The Key to Effective Relationship Therapy

As a relationship therapist, my job description includes destabilizing the status quo of relationships that aren’t working. No matter how much you want your relationship to change, change is uncomfortable. It involves trying new things, adjusting to new ways of being and relating, digging deep for empathy and generosity of spirit, and generally wading into the unknown. 

Relational therapy also involves a commitment to personal growth. That often requires quite a deep look at oneself, which can be surprising and unsettling. Usually people start therapy when they feel very frustrated and dissatisfied with their relationship. Often this shows up as a strong desire for change in one’s partner: “If only my partner would change this, that, and the other thing, our relationship would be great.” So then, it might come as a bit of a surprise when you arrive in my therapy room, that the first thing I want to discuss is what you might want to change in how you are showing up in your relationship. 

I start there because, in my opinion, this is the difference between relational therapy that does work, and relational therapy that does not work. If each partner is able to identify at least one or two things they are doing that aren’t working very well in their relationship, that is a good start. The next step is to find individually-motivated reasons why each partner would want to change those things. “Because my partner wants me to” isn’t as effective a motivator for change as (for instance) “because it is the kind of person I want to be.”

It is so easy to look for external changes to circumstances (my partner changed and our relationship got better) rather than internal ones, but here is the unfortunate (and hopeful!) truth:

You can’t be the same person you are in the current non-working relationship and expect to have a relationship that DOES work. You have to become the person you want to be in the relationship you want to have and then observe what happens next. Hopefully, you will find that the relationship transforms as well.

How Asking About Satisfaction Can Guide Your Treatment Plan

Very often therapists ask me how much to focus on the sex issues in therapy, and how much to focus on the relational issues. This is a very important question, because of course the sexual and relational aspects of sex issues are intertwined. Therapists who don’t feel comfortable discussing sex in therapy will focus on the relational issues, thereby missing multiple rich opportunities to help, but focusing on the sex issues to the exclusion of relational dynamics would almost always be totally unproductive.

If you’ve watched my Will Lily workshop, you’ll know that the final question I ask on my introductory sex issues assessment is “When a sexual encounter is over, do you feel satisfied? Would you do it again?”

This question is a little broader than the others I ask in the assessment. Instead of pinpointing a specific issue, or pointing to an immediate and urgent intervention, it invites the client to take a broader view, to step back and assess the sexual encounter as a whole. Often by the time you ask this question you have a pretty good idea of the answer, but this question points to exactly where the distress is, so you know where to focus once the urgent matters are addressed.

It can also be very interesting when you get an answer that surprises you. It’s a cue to ask more questions and rethink some of your assumptions.

Your clients’ answers to the satisfaction question are also important because they open the door to looking at the relational distress. Satisfaction resides at the intersection between sex issues and relational issues. When you ask this question you have already gathered quite a bit of specific information about sex, and now you will learn how all together affects the clients and their relationship. The answer to the question about satisfaction will shape your long-term treatment plan as you help the clients understand the sex issues in the context of the relationship, and vice-versa.