Why Couples Therapy Doesn't Work.

Image by Nasrul Ekram on  Flickr .

Image by Nasrul Ekram on Flickr.

Have you been to couples therapy before?

Did it completely suck? Or are you one of the lucky ones who walked away from the experience thinking it was positive, but also not totally sure why? There's usually a good reason for this, and after having worked with couples for nearly a decade, I think I've figured out why so many couples don't benefit from counseling like they hope.

When you go to the doctor, you go because you feel bad. And most of us hope to walk away from the office with a plan for what we need to do or maybe even an antibiotic or some medicine to help us go about our day. The point of going to the doctor is to get better so we can get on with our lives.

Medicine is transportable. You go to the office, get the diagnosis, take the prescription and leave. If only problems in intimate relationships were so easy. Wouldn't it be nice if you could stroll into my office with a sick relationship, spend a few hours more in the waiting room than you thought and leave with some medicine after just a 30 minute conversation?

This is why counseling doesn't work for a lot of people:

Couples therapy isn't transportable.

You can't take it home. My colleagues have spent years working on how to make the experience of couples therapy effective, but we haven't spent nearly that amount of time working on how to take couples therapy home.

The closest we've come to creating an experience for couples to sustain them when they leave is something we call..."homework."

If that's not the shittiest name for a transportable couples therapy intervention, then I don't know what is. Think back to the last time you did homework. Did you leave class thinking, "Oh, thank God! Homework! Now the learning can really begin!"


No one likes homework. So why would you enjoy it at one of the most stressful points in your life? Some people enjoy couples therapy. I enjoy working with those folks. It's like the walking portion of a marathon (Yes, that's a thing. Don't argue.). It's refreshing. But the bread and butter of my work is with folks who have about as much interest in couples therapy as they do in homework. But, despite their interest, they still need the process to be effective.

Couples therapy has a long legacy of falling flat. Just look at the way we're portrayed in the media. Stuck up, boring, pretentious know-it-alls with half-hearted and useless insights. I discovered this early on in my career when I made the mistake of thinking that if I did everything right in therapy, change would follow. But what makes my work different from a physician's work is that I'm not dealing exclusively with biological systems that can be tested with foreign substances like antibiotics.

In my room, I create change with clients through the complex systems of language and experience. But I'm not interested in what creates change. Lots of things create change. I realized this when traditional methods failed me, and I started to experiment. I was surprised by the things that actually created change:

Things like being a real person with my clients. Or metaphors. Or humor. Or challenging my clients' most sacred ideas about each other. Being willing to take risks with my clients - risks I know they both need me to take and might hate me for. But it's the job.

But, like I said, I'm not ultimately concerned with what creates change. I'm concerned with what sustains it. And that's not about what happens in my office. That's about what happens at home.

Sustained change is the only thing that makes couples counseling transportable.

Marriages don't change because people are educated. Our brains don't work that way. Education is one tool for change, but not everything. And traditional couples therapy is mostly education. 

But your partner didn't sit you down across the years and give you a prepared lecture about why she or he is mad at you. You got here because you had experiences you didn't want. So now, we have to have corrective experiences. And when therapy doesn't work, it's not because the tools aren't effective or - god forbid - you didn't get good homework. It's because you're not having the experiences you need in therapy to sustain the change that you want when you leave.

Ideally, my office is a change laboratory.

We experiment together. But we have to experiment in ways that are different than how you experiment at home. This is why it's likely that at least one of the partners in a relationship I work with will be really mad at me at some point. Changing a relationship in distress is like trying to turn an oil tanker with a paddle boat. The amount of cognitive effort couples (or throuples or poly folks) have to make in order to change distress is like running an ultra-marathon. It's hard work.

So why would you want to work your ass off in therapy and then leave only to be given more "homework"?

I don't do homework. I do experiences. Sometimes I ask you to take those experiences home. But they're always optional, never required to produce change and they always teach something - even when couples choose not to complete them. That's a learning experience as well.

Couples therapy has not been historically effective because, in my field, we're measuring the wrong outcomes. We're measuring what happens in the office as opposed to what happens outside it. What happens in the change laboratory is only important to the extent that it directly relates to some positive change that happens for you at home.

So in my office, I'm a bit of a mad scientist. I have to be. I'm limited by time and space. I wish I was a therapist in the future, after we've created teleportation. So I could just show up at clients' house in the middle of the clusterf**k. That would probably expedite the process much more quickly - if I could see clients in their natural environment. But, unfortunately, I live in a time when we still burn fossil fuels and live behind gated communities.

So no teleportation therapy.

Until then, I'll keep experimenting. If you've been to couples therapy before, and it didn't work, you're in good company. I can't promise that working with me will feel good or even completely safe, but I can promise you won't be the same when you leave.

Dr. Mathis Kennington, LMFT