Arguably best captured (ironically) by the umbrella term Akrasia^(1.) (or, mental incontinence: acting against one’s best interests) and variously called reactance, refusal, ambivalence^(2.), denial, stonewalling^(3.), nonadherence, detachment, intractability, noncompliance^(4.), reluctance^(5.), nonengagement^(2.), withdrawal, and self-sabotage/undermining^(6.), Freud’s (1920) term psychotherapeutic resistance crystalised centuries of thought (Aristotle described ambivalence as ‘the man who is equally hungry and thirsty’) as to why some individuals are inexplicably opposed (intentionally or subconsciously^(7.)) to psychotherapeutic interventions to improve the well-being of their own relationships.

Based on findings from current research (beginning in the 1950s, from which time ‘professionals’ increasingly supplanted elders and other culturally significant leaders as marriage/relationship counsellors^(8.)) which refute the traditional view that resistance signals a defect of character or disorder of mind, this article aims to further an understanding of the identification and causes of the phenomenon, and proposes a step-wise preparation strategy to address key issues found by rigorous research in several disciplines to be critical to facilitating the successful engagement of a resistant partner.

Please note: beyond the scope of this article, research into relationships that feature coercive control or intimate partner violence^(9.), autism^(10.), or diagnosed narcissistic personality disorder^(11.), was not considered in this brief review. Specialist^(12.) advice should be sought regarding the risks of attending couples therapy in these cases, with discernment counselling (see below) also an alternative worthy of consideration.

Step 1: Know the Background Theory

Couples counselling: the jury is in.

Research^(13.) demonstrates that marital problems are among the most stressful conditions people face (relationship difficulties appear in the ‘top five’ reasons for seeking counselling^(6.)), and distressed partners are more likely to experience depression, anxiety, suicidality, and substance abuse as well as direct effects on cardiovascular, immune, endocrine, and other physiological systems.

Indeed, contributing to nearly 50% of admissions to mental hospitals, couple issues have also been shown^(8.) to cause or worsen behavioural and psychological issues in children.

For those contemplating couples therapy, the ‘big picture’ evidence is irrefutable, with meta-analyses of outcome studies finding^(14.) that couples therapy positively impacts 70 percent of participating couples (90 percent of clients reported an improvement in their emotional health and over 75 percent reported an improvement in their relationship).

Despite this roseate picture, some prudence is recommended when extolling the virtues of therapy: the statistics are predicated upon the following tenets of successful therapy^(13.): (1) both partners must feel equally comfortable in the therapeutic setting; (2) both partners need to feel understood; (3) and both partners must be convinced therapy is “balanced,” that is, the therapist is not aligned with the views and interests of one partner over the other (more on this below).

The couple as a system: chaos before change

With couples who show resistance to change having been found^(8.) to be chronically distressed, more disengaged emotionally, more polarised on fundamental concerns, other-blaming, or older, the matter is further complicated by longstanding personality traits and attachment issues.

Additionally, distressed couples often become caught up in power struggles^(4.), with competing claims and perspectives. When escalated, partners may become reactive and unkind.

According to social sciences theory^(15.), an intimate relationship is a system; therefore, in order for a significant change to occur pertaining to patterns, boundaries, rules, and roles, the system must go through a stage of chaos.

A review of the Transtheoretical Stages of Change and Therapeutic Alliance models^(5.) yields findings relevant to effecting change:

In the precontemplation stage, a partner is often unaware that a behaviour they engage in is maladaptive and results in negative consequences. They may have difficulty weighing the consequences of keeping a symptomatic behaviour versus changing it. In this stage, the individual may prefer to focus on mildly distressing interpersonal problems that are “low hanging fruit,” rather than dealing with root causes.
Even in the contemplation stage, where a partner recognises that their behaviour impedes their goals, they may still feel ambivalence towards change. Ambivalence is having conflicting attitudes toward a valued need (feeling pulled in different directions), and may manifest as procrastination, inconsistency, and indecisiveness^(5.). Importantly, a period of some level of ambivalence is natural and necessary for change to occur.

On an implicit level, each partner is negotiating specific desires derived from their underlying motivational needs for agency (self-definition) and communion (relatedness), and the existential need for mutual recognition (to see another’s subjectivity and to have another see one’s own as the culmination of knowing one exists).

Several authors^(7.) suggest that ruptures invariably occur as result of the inherent tensions in the negotiation of these dialectical needs, leading to withdrawal (movements away from self or other: that is, movements towards isolation or appeasement at the expense of agency) or confrontation (movements towards control or aggression at the expense of communion), characterising the repair of these ruptures as critical change processes.

The Therapeutic Alliance in couples counselling

A therapeutic alliance, or working alliance, is a partnership between clients and their therapist that allows them to achieve goals through agreed-upon tasks.

