Couples Therapy
Most relationship problems aren't really about the argument you keep having. They're about what's underneath it.
What is couples therapy?
Couples therapy at Sweetnam Psychology is depth-focused work with two people in the room. I use the same approach as individual therapy, actively looking beneath surface behaviour to the emotional patterns driving it, applied to the dynamic between you.
That means we're not just teaching communication scripts or conflict resolution techniques. We're looking at what each of you brings into the room: your histories, your defences, the ways you've each learned to manage difficult feelings. And we're working in real time with what happens between you when things get hard. Over time, that leads to greater awareness of your partner, more empathy in conflictual moments, and the ability to put your emotional experience into words in a way that actually moves things forward.
Sessions are available in clinic at Miami or Pottsville, or via telehealth.
Common ExperiencesWhen does couples therapy help?
Couples therapy can support you if any of this feels familiar:
The same argument on repeat. Different trigger, same fight. Nothing ever actually resolves.
Feeling more like housemates than partners. The connection is still there somewhere, but you've stopped finding each other.
A breach of trust. An affair, a betrayal, or something that broke the foundation and hasn't been repaired.
Parenting and family stress. Disagreements on how to raise your kids, blended family tensions, or the strain of new parenthood on your relationship.
Growing apart through a life transition. A move, a career change, a loss, or retirement that has left you less aligned than you used to be.
Intensity that keeps escalating. Frustration that tips quickly into something harder to come back from.
Not being able to say what you actually need. Difficulty knowing your own needs, let alone expressing them in a way your partner can hear.
Couples therapy isn't only for crisis. Some people come because they want to understand their dynamic before it becomes one.
My approach
I work psychodynamically with couples, which means I'm interested in what's driving the pattern, not just the pattern itself.
In practice, that means tracking what's happening in the room between you in real time. Both of you bring your own emotional history, your own defences, your own ways of managing closeness and conflict. When those systems meet, they create a dynamic. Often that dynamic is what's causing the pain.
My job is to help the two of you bring clarity to what is driving the challenges in your relationship, put words to what's actually happening emotionally, and find a way to move through it together.
What to expect
Sessions are 50 minutes. Couples work typically runs weekly, especially in the early stages. The timeline varies depending on what you're working through. Some couples need a focused piece of work, others stay longer. There's no fixed endpoint. We work until the dynamic has shifted and you feel equipped to continue without me.
Backed By ResearchWhy couples therapy works
Early experience shapes adult relationships
Attachment research consistently shows that the patterns formed in early life don't stay in the past. They show up in how we respond to perceived rejection, how we manage conflict, and how much emotional closeness we can tolerate. When two people with different attachment histories meet, those patterns interact in ways that are often invisible to both people until named.
Change happens in the room, not just in reflection on it
ISTDP, the primary model I draw on, has a growing evidence base demonstrating its effectiveness with relational distress. Its focus on moment-to-moment emotional experience means the work is live and immediate, tracking what's happening between you in real time rather than analysing it after the fact.
The relationship with the therapist matters as much as the technique
Research on couples therapy consistently shows significant improvements in relationship satisfaction, communication, and emotional connection. Importantly, the evidence suggests that the quality of the therapeutic relationship and the therapist's ability to remain neutral while actively engaged are stronger predictors of outcome than any specific technique.
Common questions
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No. My focus is the relationship, not who's right. That said, I will name what I observe directly, including when one person's behaviour is causing harm. Neutrality doesn't mean I stay quiet.
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Individual therapy can still help. Working on your own patterns, understanding what you bring to the dynamic, and deciding what you want is all valuable. If your partner later wants to join, we can discuss whether that's workable, though I'll be honest with you: when one person already has an individual relationship with me, bringing a partner in has limits. The new person may reasonably question whether the room is level. I'd rather name that upfront than have it become a problem.
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Most of the couples I see are people who care about their relationship enough to do something about it. Or care about and respect each other as individuals enough to bring empathic discussion to something difficult.
It’s a big move, and it’s a brave one. But no, I don’t think it means something is broken.