top of page
Leaf Pattern Design

Couple Therapy

In addition to a mental health psychotherapy license, Clinical Director, Nicole Story is also a licensed Marriage and Family Therapist (LMFT) with specialized training in relational and systemic therapy. She served as President of the Northeast Florida Association for Marriage and Family Therapy and serves couples from diverse backgrounds and cultures.

Marital Distress

Marital distress is one of the most frequently encountered and disturbing human problems. Everyone who is married experiences difficulties, but for some, these troubles reach the point that partners become profoundly disappointed and upset about their marriages and may even come to question whether they want to continue to remain married. Marital distress is very unsettling and the ways marital problems often progress make it easy for things to go from bad to worse. However, in most situations, this flow in a negative direction can be altered. Most marriages can return to being satisfying. Sometimes people can make these changes on their own, but frequently help from a couples therapist is needed.

We offer HIPPA compliant online options via Psychology Today Sessions and from the convenience of your home or private workspace.

You can log in together or separately.

How Do You Know When to Seek Help or Suggest Doing So to a Friend?

No one has a perfect marriage, and almost every couple can benefit from some help at times with their marriage. Pre-marital preparation and marital enrichment programs such as the Prevention and Relationship Enhancement Program (PREP) and the Relationship Enhancement Program are available in many localities and most people find them helpful regardless of how well their relationship is going. And many people seek couple counseling with a trained therapist to improve their marriages even when their marriages are not unduly distressed. You don’t need to be in a distressed marriage to be in marital therapy. Many people with very solid marriages choose this path to enhance their relationships.


Experiencing marital distress, however, represents a different state from the ups and downs of life in marriage that most people experience. In distressed marriages, people feel fundamentally dissatisfied with their marriages. Disappointment in the relationship doesn’t just come and go; it is a constant companion.


Most frequently, couples with high levels of marital distress fight a good deal and their fights don’t lead to resolution, but simply a sense of being worn out. Or they may not fight, but simply feel completely disconnected. People stop doing nice things for each other, they stop communicating, and things tend to go from bad to worse. Frequent arguments that don’t get resolved, loss of good feelings, and loss of friendship, sex and vitality are other signs that a marriage is distressed.


Other signs, such as contempt, withdrawal, violence, and a complete loss of connection signal that a marriage is in desperate trouble and that it is at high risk for divorce. And you need not be legally married to have “marital distress.” Serious, long-term, committed relationships can experience these kinds of major problems, too.

Sometimes marital problems are purely about problems in the relationship such as communication, solving problems, arguing, intimacy, and sex. These kinds of problems often begin with partners simply not having a good sense of how to be married and how to communicate and provide support. Other times couples may do well for a while, particularly in the earliest stages of their romance, but they are not ready for the longer-term tasks in marriage. Studies of couples show that while the risks for marital distress and divorce are highest early in marriage, these risks also grow just after the transitions that occur when couples begin to have children and when the children reach adolescence.

Other times, marital problems are directly the result of individual problems, such as substance abuse. And marriages can even seem to be going well, but one shattering event like an extramarital affair will throw a marriage into distress.

Marital distress has powerful effects on partners; often leading to great sadness, worry, a high level of tension, and problems such as depression. If prolonged, it even has been shown to have direct effect on physical health. The effect on families is also profound, especially when conflict is high. Children raised in high conflict homes tend to have many more problems than other children. And once marriages are distressed, a progression begins that easily becomes a cascade downward, ultimately leading to the ending of a marriage.

The Kinds of Help That Work

The good news is that there are effective treatments for marital distress. Given a willingness to work on a marriage, most people can make their marriages satisfying again.

No one begins as a perfect partner. Marriage depends on a number of skills, such as being able to understand yourself, understand your partner, fight well, problem solve, and negotiate differences. Sometimes patterns we learned in our families growing up aren’t effective, but are carried over to a marriage. And sometimes the stresses of life make it difficult to stay happily married.

Treatment for marital distress is in part building or rebuilding the skills that work in marriage, such as learning to communicate and problem solve, and how to fight without engaging in too much hurt. Partly, marital therapy is about partners working to see each other as people, to understand where they are coming from, and to negotiate those differences that can be negotiated and accept those differences that cannot. Couples all have issues that stay with them; the key is to build a process that can help find a way to talk about those issues, to find solutions, and not have the problems that emerge in life become overwhelming.

Couples therapists have special training in couples therapy. They know how to help couples to gain a sense of progress even as they struggle with difficult issues. There are many kinds of effective couples therapy. Some promote skills and practice, others look more at the past and how things got this way; most combine the two. Be sure the therapist has specific experience and training in couples therapy, as licensed marriage and family therapists (LMFT) do.

Beginning couples therapy is not easy. For most people, it’s hard to begin to share with a person you don’t know about marital difficulties, and it’s hard not to be discouraged as you argue about these issues at first in front of a therapist.


Couples with marital distress are often discouraged and have trouble believing that couples therapy can help. But couples who begin marital therapy begin to create a process for overcoming their difficulties. Sometimes the resolution of problems happens very quickly, though more typically a longer period is needed. For most, it’s hard to work on these problems at first, but ultimately that becomes easier and problems are resolved.

What Should You Do if Your Partner Won’t Go to Therapy?


Some people with marital problems won’t seek help even when it is essential. If your partner won’t go to therapy, try to encourage them. It’s hard to fix a distressed marriage on your own. Still, if they won’t go, you can begin to do some things yourself. A marriage and family therapist is likely to have some useful ideas about how to improve the relationship without both of you getting into therapy and about how to find better ways to approach your partner about the idea of entering treatment together. It is possible to work on a relationship in individual counseling with a couples trained therapist.


The text of this brochure was written by Jay Lebow, PhD.

AAMFT consumer updates.

Nicole Story, Ed.S, M.Ed, LMFT, LMHC is a licensed Marriage and Family Therapist with training from the University of Florida and 20 years of experience in EFT, relationship counseling and supervising therapist interns in the practice of couples therapy. She served as President of the Northeast Florida Association for Marrriage and Family Therapy.

What is a healthy marriage?

Consumer Resources

And Baby Makes Three: The Six-Step Plan for Preserving Marital Intimacy and Rekindling Romance After Baby Arrives, John Gottman Ph.D. and Julie Schwartz Gottman

Fighting for Your Marriage: A reference for learning the essential skills that help lead to satisfying marriage, H. J. Markman, S. M. Stanley, and S. L. Blumberg

Getting the Love You Want: A Guide for Couples, HarvilleHendrix

Hold Me Tight: Seven Conversations for a Lifetime of Love,Sue Johnson

Passionate Marriage: Keeping Love and Intimacy Alive in Committed Relationships, David Schnarch

Safe Haven Marriage. Building a Relationship You Want to Come Home to, A. Hart and S. Hart-Morris

The Sex-Starved Marriage: A Couple's Guide to Boosting Their Marriage Libido, Michele Weiner-Davis

The Seven Principles of Making Marriage Work: Provides insights about what makes marriage last, J. M. Gottman and N. Silver


Attachment Relationships and Couples Counseling, Oceanside Family Therapy, Nicole Story, LMFT, LMHC

bottom of page