The Real Reasons (That Nobody Tells You) About Why Therapists Don’t Accept Insurance

The Real Reasons (That Nobody Tells You) About Why Therapists Don’t Accept Insurance

When you’re thinking about starting therapy, it’s normal to have a lot of questions: What style of therapy is right for me? How do I choose a therapist? Do therapists take insurance?

Deciding to start therapy is a huge milestone in life. I’d even say it’s as big as getting married or starting a new job. I mean, think about it. What could be more important than committing to work on yourself and become the best version of yourself? Who you are and who you become influence every part of your life.

That’s why choosing the right therapist is SO important. It’s essential you and your therapist are a good fit and that the person you choose has the experience and expertise to get you to the next level in life, whether you’re working on career goals, relationships, self-exploration or all of the above.

One of the considerations you might take into account when looking for a therapist is whether that therapist accepts your insurance. 

So, Do Therapists Take Insurance?

For many people, whether or not a therapist takes insurance is a deciding factor when choosing someone to work with.

After all, you’re paying a premium every month for your insurance so why wouldn’t you want to use it? It can save you money on your session costs and it can help you narrow down your search by ruling out therapists who don’t accept your plan. You use your insurance for all other doctors so why not do the same for therapy, right?

Unfortunately, new therapy seekers with this belief are often confused and frustrated by the number of therapists they find that do not accept insurance. It can be really difficult to find someone that specializes in your area of need, is close to home, fits your personality, and accepts your insurance.

But why is it so hard? Why don’t therapists take insurance? 

Many consumers don’t realize that there are several downsides for both therapists and clients when using insurance to pay for therapy.

So what do private pay clients who are shelling out big bucks for therapy know that you don’t? Let’s dig deeper into the question, “do therapists take insurance?” and figure out why many don’t.

Two women sit in an office talking about do therapists take insurance

Here are 4 reasons why you should not use insurance to pay for therapy:

1. Less Confidentiality

Everyone knows that what happens in therapy stays in therapy. Your therapist is required to keep everything you say confidential no matter what, right? 

Wrong! When you use insurance to pay for therapy, your therapist is required to provide your diagnosis and treatment notes to your insurance company in order to get paid. This undermines the basic premise of therapy and also gives a lot more people access to private health information about you. 

If this is news to you, you’re not alone. It’s all written into the HIPAA document you get when you start therapy (or go to any doctor’s office) but most people don’t read all the fine print.

2. Higher Insurance Premiums

Even if you’re okay with your information being shared with your insurance company from a confidentiality standpoint, you probably didn’t realize that sharing this information can have unintended consequences in the future.

As mentioned above, your therapist has to provide your insurance company with your diagnosis to get paid. But what if you don’t have a mental illness? After all, many people seek therapy for personal growth and exploration, not because they are depressed or anxious or have a serious mental illness.

In the eyes of your insurance company, these are not valid reasons for seeking therapy on their dime. If you don’t have an actual diagnosis, they aren’t interested in paying for your sessions and will not continue to authorize future sessions.

This puts your therapist in an awkward and ethically challenging position if you don’t meet the criteria for a mental illness. 

How do therapists get paid by insurance? 

If you don’t have a diagnosis, he or she is left with choosing between 3 options.

  1.  Assign a diagnosis you don’t meet the criteria for so that your insurance company will continue authorizing sessions.
  2.  Discontinue therapy.
  3.  Continue to work with you without assigning a diagnosis but risk having claims denied and not getting paid for the work.
A man and woman sit and talk to a therapist after answering the question, "do therapists take insurance"

At this point, you are probably starting to understand why so many therapists don’t accept insurance.

Ok, so you might be wondering how this all relates to increased premiums for you.

Let’s say your therapist opts for option 1 and assigns you a diagnosis so that your insurance company will authorize future sessions. Maybe you meet criteria for a diagnosis, maybe you don’t. Either way, you now have a diagnosis on record with your insurance company.