Preparatory to successfully on-boarding a partner is some understanding of the therapeutic triad^(16.):

As pictured, the therapeutic triad involves the relationship between each partner and the therapist (between-system) and the relationship between the partners (within-system), with research^(17.) having identified the four dimensions of coherence required for successful outcomes:

Engagement in the therapeutic process refers to the client viewing the treatment as meaningful because they are willing to work with the therapist and negotiate goals and tasks–that the process is worth taking seriously, and change is possible.
Emotional connection to the therapist: each client views the therapist as an important person in their life, and there is a relationship of trust, care, and concern.
Safety within the therapeutic system: each participant views therapy as a place to take risks, be open, vulnerable, and flexible; a place where conflict can be handled without harm, defensiveness is unnecessary, and new learning experiences will take place.
Shared sense of purpose within the triad means that all members see themselves as working collaboratively to improve in- and between-system relationships and achieve common goals in unity

Key research findings^(16.) include that therapists actively seek the establishment of an alliance with couples and that the formation of an alliance is not a given. Imbalance in therapeutic alliance is common to the endeavour of couple therapy, particularly at the outset.

The following table summarises other salient features gleaned from the research-based alliance topologies reviewed^(16.,17,18) for this article (nb Ancillary research reveals questionable support for this modelling, and proposes the presence of a continuum of resistant behaviours, anchored on its poles by oppositional and compliant patterns, respectively, with passive non-compliance in the centre):

Split alliance:

Members differ considerably in the strength of their relationship with the therapist.
Considered endemic to couples therapy, with studies reporting that 40-60% of couples have observable split-alliances in session.
Predictive of a negative counselling outcome^#.

Within-system alliance:

Members share a sense of purpose. Within-systems alliance is a prerequisite for change, suggesting that not only does a shared sense of purpose influence a couple’s decision to continue in therapy, but it also affects their outcomes.
Predictive of a positive counselling outcome^#.

Strong alliance:

Members display some specific behaviours that indicate the strength of the alliance, namely having done the homework, expressions of optimism, indifference about the tasks or process of therapy, sharing light-hearted moments, varying emotional tone, and showing vulnerability.
Predictive of a positive counselling outcome^*#.

* Interestingly, researchers found^(13.) that a strong alliance in couples therapy was associated with positive outcome only when both partners shared a similar view of the alliance. The authors suggested that if one member of the couple perceives a stronger alliance between the therapist and the other partner, this could evoke feelings of envy or anger and interfere with the therapeutic work.

# Additionally, alliance in the first session predicted premature termination of treatment.

Reactivity vs. choice: the neurobiology of alliance

When a person feels threatened, the prefrontal cortex—the higher brain—goes offline, as the amygdala, in the emotional brain, takes over. The amygdala is constantly scanning for danger; if threat is detected, the amygdala triggers the fight-or-flight response (or freeze in life-threatening or traumatic situations).

In this state, partners do not have access to their higher brain with its compassion and thoughtfulness.

In contrast, couples who are aware of, and practise, calming/embodiment techniques, are better equipped to see and appreciate the experience of the partner as well as their own^(4.). Rather than acting on autopilot with kneejerk reactivity, partners learn to access their higher brain and cultivate choice based on their own values, as they reach for their best self.

While change is possible in the brain (a capacity called neuroplasticity) throughout life, it is harder in adulthood. Understanding the power of habits from a neurobiological perspective can give couples more compassion when one partner resists interventions for change.

It may also be reassuring for partners to understand that backsliding or returning to habitual, albeit unproductive habits, is a normal human propensity; they have not failed in therapy if at times they revert to old patterns.

Sex* differences

* Editor’s note regarding terminology: for brevity, and in accordance with World Health Organisation 2021 guidelines and the majority of extant research in the field, this article primarily uses biological (sex chromosome) correlates when referring to ‘women’ or ‘men’, whilst acknowledging that gender (a cultural, temporal, and contextual construct) and sex are inseparable and neither can be fully understood in the absence of the other.

Reiterating the centuries-old notion that women are the barometers and main beneficiaries of marital health, subsequent research in the field of sex roles has confirmed that the ‘emotional well-being’ of couples’ relationships has been largely undertaken by women^(17.), with men being less likely than women to talk about or consult with others regarding the quality of their intimate relationships.

Indeed, men are less likely to seek out and receive psychological help, hold more negative attitudes towards therapy, display less motivation in therapy, and tend to exhibit more aggressive, abusive, emotionally restrictive behaviour in therapy, than women^(13.).

While 79% of males think their partner would be open to couples therapy, only 66% of women think their partner would go.
Forbes Magazine, 2023. Kimberly Dawn, Marriage Counseling: What Is It And Does It Work?

