Couples Therapy


Successful couples therapy is a process of growing together. It increases each individual’s freedom to act and brings partners closer to one another. In doing so, couples therapy strengthens each individual’s capacity to take care of themselves. Their actions become less constrained and are no longer shaped by personal patterns or shared dynamics. In this sense, freedom, personal development, and couples therapy are all elements of the same process of growth.


Growth means continuously increasing our ability to find balanced responses to the situations we find ourselves in. It’s incredible how easily even little things can knock us off-course. We feel it when we’re stuck behind a slow driver at a green light, when we hear a note of tension in our partner’s voice, or when our kids refuse to leave the playground when it’s time to go home. Even little frustrations like these can strain our capacity to deal with things and leave us without clear strategies for managing the situation. So what happens when we feel like our integrity is being questioned during an intense disagreement with our partner? There’s often a dramatic irony to our behavior in these situations: the more we need something, the less able we are to ask for it.

Our partner interprets our distress and vehemence as unreasonableness – and we ourselves often to too. Whatever is really bothering us gets lost in the noise. During these arguments, we behave in ways that lead to us getting precisely the opposite of what we want. Growth means realizing this, acknowledging it, and learning to take care of ourselves more effectively. Often, the patterns of behavior we follow were effective strategies for obtaining love and affection when we were children. I While they served a purpose in the past, they are no longer helpful to us today. That means it’s time to let them go – and with them all the old emotions we carry into new arguments. If we manage to remove these barriers, the love within us – and between two people – can flow freely again.

Taking Responsibility

Whichever way you look at it, we are all responsible for our own reactions and for finding ways to look at situations positively. (Responsibility = the ability to find a resolution to a situation. Think about how the word itself is made up: “response ability.”) Relationships allow us grow together with another person. They continually provide us with new opportunities to develop and hone these skills. For that reason, successful couples therapy primarily means confronting your own feelings and taking responsibility for them.


Couples therapy helps people find a way of interacting in which they no longer point their fingers at each other, but| rather at the situation they need to overcome. Successful couples therapy creates a framework for this by laying foundations such as: Finding your own strength. Many people exhaust themselves by trying to be there for others. However, this eventually becomes unsustainable. As family therapist Jesper Juul puts it: In the long run, children can only do as well as their parents are doing. The same applies to couples in relationships. People who are able to look after themselves will find that they have the energy and strength to support others as well. Not only is self-care allowed, it’s a basic skill for being in a relationship. And caring for yourself is not the same thing as treating a partner badly.

Being open and committed

Your ability to open up to others is closely related to your ability to enforce boundaries. If people are constantly overstepping your red lines and you aren’t able to respond in an appropriate way, it doesn’t make sense to make yourself available to them. But it also doesn’t make sense to allow yourself to be tormented by repeated, gnawing dissatisfactions. This happens, for example, when you frequently compare yourself to others and set constantly changing expectations of the relationship. When you learn to take life as it comes, you will be also be able to cultivate a more contented life.


Imagine a situation in which your partner seems to be behaving completely unreasonably. What if you could internally respond to that by thinking “That’s interesting – my partner is so upset that they’re losing their self-control. This must be very important to them. What do they probably really need right now?” Learning to react in this way takes effort, but it pays off in equal measure. One prerequisite for responding in this way is recognizing the patterns that keep you and your partner trapped in vicious cycles. We often find ourselves at the mercy of the knee-jerk responses we exhibit when our own sensitivities are prodded. Qualities like curiosity forms the soil in which love, affection, and intimacy are nurtured. This kind of love depends not on the behavior of the other party, but is based instead on one’s capacity to meet the world with openness.

Frequently Asked Questions

Can couples therapy be covered by my health insurance?

The costs for couples therapy are not generally covered by private or statutory health insurance. Health insurance companies only cover therapy costs for individuals who are being treated for a diagnosed mental illness. If a patient’s condition is putting a significant strain on their relationship, joint sessions with the patient’s partner may be helpful. These may be covered by the patient’s health insurance as part of their individual treatment.

Couples therapy is exempt from VAT if it has been identified as preventative or curative psychotherapy treatment. You can deduct therapy costs from your taxes as an exceptional expense. My services are aimed exclusively at self-financing customers.

What is the success rate for couples therapy?