When it comes time to renew your insurance or switch plans, your premiums could rise as a result of your “pre-existing condition.” In addition, you may be required to share your diagnosis in future job interviews, which is awkward, to say the least. I would like to add that it’s rare to have to disclose something like that for a job but it can happen in security, government, and some other professions.

3. Insurance-Driven Treatment Plan

When therapists take insurance, they are required to use treatment methods that are covered by your plan. This means they have less say in how to treat you based on your specific and individual needs. 

Ironically, the people who work in your insurance company and decide which methods of therapy can be used, are usually not even therapists! And they certainly haven’t met and assessed you personally like your therapist has.

This leads me to my next point…

4. Questionable Quality

Do therapists take insurance because they can’t build their practice otherwise? Possibly.

Let me preface this by saying that there are some fantastic therapists who take insurance. Sometimes highly skilled therapists accept insurance clients as a way to “give back” to society and offer high-quality services to those that wouldn’t be able to afford it any other way. 

If you don’t know anything about insurance payouts (and why would you if you’re not a therapist or a doctor?), this last statement probably doesn’t make sense. Bear with me while I help clear that up and give you some rarely discussed insider info from the therapist’s perspective.

The going rate for a great therapist in most major cities is between $150-$350 per session. Most insurance companies pay therapists between $40-$90 per session. This is a fraction of what therapists receive from private pay clients and it requires a lot more paperwork and time to get paid by insurance companies. Submitting insurance claims is time-consuming and confusing as is getting approved to be on insurance panels in the first place. Many therapists have to hire a billing professional to help them manage insurance claims and make sure they actually get paid.

So why do therapists take insurance if they get paid less and have to jump through paperwork hoops to get paid?

The answer is because they have to. Let’s explore this in more detail…

a man's hand writes on a white paper on a black clipboard while answering the question, "do therapists take insurance?"

Do Therapists Take Insurance Because They Have To?

Something that is rarely discussed with consumers is the fact that insurance companies provide a steady flow of referrals to therapists. Let’s take a moment to think about who might need a steady flow of referrals to their practice and would be willing to take a major pay cut for said referrals.

New therapists just starting a private practice. 

Therapists who just graduated usually have some serious student loans to pay off and they need to start making money fast. It can take time to build up a positive reputation in a community so getting referrals from insurance panels (even if it means making significantly less per client) is a great way to get started. 

Often, therapists who opt for this route will start phasing out insurance clients as their reputation grows and they start getting more organic referrals from satisfied customers.

Therapists who don’t want to market themselves.

Sometimes therapists get and stay on insurance panels for the bulk of their career because they prefer the safety of knowing they will always have referrals. Perhaps they don’t know how to market themselves, don’t want to invest in marketing, or are risk-averse and can’t or don’t want to risk having fewer clients when they are getting started as private pay.

Working with insurance long-term is more likely to lead a therapist to burnout because they are doing double the work for half the pay. There is a higher chance that this therapist will be overworked and less passionate about their work as a result.

Therapists in low-income areas. 

If there are very few clients that can pay full price for sessions in the area, therapists in private practice may opt to accept insurance or move to a community where there are more affluent people. For this reason, lower-income communities do not have a lot of therapists in private practice but they do have more government-subsidized community treatment centers where people can get help. 

This is a sad truth about the systemic issues and barriers that limit low- to moderate-income folks when seeking mental health care. If insurance companies paid therapists rates commensurate with the amount they have to spend on their education, many more therapists would opt to be in-network and many more people would have easily affordable therapy.

Therapists who do not have a lot of satisfied customers. 

As a therapist myself, this is a delicate situation for me to discuss and I suspect it will upset some of my colleagues. That said, the ones it offends are probably the ones who fall into this category. Many therapists who accept insurance do so because they are not good enough at what they do to facilitate referrals and command a higher fee.

Yep, I said it.

Satisfied customers talk. They leave positive reviews online. And tell their friends and family how happy they are with their therapist and they refer the people they love. They build their therapist’s practice for them by becoming walking billboards. Their friends and family start to notice positive changes in their personality and ask them what they are doing…and they tell them about their therapist.

