What It’s Like to Go to Couples Therapy - with a Sex Therapist
The Pomegranate Institute offers relationship therapy, whether you’re a monogamous couple, a non-monogamous couple, a polycule, or a queer platonic partnership. In our practice, we say “relationship therapy” but the SEO gods have declared with have to say “couples therapy” if we want google to show you this article (rude) so we’ll say couples therapy, but just know a little piece of our soul is dying.
Why do people go to couples therapy?
People come to couples therapy for all sorts of reasons — not just because something is “wrong.” Sometimes it’s to strengthen communication, navigate life changes, rekindle intimacy, or learn how to support each other more fully.
In our practice, we see people seek couples therapy for:
- Getting stuck in the same old argument over and over again
- Needing support making a major life decision (like having kids, or moving)
- Deciding whether or not they want to open the relationship
- Mismatched sexual desires, kinks, or libidos
- Supporting each other through grief, illness, trauma or major transitions (like perimenopause, or a career change)
- Wanting to reconnect as romantic partners
- Processing infidelity or other breaches of trust
Does my relationship have to be in trouble to go to couples therapy?
No! Think about it like getting an oil change, or baby botox, it can be part of preventative maintenance.
We can teach you skills for strengthening your communication so you can be ready to have tough conversations, before they turn into unsolvable fights.
Do You Have to Talk About Sex in Sex Therapy?
Most of our patients seek us out because they want to talk about a project related to their sexual health, this could include talking about:
- Mismatched libidos
- How to “turn on” your partner and be aware of what turns them off
- Opening up about trying new things in bed
- Disclosing new information about sexual preferences (like who you’re attracted to, or kinks and fetishes)
- Defining the relationship and articulating clear boundaries for what partnership is going to look like
- Unpacking cultural shame around compulsory monogamy
- Evaluating ways that “couples privilege” accidentally shows up, even when you’re trying to be non-hierarchical
If you want to learn more about what sex therapy entails, check out our article What Happens in Sex Therapy? A Realistic Guide to What to Expect.
On the other hand, some of our patients choose to work with us because they figure sex therapists are non-judgmental people by nature who aren’t going to bat an eye at whatever they want to discuss. And this is totally true!
Why does our practice focus on polyamory-affirming therapy?
We’re passionate about supporting patients in non-traditional relationship structures. Our entire practice is dedicated to erotically marginalized identities. This means we’re focused on serving patients who are at risk of being discriminated against in and out of the therapy room because of aspects of their identity like queerness, non-monogamy, kinks, fetishes, or involvement with sex work.
We think polyamory is a valid relationship structure, and we want to support our community in getting the best quality care possible!
What do you actually do in couples therapy?
In our work with couples — including those in non-monogamous, queer, or nontraditional relationships — we use something called the Developmental Model of Couples Therapy. This model sees relationships not as “healthy or unhealthy,” systems that move through different stages over time. Each stage has unique challenges and opportunities to strengthen the relationship.
This involves stages like:
- Bonding: the initial stage of a relationship where you’re focused on falling in love and blending your lives
- Differentiation: wanting to re-introduce a bit of separateness or individuality
- Practicing: starting to explore the world outside of the relationship
- Rapproachment: coming back together with lessons learned
If we want to learn more about couples therapy what should we do first?
The Pomegranate Institute offers a free 30-minute consultation to prospective patients who live in Massachusetts. In a consultation, people can meet us, tell us a little bit about what brings them to therapy, and ask us questions, all so they can figure out if they are comfortable working with us.
What happens next?
If the stars align, and everyone (the therapist and all of the people who are going to be coming to appointments) say “yes”, then we can go ahead and schedule intakes for everyone. An intake is a longer appointment (90-minutes) where we’ll review some paperwork (our financial agreement, notice of privacy practices, consent to receive therapy, etc.) and then talk about what you would like us to know in order to be an effective therapist for you. We might talk about:
- Your unique perspective on the project that brings you to therapy
- Your past experiences in therapy
- Your upbringing
- Your relationship history
How does privacy work in couples therapy?
It’s important to us that we strike a balance between privacy and collaboration. When you start therapy, you’ll give us written permission to attend therapy together and acknowledge that you know we don’t keep big secrets (affairs, job loss, medical diagnoses etc.) from your partner.
The majority of our sessions will take place as a group, and the session notes will be shared with each person who attends.
We maintain separate charts for each person in the relationship, so that everyone can access their own treatment record and can message their therapist privately. We do this because we want to deconstruct the expectation that one member of the couple is going to be the default “manager” of therapy, and responsible for scheduling or canceling sessions.
How Often Do We Meet, and for How Long?
“How long does couples therapy last?”
It depends on the project that brings you to therapy, sometimes folks stay in therapy for a few sessions, but it’s
“Do you offer virtual sessions?”
The Pomegranate Institute offers virtual therapy to patients living anywhere in the state of Massachusetts.
“Can we see you as individuals too?”
The Pomegranate Institute offers individual therapy and relationship therapy, but we don’t mix and match.
Interested in Couples Therapy in Massachusetts? Let’s Talk.
If you’re curious about starting couples therapy we’d love to chat!
At The Pomegranate Institute, we offer inclusive, sex-positive therapy for couples of all kinds, including those in non-monogamous or queer relationships. We’re based in Massachusetts and offer virtual sessions across the state.
Click here to schedule a free consultation – we can’t wait to meet you!
Sarah Chotkowski, LICSW | Kink-Aware Therapist in Massachusetts
Based in Western Massachusetts, Sarah is a therapist who specializes in treating patients from erotically marginalized communities. She is queer, LGBTQIA+ affirming, kink-aware, pleasure-positive, and passionate about working with people who practice Ethical Non-Monogamy/Polyamory and folks who have been or are involved in sex work.
