Ep. 18: The 5 Situations that a Couples Therapist Can’t Really Help
Apple Podcasts | Spotify | Pandora
The 5 Situations that a Couples Therapist Can’t Really Help
There are some situations where couples therapy either won't work, or flat-out isn't the right first step. Problems that are so big, so entrenched, or so actively ongoing that they're blocking all the light to the relationship — and no amount of better communication is going to fix that until the bigger issue is addressed first. I also think there are people in these situations right now who are so deep inside the crisis that they can't see it for themselves. And maybe this episode is for someone you love, even more than it's for you.
Here are the five situations I cover:
1. Domestic Violence When there is violence in the relationship, the abused partner is not safe to speak freely in the presence of their abuser. Couples therapy cannot work — and attempting reconciliation without sustained, demonstrated change on the part of the violent partner doesn't hold them accountable; it just papers over the rot. Physical safety comes first, always. (And it's worth knowing: if a partner is abusing children and the other spouse knows and does nothing, that bystander can be held legally liable. In therapy years later, it's often the bystander parent — not the abusive one — who children have the hardest time forgiving.)
2. Ongoing Infidelity Couples therapy can help couples heal from infidelity — but only when the affair is truly over. If there hasn't been a clean, witnessed, verifiable cutoff of the outside relationship, you can't do meaningful couples work, because one person is in the marriage and the other isn't. I talk about what "closure" actually needs to look like and what real repentance and transparency require. (I'm tipping my hat here to Dr. Terry Hargrave, founder of Restoration Therapy and one of my mentors, whose thinking informs some of this.)
3. Active Addiction When someone is in an active, untreated addiction, there is no stable foundation for trust — because the addiction will always win, no matter what their words say. The ongoing injury to the relationship continues as long as the addiction does: financial deception, safety risks, untrustworthiness. Rehab, a 12-step program, and sustained accountability have to come first.
4. Personality Disorders The DSM-5 defines a personality disorder as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture" — something pervasive, inflexible, and deeply baked into a person's sense of being. I'm not going into deep clinical detail here (I don't want to give anyone just enough information to start misdiagnosing everyone around them), but I do want you to know this is a real category of thing. A diagnosis is not a life sentence, but it does require skilled, focused individual treatment before couples work can be effective. The gold standard for borderline personality disorder, for example, is DBT (dialectical behavior therapy).
5. Complex Trauma Complex trauma — the kind that results from recurring, overwhelming experiences over time, like childhood abuse — leaves fingerprints that color every corner of a person's life, including their marriage. When a traumatized partner gets triggered, they're responding from a nervous system that is still living in the original event. Couples work layered on top of unresolved complex trauma is like trying to do a puzzle together while one person is wearing a blindfold. EMDR with a certified (not just trained) therapist is a great first step.
I close by speaking directly to anyone navigating a relationship with someone who has been untrustworthy or harmful: you do not owe someone your trust simply because you love them. Forgiveness is not the same as unconditional access. You can't rescue someone else by sheer willpower — but you can refuse to enable what's unacceptable, hold to strong boundaries, and focus your energy on getting the right support for yourself.
I'm rooting for you.
🔗 Resources & Links Mentioned
Domestic Violence:
National Domestic Violence Hotline: Call 1-800-799-SAFE (7233) or text "START" to 88788
thehotline.org — safety planning resources for you, your children, and your pets
In immediate danger: Call 911 and stay on the line
Infidelity:
Healing from Infidelity by Michele Weiner-Davis
Addiction:
Al-Anon — support for partners and family members of those struggling with addiction
Personality Disorders:
Find a specialist therapist: PsychologyToday.com, MentalHealthMatch.com or TherapyDen.com
Complex Trauma / EMDR (Eye Movement Desensitization & Reprocessing therapy):
Find a certified EMDR therapist: emdria.org
Boundaries:
Boundaries by Dr. Henry Cloud & Dr. John Townsend
Boundaries in Marriage by Dr. Henry Cloud & Dr. John Townsend
Listen & subscribe: