Can Couples Therapy Help Emotional Abuse? A Therapist’s Candid, Clinical Guide
Many couples in Issaquah and the greater Seattle area reach out to me with a painful question: “Can couples therapy help if there’s emotional abuse happening in our relationship?” As an LMFT who specializes in highly distressing relational dynamics — including emotional abuse, high-conflict patterns, and escalating reactive cycles — I want to give a clear, honest, and clinically grounded answer.
The short version is this: Yes, couples therapy can help emotional abuse… but only under certain conditions.
And when those conditions aren’t present, couples therapy can make things worse — or simply won’t work.
This article explains how emotional abuse shows up in relationships, when couples therapy is appropriate, when it’s not, what treatment looks like in session using PACT and ISTDP, and how to determine whether a partner is capable of change.
Can Couples Therapy Help Emotional Abuse?
The long, honest answer:
Couples therapy can help when emotional abuse is present — but only if there is safety, no coercive control, and both partners want the relationship to heal.
It’s not an easy topic to address without seeing a specific couple and it requires direct, explicit discussion. Emotional abuse is often misunderstood, minimized, or mislabeled. And sometimes what looks like “abuse” is actually high-conflict patterns, where both partners escalate but neither is trying to exert power or control.
Distinguishing the difference is the first and most important step.
What Emotional Abuse Actually Looks Like (Direct & Explicit)
Emotional abuse is not a single moment or a bad fight. It is a pattern of behaviors that degrade, blame, shame, intimidate, or control a partner. Examples include:
Gaslighting
Chronic criticism
Mocking or belittling
Withholding affection or connection as punishment
Verbal attacks
Threats, intimidation, or explosive outbursts
Blaming the partner for the abuser’s own behavior
Controlling decisions, access to money, or communication
Repeatedly crossing boundaries after being asked to stop
The core element is power and control.
High conflict ≠ emotional abuse.
High-conflict couples may have reactive patterns, poor emotional regulation, or defensive behaviors — but their goal isn’t to dominate or overpower each other. This is an essential distinction I make early in therapy.
When Couples Therapy Is Appropriate for Emotional Abuse
Couples therapy can be effective when:
1. There is no pattern of coercive control.
Coercive control is the single biggest contraindication for couples therapy. If a partner is controlling finances, isolating the other, monitoring communication, threatening harm, or limiting autonomy, couples therapy is unsafe and ineffective.
2. Both partners feel physically safe — in and out of session.
3. Both partners are able to speak openly without fear of retaliation.
4. The partner using emotionally abusive behaviors shows signs of:
Remorse
Accountability
Understanding the impact
Willingness to change
Ability to regulate emotional states
Openness to feedback rather than defensiveness
An actual desire to save the relationship
5. The relationship is one both people still want.
If one partner has already emotionally or psychologically left the relationship, couples therapy becomes a forced process that cannot repair what someone has already decided to exit.
6. There is safety to leave the relationship if needed.
If a partner cannot safely leave or separate, power dynamics make couples therapy inappropriate.
When these criteria are met, emotional abuse can decrease significantly, and couples often rebuild safety and connection.
When Couples Therapy Is Not Appropriate
There are circumstances where couples therapy is contraindicated or can even worsen emotional abuse.
1. There is a pattern of coercive control.
This is the most important exclusion criterion. Couples therapy cannot treat coercive control, because the abusive partner uses the therapeutic space to manipulate, intimidate, or regain power.
2. One partner does not feel safe talking openly.
3. One partner fears emotional, verbal, or physical retaliation after sessions.
4. The partner using the abusive behaviors denies, minimizes, or defends the behavior.
If they dig in, blame their partner, or get combative with me as a therapist, that is a clear red flag.
5. The relationship is already over.
If one partner has firmly decided to end the marriage, the work shifts to separation support, not repair.
6. Emotional abuse escalates outside of session.
If sessions trigger retaliation, therapy is paused and safety planning is initiated.
In these cases, I redirect the couple to individual therapy, safety planning and domestic violence support.
How I Treat Emotional Abuse Using PACT & ISTDP
I primarily use PACT (Psychobiological Approach to Couple Therapy) combined with ISTDP (Intensive Short-Term Dynamic Psychotherapy). Together, they allow me to address both the moment-to-moment relational patterns and the underlying emotional drivers of abusive behaviors.
PACT helps by:
Bringing awareness to how real-time expressions of threat, control, and withdrawal impact the sense of safety in the relationship
Tracking microexpressions, tone, and body language during conflict, to prevent quick escalations
Rapid intervention in “hot zones” of dialogue
Teaching rapid nervous system co-regulation
Helping partners take genuine responsibility in real time and repair with each other
ISTDP helps by:
Confronting maladaptive, defensive behaviors head-on
Bringing unconscious emotion and anxiety into conscious awareness
Helping clients make different choices instead of acting out
Interrupting abusive patterns rooted in fear, shame, or insecurity
Strengthening tolerance for intimacy and closeness so partners express vulnerability instead of aggression
Both modalities are active, present, and direct.
I call out abusive behaviors clearly and immediately.
For example, I regularly say things like:
“If you threaten your partner, you won’t get the support and understanding you’re seeking.”
“Stop. You’re getting bigger and louder. If you yell, your partner won’t listen. No one likes being yelled at.”
“Your partner is shutting down because they don’t feel safe. Continuing to pursue them can be intimidating.”