This general reticence among males to engage in therapy is often attributed to the incompatibilities of therapy with stereotypical male values and relational styles, barriers routinely associated with masculine socialisation.

Specifically, it has been argued that seeking mental health support challenges traditional masculine ideals of self-reliance, stoicism, and restricted emotionality^(13.), and that needing therapy can amplify men’s narratives of shame and dependence.

Despite some evidence that this trend is waning, the notion that men may ‘have a harder time buying into therapy because they struggle to ask for help in this area of their lives’ remains a useful axiom.

Of additional note:

Evidence^(19.) suggests that men are more likely to initially turn to a non-professional, such as a partner or family member for help when distressed, with some evidence that these non-professionals are influential in encouraging men to seek help from a professional.
Among those in couples therapy, men are less likely to initiate couples therapy, and more frequently cancel sessions and drop out prematurely compared to their female partners^(13.).
Male partners are more likely (59%) to be influenced by female partners to engage in couples counselling than the reverse case (where men initiate the seeking-out of professional help).
While the emotional connection is important for both males and females, research^(17.) indicates that the male alliance has a stronger link to therapeutic outcomes than the female alliance, that is weak male alliance is more predictive of early drop-out/termination than female alliance.
Male partners who experienced interpersonal trauma had lower levels of bond with the therapist at session 2 than male partners with no experience of this type of trauma^(20.). This difference was not found for female partners.
A 2021 study of 421 Australian therapists’ perceptions of the challenges of working therapeutically with men consistently identified the group as ‘ill-equipped for therapy’, ‘wavering with regard to commitment and engagement’, and ‘requiring an approach adapted to focus on men’s unique features, vulnerabilities, and strengths’.

The palette of evidence-based couples counselling approaches

Besides attachment theory (see below), numerous psychological models and perspectives^(7.) accommodate partner resistance specifically, including (but not covered in detail here) Psychodynamic, Cognitive Behavioural, Humanistic, Gestalt^(5.,18), Systemic, Paradoxical^(5.,77), and Narrative-based therapies for couples.

Specifically, the evidence-based approach reported^(6.,15) most often by psychologists is currently emotionally focused couple therapy (EFCT; 53%). Other endorsed approaches reported are cognitive behavioural therapy (40%), family therapy (systemic, strategic and structural; 40%), acceptance and commitment therapy (20%), psychodynamic psychotherapy (20%), narrative therapy (13%) and dialectical behavioural therapy (6.7%). Other guiding theories include client-centred theory (6.7%), learning theory (6.7%), and behavioural couples therapy (BCT; 6.7%).

Psychedelic-assisted therapy (PAT) is now also on the menu (on a restricted basis), with much evidence for the effectiveness of both Ketamine^(64.) and MDMA^(15.) in couples therapy supported by ‘gold standard’ research.

Finally, foremost of the evidence-based proprietary approaches, the Gottman^(3.) package is worthy of consideration. Primarily informed by attachment theory and adopting a relatable metaphor (“The Four Horseman of the Apocalypse”), this approach addresses four maladaptive relationship behaviours proposed by the model to contribute to therapeutic resistance: criticism, contempt, defensiveness, and stonewalling.

Attachment-based therapies: the basics

The neurobiology of attachment tells us that parent-child interactions in the first two years of life actually encode within the brain pathways of responses to stress and difficulty in our relationships, with research^(6.) finding that the drive to self-protect through self-defeating behaviours is often a result of insecure attachment styles and past relationship experiences.

In a sense this means knowing we are all ‘preprogrammed’ with different expectations of how others will respond to us in times of relationship stress and difficulty. This can then set the tone for our own emotional responses and behaviour towards others within your close relationships.

For couples it can be helpful to understand how your individual attachment style may link into your patterns of relating or behaviour as a couple.

Here follows a rough typology of romantic attachment ‘styles’:

Secure: you feel positive about yourself and feel comfortable displaying affection within your relationships. You are able to prioritise your relationships and establish and stick to boundaries. You are emotionally flexible and balanced and able to accept conflict and appropriately repair conflict within your relationships.
Anxious-preoccupied: you often feel anxious about the state of your relationships. You often feel negative about yourself and have trouble trusting in your relationships. You often feel the need to be close to your partner seeking reassurance that things are alright. You put your partners needs above your own and are preoccupied with your partners moods. You overthink things and are unable to fully understand why your partner doesn’t seem to feel or act the way you do.
Avoidant-dismissive: you often feel positive about yourself and are quite independent and self-sufficient. You can often feel quite negative about your relationships and find you keep people at a distance. When relationships get too close and intimate you can feel uncomfortable. You are quite rational about life and relationships and do not understand why others are so needy. You often feel “suffocated” within your relationships and adopt strategies and behaviours to avoid commitment or emotional intimacy.
Fearful-avoidant: you often feel negative about yourself and others this leads you to have quite mixed feelings about your relationships. You wish for closeness and intimacy yet are quite fearful of it. In your relationships you can easily feel overwhelmed by closeness and unable to trust your partner. Your relationships are often quite volatile, in a push and pull pattern, of volatile rows and separations and then making up and the pattern repeats.

