March 19, 2012

Six Ideal Times To Seek Couple Counseling

by Marianne Miller, PhD

As a marriage and family therapist and educator, I have found that couples often come to counseling too late. Either they are so ingrained in destructive patterns that it takes Herculean effort to unravel, or one partner already has one foot out the door.

I would like to share six times that may be challenging for couples and therefore ideal to seek help through counseling.

Time #1: Before a big commitment.
Whether a coupleis planning a wedding or a commitment ceremony, or they are moving in together,the change represents a difference in how they, their families and friends, and the rest of society views their relationship.
There will be new pressures on the couple, such as managinga household, negotiating finances, and interacting with parents and extended family.
It is helpful to receive counseling from a couple therapist or a clergyperson trained in couple counseling. Not only will the counselor assess the strengths of the partners, she or he will address areas in which these couples often struggle, such as finances, in-laws, sex, and children.
Families with step-parenting situations especially benefit from therapy, as many common pitfalls can be avoided by having an experienced guide to help you through it.
Time #2: Before a significant family transition.
All couples experience important transitions throughout their lives. Situations such as having a child,returning to work, facing empty nest, and retiring can be tumultuous on the entire family.
Couple counseling can help partners openly acknowledge the new stressors and normalize the adjustment the family will be facing so that they can better prepare for the transition.
Often couples think of the logistics of the change, such as financial adjustments and the effect on schedules, but partners do not discuss (and often do not know) how such transitions will influence their relationship.
Couples therapists are trained to create a safe space to help the partners explore any fears and concerns that may be present.
Time #3: During financial stress.
Many couples are struggling with serious financial burdens, whether it is unemployment for one or both partners or significant debt. Financial stress is one of the top reasons for conflict for couples(along with children, in-laws/family, and sex).
Partners may think that they cannot afford counseling, but there are many low-cost, sliding-scale options that do not require insurance.
Local universities may have family therapy graduate programs with community clinics where masters and doctoral students work, closely supervised by faculty with cutting-edge knowledge of family issues.
Also, if you plug “lowcost” or “sliding scale” and “couple counseling” and the name of your city/town into a search engine, several names of clinics and individual therapists should come up.
Time #4: After a loss
Sometimes the death of a child or loved one is anticipated, other times it comes unawares and the shock is unreal. Either way,the experience of losing a family member, especially a child, is often traumatic, and it is very hard on the couple relationship.
It may feel as though you and your relationship will never recover. It will never be the same, but many couples do get through it and find that their relationship is the stronger for it.
One of my former students, Kerry L. Essakow, PsyD, interviewed eight people in resilient marriages who had endured a violent death of a child. One of her male participants shared:
That marriage, that broken plate, was shattered and it was shattered by the murder. And eventually because it’s a family heirloom you pick up all the pieces, you glue them backtogether.
You can put the plateback on display again, but the cracks will always be there.
Having a therapist walk couples through this devastating experience was one of the resources that helped the parents recover.
Their relationships were broken; however, the partners were able to grieve, look to each other for support and safety, and repair their relationships.
Time #5: When enduring chronic pain or illnesses
As a therapist,I treat individuals and couples who struggle with chronic pain and illness. I also suffer from chronic pain, which has affected my relationship with my husband over the years.
Before I injured my back, I was a very active participant in our marriage. I would cook, clean, and participate in other household management activities.
After myinjury, my husband had to take over all of my responsibilities while I was bedridden. He essentially took the roles of both partners so that our family could keep functioning.
It was very difficult on him and quite burdensome; however, it’s what we had to do to survive. Family, unfortunately, lived in other states.
Over time, wewere able to recruit outside help, and friends came over periodically with foodor to help drive me to doctors’ appointments.
I eventually improved, and my pain lessened to the point at which I could do some of what I used to do, albeit not everything.
During that difficult time, we sought couple counseling to help work through the trauma of my injury and subsequent challenging medical treatments.
With our therapist, we worked through difficult emotions and resentments that had emerged, even though we had a very strong marriage. Therapy helped us move past the stuckness we felt so we could reorganize our relationship and move on with our lives.
Time #6: When facing death
Couples often don’t like to talk about the possibility about one partner dying, but having assistance when dealing with a terminal illness can be a lifeline.
Hospice often provides free counseling for couples and individuals.
These counselors have specific training in grief work, and they will help both the dying and surviving partners work through the anticipatory grief, as well a scope with the physical challenges of dealing with the pain of dying.
Hospice therapists also co-ordinate with hospice medical workers, and together they can provide an integrated treatment team to the couple.
Final Tips
When people I know seek couple counseling, I give them three tips.
First, gather the names of three therapists and make initial appointments with all of them. See who you like of the three, and continue working with that person.
Second, find therapists other people recommend—it’s the best consumer report out there. It is helpful to have counselors who have specific training in couple therapy.
Third, trust the process. Couple counseling can take a while, so be patient. The rewards will be worth the work.

About the author
Marianne Miller, PhD, is an Associate Professor in the Couple and Family Therapy Programs in theCalifornia School of Professional Psychology of Alliant InternationalUniversity, San Diego Campus.
Dr. Miller is a California Marriage and Family Therapy Registered Intern#62559, employed by Sally LeBoy, MFT#14768.
She is also a Licensed Marriage and Family Therapist inTexas, #5209. See her website at