The effectiveness of couples therapy is difficult to measure and is dependent on a number of factors: the therapeutic approach, the rapport between the clients and the therapist, the degree to which the conflict has already escalated, and – last but not least – the willingness of the clients to actively engage with therapy in order to improve their relationship.

My approach combines methods from different schools of therapy and is based on person-centered psychotherapy and emotion-focused therapy (EFT) for couples. EFT for couples has been thoroughly researched and its efficacy has been confirmed in a large number of studies. Take a look at an overview of relevant research on this topic.

What is emotion-focused therapy (EFT) for couples?

Emotion-focused therapy for couples was largely developed by Les Greenberg and Sue Johnson. Learning how to perceive, organize, and transform your own emotions is the foundation of emotion-focused therapy. The aim of couples therapy is to strengthen and repair the emotional bond between two partners. 

Emotion-focused therapy is one of the most effective ways of doing this. I completed my advanced training in EFT for couples under Les Greenberg.

What does couples therapy achieve?

Couples therapy helps couples find a long-term solution for everyday arguments and to work on their relationship in a future-focused way. It often enables couples to make very quick progress in areas such as:
- gaining clarity and certainty about what each partner wants for the future
- feeling heard and understood by their partner
- being able to make their feelings known and to address them openly
- discovering approaches to conflict resolution and implementing them successfully
- finding a shared way of dealing with specific problems and challenges
- daring to make changes and learning how to cope with them
- growing as individuals and expanding each partner’s own freedom to act
- strengthening the ability to remain open and honest even in difficult situations.

In the long term, couples therapy can be the key to each partner understanding both themselves and their relationships. Couples therapy can help both partners move past feelings that are weighing them down, rediscover their energy and happiness, and experience greater intimacy and emotional security together.

How is the couples therapy process structured?

At the start of the therapy, the focus is on recognizing the dynamics within the relationship and developing a common understanding of the goals of the therapy. During the intensive stage, it is helpful if we can meet every week – or at least every two weeks. This stage usually lasts five to ten sessions. How intensively the couples therapy is continued after this stage varies from case to case. Sometimes couples reach their goals after just a few sessions.

The success of couples therapy is heavily dependent on how motivated and willing the partners are to change their behaviors, to move past automatic patterns of behavior, and consequently to expand their personal freedom to act.

What books and podcasts on couples therapy would you recommend?

Different books about couples therapy often present very different approaches. You’ll get more out of these books if you read them not in order to find the “one true answer”, but to assess what methods suit you and your situation best.

One of the main differences, for example, lies in whether the author believes that individuals need to develop a strong, flexible self before they are truly ready for a relationship (an attitude taken by – among others – David Schnarch in Passionate Marriage), or whether they posit that, by its nature, a functional partnership should enable the partners to emotionally support one another and to receive things from their partner that they cannot (yet) provide to themselves as individuals (as argued by e.g. Sue Johnson in Hold Me Tight). You will find a lot of ideas that apply to your relationship in both these books.

Esther Perel has gained acclaim with her podcast Where should we begin? The podcast gives you the opportunity to listen in on other couples’ therapy sessions.  Her book The State of Affairs, too, offers many suggestions for readers rethinking their own ideas about relationships.

On the lively German-language podcast Paardiologie, hosts Charlotte Roche and Martin Keß-Roche talk candidly about their life as a couple and provide plenty of entertaining topics for listeners looking to discuss their own relationships to start from.

When is it worth going to couples therapy? Does couples therapy make a difference?  

My clients come to me when they find themselves in situations we’re all familiar with. They may want to...
- reduce stress in their working and daily lives 
- restore trust in their relationship 
- process a death or other misfortune in the family 
- overcome a physical or mental illness 
- find a way of dealing with a personal crisis affecting one of the partners 
- reinvigorate their sex lives 
- or simply enjoy more closeness and security in a relationship or friendship.

Couples therapy can help with all these issues. Relationships should be energizing and help the people in them joyfully get the most out of life. Not just today and tomorrow, but in the long term.

In my view, whether or not therapy will be successful depends less on the reason my clients chose to come to therapy than on their willingness to get to know themselves and their patterns of behavior, as well as on their willingness to seek an end to negative dynamics in their relationship.

What can I do if my partner doesn’t want to go to couples therapy?

