What Makes a Couple’s Therapy Psychodynamic?
Therapists seem to either love or hate working with couples. The shift from being an individual therapist to a couples therapist can be both fascinating and terrifying. Many of us don’t set out to be couples therapists; we find ourselves dropped into the work, often with minimal preparation and support. We learn the complexities of couples therapy on the job-one couple and one conflict at a time.
Therapists who love working with couples often talk about loving the immediacy. Whatever is causing pain is right there in the room with you, happening right in front of you.
The Couple as a Living System
The image I hold in mind when working with a couple is of them as a stream, moving and flowing right in front of me. The stream is flowing over rocks, around roots anchored by the shore, the boundary of their relationship.
As therapists, we put our hand gently, deliberately into the stream and see how the moving water responds to the presence of our touch, our intervention, our words. We observe what changes and how it changes, and based on those observations, we decide where to put our hand next. Where we “put our hand” is not a random choice; it is shaped by what we know and understand about psychodynamic theory.
The Psychodynamic Perspective
Psychodynamic author Nancy McWilliams says:
“The more honest we are with ourselves, the better our chances of living a satisfying and useful life.”
This is at the heart of psychodynamic treatment, whether we are working with individuals, groups, or couples.
In psychodynamic treatment, our goal is not simply to change our patients—or ourselves. Instead, we work toward developing new ways of experiencing ourselves and others in the world. We cultivate curiosity about ourselves, our relationships, and the patterns that shape how we move through them.
We are in the business of asking questions. We work toward developing new thoughts and experiences. We cultivate an increased capacity to recognize and acknowledge what is not conscious. As these previously unconscious experiences become more accessible to thought and reflection, there is often greater freedom to respond differently—and, ultimately, relief from symptoms and distress.
Why the Unconscious Matters
Psychodynamic theory is grounded in the belief that unconscious thoughts, feelings, and inner conflicts influence our current behavior and relationships. Our unconscious inner psychic world begins developing through our earliest relationships and experiences, particularly with parents, caregivers, and siblings.
As infants and young children, we are emotionally and cognitively limited by our developmental stage. When emotional experiences are too overwhelming and the resources needed to process them are not available, a child may not be able to make sense of or work through what they are experiencing.
When a caretaker does not adequately contain, mirror, or respond to a child’s feelings and needs—or instead neglects, punishes, or shames those feelings—the child’s emotional system can become overwhelmed. Feelings that are too difficult to experience or express may move outside of conscious awareness.
These early experiences can remain with us into adulthood. We may carry feelings, expectations, and ways of relating that were shaped long before we had the capacity to understand them. We may then find ourselves repeating relational patterns without fully understanding why.
What This Means in Couples Therapy
As psychodynamic couples therapists, we operate from the understanding that:
Human behavior is unconsciously motivated by our early experiences.
Each new relationship throughout our life is experienced against the backdrop of our earlier relationships and experiences-usually unconsciously.
Sometimes this functions well for people, but for the couples who come into our offices, it has created pain and distress.
This is what makes couples therapy psychodynamic.
We treat the couple’s distress by working towards making the unconscious conscious.
We focus on and encourage the expression of feelings, particularly feelings that have been neglected, avoided, or experienced as unacceptable. We work to reduce the barriers that make it difficult for each person to give voice to those feelings and, in doing so, create greater opportunities for connection and understanding.
We look for the ways past experiences are showing up in the current relationship—sometimes in destructive, repetitive, or unsatisfying ways. We become curious about what is happening between the couple in the room and what may be happening beneath the surface.
When we are thinking from a psychoanalytic perspective in our work with couples, we learn to ask ourselves and our patients:
What do I think?
Why do I think that?
What do I feel?
Why do I feel that?
These questions invite curiosity rather than certainty. They help us slow down the interaction, look beneath the immediate conflict, and begin to understand the emotional experience that is shaping the relationship. That is the work of psychodynamic couples therapy.
If you’re looking for further guidance, training, or consultation on relational dynamics in individual therapy, reach out to schedule a consultation or learn about upcoming trainings.