Traditional Couples Therapy: What Most People Think They’re Signing Up For
- David Gettenberg
- Jan 2
- 7 min read
Updated: 4 days ago
Why your sessions can feel “polite but stuck,” and what that usually means.
Not sure this fits you? Read the companion guide: When Talking More Makes It Worse: A Different Approach to Couples Therapy
Traditional couples therapy is the model most people imagine: two partners, one therapist, and a conversation that finally creates change. Sometimes it does exactly that. Other times, the structure itself becomes the barrier, especially when deeper fears, unsafe truths, or unequal communication styles shape what happens in the session, whether you meet in an office or on video.
This guide is for couples who want to understand one specific question: If we’re showing up and trying, why isn’t it moving? The goal is to help you self-diagnose what may be limiting progress without concluding that either of you is “the problem.”
What traditional couples therapy is designed to do
Traditional couples therapy brings both partners into the same session. The therapist helps you slow down the cycle, translate intent, and practice a different kind of conversation.
Step 1: Both of you are in the same session (in person or virtually).
Step 2: The therapist slows the interaction so you can hear each other more accurately.
Step 3: You learn tools (repair, de-escalation, clearer requests, better boundaries).
Step 4: You practice those tools on your real conflicts.
Common goals include:
Improving communication
Reducing blame and reactivity
Strengthening closeness and trust
Resolving recurring conflicts
Building skills for future conversations
Checklist: Is traditional couples therapy the right fit?
If you want a quick self-sort, start here:
We can disagree without one of us storming out, threatening divorce, or disappearing for days.
I am not afraid my partner will retaliate later for what I say in session.
Most of our conflict is about the present, not a past trauma, betrayal, or ongoing crisis.
If you checked all three: traditional couples therapy is often a strong fit.
If you didn’t: the issue may be the structure, not your effort. Read on.
Who is traditional couples therapy best for?
This model tends to work especially well when:
Both partners feel psychologically safe together
Neither partner escalates or shuts down rapidly
The conflict is driven more by miscommunication than fear
You need tools and repair more than deep excavation
Both partners want repair, not a referee
When those conditions are present, progress can be fast.
Where the model can struggle (structural limits, not personal failure)
Some couples get stuck because the shared session becomes a high-pressure environment. If the session becomes a performance (to avoid conflict), you can improve language without changing the cycle.
Common structural limits include:
Self-censoring under pressure: One or both of you withholds the truths the therapist most needs to hear.
Fluency imbalance: The more verbal partner unintentionally dominates; the quieter partner’s inner world stays hidden.
Escalation before insight: The session becomes firefighting rather than understanding.
Deep fears stay buried: Abandonment, humiliation, failure, control, and power rarely surface safely with your partner present.
Subtle triangulation: Each partner wants the therapist to validate their view, pulling the work toward point-scoring.
The pattern starts before the session: You arrive braced, shut down, or reactive; the therapist sees only the surface.
Ambivalence turns into theater: If one partner is half in, half out, the shared session becomes “looking good” instead of telling the truth.
A split-screen moment: what gets said vs. what gets swallowed
Below is what “polite but stuck” often looks like:
What gets said in the shared session (what the therapist hears) | What’s happening underneath (the hidden fear) |
“I just want more help with the kids. I’m overwhelmed.” | “If I say how alone I feel, you’ll dismiss me, and I won’t recover from that.” |
“Tell me what you want and I’ll do it.” | “If you’re disappointed, I feel like I’m failing, and I’ll defend myself.” |
“We’re fine most of the time. We just argue about logistics.” | “We’re avoiding the real subject because it feels too dangerous to name.” |
“I’m not trying to attack you. I’m just frustrated.” | “I’m terrified you’ll leave if I stop pushing for reassurance.” |
“I don’t know what to say when you get upset.” | “If I engage, I’ll be shamed. Silence feels safer, even though it hurts you.” |
The therapist hears a conversation about logistics. The relationship is often living inside two private alarms: fear of being dismissed on one side, fear of being shamed on the other. If those fears cannot be spoken safely in the shared session, the work can look calm and reasonable and still remain stuck.
Why the therapist may only be seeing the argument
A therapist can spend weeks hearing about dishes, tone, parenting, sex, or money while the real drivers stay out of reach. Underneath the surface topic are fears like abandonment, humiliation, failure, control, or helplessness. If naming those fears feels unsafe with your partner present, the shared session keeps circling the visible argument.
