Most couples put off the first appointment for the same reason. They do not know what happens in the room. Because of that, the unknown feels riskier than the problem they already have. So here is a plain account of what to expect in couples therapy, based on how the work actually runs in this practice.
Before the First Session
It starts with a phone consultation, not a booked session. The call runs 15 to 40 minutes. Its only job is to work out whether the three of us are a reasonable fit. Calls that flow easily tend to be a good sign, and calls that feel stiff are useful information too.
Both partners do not have to be on that call. However, it helps if both have agreed to the idea before it happens. Therapy that one person was volunteered for tends to start slowly.
The First Session
The first session is about why you are here now. Not why the relationship has been hard for six years, but why this month. That question is more useful than it sounds, because the answer usually points at the real trigger.
Each partner gets to describe the problem in their own words. Therefore both accounts get heard before anything is analysed. Expect to disagree about facts. That is normal, and resolving who is right is rarely the point.
There is no pressure to cover everything. In fact, couples who try to compress six years into fifty minutes usually leave feeling worse.
The Second Session
The second session picks up what stayed with you from the first. What resonated? What annoyed you afterwards? Has anything already shifted, even slightly?
By this point most couples can answer a specific question. If this works, what will each of you be feeling, thinking or doing that shows it worked? Those answers then direct the rest of the work.
What the Middle of the Work Looks Like
After the first few sessions, the focus narrows to the loop. Every couple has one. It is the argument that changes topic but never changes shape.
The work identifies what each person does inside that loop, and what happens just before it starts. As a result, the conversation moves away from who is at fault and toward what each of you can actually control.
Repair gets attention too. Most couples are not undone by conflict itself. They are undone by never quite finishing it.
Common Worries, Answered
Will the therapist take sides? No. Although one person often arrives expecting to be judged, the relationship is the client rather than either partner.
Will we have to talk about sex? Only if it is relevant. That said, it usually is, and this office is also that of a certified sex therapist, so it can be discussed directly rather than skirted. See sex therapy for couples.
What if one of us has already decided to leave? That happens. Discernment work is legitimate work, and a clear decision is a better outcome than a long drift.
How long does it take? It varies. Couples who come in early usually need fewer sessions than couples who waited until the situation was severe.
When ADHD Is in the Picture
If one partner has ADHD, the loop often runs on forgotten agreements. Meanwhile the other partner reads those lapses as indifference. Because the mechanism is different, the repair has to be different too. See adult ADHD therapy.
Booking a Consultation
Couples therapy takes place at 13101 W. Washington Boulevard, Suite 454, Los Angeles, CA 90066, in Mar Vista. In addition, telehealth is available anywhere in California. Call (310) 927-1755 or use the contact page to arrange a free consultation. You can also read more about couples therapy in Los Angeles.