In this case, it’s worth considering why your partner doesn’t want to join you in couples therapy. If your partner believed that couples therapy would help you both feel more heard and understood, and would help you find more closeness, trust, and security in the relationship, they probably wouldn’t hesitate to go to therapy with you.

However, it’s possible that your partner has picked up the opposite view of therapy: that it’s somewhere they’ll be interrogated and be asked to justify themselves, and where one party is found guilty and forced to change who they are. On top of that, the unspoken accusation that they are perpetuating the problems by refusing to go to therapy then becomes the unhelpful elephant in the room.

Ultimately, nobody can be forced to go to therapy – and forcing someone to go would be pointless, as couples therapy under those circumstances would be unsuccessful. But if you can manage to take your partner’s resistance seriously, and try to understand what your partner associates therapy with – without judging those feelings – they may be willing to let down their defenses a little. Perhaps they’ll agree, for example, to meet a therapist for an individual counseling session. Ideally, that will allow them to discover that therapy is also about them as an individual, and about what they need to be happier in the relationship. When their idea of therapy is no longer threatening, it can become an invitation to find common ground instead.

Are there any differences when it comes to couples therapy for the LGBTQ community – for example, for gay couples or trans* people?

Fundamentally, couples therapy is about relationship skills, and those don't depend on sexual orientation, a specific relationship model, or the partners’ locations on the gender spectrum.

People are more likely to need specific things from therapy as a result of their past and present experiences; their experiences of belonging, of attachment, of pressure to conform to society or of being excluded from it.

Some groups of people, for example, share experiences of significant structural discrimination. They face similar challenges and repeatedly find themselves embedded in a societal context that does not meet their needs. Understandably, that has an impact on how these people experience relationships and how they act within them.

The fact that the spectrum of relationship configurations in the LGBTQ community is more varied than it is for mainstream heteronormative society can be both a relief and a challenge. Furthermore, outsiders’ perceptions and their associated acceptance or non-acceptance of different relationship types influence the internal dynamics of the relationship.

The ways in which these lived experiences affect the therapy process vary from case to case. In all cases, however, the most important factor is that the clients feel safe with their therapist, and that the therapist is able to help them process their lived experiences with the necessary sensitivity.

Under what circumstances will couples therapy not help?

The most important factor is the willingness of both partners to examine existing patterns of behavior and find new ways to act. This desire to find more happiness and energy can be strengthened over the course of the therapy. People who had limited motivation at the start of the process may find and develop their reasons for taking part in the therapy sessions.

However, even if this motivation remains absent, therapy can still contribute to a less painful and even amicable parting of ways. Whether or not the therapy “helped” is very much in the eye of the beholder, and the people involved may have different interpretations of whether it was useful.

I would not consider therapy during an ongoing, long-term affair, which is kept secret and not raised during the sessions, to be worthwhile. In a case like this, the opportunity to find a way of being together more deeply and authentically has been passed up.

Should I end my relationship, or can I save it by going to couples therapy?

Everyone’s answer to this question will be different. Frequently, it requires weighing up two questions:
- Have any red lines in the relationship been crossed? What are my dealbreakers? Am I able to protect myself? Can I learn to advocate for my needs in the partnership without crossing any red lines? And do I believe there is a real hope of the relationship dynamics changing?
- Am I able to open myself up to others and accept closeness and intimacy? Am I passing up an opportunity to grow with my partner? If I leave now, will I just transfer my patterns of behavior onto my next relationship and be faced with similar difficulties in future?

Couples therapy can help clients find their own answers to these questions.

Should couples go to therapy if one of the partners has doubts about continuing the relationship?

Absolutely! In fact, it’s the norm for couples seeking support. Couples therapy can help clarify how serious these doubts are. It can identify what each person needs in order to choose to stay with their partner – or to what extent the decision to part ways has already taken place. In this case, couples therapy can help couples navigate their separation. You can find information about different approaches to separating amicably in this way online, for example by using the search term “conscious uncoupling”.

Can couples therapy be carried out via video call?

For most people, counseling via video-calling software such as Zoom or Skype works just as well as in-person consultations. At present, therapy is usually conducted online due to coronavirus restrictions and the risk of COVID-19.


Get in touch

Piotrowski, Ph.D.

Knaackstrasse 84
10435 Berlin

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