When a couple comes into treatment, it is a very different process. Whereas there is a back-and-forth dynamic to individual work, a couple’s therapist is more of a mediator, translating and reframing the problems into language that both patients can relate to. The couples therapist also must discover the reasons why the relationship problems developed. There are usually two all-important components to couples work. One is the breaking down of the “victim” perspective. Unfortunately, when a couple comes into treatment, each person is feeling quite beaten up. And it’s true; they are both emotionally “beaten up.” But the injuries usually come from how the personalities have been relating to each other. So each makes a critical transition from victim to collaborator. This generally brings more positive energy back into the relationship and that energy gets things moving in a healthier direction. Crucial to that change is the development of new communication skills. Couples work is very dear to me. When I get a holiday card from a couple telling me that their marriage is better than ever, it’s an awesome feeling.