Not only do satisfied customers refer to skilled therapists, other professionals do too. Medical doctors hear from their patients that they got great results working with a therapist and they send more patients. Other therapists who get asked by friends and family for referrals, send them to other skilled therapists in the community.

Why Therapists Don’t Take Insurance (And Why You Should Pay Them Anyway)

Therapists who don’t take insurance have to be really good in order to create and maintain a thriving practice. With therapy, you usually get what you pay for and if someone is charging a high fee, it’s usually because they are worth it.

Speaking of that price tag, I know it can feel scary to drop a couple of hundred dollars on a therapy session every week, especially if you don’t have a ton of disposable income. 

So, are therapists worth it?

What I’ve seen in my practice (and in many other settings besides therapy) is that those who pay the full fee and make a substantial investment, are actually more committed to doing the work than those who pay less.

Think about it. If you paid $20 for a meal or $200, would there be a difference in how you treated it? Would you rush through the $200 meal and then throw half of it away if you didn’t feel like eating anymore? I’m guessing not. You would savor that meal and ask to take anything you couldn’t eat home with you to enjoy later.

People who pay more for therapy are literally and figuratively more invested and it shows in their results. They make the most of every session, they do their homework, and they get great results. 

In my opinion, there is nothing worth more than your personal growth. If you take the work seriously, you will see your investment pay off in every area of your life. 

By the way, this is coming from someone who has spent a lot of money on personal growth. I truly feel it’s been worth every penny.

Two women sit and talk in chairs in front of a brick wall, enjoying a therapist session after determining, "do therapists take insurance?"

What to Do When Therapy Doesn’t Take Insurance

Ok, but what if you literally CANNOT afford to pay the full fee but you also want to make sure you get a great therapist? Fortunately, there is sometimes an in-between option.

Depending on your insurance, you may be able to get reimbursed for out-of-network benefits. This can mean savings of up to 20-60%. This is typically available with PPO plans. To find out, call the number on the back of your insurance card and ask how much your plan pays for out-of-network therapists.

Then, if you do have out-of-network benefits, ask your therapist if they can provide a superbill for you to submit to your insurance for reimbursement. You will pay your therapist for the sessions up front. Then, your insurance company will reimburse you for some of the session fees. 

Your therapist will still have to provide a diagnosis on your superbill in order for you to get reimbursed. Not every insurance plan has this benefit but it’s definitely worth a phone call to ask!

The other option is that you can use your health savings account (HSA) or flexible spending account (FSA) to pay for therapy. This allows you to save money because you are paying with pre-tax dollars.

Finding The Right Therapist for You

So there you have it. That is the good, the bad, and the ugly of using your insurance to pay for therapy as I see it.

Still not sure how to find the therapist that is right for you? Consider your mental health needs and your schedule to determine if a specific type of therapy might work best. For example, virtual therapy or couples therapy might be an option.

Do online therapists take insurance?

It depends. Just like in-person therapy work, online therapists have to go through many steps to accept insurance as payment for their services. Finding an online therapist will be unlikely to affect how much you pay for therapy. It can help make it more accessible.

Do couples therapists take insurance?

Some do! Just like individual therapists, there are many couples therapists who accept insurance and many who do not. While it’s very valid for cost to be a factor when choosing a therapist, when it comes to couples therapy the most important thing is to make sure your therapist has experience helping couples through the challenges you and your partner are facing. It’s also important to ensure both you and your partner feel comfortable with the therapist you choose.

Explore online therapy with Couples Learn

Still have questions? We’d love to hear from you. You can contact Couples Learn at any time to ask questions or book a free consultation.

Have you used insurance to pay for therapy in the past? If so, how did it go for you? Let us know in the comments on this Facebook post.

Want A Healthy Relationship? Learn To Dump Your Assumptions!

Want A Healthy Relationship? Learn To Dump Your Assumptions!

As a couple’s therapist, one of the things that always amazes me is how two different people can experience the same situation in completely unrelated ways. It’s one of the reasons assumptions in relationships can be so damaging.

