Patricia Williams LCSW

What Happens in Couples Therapy

and Other Questions

People tell me that one of the hardest things about couples therapy is picking up the phone in the first place. I’m hoping that by giving you some idea of how I work and some of what happens in a couples session, it might help make it easier.

We all want to be loved. When we are able to be in a safe and secure relationship that we help to create, we thrive together and individually.

My advanced training along with my own life experience has taught me that couples (regardless of their own history) can overcome their “stuck” patterns and learn to be in securely functioning relationships.

In simple language- it means that the relationship comes first. Partners make an agreement to put their relationship before anything else. It is in the words of Stan Tatkin, founder of PACT, a “couple bubble.” Partners keep each other safe and secure. They are in each other’s care. They have each other’s back. This is not easy, or perfect. It is an ongoing process to maintain. It does not mean giving up oneself, or forsaking others. It is a principle which supports a safe haven and a secure base.

Most couples come into therapy in distress so the idea of being in a bubble together may seem pretty unattainable. In truth, it is the work of therapy- to commit to the principle and work together with me to develop your “bubble” and keep it shiny and secure.

So what does that work actually look like?

A Psychobiological Approach to Couple Therapy (PACT) looks at three areas, developed out of cutting-edge research:

Neuroscience – which is the study of the human brain. Understanding how the brain works provides a basis for understanding how people act and react in a relationship.

Basically, some parts of your brain are wired to establish loving connection and togetherness while others are geared to assess danger, reduce threat and find security.

Attachment theory – the wired in need from birth (to the grave) to bond with others. Experiences in your early relationships create the template that shapes the experience of safety and security that you bring into your adult relationships. These templates can create real troubles for a couple if they are not understood and resolved.

Human arousal – basically this means the biology of how we manage our energy, our ability to engage, our presence. Learning to manage each other’s arousal is one of the principles of being in a secure relationship. It means learning to read each other, to repair quickly – among other things.

So in a session, these are some of the things that I may do and teach you to do:

• I will focus on moment to moment shifts in your face, body and voice and ask you to pay attention to these as a couple
• I will ask you to re-create experiences similar to those troubling your relationship and help you work through them in my office with me.
• I may ask your permission to videotape a session and play it back to you right away to give you feedback.

Sessions and Fees

The first session is usually one hour. This gives you both a chance to see if you feel comfortable with me and for me to get an idea of how you relate to each other. Subsequent sessions are a minimum of one and a half hours; sometimes two or three hours. This gives ample time to do significant work with less frequency.

I offer weekend-intensives (a minimum of three hours per day).

I don’t participate with any insurance companies. If you have out-of-network benefits, you can submit a claim for reimbursement for my services. I’m happy to provide a statement to assist you with that process. I accept checks and some forms of digital payment.