Taken together, the evidence shows that, compared with secure individuals, insecure individuals are more likely to understand their partner’s behaviour as negative.

Accordingly, investigations have linked self-defeating traits, such as rejection sensitivity (i.e., anxious expectation of rejection in situations involving significant others- see below), to anxiously attached individuals, and fear of intimacy (i.e., the lack of ability to exchange feelings or thoughts with significant others) to avoidant attached individuals.

In couple counselling some of the process can be around helping each partner ‘see’ the differences in how they experience the same issue or problem and each other within it and how this may link into their own attachment style. This awareness, or insight around how conflict or difficulty is managed within the couple may lead to more open communication and flexibility into how you respond and react to each other to begin to shift your old familiar patterns.

Historical factors affecting relationships- trauma and family of origin issues

Steven shuts down when he feels criticized by his husband Roger. Steven’s father died at a young age of a heart attack in the context of a highly conflicted marriage. Steven determined that he would never be in his father’s position. Now, when his husband is “on his case,” Steven shuts down to calm his pounding heart. For him, this is literally about survival. But what is lifesaving for Steven is toxic for Roger. Roger grew up in a home where he felt abandoned by his emotionally remote parents. Steven’s stonewalling throws Roger back into memories of his unhappy childhood. Roger gets furious, which is damaging to Steven, who now leaves the room in a huff. Each one’s survival strategy has negative ethical implications for the other^(4.).

Copious research^(22.) has identified family of origin issues including childhood and intergenerational trauma as creating relational injuries that further impact on an individual’s ability to build and maintain healthy romantic relationships in adulthood.

Survivors of trauma are found to have a heightened risk of experiencing intimate relational distress (including trust issues and disturbed parental capacities). Additionally, partners of trauma survivors are likely to be negatively affected as they are exposed to secondary traumatic stress^(4.).

Notably, male partners who experienced interpersonal trauma recorded lower levels of bonding with the therapist at session 2 than male partners with no experience of this type of trauma. The difference was not found for female partners.

Alluding to the necessity of a ‘back-up plan’ for these contexts (see below), the choice of a suitably trained and experienced couples therapist is of particular importance here.

For the extra-deep divers…

Measuring partner resistance

From the plethora of general psychometric scales of resistance available^(18.) to those prepared to invest the time and money required to obtain reliable measures of this predisposition, several professionally administered assessment tools have been developed specifically for the couples therapy context, including the multi-construct Relationship Self-Sabotage Scale^(6.), which quantifies defensiveness, trust difficulty, self-esteem, controlling tendency, destructive tendency, and relationship skills.

Beyond the scope of this article, readers may wish to pursue further research findings regarding self-defeating cognitions and emotional responses and behaviours in romantic relationships including:

Rejection sensitivity: an anxious expectation of rejection in situations involving significant others. People with this trait respond in four ways: (1) expect and readily perceive intentional rejection in their partners’ ambiguous behaviours; (2) feel unsatisfied with their relationship; (3) retaliate to perceived rejection or threats of rejection with maladaptive emotions, such as resentment and anger; and (4) exaggerate their partners’ feelings and attribute their actions to dissatisfaction and a desire to leave the relationship.
Self-silencing: the maladaptive self-regulation (suppression, submission, self-sacrificing) of thoughts and feelings to protect a relationship. Notably, a significant gender difference exists for this trait, with males reporting more self-silencing strategies than females (avoiding self-disclosure to maintain control), while females reported practising self-silencing to ‘prevent being hurt’.
Self-sabotage: research^(6.) indicates seven main motives for this behaviour:(1) fear (of being hurt, of rejection, of abandonment, of loneliness and of commitment), (2) difficulty with self-esteem and negative self-concept, (3) broken trust, (4) past relationship history, (5) high expectations, (6) lack of relationship skills and (7) dissonance between behaviours and expectations.

Having insight that one might be self-sabotaging one’s relationship is an important step towards implementing change. This insight will also inform the relationship expectations and health strategies needed to maintain long-term health engagements.

Step 2: Anticipate your partner’s concerns.

Below are listed the 12 most common concerns about starting couples counselling that are prevalent in the literature, along with tips for forestalling these impediments:

1. The therapist will “pick sides”.

Firstly, you may wish to acknowledge that (1), based on rigorous research^(20.) demonstrating sex-based differences in perceptions of therapist responsiveness, partners may vary according to sex in the hopes, needs, and expectations they bring to couples therapy, and, (2), there is some truth to male presentiments of this ilk; the literature is replete

with studies finding that a (small) proportion of couples therapists have a ‘“preferred spouse”, with whom they tended to affiliate more through increased interaction, leading to the exclusion and marginalisation of the other partner’^(13.).

