship. Rebuilding trust often requires careful, structured support that acknowledges both the hurt and the desire for repair or clarity.

Intimacy and Sexual Concerns

Differences in desire, changes in intimacy, or unspoken shame or discomfort around sex can create tension and misunderstanding. These concerns are more common than many couples realise, and therapy can offer a respectful, safe space to explore them.

Life Transitions and Stress

Parenthood, caregiving responsibilities, work pressure, financial concerns, or extended family dynamics can place strain on even strong relationships. Therapy can help couples navigate these stressors together rather than feeling divided by them.

How Does Couples Therapy Work?

Couples therapy is not a one-size-fits-all process. However, most therapy follows certain guiding principles that help create safety, understanding, and meaningful change.

Creating a Safe and Supportive Space

One of the therapist’s primary roles is to create an environment where both partners feel emotionally safe. This includes setting clear boundaries around respect, listening, and confidentiality. Therapy is not about putting either partner on the spot or forcing difficult conversations before you are ready. Instead, it is about pacing the work in a way that feels manageable and supportive.

Feeling safe allows couples to explore topics that may otherwise feel too overwhelming or risky to discuss on their own.

Understanding Relationship Patterns

Many couples find themselves stuck in repeating cycles, the same arguments, the same misunderstandings, the same emotional reactions. Couples therapy helps slow these patterns down so they can be understood.

Rather than focusing only on what was said or done, therapy explores:

• What emotions were present underneath the conflict

• What each partner was hoping for or needing in that moment

• How past experiences or attachment patterns may be influencing reactions

This deeper understanding often brings relief. Couples begin to see that the problem is not one another, but the pattern they are caught in together. See our article on what to expect on your first couples therapy session to further understand how the session will flow.

Building Awareness and New Ways of Relating

As therapy progresses, couples are supported in developing new ways of responding to one another. This may involve learning how to express needs more clearly, listen with greater empathy, or recognise emotional triggers before conflict escalates.

Change in therapy is not about perfection. It is about increasing awareness, flexibility, and emotional responsiveness, small shifts that can make a meaningful difference over time.

What Happens in a Typical Couples Therapy Session?

For many people, uncertainty about what actually happens in therapy can be a barrier to seeking support. While each therapist works slightly differently, couples therapy sessions often share common elements.

Sessions typically involve:

• Time for each partner to share their perspective

• The therapist reflecting and clarifying what is being expressed

• Gentle guidance to help conversations stay constructive

• Exploration of emotions, patterns, and underlying needs

The therapist does not take sides or act as a judge. Instead, they work to ensure that both voices are heard and that difficult conversations unfold in a way that feels respectful and contained. Some sessions may feel emotionally intense, while others focus more on reflection, understanding, or practical adjustments.

What to Expect in Your First Couples Therapy Session

The first session often focuses on understanding your relationship and what brings you to therapy. You may be invited to share your concerns, hopes, and what you would like to be different. The therapist may ask questions to gain a sense of your history together, your communication patterns, and what feels most important to address.

It is common to feel nervous, uncertain, or emotionally exposed during the first session. These reactions are understandable. A skilled therapist will help set expectations, explain the process, and ensure that the pace feels appropriate for both partners.

How Long Does Couples Therapy Take?

There is no fixed timeline for couples therapy. The length of therapy depends on many factors, including the nature of the challenges, the goals you bring, and how ready both partners are to engage in the process.

Some couples attend therapy for a limited number of sessions to address a specific concern. Others choose to continue longer-term to work more deeply on patterns that have developed over time. Progress is rarely linear. There may be periods of insight and closeness, as well as moments that feel challenging or uncertain.

Therapy works best when it is viewed as a process rather than a quick solution.

Does Couples Therapy Mean the Relationship Is Failing?

This is a common concern, and an understandable one. Many people grow up with the belief that seeking therapy means something has gone seriously wrong.

In reality, couples therapy is often a sign of commitment, a willingness to invest time, energy, and care into the relationship. Many couples seek therapy not because they want to end their relationship, but because they want to understand one another better or prevent issues from deepening.

At the same time, some couples come to therapy feeling uncertain about their future together. In these situations, therapy can help create space for thoughtful reflection and honest decision-making, without pressure toward a particular outcome.

Different Types of Support Within Couples Therapy

Couples therapy can take many forms, depending on the needs of the relationship.

Infidelity Counselling

Support for couples navigating the impact of betrayal, focusing on safety, accountability, emotional processing, and clarity about next steps.

Communication-Focused Therapy

Helping couples understand and change unhelpful interaction patterns, develop emotional attunement, and communicate more openly.

Sex Therapy

Addressing concerns related to intimacy, desire, and sexual connection in a respectful, professional, and emotionally informed way.

Premarital and Marriage Preparation Counselling

Supporting couples who want to strengthen their foundation, explore expectations, and develop skills before or early in marriage.

Family Therapy Integration

When extended family dynamics, parenting, or blended family concerns affect the relationship, therapy may broaden to include a family systems perspective.

Divorce and Discernment Counselling

Providing support for couples who are considering separation or divorce, helping them make thoughtful, informed decisions with care and respect.

How to Know If Couples Therapy Is Right for You

Rather than asking whether your situation is “serious enough,” it may be more helpful to reflect on questions such as:

• Do we feel stuck in patterns we cannot change on our own?

• Are difficult conversations becoming harder rather than easier?

• Do we want support in understanding one another more deeply?

• Are we navigating uncertainty and needing space to reflect together?

Couples therapy does not require certainty. It begins with curiosity about yourselves, your partner, and your relationship.

Couples Therapy at Hirsch Therapy

At Hirsch Therapy, couples therapy is approached with care, respect, and clinical integrity. Therapy is tailored to each couple’s unique context, values, and goals. The focus is on creating a safe, collaborative space where both partners feel heard and supported.

Our work is grounded in evidence-based practice, while remaining deeply human and relational. We believe that meaningful change happens through understanding, compassion, and thoughtful exploration, at a pace that feels right for you.

Taking the Next Gentle Step

Relationships are complex, and seeking support can feel like a vulnerable step. If you are considering couples therapy, you do not need to have all the answers. Simply recognising that something matters enough to explore is often where change begins. We offer a complimentary 15 minute call if you'd like to find out more whether couples therapy can benefit you.

Whether you are hoping to strengthen your connection, navigate a challenge, or gain clarity about the future, couples therapy can offer a space for reflection, understanding, and growth together.