When I ask a couple to tell me about something that happened, sometimes it seems impossible that both partners were at the same event, given the opposite nature of their stories. This reminds me that so much of what we experience comes from our own viewpoint, made up of our unique thoughts and feelings, which, in turn, color our world.

When it comes to thoughts that can wreak havoc in even healthy relationships, assumptions are a big one. 

What Is An Assumption?

An assumption is a belief that one person thinks is true but really has not been proven. We make assumptions all the time. When we meet someone new, our first impression of that person is a series of assumptions we form based on her appearance. How is she dressed? Does she make eye contact? Did she smile? It only takes a minute for our brains to answer these questions and form opinions.

Assumptions In relationships work much the same way. Say, for example, your partner tells you he’ll be working late one night. What is your first thought? If you grew up in a family where “working late,” was code for being unfaithful, then you might assume that your partner is lying. 

Even if he hasn’t given you any prior reason not to trust him, you still might assume the worst, because of your own past and the assumptions you created as a result. Do you see how this could ruin a perfectly good relationship?

A couple yelling at each other in a kitchen, arguing due to assumptions in relationships

Managing Assumptions in Relationships

In order to manage your assumptions in relationships and prevent them from ruining your partnership, you need to be willing to take a good look at your own beliefs. 

Where do they come from? How are they helping or hurting you? Do they hold up to questioning? What is the evidence that supports that belief? The evidence against it? Could there be another way of looking at things or an alternate explanation? 

By asking yourself these questions, you can better understand your personal assumptions and the effect that they are having on your relationship.

Now that you are aware that some of your beliefs may not be true, I’m going to tell you something that will make you feel better. Your partner’s beliefs are no better!

Both you and your partner are likely making assumptions about the other and the world in general. What seems like “the” answer or “the” situation to you, is just one of many viewpoints on the same situation. Thus, the best thing to do is to make it a habit to check in with each other to be sure that you are not making assumptions in relationships.

How to Know When Assumptions in Relationships Are Causing Problems

It may seem straightforward to check in with your partner about assumptions each of you may have in your relationship, but actually doing this is easier said than done.

For example, how do you know when it’s time to check-in? Do you set a weekly reminder to ask about assumptions? Or do you wait until you’re in a full-blown argument?

In reality, somewhere in between those two extremes is usually a good solution.

Anytime that you and your partner are having an argument where something doesn’t quite click or where his reaction to what you said seems really off, it’s probably a good time to ask him what he is thinking or whether he may be reacting based on an assumption (in a nice, non-threatening tone, of course).

For example, if you tell your significant other that you want to go to the mall and he responds by immediately faking the flu, you might want to look into that a little further. 

You could say something like: “It seems that what I said is having an effect on you. Could you tell me what you think I meant?” He might then say, “I know what going to “The Mall” means. You want me to buy you a ring!”

Well, now you know why he was faking the flu, but, clearly, the two of you have some other issues to discuss!

two women argue due to assumptions in relationships

Common Questions About Assumptions in Relationships

How do assumptions affect relationships?

As you can see in the example above, making assumptions in a relationship can really hinder your ability to communicate and connect with your partner. Making assumptions can lead to not only misunderstandings and arguments, but can even cause enough harm to end a relationship.

How would you react if it felt like your partner was always assuming the worst about you? You probably wouldn’t feel particularly connected or loving with them.

What causes assumptions in a relationship?

Many times, what causes assumptions in relationships is past experiences, either with your current partner or with past partners. If you were cheated on in a past relationship, for example, you might assume your partner is being unfaithful if they stay late at work or aren’t totally forthcoming about their weekend plans. For all you know, they’re planning you a surprise party! But if you accuse them of cheating every time they’re away, they likely won’t be in a very party-ready mood.

How do you stop relationship assumptions?

The best way to put a stop to assumptions in relationships is to communicate, communicate, communicate. Don’t hold your assumptions in – be honest! It’s better to share your assumptions or fears with your partner than let them (often incorrectly) shape the way you feel about your partner or your relationship.