Vignette 1: When politeness hides fear
Clara and Ben looked calm and thoughtful in sessions. They used careful language and tried to stay open. Yet nothing changed.
Underneath their careful exchanges were two fears:
Clara feared disappointing Ben.
Ben feared making things worse.
They weren’t revealing themselves. They were managing each other. The therapist saw a courteous couple. The real relationship, two people protecting each other from pain, stayed hidden.
When the structure later included some individual time as well as joint sessions, Clara could finally say what she had been shielding Ben from, and Ben could hear it without feeling ambushed. Once the fear entered the workplace, the pattern moved.
Vignette 2: When fluency wins the session
Jonah processed emotions quickly and spoke with ease. Selene needed time to settle and think. In the shared session, Jonah looked like the “better communicator,” and Selene left feeling overwhelmed and unheard.
The structure unintentionally favored one partner’s style over the other’s experience.
When Selene had protected one-on-one time, the pace changed. In joint sessions, Jonah practiced pausing and tolerating silence. Selene began speaking earlier and more fully. The session stopped being Jonah’s stage and started being their shared space.
A clinical note: many therapists already flex the structure
Some couples therapists include a few individual sessions early, or add them later when the shared session isn’t enough. The question is not the label. The question is whether the structure gives the therapist access to what actually drives your pattern.
When this model is not enough on its own
If there is physical violence, credible fear of harm, coercive control, or severe, ongoing substance use that destabilizes the relationship, a shared-session model can be unsafe or ineffective. In those cases, safety planning and individual stabilization come first.
What you can do this week if you feel stuck in traditional couples therapy
If you are already in couples therapy and it feels “polite but stuck,” shift the focus from effort to structure:
“Are there topics we are avoiding because the session feels unsafe?”
“Would you consider a brief period of individual sessions to map the pattern?”
“How do you handle shutdown or escalation when it happens early?”
“Do you see a fluency or power imbalance in how we use the time?”
“What would you need from us to make the shared session safer and more honest?”
A therapist who can name the structural constraint and adjust the plan often unlocks progress quickly.
Bottom line
Traditional couples therapy is powerful when there is enough safety for honest conversation. It can sharpen understanding, deepen closeness, and give you tools you’ll use for years.
But when deeper fears, hidden resentments, or old nervous-system patterns shape the dynamic, the shared-session structure can become too narrow. In those moments, it’s not that you’ve failed. The pattern may need a different architecture.
Next in this mini-series: The companion guide explains the combined-format model this post points toward: When Talking More Makes It Worse: A Different Approach to Couples
FAQs
What if my partner refuses to attend couples therapy?
Individual work that focuses explicitly on how you show up in the relationship can still shift the pattern, even if your partner won’t attend. You can change your side of the dance, which often changes the whole dance.
How long should traditional couples therapy take before we see change?
Many couples notice movement within four to six sessions when the model is a good fit. If you are showing up honestly and nothing shifts, it is reasonable to ask whether structure, not effort, is the limiting factor.
Does traditional couples therapy work for high-conflict couples?
Sometimes, but only if both partners can stay regulated enough in the same session, in person or on video. If escalation is rapid and intense, a model that includes protected individual time is often safer and more effective.
Further reading
The Gottman Institute – Relationship Research
A clear overview of destructive patterns (criticism, defensiveness, stonewalling) backed by decades of data.
ICEEFT – Emotionally Focused Couple Therapy
Explains how attachment patterns shape conflict and connection, and why some dynamics need more than skills training.
Psychology Today – Couples Therapy Basics (2023)
A readable summary of when standard couples therapy tends to work well and when alternatives may be needed.
Author’s Note:
In decades of practice, we have seen many couples stall not because they lacked love, but because they were trying to solve a fear-based pattern inside a structure that could not safely reach it. These guides are meant to help you choose the right structure for the problem in front of you.
Authors
Frederic Kass, MD is Professor Emeritus of Psychiatry at Columbia University Medical Center and former Clinical Vice Chair in the Department of Psychiatry.
Betty Jeanne Kass, LCSW — Founded and directed the Columbia University Day Treatment Program. An expert in family therapy, she teaches at Rappore.
Disclaimer
This article is for educational purposes only and is not a substitute for individualized medical or psychological advice.
