At the risk of sounding a bit snobby and receiving the side eye of other clinicians: couples therapy is fundamentally different from individual therapy. It is not two individual therapies happening next to one another, and it is not simply individual therapy with an additional person in the room. Anytime we have more than one person sitting before us, we suddenly have a systemic, relational process unfolding. There is what is happening inside each person, of course, but there is also what happens between them: how one person’s protection activates the other person’s protection, how each makes meaning of the other’s response, how those responses feed back into one another, and how the same repetitive process can escalate, collapse, reverse directions, or fold in on itself in a matter of minutes.
When we work individually with a client, there is one internal system before us. That system may contain tremendous multiplicity if we are looking through an ego-state or Internal Family Systems lens. One person may have parts that want closeness and parts that fear it, parts that are furious and parts that quickly suppress anger, parts that long to be witnessed and parts that experience being seen as dangerous. Individual work is hardly simple. But we are still working with one human being who contains that multiplicity internally. Multiply that by two, or three if we are working with a triad, and then account for all the ways those internal patterns interact with one another, and we are working with an entirely different animal.
I did not fully appreciate this when I first decided to become a couples therapist. I was, admittedly, a little naive. Even after completing the Emotionally Focused Couples Therapy externship, I can now look back and realize how little I actually knew. The externship was enormously helpful, and it also gave me just enough of a lens to begin seeing a field of complexity that I had not yet developed the capacity to track. The more couples therapy training I complete and the more expertise I develop, the more I value and appreciate that couples therapy is its own clinical discipline. And the more certain I become that being a good individual therapist does not automatically equip someone to do effective couples work.
Being a good individual therapist does not automatically equip someone to do effective couples work.
A Couple Is a System, Not Two Competing Stories
One of the most important shifts in couples therapy is learning to listen systemically. Both partners will arrive with a story about what is happening, and very often those stories will sound incompatible. One person says, “I have to push because otherwise nothing ever gets addressed.” The other says, “I shut down because every conversation feels like an interrogation.” If we listen only at the level of content, we may become preoccupied with determining whose account is more accurate, whose behavior started the argument, or whose communication style is more problematic.
But much of couples therapy asks us to listen underneath the content and track the process. The more one partner pushes for contact, the more overwhelmed the other becomes. The more the overwhelmed partner withdraws, the more abandoned and urgent the pursuing partner feels. Each person’s attempt to protect the relationship or protect themselves inadvertently confirms the other person’s deepest fear. The couple becomes trapped in a feedback loop where each is responding to the other’s protection rather than having access to the more vulnerable experience underneath it.
A couples therapist has to hold multiple layers at once: each person’s attachment history, their nervous system, their internal multiplicity, their identities and cultural context, the relational history, the injuries that have accumulated between them, the meanings they assign to each other’s behavior, and then the live process occurring in the room. We are also tracking how the cycle begins recruiting us. Does one partner make a more coherent case and pull the therapist toward agreement? Does the quieter partner disappear from the room while everyone focuses on the more expressive person’s distress? Are we becoming overly protective of one partner, frustrated with the other, or tempted to move too quickly because the intensity in the room is difficult to tolerate? The therapist enters the system, and without enough training and self-awareness, we can begin participating in the very process we are supposed to help the couple see and reorganize.
The Therapeutic Alliance Is Not Separate From Skill
There is a lot of conversation in therapy spaces about whether clinicians are overemphasizing modality, specialty training, and technical skill when the heart and soul of therapy is the relationship. Can you be two humans and two nervous systems in a room together? Can the client feel your care, attunement, curiosity, and presence? I understand this argument, and I have written before about how healing the therapeutic relationship itself can be. I just do not think it is as simple as choosing relationship over skill.
The therapeutic alliance is incredibly important, but the alliance is also informed by skill. It is informed by the eyes of the person looking at you: what they notice, what they miss, how they formulate the problem, what they believe needs to change, what they address first, and how they understand the protective behavior emerging in front of them. A therapist may be warm, genuine, and caring and still repeatedly misunderstand a couple’s relational process. They may align with the partner who is more verbally fluent or emotionally expressive. They may mistake withdrawal for indifference, pursuit for control, intellectualization for stability, or emotional intensity for greater investment in the relationship. They may teach communication tools without understanding why neither person can access those tools once their attachment system takes over.
These missteps do not necessarily come from a lack of empathy. Often, they come from not having a sufficiently developed systemic map. Couples therapy requires us to build an alliance in multiple directions while also building an alliance with the relationship itself. We need to remain emotionally accessible to both people, even when each is offering a radically different account of what is happening. We need to help each person feel understood without simply corroborating every interpretation they hold about their partner. None of that is merely a matter of being likable or caring. It is a matter of clinical judgment, formulation, timing, and repeated practice.
The therapeutic alliance is incredibly important, but the alliance is also informed by skill.
Specialized Training, Privilege, and the Charge of Elitism
I can understand why there is pushback around gatekeeping and elitism in therapy spaces. Advanced clinical training is expensive. It often requires clinicians to take time away from paid work, cover travel and consultation costs, and keep investing long after graduate school has already left many people with substantial debt. Access to specialty training is absolutely shaped by money, time, geography, disability, caregiving responsibilities, and the structure of someone’s employment. Those realities should be named plainly.