Getting Help with Assumptions in Relationships

I’m going to assume, (see what I did there?) that reading this article has brought up some feelings about your own relationship. If you feel like you need additional support with managing assumptions in relationships, then couples therapy or individual therapy could help. 

If you’re ready to talk about your relationship, contact Couples Learn today for a free consultation.

3 Secrets to a Better Sex Life

3 Secrets to a Better Sex Life

Did you know that sex, or lack thereof, is one of the biggest topics that couples fight about? It’s true! But there is hope for a better – more communicative – sex life, thanks to the sex tips for couples we’re sharing today.

But first, why do so many couples fight about sex? Besides the obvious reason that sex is a very important part of a healthy romantic relationship, there’s the added factor that talking about sex (even sex in a marriage!) is often considered taboo. That’s a major problem! 

How are couples supposed to work on developing a safe, loving, and exciting form of intimacy when they can’t even share what turns them on and what doesn’t?! The short answer is, they can’t.

That’s why it’s so important to learn how to talk to your partner about sex (this is the first of our sex tips for couples). Yes, you may feel awkward or embarrassed at first but remember, that’s from years of conditioning. If you think about it, it’s pretty silly that you can get naked and have sex with someone, as long as you don’t talk about it.

So, in order to break the silence, here are 3 sex tips for couples.

Top 3 Sex Tips for Couples

1. Be Kind But Direct

One of the things that is so beautiful about sex is that you get the chance to learn about each other’s bodies. He likes when you kiss his neck but she can’t stand anyone touching her feet. Everyone has their own specific likes and dislikes and there really is no right or wrong when it comes to each of your preferences. 

However, if you want those preferences met, and your partner hasn’t figured it out yet through trial and error, you need to be willing to talk about what you do and don’t want. That’s why actually talking about sex is one of the most important sex tips for couples – it’s the path to mind blowing sex!

What if you don’t know what you like and dislike? That’s ok! Let your partner know that you would like to explore different types of foreplay, new positions, and maybe even role play and the use of sex toys to learn what turns you on.

If you need some inspiration, two great instructional books are Passionista: The Empowered Woman’s Guide to Pleasuring a Man by Ian Kerner, Ph.D. and The Man’s Guide to Women: Scientifically Proven Secrets from the “Love Lab” About What Women Really Want by John Gottman, Ph.D. and Julie Schwartz Gottman, Ph.D.

Handling Tough Sex Discussions

Ok, but what if you have to share something unpleasant? Like the fact that you can’t handle his smell when he comes home from playing basketball? Or the fact that the way she kisses doesn’t turn you on? It’s better to tell your partner what’s really going on rather than pretend you’re not in the mood.

In the case of the smelly basketball player, maybe suggest taking a shower together or say something like “I’m so excited to continue this make-out session when you get out of the shower so please hurry back to me.”

In the case of the bad kisser, try saying something like “I love it when you kiss me slowly and gently” or “It’s my favorite when you kind of tease me with soft kisses and nibble on my lower lip.” Tell her what you do like vs what you don’t like.

With both examples, you save their ego and encourage more of the behavior you do like vs discouraging what you don’t like. This simple switch is one of the best sex tips for couples to encourage kind and direct communication.

2. It’s Okay To Play

Don’t be afraid to be playful and laugh as you learn about each other’s hot spots. After all, sex is supposed to be fun! Having a carefree attitude is one of our favorite sex tips for couples, and can help bring the pressure of a perfect night of sex way down. It can also help when the unexpected (read: fart) happens.

Two pairs of feet are tangled together under a sheet after trying out these sex tips for couples.

3. Remember That Sex Is Emotional Currency

As it turns out, sex means different things to women vs. men. Of course, there are exceptions to this rule. Increasingly more women are discovering their inner Samantha from “Sex and The City.” 

But, as a general tendency, men feel more connected to their partners through having sex. Women, on the other hand, need to feel connected first, in order to want sex. Do you see how this could be a problem?

To bridge the gap, try to make an effort to understand what sex means to your partner. This is one of the top tips for a better sex life because it can actually lead to more sex.