Direct naming is essential.
Good couples therapy does not validate emotional abuse. It does explore the feelings underneath, once safety is established and boundaries and limits are clear.
Fictionalized Case Studies (Completely De-Identified & Not Based on Real Clients)
Case Study 1: When Couples Therapy Helped (J & L)
(Fictionalized initials; this does not represent any real couple.)
J and L arrived reporting escalating conflicts. Over the first few sessions, it became clear that J was engaging in emotionally abusive behaviors — name-calling, intimidation, and gaslighting.
When I named this explicitly, J’s response was:
“I didn’t realize that’s what I’ve been doing. I feel sick hearing it described that way.”
This mattered.
He showed genuine remorse.
He listened to L’s experience without defensiveness.
He expressed clear desire to change.
He tolerated discomfort when confronted.
He practiced new communication strategies.
L reported feeling increasingly safe, respected, and hopeful.
Over months, J’s abusive behaviors decreased dramatically. The couple rebuilt safety with firm boundaries and real accountability. They ultimately described the process as “turning point” for their marriage.
This is the kind of couple therapy can help.
Case Study 2: When Couples Therapy Was Not the Right Modality (R & M)
(Fictionalized initials; not based on any specific clients.)
R engaged in emotionally abusive behaviors toward M — dismissing her feelings, verbal attacks, and escalation during conflict. When named, R responded with denial, blame, and hostility.
Meanwhile, M shared privately that she had already decided to divorce.
This mattered.
Couples therapy was not appropriate because:
R lacked insight or remorse
M no longer wanted the relationship
Safety and stability couldn’t be established
The therapy would’ve been harmful, not reparative
I recommended discontinuing couples work and supported M in connecting with resources for separation and individual therapy.
This is an example of when couples therapy should not continue.
How I Assess Whether Couples Therapy Will Help
I look for specific patterns.
Couples therapy can help when:
The partner using abusive behaviors shows remorse
They do not dig their heels in in session with me
They do not escalate in defensiveness
They are receptive to education about emotional abuse
They can tolerate discomfort without attacking
Both partners show willingness to repair
Couples therapy cannot help when:
A partner becomes combative with me and attempts to take charge over couples therapy
They refuse to acknowledge abusive behaviors
They retaliate after sessions
There is a pattern of escalation outside of therapy
One partner does not feel safe speaking in therapy
There is evidence of coercive control
One partner no longer wants the relationship
I check in about safety continuously.
I ask:
“Do you feel safe to speak freely right now?”
“How does what I’m seeing in session compare to what happens at home?”
“Have your fights escalated recently?”
“What’s the worst fight you’ve ever had, and how does that compare to now?”
These questions are essential.
Can Couples Therapy Make Emotional Abuse Worse?
The nuanced answer: Yes — if coercive control is present or if the abusive partner retaliates after sessions.
This is why proper screening matters.
Even in Issaquah, where many couples are high-functioning, stress patterns can hide deeper dynamics. Naming emotional abuse can surface fragility, shame, or defensiveness. If a partner cannot tolerate accountability, couples therapy can trigger escalation.
When that’s the case, I stop the couples work and shift into a safer structure.
What If You’re Not Sure Whether It’s Abuse or High Conflict?
Many couples I see in the Issaquah and Seattle area aren’t sure how to categorize their dynamic. They often arrive saying:
“We’re just toxic.”
“We both say ugly things.”
“We don’t know if it’s abuse or just bad fights.”
A good couples therapist helps you discern this clearly and directly — not with labels meant to shame, but with information meant to protect and clarify.
If you’re unsure, that is a good reason to seek the professional advice of a high-conflict couples therapist. Individual therapists often get one-sided stories and cannot assess a relationship they don’t see, especially with the bias they have towards their client.
Clear Steps to Take If You Suspect Emotional Abuse
1. Assess current safety.
Do you feel safe in your home and relationship?
2. Notice patterns, not isolated moments.
3. Pay attention to remorse vs. defensiveness.
4. Seek an evaluation from a trained couples therapist.
Preferably one experienced with trauma, emotional abuse, and advanced modalities.
5. If safety is uncertain, seek individual therapy first.
6. Create a safety plan, even if you’re unsure.
7. Use trusted resources (listed below).
Resources for Emotional Abuse & Domestic Violence (Washington)
National Domestic Violence Hotline: 1-800-799-7233
Washington State Domestic Violence Hotline: 1-800-562-6025
King County DAWN Program (24/7): 425-656-7867
New Beginnings (Seattle): 206-522-9472
Issaquah Police Non-Emergency: 425-837-3200
Couples Therapy & Intensives in Issaquah, Seattle & Across Washington
If you’re unsure whether what you’re experiencing is emotional abuse, high-conflict, or something in between, you don’t have to figure it out alone. A skilled, direct assessment can help you understand what’s happening — and what steps will truly support your safety and well-being.
I offer:
Virtual couples therapy across Washington, Oregon & Utah
In-person and online weekend intensives in Tacoma (an easy drive from Issaquah)
Assessment-focused sessions to determine whether couples therapy is appropriate
PACT- and ISTDP-informed treatment for high-conflict and emotionally abusive dynamics
If you’re ready to take the next step toward clarity, change, and safety, you can schedule here:
Your relationship deserves the chance for clarity — and you deserve to feel safe.