Indeed, a main complaint reported by men in couples therapy is that the therapist routinely takes the side of the female partner through subtle, often non-verbal signs of approval that support her bids for increased communication and connection while regarding his more problem-solving approach as dysfunctional.

Importantly however, data from the same research finds that a similar majority of therapists ‘consistently and frequently engage in efforts to rebalance asymmetries by shifting attention back to the neglected partner or addressing the couple as a single unit’^(13.).

Partners may be reassured that a good couples therapist is not there to pick sides, but rather to challenge and help both partners integrate difficult feedback, understand see each other’s blind spots and growth areas, and see that issues experienced as a couple are a product of the dynamics inside that relationship rather than a problem caused by either of the partners alone.

Reinforcing the notions above by citing an example of where your partner triggers one behaviour in you which typically leads to another behaviour being triggered in your partner (and so on, forming a ‘vicious cycle’) will further support the necessity of ‘third-party’ mediation/intervention.

2. I will just be attacked from more sides; I feel like I’m being punished

Clinicians commonly report that one or both parties may be reluctant to try couples therapy when it is used as a threat to one another. Avoid ultimatums to prevent resentment; therapy should never be something you threaten your partner with or force them to go to through.

Remember that nobody wants to be attacked — especially in front of a stranger. Try to point out that the goal of therapy isn’t just to air your grievances, and that it might actually provide you both with the safe space- being able to hear and feel heard- you need to avoid feeling attacked.

If they feel like therapy is a punishment, try to reframe why you want to go. Sometimes just being honest about why you want to go can help them understand why this is important to you and what your actual goal is.

3. Isn’t going to a relationship counsellor a sign of failure or weakness?

For all of its benefits, “counselling” is still a dirty word to a lot of people. Some people think that if they see a counsellor, it means there’s something wrong with them. Similarly, if they need a marriage counsellor, there’s something wrong with their marriage.

Help them see that counselling is not just for ‘broken’ relationships; try proposing the alternative view that the most successful people today all have coaches, counsellors, and mentors. It’s about accepting that a trained third party can be helpful and provide insights and alternative ways of viewing things that can sometimes change the way you see things.

If you sense that your partner may refuse to go to couples therapy, don’t panic. Their fear is valid; going to couples therapy is scary for most people. It makes complete sense if they’re afraid and even resistant.

4. I don’t want to tell a stranger our problems.

Many people don’t like the idea of airing their ‘dirty laundry’ with a stranger. The conflicts and the challenges in their relationship feel like they should be kept private and there may be a lot of shame there.

If this is how your partner feels, try to be compassionate. “It makes sense that they would be worried about entering an unfamiliar space with a stranger to confront difficult issues that require taking huge emotional risks,” she continues. “Most people would be afraid of doing this. It’s human for us to have these fears.”

5. I don’t want more fighting.

Again, this is a valid concern; couples counselling will dredge up sensitive issues that may bring about more conflict (particularly issues already being avoided intentionally).

If you are struggling with constant heated arguments and angry outbursts, perhaps suggest that having a third party present can soften the intensity of the arguments and give both of you a chance to speak and feel heard.

The danger of ‘I don’t want to hurt his/her feelings or cause more fights’ is that by not being able to have important conversations, nothing will change and the relationship will slowly deteriorate.

Explain that while the same sensitive issues may come up, the therapist will help guide you both through the conversations in a way that promotes understanding and connection, providing an opportunity to have a new, reparative, and corrective experience around old topics.

Additionally, you may wish to demystify the process, specifying examples of guidance e.g. “there’ll probably be some communication skills building and a safe place for each of us to dig into our personal thoughts and feelings to better understand why we react the way we do, leading to new insights and the tools for creating more adaptive patterns of relating to each other”.

Notwithstanding the above, partners should be aware that much research^(2.) has found that both conflict avoidance and intense engagement/escalation are not necessarily dysfunctional (especially where the latter occurs in the presence of a mediating therapist).

Indeed, intensely negative exchanges appear to be dysfunctional only when they are not balanced with about five times as many neutral (reflective) or positive (affirmatory) interactions, or when there are extreme levels of complaining, criticising, defensiveness, contempt, and stonewalling (the listener’s withdrawal from interaction).

6. There’s nothing really wrong with our relationship.

If your partner doesn’t see any major problems and is broadly happy with things as they are, they may not see the point in having counselling – even if you do.

At this point, avoid amateur psychologising (e.g. ‘you’re in denial’); instead, try to reframe counselling as an opportunity to prioritise and maintain/improve the relationship.