I will also be direct about my own position. I was privileged insofar as I made a good decision for my circumstances and completed an asynchronous graduate program, which allowed me to continue working full time. That allowed me to save money, and I poured a significant amount of that money into advanced specialty training. Graduate programs give us essential theory, ethics, assessment, and a foundation for clinical work, but much of what eventually sets clinicians apart is the depth of skill they develop after graduate school and their capacity to work responsibly with more specialized, niched populations.
We can and should question why so much of the training clinicians need is financially inaccessible. We can advocate for employers to fund continuing education, for training organizations to offer meaningful scholarships and lower-cost pathways, and for graduate programs to provide more than a broad introduction to complex areas of practice. But the existence of access inequity does not make expertise imaginary. Those are two different conversations, and collapsing them does not ultimately serve clinicians or clients.
Sometimes I see hot takes criticizing clinicians who pursue extensive training, develop a niche, or place real value on modality. And I will say this as a human rather than finding the most professionally polished version of it: at times it begins to feel like taking shots at people for caring deeply about developing expertise. I do not think every expensive certification is inherently valuable, and I certainly do not think collecting acronyms automatically makes someone a good therapist. Training can become performative. But the answer to those problems is discernment, not a wholesale dismissal of training itself.
The more I learn, the more finely I can perceive what I am not yet able to do. Expertise has not made me feel finished. If anything, it has made me more respectful of the work and more aware of how much responsibility it carries.
Why I Continue Training Outside My Primary Model
Emotionally Focused Couples Therapy remains my clinical home. I believe it is one of the soundest models available for understanding the attachment-based feedback loops that organize so much relational distress. My autistic and ADHD brain is good at pattern recognition, and EFT offers a remarkably coherent way to track what happens between partners without reducing either person to the problem. It helps us understand how protective strategies that look irrational, hostile, detached, or controlling from the outside often make sense within the person’s nervous system and attachment history, and how those strategies begin triggering and reinforcing each other.
I also do not believe any one model can be the answer to every couple or every clinical circumstance. That is why I continue training beyond it. I began studying the Psychobiological Approach to Couples Therapy in the spring and decided to pause because, frankly, there were significant parts of the model that I did not enjoy. I am returning to the training because disliking aspects of a model does not mean it has nothing to teach me. Looking through another lens challenges the biases that can develop when we become deeply immersed in one way of understanding couples, and it may give me two or three additional tools for a specific presentation that is not responding to EFT in a straightforward way. Next year, I plan to continue investing in the Developmental Model developed by Ellyn Bader and Peter Pearson, particularly because of its emphasis on differentiation. That lens is especially relevant in my work with open and expansive relationship structures, where secure connection cannot be built by erasing separateness, autonomy, ambivalence, or difference.
Training across models does not dilute my confidence in EFT. It makes that confidence more grounded. I am not choosing EFT because it is the only couples therapy model I have encountered or because I need the model I trained in to be the best. I choose it because, as I compare lenses and continue treating complex couples, I repeatedly find its formulation of relational process clinically sound and deeply useful.
Individual Therapists Need Couples Therapists Too
I work with a number of individual therapists who come to me for couples therapy. I think that fact illustrates the distinction I am trying to make. These are often thoughtful, highly skilled clinicians with significant expertise of their own. They understand attachment, trauma, defense, family history, and relational patterns. But when they enter my office with a partner, they are not looking for a more knowledgeable individual therapist. They are seeking something specific to the problem before them: someone who can see the relational system they are living inside, track it while it unfolds, and help both people access experiences they cannot simply think their way into.
Knowing a great deal about psychology does not place anyone outside their own attachment system. Therapists become activated, protective, defensive, ashamed, pursuing, withdrawing, intellectualized, and lost inside repetitive cycles just like anyone else. Insight can help us name what is happening, but insight alone does not necessarily reorganize the interaction. A couples therapist has to do more than explain the cycle accurately. We have to create the conditions for each person to experience themselves and their partner differently while the old process is happening in real time.
This is why I believe people seeking couples therapy should ask about more than whether a therapist lists “couples” among the many populations they serve. What couples-specific training have they completed? What model helps them understand relational distress? How do they think about individual trauma and the systemic process between partners? How do they work when there are questions of neurodivergence, sexuality, non-monogamy, betrayal, dissociation, substance use, or power? A therapist does not need to have every possible specialty, and no amount of training guarantees that they will be the right fit. But couples deserve a clinician who has prepared specifically for the work they are offering.
Couples Therapy Deserves to Be Treated as Its Own Discipline
I do not make this argument for the sake of professional elitism, nor do I believe there is only one legitimate route toward becoming an excellent couples therapist. I make it because the work itself has shown me how much it asks of us. Couples therapy requires layered systemic thinking, a multidirectional alliance, the capacity to track multiple nervous systems at once, and the humility to recognize when our favored theory does not fully account for the people sitting before us. It asks us to understand without excusing, validate without indiscriminately agreeing, and intervene in a process that is often moving faster than either partner, or the therapist, can consciously narrate.
The more I do this work, the less casual I feel about it. I can look back at earlier versions of myself, including the version who had already completed meaningful couples training, and see how much she still could not perceive. I imagine I will look back several years from now and feel the same way about the therapist I am today. That does not make me doubt the value of developing expertise. It is precisely why I keep developing it.
The more I learn, the more finely I can perceive what I am not yet able to do. Expertise has not made me feel finished. If anything, it has made me more respectful of the work.