It’s possible that a woman who knows that sex is her man’s way of wanting to feel close to her will be more willing to rumple the sheets than if she thought he was only interested in a physical release. Similarly, a guy may make the extra stride toward emotional closeness if he knows that it will make his girl weak in the knees.

Go Beyond Sex Tips for Couples

Speaking of emotional closeness, does your relationship need a little boost in the romance department?

Check out this simple exercise that will help bring back the romance in your relationship

Do you need to go beyond sex tips for couples ? Do you want personalized, one-on-one help for your sex life or relationship in general? Explore our online couples therapy and individual therapy services.

If you would like to learn more about how to improve your sex-life with your partner, contact Couples Learn for a free 30 minute consultation today!

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Venting About Your Relationship: Helpful or Harmful?

Venting About Your Relationship: Helpful or Harmful?

Imagine this: your spouse or partner does something that really makes you angry. What is your next move? Well, hopefully you talk to your partner about it. But if you’re like a lot of people, you may also start venting to friends about relationship troubles.

Venting about your relationship is a common way of coping with anger, resentment or even simple annoyances. But is it ok to vent to your friends about your relationship? That’s exactly what we’re going to explore today.

While complaining in a relationship is normal, venting to friends is typically more common among women. One thing that makes female friendships different from male friendships is that females tend to talk about everything

While men are more likely to bond over watching sports or playing video-games, women bond by discussing thoughts, feelings, and actions we took in response to our thoughts or feelings.

So, given that women share the inner workings of their minds with each other, it’s only natural that relationship talk will become part of the conversation with close friends. 

The question is, how much relationship talk, if any, is healthy for your relationship? Can venting to friends about relationship issues actually make those issues worse? Let’s dig into this question a little further.

Is Venting to Friends About Relationship Issues Bad?

On the one hand, it’s wonderful to have people to vent or gush to about your relationship, especially if you’ve been spending all of your time with your significant other.

Having an outside perspective when dealing with relationship issues can be extremely helpful, and since it’s your friend, she will probably have your back.

Still, there are dangers to spilling about your latest lover’s quarrel, and there’s definitely such a thing as complaining too much in a relationship. And when venting becomes toxic, it has the potential to do more harm than good.

So, how much is too much when it comes to venting to friends about relationship challenges? Here’s some things to consider.

4 Things to Consider Before Venting to Friends About Relationship Issues

Two women sitting on a couch and venting to friends about relationship issues.

1. The Jury Is Stacked

Your friends will probably be on your side regardless of what happened between you and your partner. While it is always nice to feel validated, that is not always the most helpful thing, especially if you are in the wrong. 

Sure, you probably have that one friend that always tells you the truth even when it’s hard to hear, but when you are angry, she’s probably not the one you’ll go to when you’re venting to friends about relationship challenges. Am I right? 

Instead, you’ll most likely opt for the friend who will tell you how horrible he is, and how angelic you are. While this is nice to hear, it might not be great for the future of your relationship. 

If you truly want to repair your relationship and heal whatever hurt has been done, consider how unconditional validation of your anger might make that harder.

2. The Plot Is Skewed

Without even realizing it, you will probably end up telling more of the bad stuff about your relationship to your friends than the good. Maybe you don’t want to feel like you are bragging or make them jealous by sharing all of his sweet gestures. Or perhaps you simply consider his loving texts and gestures private.

But when venting about your spouse or partner becomes the bulk of what you share about your relationship, you are painting a skewed picture of your partner. 

This can make it hard for your friends to forgive him or see him in a positive light when the two of you make up. You may even find that your friends remember his flaws long after you’ve forgotten why you were fighting in the first place!

Unfortunately, venting to friends about relationship issues can lead to trouble between you and your friends down the road or awkward feelings between your friends and your partner. 

You want your friends to like your partner and they do too! So think twice before you tell them every negative and annoying quality he has.

3. Advice Is Easier Said Than Taken

Well-meaning friends want the best for you and they hate to see you hurt. As such, they might be quick to tell you to break-up with your love to avoid pain and heartache – especially if you’ve been doing a lot of venting about your relationship. 

