There are many different kinds of couples therapy. Some, such as Imago Therapy, tend to focus on helping couples communicate more effectively. Others, such as the Gottman approach, attempt to help couples understand each others better and, hopefully, then feel more loving toward each other.
My own preferred approach is Emotion Focused Couples Therapy (EFT) which deals with attachment issues, emotions and the negative interactions that go on between couples. These negative interactions drive couples farther and farther apart, often resulting in divorce or years and years of loveless relationships. The EFT therapist helps them learn new, positive, interactions, increasing their ability to resolve conflicts and experience love and safety in their relationships.
EFT involves a number of steps.
The first step in typical EFT therapy, which tends to be short-term, is helping each person feel an empathic alliance with the therapist. The therapist does this by taking a kindly, non-judgmental attitude in helping the person understand his or her emotional response to the other person. Usually, these are reactive emotions, such as anger and defensiveness, which cover up underlying emotions such as fear, hurt and feelings of weakness and inadequacy. Frequently the person defends against the underlying emotions by putting up a wall and withdrawing from the partner or angrily attacking and blaming the partner.
Next, the EFT therapist observes the negative cycles of interaction between the partners. If one partner attacks and blames the other person, it is usual for that person to withdraw from the attacking partner. He or she does this because of feelings of guilt, fear or shame, perhaps even feeling that the partner is correct in his or her negative view. But the withdrawing behavior usually only makes the blamer feel abandoned and he or she then increases the blaming and attacking, which further results in more withdrawing by the other. The usual result of this repetitive negative cycles of interaction is resentment, distance and loneliness.
Another common scenario is that instead of the blamed person withdrawing, he or she attacks back, the result often being an escalation of anger in both persons into yelling and screaming.
The therapist then helps each person understand and experience the emotions and needs that the surface behaviors are defending against. These are usually more vulnerable emotions such as fears of abandonment, shame, feelings of worthlessness and unworthiness, mistrust, and deep hurt. The needs are those that every human being has: for recognition, love, acceptance, approval, safety, and a sense of belonging.
The next step is to help each person communicate these more vulnerable emotions and needs to the other partner. This often results in greater understanding of the partner, a softening of attitude and the courage to voice his or her own vulnerable feelings and needs. But frequently the other person is suspicious or fearful of taking the risk of being more vulnerable and he or she then reacts negatively. The therapist must then help that person understand the fears that motivate this defensive reaction. When these fears are dealt with sufficiently, that person is usually able to take the first, tentative steps in his or her own more open, vulnerable reactions.
The final step in the therapy is helping the couple find new solutions to old problems and consolidating the new positions the partners have learned to take with each other. The result is that each person is able to meet his or her own individual needs and experience the kind of close, loving relationship that every human being desires. At this point the couple is ready to terminate the treatment.