Psyched in San Francisco: Getting Your Money’s Worth in Therapy

“The way to have a successful and rewarding couples therapy experience involves you becoming an active partner in the process—being willing to address hot button issues, setting and pursuing goals for yourself, and listening to your partner’s challenging viewpoints with an open attitude. “ - Julia Flood, LCSW

Getting Your Money’s Worth in Therapy

by Julia Flood, LCSW

Many couples are at their wit’s end when they begin couples therapy and look to their therapist as an expert to provide direction, tools, and a safe environment to practice these in. These are all perfectly reasonable expectations at the outset of therapy. However once you have shared your point of view of the problems, have gotten some outside feedback, and are feeling comfortable, that’s the time when you need to become a partner in the therapy process. Instead of thinking of couples counseling as a service provided to you, a more accurate way to see it is in terms of education and coaching. It’s just like with a personal trainer at the gym: if you don’t actually do the work, things won’t improve. And more than that, it’s not just about making the most out of the session, but making lasting changes in your relationship.

Some couples sort of just “attend” couples therapy – they show up ready to spend an hour of their time and the session fee, but don’t arrive mentally prepared. This can lead to frustration and even disillusionment: The progress seems slower and slower, and the positive experiences of connection and renewed hope you felt in the beginning become distant memory, making it even harder to continue. You find yourself doubting the entire therapy process, and wonder if you should perhaps cut back or even discontinue. However, attending sessions irregularly because you are ambivalent and disengaged is pretty much a recipe for an even more frustrating and unsuccessful experience.

The good news is, the power to break out of this downward spiral (which isn’t just about the end of therapy but possibly the end of your relationship) lies in your hands. The way to instead have a successful and rewarding couples therapy experience involves you becoming an active partner in the process—being willing to address hot button issues, setting and pursuing goals for yourself, and listening to your partner’s challenging viewpoints with an open attitude. Here are a few tips on how you can work to make therapy both cost-effective and rewarding:

1. Make a commitment

The commitment I’m talking about is not necessarily the one to staying with your partner - maybe you’re still trying to figure that one out - but to the process you started in couples therapy. And, yes, part of that package is not throwing the word “break-up” around like a weapon every time things don’t go your way. Even if you don’t mean it, it’s a low blow and ultimately not effective in getting the positive reactions you crave. There’s always time for a break-up, but there may not always be time to work on your relationship. For some couples it is helpful to commit to an agreed-upon time frame during which you will try to work things out and participate in therapy weekly. If you make the effort of investing time and money, then why not give it all you can?

2. Put in the time, make the effort

The higher your level of conflict or disconnection, the more regularly you will need to come to therapy. Couples therapy is seldom a quick fix. However, what happens in between the sessions may be as or even more important. Did you take any notes during the session or afterwards? Do you know what you will be working on this week? Do you know your partner’s goals, so you can spot his or her efforts throughout the week? What gets in the way of making an effort this week, and how can you plan ahead to make it work anyway? “It only works if you work it”, as they say.

3. Create goals for yourself, not your partner

Focusing on what your partner needs to change comes natural but simply isn’t an effective strategy and ultimately doesn’t get you what you want. When you’re stressed, do you try to control, nag, or whine? Do you avoid and withdraw? These are very common responses, but – as you know – very ineffective ones. What hinders you from “taking the high road”? Take an honest look at your behavior towards your partner this week. Which ineffective behaviors did you resort to? Where did you make an all-out effort? Identifying more effective behaviors on your end will make up your goals for therapy. Start with the only place you actually have control over: yourself! And don’t forget: What did your partner do well this week? Complimenting your partner’s efforts is a very effective way to have an influence.

Put yourself out there and try to get to the “feelings behind the feelings.” Often what we feel on a surface level in a relationship is anger, annoyance, resentment, and judgment for the other. Try to dig deeper and get in touch with what triggered those thoughts and feelings. It is much easier to say that you are “irritated” and “frustrated”, than admitting that you feel disappointed, guilty, ashamed, insecure, or are having visions of being abandoned. Owning up to your deeper feelings takes a lot of courage. Nobody enjoys being vulnerable, especially when you’re feeling emotionally threatened. But defensiveness breeds even more defensiveness. Often both partners have no idea how threatening they seem to the other when they resort to ineffective behaviors, and thus perpetuating the vicious cycle.

A successful outcome of therapy in the least amount of time is something all parties desire. A couple’s willingness to work hard, stretch out of their comfort zone, and stick with it is probably the greatest predictor for a successful therapy outcome, and consequently of the total cost of investing in couples therapy.

Julia Flood, LCSW is a licensed psychotherapist practicing in San Francisco's Lower Pacific Heights neighborhood. She has been working in the mental health field since 1996 and specializes in couples therapy/marriage counseling, helping partners in crisis to break out of the vicious cycle of hurting and being hurt. You can find out more about Julia on her website: www.newstarttherapy.com, or by calling (415) 820-3210 to arrange an initial phone consultation. She is bilingual in English and German.