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                  By Jamey Collins, LCSW

There are countless reasons why gay/lesbian, straight or other couples might seek counseling. In this article, I will briefly discuss couples therapy in general, my approach to helping relationships succeed and some issues specific to gay and lesbian couples.

Many couples who want help wonder what therapy is going to be like, or how it might help. Here are answers to some of the most common questions about couples therapy.
What is couples therapy?
Couples therapy is a process of healing and growth. "Healing" to me means reducing (releasing at times) emotional suffering in order to create a more satisfying life. The therapeutic relationship between the couple and the therapist may resemble a mentoring or coaching relationship. All parties come together to understand what is going on in the relationship, what the needs are, and how the couple may more effectively meet those needs.  
What are the benefits of couples therapy?
Good therapy helps us recognize the individual strengths and weaknesses we bring to our relationships. It helps us discover new skills to better navigate the challenges of healthy relating. Most of us grow up believing that if a relationship is right, it will just evolve. This is a romantic notion that could lead to much pain and suffering.
"Real love" is discovered after much work. It is the byproduct of developing understanding, empathy and forgiveness for yourself and partner, good communication skills, flexibility, the ability to tolerate difficult feelings, and a willingness to take risks.
Couples therapy provides people with a safer space to discuss difficult feelings. The therapist guides the discussion in a balanced and fair manner. This allows the clients to feel more comfortable to speak frankly about their feelings. 
The good news is there's room for fun and romance throughout the work.
How does therapy work?
Healing and change usually occur when these elements come together:
1) Clients and therapist are willing to be open, genuine, honest, and authentic;
2) The couple and the therapist sense they can work well with each other;
3) Goals and the process are discussed and agreed upon by all parties;
4) The couple is willing to work inside and outside the sessions, and willing to bring their issues to the sessions;
5) The therapist is well trained and has some personal, significant life experience in a coupled relationship.
The initial stage of therapy clarifies issues, establishes an understanding of what the work will be like, and involves a commitment to the therapy. From there, the healing process takes shape. The therapy approach must be tailored to each couple. The approach may be short term or longer, remain more superficial or move deeper based on each couple's needs and motivation for the work.
When the process begins, many couples are fearful, are experiencing power struggles, and are wondering if a split-up is imminent. It is not the intent of therapists to prevent couples from splitting up -- that is the couple's decision. These power struggles and fears may suggest to the couple that they prematurely end their relationship. However, therapists may encourage the pair to work through these issues.
What approach do you take to couples therapy? 
Couples therapy models have come a long way. Like most therapists, I utilize different models depending upon the needs of the couple. Primarily, I draw from Imago Relationship Therapy, as designed by Dr. Harville Hendrix and described in his book, Getting the Love You Want. I am certified by Dr. Hendrix to provide this therapy.
Dr. Hendrix's approach offers exercises that help reveal the unconscious emotional agendas in the relationship. This agenda is about healing or completing the emotional business of childhood. Exercises on communication, conflict resolution, requesting a partner to change his/her behavior, dealing with anger and rage, and re-romanticizing the relationship are all part of the therapy.
Couples therapy is not always problem focused. Often, it is an opportunity for couples to have guidance through a mentor or coach. During adolescence, gays and lesbians have few or no role models when it comes to healthy same-sex relationships. They must be their own counsel. The couples therapist can teach clients essential relationship skills. 
Is it best for people to couple?
In our society, it is assumed that coupling is best. Popular myth believes we all should find the right person and build a life together. In reality, some long-term arrangements only create unnecessary suffering. It is helpful to look at coupling as a popular option among several that are open to us. Obviously, when children are involved, their needs are a primary consideration as well.
Marriage-style coupling does not work for everyone. Many people find happiness and fulfillment in remaining single. Some also find non-conventional arrangements with several partners workable. Serial relationships meet some people's needs better in this fast-paced, ever-changing world. However, in many cases, serial monogamy can also be a product of leaving prematurely when the going gets emotionally scary. Here, couples need support to better tolerate and deal with conflict and intimacy. 
I am not anti-coupling, anti-relationship, or anti-long-term anything. I believe people need to honestly explore and choose what is best for them. 
What issues do most couples bring to therapy?
Universally, couples must deal with the stresses from life's events/losses, changes, disappointments, financial pressures, parenting, and meeting competing emotional and sexual needs. Also, a challenge for all couples is to find the balance of closeness and separation that is acceptable to both partners. 
Most couples need more effective communication skills. People seldom know how to listen effectively and to communicate understanding and empathy for their partner's position. People talk and, at times, talk more emphatically and repeatedly when they don't feel heard. We have all experienced how this can turn into a verbal tug of war between adversaries, instead of the healthier scenario of allies working together for the common good.
Once couples are being heard and understood empathically, core individual issues and emotional wounds from the past may emerge. Much of a couple's arguing, blaming, judging, or criticizing of each other on the surface are rooted in these old unconscious hurting places. These often include fears of abandonment, rejection, inadequacy, neglect, and invisibility. 
What issues do gay and lesbian couples bring to therapy?
Gay and lesbian couples do present some unique issues. They face:
1) Lack of validation and support for the relationship from family, friends, and social institutions;
2) Stress to the relationship when one or both are closeted;
3) Scarcity of easily identifiable, successful roles models for coupling;
4) Lack of rituals that signify a progression of stages in committed relationships (i.e., dating, girlfriends or boyfriends, engaged, union or marriage);
5) Lack of ritual boundaries (as in a traditional wedding where the couple emotionally is joined with the family's blessing) which may create emotional cut-offs from the original family;
6) High rate of substance abuse and behavioral compulsivity due to the pressures of being gay and lesbian in this society. 
What issues are different for gay male couples versus lesbian couples?
In general, gay men often deal with the idea of sex outside the relationship, and need help in managing independent styles that may pull them apart. Men, in general, may withdraw from their partner when intensity (especially sexual) decreases. Under emotional stress, men are socialized to distance themselves. Learning to express vulnerable feelings and developing increased empathy for one's partner are important. Men often need to deal with the issue of money. Money in a relationship means power. Power differentials can create tension and conflict. Gay couples also must deal with the issue of AIDS when one or both are infected. 
Lesbian couples must often deal with too much emotional closeness. Women place a high value on relating and have been socialized to fuse when under stress. They are taught to be the emotional glue in a family. Establishing effective emotional boundaries is often part of the work. Focusing on maintaining a sense of self apart from the relationship may be important.
Lesbian couples may have more difficulty getting families to let go of them emotionally because the family invalidates the union without a man. A decrease in sexual intimacy may also be a focus of therapy. Many lesbian couples deal with having children or adopting and parenting.
Gay, straight or other couples share many of the same issues, dynamics and challenges. Gay/lesbian couples may have some variance in their issues as detailed above. All people yearn for and deserve the love that reconnects them to original wholeness. The good news is that you can learn the skills and practices that return you to that wholeness. I wish you love and the fullest of journeys!
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