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For many people, their first visit to a couples counselor is their first experience of being in a therapist’s office – at least since seeing the school counselor in eighth grade.

And, frankly, it’s hardly on anyone’s bucket list. So it may be hard to understand exactly how it can work for you.

I’m sure you can imagine the typical reasons why couples seek therapy: too much fighting, not enough sex or intimacy, an affair or infidelity, financial concerns, problems with drugs or alcohol, parenting issues. And, of course, the old standbys, anxiety and depression, which eat away at your relationship just as they eat away at you.

homosexual couple doing breakfast on the kitchen togetherness

How can couples therapy really help us?


1. Get perspective

There are times in every relationship that it’s hard to see clearly how to get out of the hole you’re in, or how to get perspective on your situation.  Sure, friends and relatives can be a vital part of your support system – but they may also be invested in things turning out a certain way, even when they are genuinely seeking to help you. And, you may not want to ask them for as much support as you need.

2. Break your pattern

Couples counseling in San FranciscoYou and your partner have established communication patterns over the months or years that you’ve been together.  Many of these are derived from ways of coping that you have each developed over the course of your lives.

So it makes sense that these patterns would be hard to change, or even to see.  Your therapist can help you understand the cycles that you get stuck in, and find new ways to interact that allow you to deepen your connection and grow together.

3. Develop tools to take home

A skilled couples therapist will be able to help you find ways to extend your insights and changes beyond the therapy office to all aspects of your lives together.  This may be books, games, exercises, workshops, or it may mean simply finding new ways to communicate with each other, especially around difficult topics.

4. Clarify your values and goals

In the course of your busy lives, it may be hard for you to find the time to share your hopes and dreams with each other, and maintain that sense of enlarging each other’s lives.  Your therapist can help you build a sense of shared value that will be the foundation of your life together.

5. Make difficult decisions

Sometimes, couples come into therapy on the verge of breaking up, or wondering if they can make it together.  A skilled therapist can help you navigate this complex process successfully, so that – whatever the outcome – you make decisions from a place of clarity, and conduct yourselves with integrity throughout.

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About the Author

Alex Momtchiloff is a Licensed Marriage and Family Therapist at Well Clinic in San Francisco. His specialties include couples counseling and premarital counseling, and he provides therapy in English and French.


  • I absolutely love Well Clinic! From the beginning, my husband and I felt like we were in a comfortable and safe space.

    Our couple’s therapy bridged gaps in our relationship and helped us understand each other that much more.

    Ivette B

  • Well Clinic is an oasis, especially for busy professionals like me.

    It’s a relaxing and safe space, nothing like the stuffy or drab offices you’d expect when going to a therapist.

    Brianna S

  • Well Clinic’s inviting and professional design makes me feel comfortable and at ease, which probably benefits the work I am doing.

    In fact, it doesn’t really feel like a therapy clinic at all, which I find awesome.

    Jim M


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