Clearly, that’s easier said than done and they aren’t the ones that will have to deal with the consequences of that decision. Only you can decide what the best course of action is, and that’s best achieved when you have calmed down and had a rational discussion with your partner (not your friends).

4. Is All Fair In Love And War?

Regardless of how angry you are with your partner right now, you still want to act in a way that you can be proud of in the morning. Will you be happy with yourself if you share all of his shortcomings with your friends? Would you be okay if he did the same to you? 

Part of being in an adult relationship means showing respect for your partner, even when you are angry with each other. Sometimes, that means venting to friends about relationship challenges is not always the best idea.

Two women sit on the grass outside venting to friends about relationship challenges.

What To Do When Venting Becomes Toxic

Are you worried you might be venting about your relationship a little too much now that you know how complaining affects relationships? Even if you want to vent less, it can be hard to know what to do instead.

After all, you have to talk to someone when you are fighting with your boo because how are you supposed to make any decisions without outside input? 

First and foremost, learn to look within and trust your intuition. You are the expert on you but sometimes you need some help turning up the volume on that little wise voice that resides within you. 

Second, there is someone that you can vent to with wild abandon without having to worry about the consequences…a therapist!

Whether you try couples counseling or individual therapy for relationship issues, talking to a therapist about your partner is not the same as venting to friends about relationship issues.

Your therapist has no personal stake or connection to your partner or the outcome of your relationship. 

Instead, a good therapist will help you connect with your intuition to figure out what you really want – and then help you communicate those needs with your partner. All the more reason to reach out to a skilled therapist today 😉

If you’re ready to stop venting about your relationship and start doing something constructive with that anger or hurt, then contact Couples Learn to explore our online therapy services.

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The #1 Issue That Ruins Relationships: Ineffective Communication

The #1 Issue That Ruins Relationships: Ineffective Communication

People always ask me, “what is the #1 reason couples seek out your help?” Without a doubt, the answer is problems with communication. So how much of an impact does being bad at communication actually have on a relationship? As it turns out, quite a lot.

We’ve all heard that the key to a healthy relationship is good, honest communication, right? That sounds simple enough…until you actually try it. 

The truth is that when two people come together to form a bond, they aren’t just bringing themselves to the table. They are also bringing all of their past hurts, traumas, and negative experiences as well. 

It’s these latent explosives that can wreak havoc on an otherwise easy conversation and cause communication issues in a relationship. When it comes to things that ruin relationships, bad communication is definitely at the top of the list.

That’s why one of the first things I work on with all couples in session is communication. Because if you’re bad at communication, then we need to tackle that first before we can start to examine other relationship challenges.

Bad At Communication? Here’s A Way Out

So, how can you improve communication issues in a relationship? There are many different techniques that can be used in couples therapy, but at Couples Learn we use a communication technique called the Imago Dialogue.

The Imago Dialogue is from Dr. Harville Hendrix’s best-selling book “Getting The Love You Want.” Much of our work with couples is based on techniques from Dr. Hendrix’s therapeutic framework called Imago Therapy

Imago therapy really helps us to get to the core of communication issues right away, so that couples who feel they are bad at communication can start making real progress in healing their relationship. By now, you’re probably saying, “Imago…what the heck is that?”

Two women who are bad at communication talk to each other after an argument

What Is Imago Therapy for Couples?

The term “Imago,” refers to an internalized, yet, unconscious image of your ideal mate. Your “Imago” is a conglomeration of traits (good and bad) from individuals that played important roles in your childhood (i.e. parents, siblings, grandparents, babysitters, etc.).

The idea behind Imago Therapy for couples is that we have all been deeply affected by our upbringing, and that most of us have internalized this “perfect” vision of who we want for our partner without even realizing it. You go through life unconsciously searching for your Imago…the person that feels like home.

When you meet that special someone, you are ecstatic. Your conscious and unconscious minds are singing with joy at having found someone that truly makes you feel safe and complete. But after a while, you start to project your own unconscious wishes and past hurts from childhood onto your lover and that’s where your communication troubles begin. 

