Couples Therapy

What to Expect

Who This Is For

High-income professionals navigating career/relationship balance · Couples where contempt has become a communication pattern · Relationships where one or both partners feel things are “unfair” · Couples impacted by major life transitions or external pressures · Pre-divorce assessment and decision-making support

Weekly sessions recommended initially. Couples work is intensive and benefits from consistent momentum.

The Clinical Foundation

For those who want to understand the research and methodology behind this work, the sections below detail the evidence-based framework, clinical approach, and therapeutic philosophy that guide every session.

The Statistical Reality of Couples Work

Statistically, the two most predictably difficult populations in outpatient psychotherapy are (1) severely and persistently mentally ill clients and (2) couples. The base rate for meaningful, lasting change in couples work is lower than almost any other presenting problem — lower than borderline personality, lower than addiction, lower than forensic cases. Gottman’s own lab showed that 69% of conflicts are perpetual and unsolvable; the variable that separates masters from disasters is whether contempt has entered the system. Once contempt is habitual, the statistical prognosis drops off a cliff. That’s why this practice treats contempt as the singular relationship cancer it is.

My working mantra with addiction, impaired professionals, paraphilic disorders, and relationships poisoned by contempt is Plato’s line from the Symposium: “To abuse something is to discredit its proper use.” The goal is to restore the proper, life-giving use of sexuality, ambition, intimacy, or substances.

The Four Horsemen: Why Some Conflicts Destroy Relationships

Dr. John Gottman’s research identified four communication patterns that predict divorce with over 90% accuracy:

Criticism: Attacking your partner’s character rather than addressing specific behavior
Contempt: Communicating disgust, superiority, or disdain (THE most toxic pattern)
Defensiveness: Refusing to take responsibility, playing the victim, making excuses
Stonewalling: Withdrawing, shutting down, refusing to engage

Why Contempt Is the Worst

Contempt goes beyond anger or frustration. It’s the communication of moral superiority — the eye roll, the sneering tone, the “you’re beneath me” attitude. When contempt enters a relationship, it signals that positive regard has been replaced by disgust.

Research shows that once contempt becomes a regular pattern, couples almost never recover without intervention. That’s why I focus specifically on identifying and eliminating contemptuous communication.

The Gottman Antidotes

Through direct observation of how you communicate (both in session and through your descriptions of home conflicts), I help you recognize when the Four Horsemen are present. Then we systematically replace those patterns with what Gottman calls their “antidotes”:

Replace criticism with gentle startup
Replace contempt with building a culture of appreciation
Replace defensiveness with taking responsibility
Replace stonewalling with physiological self-soothing

Getting Back to Where Things Feel Fair

Most couples come to therapy when the relationship no longer feels fair to one or both partners. Someone is giving more than they’re getting. Someone feels taken for granted. Someone is carrying all the emotional labor. Someone’s needs have been chronically ignored.

Over time, this perceived unfairness breeds resentment. And resentment is the soil where contempt grows.

My job is to help both of you see clearly:

How the unfairness developed
What each person is contributing to the imbalance
What needs to change for both people to feel the relationship is equitable

This isn’t about scorekeeping. It’s about creating a relationship where both people feel their contributions are valued, their needs matter, and the emotional/practical workload is distributed in a way that feels sustainable for both.

We work toward restoring the foundation of mutual respect, appreciation, and fairness that likely existed earlier in your relationship — before contempt, defensiveness, and resentment took over.

The Stories Couples Tell Themselves

Just like in individual therapy, I listen for the patterns and themes in how you talk about your relationship:

Do you describe problems as permanent (“You always…”) or temporary (“Lately you’ve been…”)?
Do you attribute negative behaviors to character flaws or to circumstances?
Do you remember your relationship history positively or negatively?
Do you talk about your partner with fondness or with contempt?

These patterns reveal the underlying “story” each of you has developed about your relationship. Through Socratic questioning, I help you recognize when those stories have become distorted, one-sided, or calcified into resentment.

Clinical Approach

Gottman Method principles applied to communication repair
Linguistic analysis of couple’s interaction patterns to detect Four Horsemen
Focus on contempt as the primary threat to relationship stability
Narrative therapy to reframe relationship stories and restore fairness
CBT techniques for behavioral change and building positive interactions
Emphasis on individual responsibility within the relationship system