Couples Therapy

Online Couples Therapy in San Francisco and Across California and Illinois

Communicate Effectively

Learn to hear and share what matters.

Cultivate intimacy.

Deepen your Connection.

Navigate Differences

Find common ground.

Are you considering couples therapy because...

  • You and your partner having the same argument again and again?
  • You or your partner often feel so overwhelmed during arguments that one or both of you shuts down and stops communicating?
  • You feel like you don’t really know or understand each other anymore?

When communication between a couple breaks down, feelings of resentment, confusion, and mistrust often arise. A relationship that was once filled with so much promise can be swallowed by conflict and disconnection. Vacations, time with family, and day-to-day tasks like chores and housekeeping can become saturated with arguments and miscommunication leaving both partners feeling frustrated and exhausted.

You’ve tried taking breaks, focusing on the positive, and dividing labor fairly. But something seems to set one or both of you off, and you find yourselves having some variation of a fight you’ve already had again and again.

Our deepest desires for love, acceptance, autonomy, and connection bring out the best of us. However, and despite our best efforts, these desires may also cause us to think, feel, and behave in ways that are counterproductive and detrimental to our romantic relationships.

Are you ready to learn how to communicate with your partner in ways that bring you together and move your relationship forward?

All couples face challenges...

All couples go through periods of disconnection and conflict. However, when distress goes on for too long or is too intense, arguments and avoidance can do lasting damage to a partnership.

LGBTQ couples face more than the typical stressors of living in a busy and complex world, because they are often forced to navigate homophobia/transphobia from family and society.  Living in a world where basic rights and safety are under direct threat can add to the stress that occurs when navigating romantic relationships.

It’s my role as a couple’s therapist to help you navigate the roadblocks that are keeping you stuck in unhealthy cycles and move you into meaningful connection. Once this takes place, it is amazing how much easier it becomes to navigate the challenges of life as partners rather than adversaries.

How Does Couples Therapy Work?

The primary modality I use as a couple’s therapist is called Emotionally Focused Couples Therapy (EFT) that draws from over 50 years of research into adult attachment theory and is proven to be one of the most effective models of helping couples in distress, including LGBTQ couples.

As we get started in our work together, I’ll meet with you as a couple so I can gather a history of both you and your relationship. This is different than individual therapy where you might take several months exploring your past. In this process, our goal is to generate a more focused assessment of your past and current circumstances to put the work we will do together in context.

As we move forward, we’ll identify the unique patterns you and your partner get stuck in so you can see more clearly why you end up arguing or becoming disconnected.

Couples therapy isn’t about getting things perfect or checking of a list of “to-do’s.” Instead, we will focus on finding ways to interrupt detrimental cycles without getting caught up in who is wright and wrong or what did or didn’t happen. In this process each partner learns to identify and express their own needs for closeness, autonomy, and acceptance while hearing and accepting the other’s needs for the same, even if they are different.

As a couple’s therapist, my role is to guide you along the way in a non-judgmental space, making sure we stay on track, and provide direct and firm feedback and guidance as needed.

When this happens couples are better able to collaborate, problem solve, and even disagree without getting caught in old, painful cycles.

It’s important to know that individuals who engage in their own individual therapy alongside couples therapy have a higher likelihood of achieving successful outcomes in their relationship.

Maybe you're interested in couples therapy but still have some concerns...

What if you take my partner’s side and I get all the blame?

Couples therapy is not about the blame game or who wins or loses, and my role is not of judge or jury.

Our work together is about finding the deeper feelings, thoughts, and values that cause people to struggle in their relationships. I am also here to give couples new ways to communicate, rather than sparking yet another argument about who’s right or wrong.

It can be hard to admit to ourselves that there are ways we are contributing to painful dynamics, especially when we think that if our partner “could only stop/start doing XYZ,” our problems would be solved.

However, relationships are not healed with blame or shame. They are healed by finding the self-compassion to understand why we think, feel and behaves in ways that end up hurting ourselves and our partner and by using this insight to connect and repair with each other.

Several LGBTQ couples smiling and laughing with each other

Can you help convince partner to open up more, help more around the house, or learn to calm down?

While I understand your desire for change, it is important to note that aligning with one person’s agenda in couples therapy often leads to recreating the dynamics that you are already struggling with.  Focusing on one person’s agenda or attempting to change specific behaviors can often lead to further strain the relationship. My approach focuses on helping both partners come forward authentically, allowing each of you to have your needs for both closeness and independence met.

By shifting the attention away from trying to change specific behaviors, couples can explore the underlying dynamics and patterns that contribute to relationship challenges. This exploration helps to uncover the root causes of issues and enables both individuals to develop a deeper understanding of themselves and their partner ultimately leading to deeper and more meaningful change.

Doesn’t starting couples therapy mean our relationship is over or hopeless?

The fact that you are seeking support means that there is still hope. If you are both willing to try new approaches to your relationship, there are many ways it can improve.

However, it can happen when couples wait too long to get help so much damage is done to the relationship that one or both partners has already decided to leave the relationship. This is often why couples therapy is seen as a last ditch effort. If you are considering couples therapy, please don’t wait to get help.

What if couples therapy makes things worse or is too hard for us?

Couples therapy may be unpleasant at times. It might bring up strong feelings and topics that have been avoided. It will highlight strategies couples use to “keep the peace.” Yes, this can absolutely be difficult because it challenges old habits that have become familiar and comfortable in their own way. However, this temporary discomfort can lead to permanent and positive change.

Couples therapy requires a willingness to reflect, try new ways of talking and listening, and a shift from focusing on what’s “wrong” to focusing what you can do to make things better. This is challenging, but you are not doing this alone. With a compassionate and skilled couple’s therapist, you and your partner will learn new skills, strategies, and insights that work for you and your relationship.

I will not pretend it is always fun or easy, though I do find there is often laughter and “ah-ha” moments in the work I do with couples.  Couples therapy gives you the chance to know yourself and partner in deep and meaningful ways.

Getting Started

Before we begin our work together, we’ll have a 15-minute phone consultation where I’ll ask you a few questions and you’ll have a chance to ask questions to get a sense of if we are a good match. 

Once we know we are going to move forward, you’ll set up an initial appointment. You’ll have some paperwork to get completed on your own so that when we meet we can focus on getting to know each other.

If you’re ready to get started restoring your connection and enjoying your relationship, set up a consultation using the button below.



Miriam Geiger's Media Features including USA Today, Up Journey, The Addicted Mind Podcast, and Choosing Therapy.


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