So, to prevent your unconscious needs from becoming one of the things that ruin relationships, you have to practice talking to your partner on a conscious level, where you can keep your intentions clear and differentiate between your past and present needs.

If you feel like you’re already bad at communication, then the practices of Imago Therapy probably sound complicated. And the truth is, this is deep work. 

That’s why it’s great to have a skilled couples therapist guide you through this process and help you really tease out what unconscious hurts and needs are affecting your relationship. 

How The Imago Dialogue Can Help if You’re Bad at Communication

While the best step toward learning how to communicate effectively in relationships is to work with a couples therapist, you can start this work at home. 

If you feel like you and your partner are bad at communication, then the best place to start is with a specific three-step communication technique called the “Imago Dialogue Process.”

Click here to watch a video of a real couple using the Imago Dialogue to talk about an issue.
A couple who thinks they are bad at communication talks using an imago therapy script

Here’s how it works.

The Imago Dialogue

Before you start, decide who will be the sender and who will be the receiver. After completing all three steps in this imago dialogue script, you will switch roles and take the opposite stance.

It’s best to choose an issue that is not very emotional to practice with at first so you can focus more on learning the process than what you are talking about. It’s easy to get off track fast if you begin with a heated debate. 

The steps proceed as follows:

Imago Dialogue Step One: Mirroring

The sender tells the receiver how she feels about something using “I statements,” which focus on how she feels, without shaming or blaming anyone. Try to keep your communication short – 30 seconds to a minute at the most. 

The receiver then paraphrases the sender’s statements by saying something like, “Let me see if I understand what you are saying. You said that you feel hurt when I interrupt your sentences. Is that right?” 

The sender can then correct the receiver if necessary, and the receiver can ask, “Is there more to that?” until the entire message is understood. 

Do not move onto step 2 until the receiver has correctly paraphrased and understood everything the sender said.

Imago Dialogue Step Two: Validation

In this part of the process, the receiver lets the sender know that she is making sense to him. He can use phrases like, “What you said makes sense,” or “I can understand what you are saying, given that you were interrupted so often as a child.” 

In this way, the receiver is conveying his comprehension of the sender’s message and validating that what she says makes sense and is valid. 

Note: It’s not necessary for the receiver to agree with the sender here! All that is required is a sense of understanding and validation. 

You can agree that a point makes sense without sharing the same point of view (many times when a couple feels they are bad at communication, this is actually one of the core issues at play!).

Imago Dialogue Step Three: Empathy

This is where the receiver gets the opportunity to show the sender that he gets what she is feeling. He might say something like, “I imagine that you must be feeling hurt. Is that right?” And the sender can agree or correct the feeling offered.

Click here to watch a video of a real couple using the Imago Dialogue to talk about an issue.
A couple who thought they were bad at communication sips coffee together and has a good conversation

Why Imago Therapy Helps When You’re Bad at Communication

While these imago dialogue exercises might feel a little formal, especially for people who have likely seen each other pee, they are incredibly helpful. 

In the beginning it’s helpful to have the imago dialogue script and a structure to follow because these skills are not in most couples normal repertoire. If you’re feeling like you’re bad at communication, then chances are this kind of conversation is going to feel a little challenging at first.

The goal, through practice, is to make validation and empathy a natural part of your everyday dialogue to the point where you don’t need the script anymore.

Remember, when talking to your partner, you are dealing with a host of unseen forces that can affect your behavior. Putting structure and direction around sticky topics can be just the buffer you and your loved one need in order to hear each other more effectively and fix ineffective communication in your relationship.

Once you’ve figured out how to communicate effectively in relationships, then you can focus on the really important things, like who gets to use the bathroom first!

If you try this exercise at home and decide you would like more information on how to improve you and your partner’s communication skills, contact Couples Learn to set up a free consultation today!

Our Imago therapists would love to help you overcome ineffective communication through couples therapy so you can stop feeling like you’re bad at communication and start feeling confident when managing conflict with your partner.

Click here to watch a video of a real couple using the Imago Dialogue to talk about an issue.