Couples counselling: how does it work?

Couples therapy reduces damaging interactions between couples, builds emotional openness and closeness, improves communication and behaviour, changes unhelpful thoughts and perceptions, and helps the couple cope with the ordinary and not-so ordinary stresses that arise in the course of everyday relating.

When I began training to work with couples, I began with lots of preconceptions. "What do I do if they start screaming at each other?", "I'm going to have to help this couple stay together, after all that is why they are here". I could not have been more wrong. Couples therapy is less about myself and so much more about how the clients (the couple) communicate and interact. It is so much about their learning and understanding of what a relationship is long before they met.

Working with a couple could be said to be like building a house. When we begin, we start at the foundations, as with many couples they may have not created strong foundations. It is likely therefore that the relationship will hit difficult patches. Very much like building a house, if we start the build with inadequate foundations it is likely the house will hit difficult problems in the future.

Foundations for a couple begin long before they meet. If their only experience of relationships is chaotic and directed from their childhood, they're going to bring this pain and hurt into the new relationship to build what they hope will be different to what they have lived.

When we look at childhood behaviour and patterns, it doesn't necessarily mean that we have come from a broken home. As children we are constantly picking up implicit messages from adults, and these messages have a way of shaping who we will become as adults.

So for example, if a child is brought up in what is perceived to be a stable home, however there is an implicit secret that the family knows about but no one talks about, it is possible that this child could grow up to believe it's ok to keep secrets, from his spouse or from his children. Here we can see the difficulty this could present in a relationship. If a child is brought up in a stable one parent family, for all intents and purposes everything presents as fine, however when she as an adult begins to date, this could present issues depending on the reason her residing parent is single, but also her perception of her role as a grown up.

Recent government figures show that couples therapy for depression, which focuses on couple relationships to help treat depression, has significantly higher recovery rates than the most common talking therapy, CBT.