Additionally, consider using metaphors you think will resonate powerfully with your partner, for example:

Car care– “in the same way that you would take your car for a service, it cannot hurt to check in with your relationship too”’ and, “if we wait until our relationship’s ‘check engine’ light comes on it may be too late for repairs”…
Dental care– “without going to the dentist for routine cleaning and maintenance, a painful extraction becomes inevitable”.

7. It’s too expensive.

This is a very valid concern: therapy isn’t cheap, even if you have insurance. If one of the things you argue about in your relationship is money, spending money to fix the issue may seem like the last thing either of you really wants to do.

However, research; has shown over and over again that couples in low-income households are at increased risk of relationship distress, while also being less likely to participate in couples counselling because of cost.

On a practical level, look into whether your employer provides an employee assistance program (EAP). EAPs will usually offer you a limited number of free, short-term counselling sessions.

8. I’m just not good at talking about relationship issues.

Sometimes, avoiding painful issues seems like the easiest path. Going to couples therapy means you have to do difficult emotional work requiring openness, honesty, and vulnerability (that feels risky).” This tends to be an issue if a partner has a hard time expressing their feelings or doesn’t feel safe opening up.

There is no quick fix here — but if you think your partner is struggling with being vulnerable, the best thing you can do is be there for them and give them the space to feel comfortable expressing how they feel.

9. Does this mean we are going to break up?

So often, couples therapy is used as a last resort, which leads to the negative stigma surrounding it. Try to emphasise that this is the very scenario you wish to avoid.

Try pointing out that couples counselling can be a preventative or strengthening measure as well, and tell your partner of strong couples you may know who went to marriage counselling. Help them see that it’s not just for ‘broken’ relationships.

Conversely, some people strongly believe that if a relationship is meant to be, it shouldn’t need any help. Try challenging this belief with stories of therapeutic success in boosting relationship quality, and point out that couples that don’t act to fix problems are more likely to break up.

10. I tried that once before, and it was bad/made things worse/was a waste of time.

Acknowledge the reality that due (in part) to inadequate regulatory controls, some couples therapy is sub-optimal or unhelpful, with one large-scale review^(23.) revealing confounding counsellor advice including:

Told us we were incompatible. 11%
Said that he or she could not help us. 10%
Suggested that the marriage is probably beyond repair. 10%
Said that that divorce was our best or most realistic option. 10%
Told one of us that the other spouse had a personality problem that created serious problems for the marriage. 14%
Proposed individual therapy for one or both of us instead of marriage counselling. 28%.

Unfortunately, it’s hard to combat a past bad experience unless they’re willing to try again, but once again, it’s important to remember that you don’t have to stay with a therapist if you don’t trust them.

If either or both of you go to a therapy session and don’t feel comfortable, you don’t have to go back. Look for another therapist that you’re both comfortable with. After all, therapy won’t really work if you both don’t feel safe or comfortable enough to open up.

11. It will be too hard to find the ‘right fit’ for me.

Seeking professional help for something as personal as your romantic relationship can be extremely difficult and requires you to be vulnerable and honest in front of a third person about your pain, disappointment, or frustrations with your relationship. If you think your partner is struggling with being vulnerable, the best thing you can do is be there for them and give them the space to feel comfortable expressing how they feel.

It can be helpful to explore possible therapists together. You and your partner can decide if there are specific qualities you want in a therapist, which can help narrow your search. Often couple therapists do a brief consult, and it can be nice to do this together. That way both of you are able to ask questions and address any possible concerns.

Given that the first few sessions require a lot of information gathering and getting to know one another, it can be helpful to give the therapist and the process anywhere from 2-5 sessions before switching tactics. If you don’t feel like things are moving in the right direction by the 2nd or 3rd session with your couples therapist, it might not be the best fit, or the best time for treatment.

12. The logistics are impossible.

You may wish to think ahead and imagine what might ‘get in the way’ of attending therapy. Do you need to figure out childcare? Will telehealth work better for you than in-person, or vice-versa? In other words, overcome practical obstacles by offering your partner convenient choices.

Ideally, sorting out these barriers together can help you both feel on the same page and like you are working together.

Step 3: broaching the subject

Overlapping the suggestions above are the following 6 tips for when the big moment actually arrives:

1. Timing is everything.

Neurobiologically, emotionally-charged states are not conducive to rational thought and openness to new ideas (see above).

Rather than being in a ‘we’ mindset, partners may be on the defence in an attempt to protect themselves or their vulnerabilities, increasing the likelihood of outright rejection of any suggestions proffered at these times.

When asking your partner to go to couples therapy, be sure to begin the conversation at a time when you are free from distractions and it is planned, rather than in response to something that just happened, like an argument. Bringing up couples therapy during or just after a disagreement might come off like you’re weaponising that experience to put pressure on your partner.

