Why Your Couples’ Therapy Didn’t Last

All treatment effects deteriorate over time.

Posted Oct 31, 2018

Unless your couples counselor built in relapse prevention and did yearly follow-ups after your therapy ended, the chances are high that the positive gains you made during therapy didn’t last. This had little to do with the skill of your therapist or the issues addressed in therapy. The low retention rate of couples counseling has more to do with the nature of emotion regulation habits in familiar environments.

By the time we’re adults, emotion regulation habits are almost completely habituated. We respond more or less the same way in the same contexts under the same physiological conditions. That’s how smart, creative people can make the same mistakes over and over in love relationships.

In familiar environments, the brain tries to do as much as it can on autopilot to conserve energy. (The difference between an habituated response and an intentional one is hundreds of millions of multi-firing neurons.) In addition, habits rule under stress. All mammals, including humans, retreat to prior habits under stress. When stress hits familiar environments, the insights of couples counseling will be unavailable, unless they’ve been practiced in the familiar environment – home – in addition to the therapist’s office. The most primitive of coping mechanisms, which begin around age two, are blame, denial, and avoidance, and they are most likely to be invoked at home.

Automatic Defense Systems

When couples live in resentment for a length of time, they develop automatic defense systems, triggered by body language, facial expressions, tension, distractedness, hesitations, impatience, discomfort, or eagerness. It’s activated almost entirely unconsciously; by the time you're aware of any feelings, it's in an advanced stage. Think of your gut reaction when your partner avoids looking at you or merely sighs. Think of how you react when you hear the front door close, even before your partner enters the room or when he/she says something with “that tone," gets that “facial expression,” or rolls those eyes. Suddenly you find yourself in a defensive posture, prepared for the worst. When you’re both defensive, bad things are likely to happen. All good defense systems have preemptive strike capability. The missiles start flying on their own, with no one pushing the buttons. You find yourself in a battle of cold shoulders, curt exchanges, or hot arguments. You both feel powerless, irritable, impatient, resentful, or angry. You have an impulse to walk away, ignore, criticize, yell, or devalue, unless your couples’ counseling has practiced alternative responses to the earliest physiological signals of the automatic defense system.

Misinterpretation of Cognitive Dissonance

Cognitive dissonance is the discomfort generated by holding contradictory cognitions. In intimate relationships, cognitive dissonance is the difference between how you would like to be and how you are:

"I am loving, compassionate, supportive, and sexy, yet I am not these things with you."

In the Adult brain, cognitive dissonance works as a motivation to be true to your deepest values, by making you behave in more loving and compassionate ways. Unfortunately, most people under stress retreat to their Toddler brains, where they resolve cognitive dissonance by thinking something like this:

"Since I am unable to be my loving and compassionate self with you, you must be too selfish, insensitive, withholding, demanding, emotional, rigid, sick, or defective in some way."

This ill-fated resolution of cognitive dissonance makes you both feel like victims and sends you searching online for a checklist that validates your suffering and a diagnosis that nails your partner.

Cognitive dissonance undermines intimate relationships (and couples counseling), even when you are successful at getting what you want, namely, change in your partner. In that unlikely event, your self-concept is reduced to:

"I am loving, compassionate, and supportive, as long as you do what I want, think like me, and feel the way I do."

Hiding Vulnerability

Skilled therapists are able to get clients to expose vulnerability and compassionately respond to each other in the safety of the clinical setting. True intimacy requires letting down defenses and true commitment occurs when we assure one another that we will respect our human frailty. If clients don’t understand the force of habit, they will see it as a betrayal when their partners revert to blame, denial, and avoidance. They’ll once again hide vulnerability, creating more distance between them that will inevitably fill with resentment, as the couple abandons the gains of their couples counseling.