Relationships: What Do Couples Talk About in Couples Therapy?

Are you and your partner considering couples therapy?

What Do Couples Talk About in Couples Therapy?

If you've never been in couples therapy, you might be wondering whether or not you need to talk to a couples therapist.  

You might also wonder what couples talk about in their sessions.

I've written this article as a way to normalize couples therapy in general and some of the most common topics that couples discuss.

What Do Couples Talk About in Couples Therapy?

Here are some of the most common topics couples discuss in couples therapy:

Life Transitions and Stressors: Major life changes can add enormous stress to a couple's life. These transitions often include:

• Moving in together
• Marriage
• Starting a family
• Infertility stressors
• Parenting
• Purchasing a home
• Career changes
  
• Job loss
• Relocation to a different part of the city or country
• Financial infidelity
  
• Aging
• Medical issues
• Retirement
• Empty nest syndrome
  
• Taking care of elderly parents
• Separation and divorce and Co-parenting After Separation and Divorce
• And more

Communication

Identifying and working on unhealthy communication patterns and recognizing the particular negative cycle a couple goes through can save a relationship including:

• Identifying and working on triggers that lead to arguments and other misunderstandings

• Identifying ineffective strategies the couple has attempted to use

• Learning effective strategies to improve communication and create positive cycles

Trust

Trust is a major topic for many couples.

Establishing trust in the relationship is essential to a healthy relationship. 

What Couples Talk About in Couples Therapy: Trust

This includes:

• Creating an emotionally safe environment to explore emotional vulnerability

• Understanding the root cause of infidelity or other breaches of trust

• Rebuilding trust after infidelity

• Coping with doubt and suspicion

• Coping with jealousy

• Problems related to differences in level of commitment to the relationship

• Distinguishing current problems vs. problems related to past relationships or family of origin issues

• Setting clear boundaries both partners can agree on

Sexual Compatibility

No two people in a relationship think and feel exactly the same way, so it's not surprising that desire discrepancy (also known as mismatched libido) is the #1 topic that brings couples into sex therapy which is a particular type of individual or couples therapy.

    See my article: What is Sexual Desire Discrepancy?).

What Couples Talk About in Couples Therapy: Sex

Aside from desire discrepancy, the other most common issues discussed in sex therapy include:

• Differences in sexual responsiveness between spontaneous and responsive desire

• Sexless relationships where couples have sex only a few times a year or not at all

• Loss of sexual desire in one or both partners and loss of trust after infidelity

• Erectile unpredictability which includes loss of erection, premature ejaculation and delayed ejaculation

• Sexual anxiety including performance anxiety, body image anxiety for both women and men, a history sexual abuse and other related issues

• Lack of sexual experience

    See my article: What Are the Most Common Issues Discussed in Sex Therapy?

Roles and Responsibilities

A frequent topic in couples therapy that I hear from clients is how roles and responsibilities are shared (or not shared) by the couple. 

These include imbalances in various areas:

• Household responsibilities
• Financial responsibilities
• Childrearing tasks
• Decision-making tasks
• Planning

A couples therapist can provide a safe environment for the couple to negotiate these issues without hostility (see my article: Sharing the Mental Load).

Family Dynamics

Family and culture often have a significant impact on a relationship, especially when the people in the relationship come from different familial and cultural perspectives. 

Talking about family and cultural dynamics in couples therapy allows the couple to discuss these issues in an environment where each partner feels safe so they can negotiate differences.

    

    See my articles: 

Dealing With Difficult In-Laws

Learn to Stop Interfering in Your Adult Child's Relationship

Quality Time

A common problem for many couples is how much time they spend together including one partner wanting to spend more time than the other (see my article: Learning to Compromise About How Much Time You and Your Partner Spend Together).

A couple can explore their mutual interests and hobbies as well as areas each of them might want to explore on their own without their partner.

Future Plans and Goals

Creating relationship goals is an important aspect of being in a relationship (see my article: 10 Relationship Goals to Create a Stronger Relationship).

What Couples Talk About in Couples Therapy: Future Plans and Goals

Couples therapy is an ideal place for couples to identify and negotiate individual and relationship goals.

These plans and goals can include:

• Identifying individual goals
• Identifying shared relationship goals
• Negotiating individual and shared goals that might be different
• Making a plan together to achieve these goals

Getting Help in Couples Therapy

If you and your partner have been unable to work out your problems on your own, seek help from a licensed mental health professional who is a couples therapist.

A skilled couples therapist can help you to work through your problems so you can have a more fulfilling relationship.

About Me

I am a New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.