When it actually comes time to chat, a private and quiet space will allow you to talk openly together. A soft approach, or ‘start-up’ to the conversation has been found in research to be more likely to lead to a calmer conversation. This looks a bit more like “Hey, I’ve been feeling a bit out-of-sync with you lately, and was wondering if we could chat” – rather than “Gee you’ve really been irritating lately”. (Surprisingly!)

2. Make your question open-ended and/or sandwich it.

Rather than asking your partner to align with a decision you have clearly already made, try to step through the process together e.g “I’ve been thinking of ways to make the relationship we’ve grown the best it can be, and think couples therapy could give us the tools to do this- how does that sound to you?”.

Additionally, bear in mind that it’s common for one partner to be more interested in therapy than the other, so be prepared to hear a negative response and focus on listening, showing empathy, and not making any assumptions about, or interpretations of, their resistance.

Give them space to process their emotions and then ask curious and empathetic questions that show you want to understand their perspective. Try to really hear and validate their concerns.

Sandwiching a negative (something you would like to be different) between two positives (appreciation, gratitude, successful changes etc) is also useful when it comes to communicating about difficult issues.

Alternatively, consider beginning with appreciation and positive statements about what’s working in the relationship before asking what things your partner is happy within the relationship are and what areas they would like to grow in. This in itself can be a good exercise in healthy communication.

3. Put on your listening ears and avoid blame and defensiveness.

If something matters to you it can be hard to hear that someone feels differently. When bringing up couples therapy it is possible your partner will hold a different opinion about seeking help. Try and listen non-defensively.

Listening, central to dialogue and relational ethics, requires “a posture of receptivity”. Researchers in the field^(4.) endorse “listening otherwise” (p. 29), that is, letting go of preconceived notions of the other and really being present.

“When we become habituated to the familiar, we hear only what we already know, or expect to hear. Listening otherwise requires both an awareness of our habitual categories and a willingness to go beyond them” (p. 30).

The brain is wired to feel defensiveness when we feel criticised, it can feel automatic. The first step is to notice it – what does it feel like when you feel defensive? Do you feel the tension in your neck? Does it feel like an invisible wall has dropped in front of you? Knowing what defensiveness feels like will help you become more aware and catch it in the moment.

Another clue you are feeling defensive is your thoughts: are you looking for (listening for) what you believe is wrong? Are you focused on winning, and not on understanding?

Learn how to soothe your defensiveness. Do you need to take a few deep breaths or close your eyes for a second so you can truly hear your partner? What will help the best part of you show up at this moment? Often you need to practice some different ways to calm your brain down from this natural reaction of defensiveness.

Avoiding blame will also decrease defensiveness and increase the likelihood your partner is willing and able to have a conversation about this with you.

It helps if the conversation is framed in terms of what you want, rather than what your partner “needs to work on” or “fix.” For example, try stating, “I really want some help with working on myself and our relationship in couples therapy with you”.

When you mention counselling to your spouse, they may get defensive and launch counter-arguments or fresh accusations directed at you. This is normal.

Importantly however, don’t get defensive when they get defensive. As much as you want to defend yourself or reassert your position, remind yourself that getting defensive back at them can exacerbate communication problems and escalate the conflict unnecessarily.

4. Mention specific concerns and goals.

As you plan out what you want to say, think of one or two examples of specific areas of concern or relationship patterns that you feel would benefit from counselling. You might find yourself repeatedly fighting about the same few issues and struggling to come up with solutions together. Make sure to ‘speak in the I’ and frame these as “we” problems, not points of blame.

If and when possible, set clear goals with your spouse of what you want out of counselling. Decide on some metrics and benchmarks that you can point out to prove that things are getting better.

5. Suggest searching for a therapist together.

Browsing therapist profiles together may help with defusing some of the resistance to attending couples therapy. As you are reviewing practitioners together, consider making a list of some of the qualities you are each looking for in a therapist and see where you have overlap. Ask curious questions to your partner to gain a deeper understanding of what they like or don’t like about one therapist over another.

6. Think of it as an ongoing conversation.

Remember that bringing your partner on board to the idea of attending therapy may take more than one conversation; viewing it instead as an ongoing dialogue may take some of the pressure off by giving your partner space and time to reflect on the idea (this might be the first time they’ve considered it) and you the opportunity to try different angles of approach.

Even if you don’t like their initial reaction, they might just need to process those early emotions to get comfortable with it.

Additionally, remain calm and emphasise that therapy is different from the conversations you have at home. You might even consider inviting friends or family who’ve done couples therapy to share their experiences if your partner is amenable.

