Couples Therapy: Two Case Studies

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Therapy as a couple is hard and there are few guarantees. Many factors determine success or failure. Timing, willingness, the right therapist all come into play. In my experience as a therapist, some make it, some do not, some come back from the brink and some that I genuinely thought would succeed failed to take the opportunity. I have been involved with spectacular successes and some that were highly disappointing. Some of these are documented here and each one taught me a lesson for the next couple that came along. Names, of course have been changed.


Many times cultural factors play a role in communication and the expectations of a couple. So it was with this couple. David, detailed, used to working with figures and processes, from a strict eastern European background. Samantha, a more relayed “Big Picture” Anglo-Saxon type. Add the fact that both were dealing with self-esteem issues, there were two children in the marriage and there had been infidelity on David’s side, the mix was explosive. It seemed certain they would divorce and part, so bad was the situation between them.

Early therapy sessions were just crisis management and evaluating their communication styles which became clear very quickly. When conflict arose, as it did many times a day, a patterned response from both took place. Samantha, coming from a violent background quickly felt threatened physically and emotionally and closed down to the point of walking away leaving him feeling rejected and dismissed. He, on the other hand, having his own issues, wanted things to be fixed as soon as possible. This led to him “nagging” and her withdrawing even more. It was tiring for both and had a devastating effect on the family. At that time, my judgement was that is was only a matter of time. They had neglected the four pillars and were heading for disaster.

As time went on, we worked intensively on the window of opportunity they had to resolve conflict. Using David’s analytical skills, they came up with a flowchart they could use if certain things happened and they laid the foundation for effective communication. This is something that has grown between them. There is still conflict but it is managed better and they are truly “there” for each other.


Beate was a codependent, full blown. She knew it, but was reluctant to do anything about it. She confused the sacrifices and the martyrdoms that were part of her personality with love. If you are in love, you give everything and hold nothing back was her motto. She was the matriarch of the family, chief people pleaser and made it her mission to make sure everyone was happy. However, as it often is with codependents, this came with a massive expectation of return. Her codependency was essentially a control measure, protection to ensure her security in the environment around her.

John was an undiagnosed covert narcissist, somewhere towards the wrong end of a sliding scale of narcissism, self-centered, sometimes selfish, always thinking of himself, he took what he needed from Beate without giving much in return. He kept this dysfunctional cycle going by giving his wife just enough indication that she might just be able to change him, something he intended to avoid. He openly admitted in a session to manipulating Beate. While she thought she was in charge of everything, it became clear that he allowed only the control he wanted her to have

It was Beate who requested therapy for the couple. After all that had gone on between them, she found herself deeply unhappy and unfulfilled. What caused her to break the pattern was probably due to the fact her two sons had flown the nest and what was left was not enough. John found himself under pressure to do more for Beate and he responded by withdrawing further and eventually having an affair. While Beate was willing to forgive and work on the marriage, he came to the two first sessions very resistant to taking responsibility and with an air of blame towards his wife: “You made me have an affair” he often stated. When challenged, he would call Beate “a barnacle”, a clear reference to the mollusc that sticks to the bottom of a boat.

Needless to say, he failed to turn up for the third session, stating that he thought therapy was useless and all they needed to do was get back to how they were before. He blamed me for putting ideas in his wife’s head. Beate was devastated but I made her see that there would be value in continuing therapy alone.

Over a period of six months, we dealt intensively with codependency issues, setting boundaries, working on self-esteem issues and the guilt and shame she felt from childhood. The very factors that had left her disposed to being attracted to a man like John. Beate divorced John eighteen months later and is now a successful businesswoman.

She practices self-care and self-love and is aware of and has tools for her codependency should it arise. The last time I heard, John was “playing the field” around town. While one can never be truly satisfied when therapy results in a divorce, I was very happy that Beate was finally giving to herself what she had so long given to others. When this happens, relationships change and toxic people leave.

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Dr. Nicholas Jenner, a therapist, coach, and speaker, has over 20 years of experience in the field of therapy and coaching. His specialty lies in treating codependency, a condition that is often characterized by a compulsive dependence on a partner, friend, or family member for emotional or psychological sustenance. Dr. Jenner's approach to treating codependency involves using Internal Family Systems (IFS) therapy, a treatment method that has gained widespread popularity in recent years. He identifies the underlying causes of codependent behavior by exploring his patients' internal "parts," or their different emotional states, to develop strategies to break free from it. Dr. Jenner has authored numerous works on the topic and offers online therapy services to assist individuals in developing healthy relationships and achieving emotional independence.

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