At a glance
What happens in couples therapy is that you and your partner slow down a pattern you keep repeating, so that each of you is heard without having to win first. You need no diagnosis, no crisis and no agreed version of events to begin. This article tells you what the first session asks of you and what follows it.
Clinical insights from 22 years in psychotherapy
I’m Mark Colclough, MA, psychotherapist in Copenhagen. Qualified at the Psychosynthesis Education Trust and the University of East London. 22 years of full-time, face-to-face clinical practice.
- Safety comes before anything either of you wants to say. I settle safety, boundaries and confidentiality first, because what gets said in my room has to be survivable at home that evening.
- The partner who writes to me has been frightened the longest. By the time somebody books, that one has been carrying the worry alone for months, so I ask them to speak first.
- What couples least expect is that nobody is judged. I do not rule on who is right, and the relief of that lets both of them say more than they came planning to say.
Clinical notes: My observations are anonymised and compounded from my session notes since 2004.
What does couples therapy actually do?
It slows a repeating exchange down far enough for each of you to hear what the other is doing with it. I am no referee. The work is not a hearing in which the better account wins, and you do not need an agreed version of events to start. You will each describe the same Tuesday evening differently, and I take both descriptions as accurate reports of 2 different experiences.
The argument about the dishwasher interests me for the move that happens in every argument you have, not for the dishwasher. One of you says nothing is wrong and that you are overreacting. The other hears that as proof nothing will ever change, and the chest tightens before either of you has said anything new. It is also possible that the partner saying nothing is wrong is holding very still because they expect the next sentence to be about leaving. Neither of you knows which it is until somebody asks, and at home nobody asks. Some couples end this work closer and some end it clearer about separating, and both can begin from the same first session. Read more about falling out of love and divorce therapy.
What happens in the first session?
Mostly I listen: what brought you now, what each of you wants, and what happens between the 2 of you while you talk about it.
- Practicalities first. Safety, confidentiality, and what I do with anything you tell me on your own.
- What brought you now. Not the whole history. What made this the week one of you wrote to me.
- What each of you wants. Asked of you separately, because the answers sit further apart than either of you expects.
- A live sample. At some point you talk to each other instead of to me, and I watch what happens to you both while you do.
- A reading back. I say what I saw, in plain words, and you tell me whether it fits.
- A decision. At the end you decide whether to carry on, and what the next session is for.
Sessions here run for 2 hours. An argument needs room to start, and a shorter hour ends it by the clock rather than by anything being understood. Read more about couples therapy in Copenhagen and finding the right therapist.
What happens in the room when an argument starts?
I let it run long enough to see the shape of it, and I stop it where the shape is clear. Then I go back 3 sentences and ask what each of you heard, because what was heard and what was said are rarely the same sentence. I ask what you wanted at that moment: agreement, an apology, or to be told that the thing upsetting you is real. I ask what you were afraid of. Pressing your case harder keeps you from hearing the answer you dread, so the pressing looks like conviction when it is closer to fear.
Then I follow the loop. One of you raises the volume. The other goes quiet, and the quiet reads as contempt, so the volume rises, and within a minute neither of you is answering the original matter at all. You are each answering the other reaction. In most couples I see, one has been doing the pursuing for years and the other the withdrawing, and that load is not even. Saying who carries which part is not the same as deciding who is at fault. Nobody is asked to concede either: being heard is not a reward for the better case, and it arrives before either of you has given anything up. Read more about trust in a relationship.
What if only one partner wants to come?
Useful work is possible with one of you in the room, and it changes what the work is for. I look at your side of the pattern: what you keep doing, what it costs you, and what you are protecting by doing it. What it does not become is a way of adjusting your partner from a distance, and I will say so if that is what the sessions start to be for.
Your partner might never come. The question then becomes what you want to do about living with that, which is a different and harder conversation than the one you booked for. Read more about couples therapy alone.
Does couples therapy actually work?
The work has reasonable support in general and thin support for any one method being best, which is the opposite of what a site selling a method tends to say. Couple and family therapy shows consistent evidence of effectiveness across a large body of outcome studies1, with the caveat that reporting in that literature is uneven and the publication system favours positive results. What shows up more reliably than any particular method is the working relationship: how well a client and therapist work together is consistently associated with how therapy goes, and that holds across countries, across treatment approaches and whoever is doing the rating2. It is an association, not evidence that the relationship by itself produces the outcome.
So ask which school of couples therapy someone works in, and give at least as much weight to whether the 2 of you can work with this particular person. That question carries more weight in Denmark than it should, because psykoterapeut is not a protected title3, so ask any therapist what they trained in and for how long. Read more about whether couples therapy is worth it.
How do I ask my partner to come to couples therapy?
Ask for one session about one specific thing, and say what you want rather than what they are doing wrong.
- Name the want, not the fault. That you want to stop having the same evening lands differently from the evidence for why they should agree.
- Make it small. One session, not a commitment to a course of them.
- Say what you are afraid of. If you are asking because you want to stay, say that before they assume the opposite.
- Let them set a condition. Partners agree more readily once they hear they are not walking into a tribunal.
- Go first if they refuse. Starting alone changes the pattern from one side, and some partners join once they see it is not an ambush.
- Bring the asking itself. If asking at home turns into the argument, that is the thing to open in the first session.
That a request lands better when it names a want rather than a fault is my clinical judgement rather than a measured finding.
None of this is right when you are frightened of your partner, when one of you is gathering material for a case rather than trying to be understood, or when drinking or drug use makes the conversation unreliable from one week to the next. Those need addressing on their own terms first, and sitting down together too early makes some of them worse. What stays uncertain at the beginning is whether the 2 of you want the same relationship, and that is worth opening in the room rather than settling alone at the kitchen table. A session or the free 30-minute call is a reasonable place to begin.
Questions people ask
How long does a session last, and how often would we come?
Sessions run for 2 hours, and I suggest a fortnight between the early ones. That spacing is a suggestion rather than a rule, and you can set it to suit what you are working on.
Do we both have to want to come for it to be worth booking?
No, one willing partner is enough to make a first session useful. What changes is the purpose of the work, which becomes your side of the pattern rather than the pattern between you.
Can we book one session to see what it is like before committing?
Yes, and that is a reasonable way to start. You decide at the end of it whether to carry on, and I say plainly whether I think the work suits what you brought.
Will you tell us which of us is right?
No, and a therapist who does that is of little use to you. I describe what I see happening between you, which is more useful than a verdict either of you would then have to live with.
Can couples therapy run in English if one of us is Danish?
Yes, sessions here run in English or Danish, whichever serves the 2 of you. Say in the first session if one of you is working in a second language, because it affects who finds it easier to speak.
When you feel ready to try it, my page on couples therapy in Copenhagen explains how I set up the first sessions with you both.
You may also find these helpful
Sources
- Stratton, Silver, Nascimento, McDonnell, Powell and Nowotny, Couple and family therapy outcome research in the previous decade: what does the evidence tell us?, review of 225 outcome studies published 2000 to 2009, Contemporary Family Therapy, 2015
- Flückiger, Del Re, Wampold and Horvath, The alliance in adult psychotherapy: a meta-analytic synthesis, 295 samples and about 30,000 adult clients, Psychotherapy, 2018
- Videnscenter for Psykoterapi, Hvem udøver psykoterapi? accessed 11 October 2026
How this article was written: I choose the subject and the angle. An AI assistant researches and drafts. I read the draft, correct and improve it and stand behind every clinical statement. The professional and clinical judgement is mine.