Step 4: Have a ‘plan B’

Two valid alternatives to couples counselling can be discerned from the literature:

1. Discernment counselling.

What is discernment counseling? First and foremost, it is not couple therapy^(24.), but rather targets “mixed agenda” couples (where one partner is said to be “leaning in” while the other is “leaning out”) that are simultaneously unsure of their desire to remain in a marriage and conflicted about divorce as an option.

That is, it becomes a safe and structured ‘holding place’ for couples to consider their options before they prematurely follow one of three courses: (1) maintain the status quo (a couple may decide to keep a decision on hold for now; (2) pursue a good divorce; or (3), commit to six months of couple therapy with the divorce decision off the table during that time.

Typically lasting one to five sessions (couples agree upon a number in the initial session), the goal of discernment counselling is to arrive at an understanding of marital dynamics that fosters greater clarity and confidence in making a decision about the future direction of the couple’s relationship.

Although there currently exists scant research into the effectiveness of discernment counselling, at least one study^(25.) has found promising preliminary data to suggest that communication between former partners and coparenting efforts after divorce is enhanced by going through discernment counselling prior to the event.

2. ‘Going it alone’.

… for ultimately and precisely in the deepest and most important matters, we are unspeakably alone; and many things must happen, many things must go right, a whole constellation of events must be fulfilled, for one human being to successfully advise or help another.
Rainer Maria Rilke, Letters to a Young Poet, 1903

Opinion varies widely^(26.) regarding the option of pursuing individual counselling before, or as an alternative to, couples counselling.

For the sake of completeness, these (non evidence-based) arguments include, for the ‘yes’ case:

Research shows that clients who engage in individual therapy for a couples therapy related issue will divorce or leave their partner at a significantly higher rate than those who engage in couples therapy, with the dominant narrative being (roughly) ‘the partner attends individual therapy, gets their emotions validated, and becomes empowered as an individual instead of in the context of a system (in this case the relationship, which is ‘unrepresented’), favouring discontinuation (to various extents).
Working on a relationship problem individually is problematic in that the other partner doesn’t know what’s being discussed or the tools that are shared, which sets up false expectations and inevitable failure.
‘If I’m going to therapy and start using the tools my therapist gives me, but my husband is blissfully unaware of what I’m doing and he doesn’t respond the way I want him to, I’d likely get bitter and hold it against him or have the belief that therapy just doesn’t work’.
It’s also assuredly a reflection of the unhealthy dynamic present in the relationship anyway, that will be exacerbated by the new pattern. Likely the partner going to therapy is an over-functioner, wants to fix everything, takes on the responsibility for making things better, pushes the other partner away or refuses help-and the non-therapy partner is oblivious, doesn’t understand how to meet their partner’s needs, under-functions, is not attuned, or feels pushed out. This dynamic being reinforced in a new and different way by a professional will doom the relationship.

…and the ‘no’:

“One of the really cool things about a system such as a relationship is that if one part of the system changes, the whole system changes”. In other words, even if you go alone, your relationship might benefit and get better. That is, given that modern relationships are complex, and conventional therapies struggle to achieve the level of efficacy needed to improve relationship satisfaction holistically, you’re better off improving individually; the progress you make might also be enough to convince your partner to reconsider couples therapy, too^(15.).
Remember, most individual therapists are trained to deal with very specific symptom-related disorders, not relationship issues.

..or a (seemingly) logical combination (yes and no):

‘Ideally, both you and your partner would go to couple therapy. Sometimes that is not possible. In those situations, it can be helpful to seek out therapy individually. In these cases, try to seek out a therapist that will help you see the big picture and help you take accountability for areas you can grow as a person and a partner. You want a therapist who can help you figure out how to show up differently and break the patterns that leave you and your partner feeling stuck. You can get the most out of individual therapy if you approach the process from the mindset of trying to become a better version of yourself and a better partner, rather than using that space to vent about your partner’.

Conclusion

If you think you or someone you know might benefit from evidence-based couples counselling or individual counselling for relationship-related issues delivered by registered psychologists trained and experienced in the field, please call (07 3831 4452) or email us for more information.

You can access immediate support and advice by phoning:

Lifeline on 13 11 14
National Sexual Assault, Domestic Family Violence Counselling Service on 1800 RESPECT (1800 737 732).

For information and advice about services in your area, try:

Relationships Australia on 1300 364 277
Family Relationship Advice Line on 1800 050 321
Psychotherapy and Counselling Federation of Australia
Australian Psychological Society

Young couples can access information and advice about family relationships and care (https://www.qld.gov.au/youth/family-social-support/family-relationships-care)

References

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2. Peräkylä, A., et al. (2023). The paradox of disengagement: Bodily displays of inattention in couple therapy. Front. Commun. 8: 106: 6475.

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Couples Counselling: Four Steps to Overcoming Partner Resistance