COUPLES THERAPY

Couples therapy can be an effective way to resolve the issues that are creating disconnect or conflict in your partnership and is an investment in a stronger base from which to live your life. 

Being in partnership lands us at the core of a human dilemma: our need for and interdependence with others, along with equally core needs for freedom and autonomy. 

To cope with this dilemma we often shield or downplay parts of ourself. We might pull away or become insecure and cling tighter. We might start to feel distrustful in our choice of partner or chronically dissatisfied and irritable.

In response to our partner making one or more of these moves, we stand the chance of doubling down on our own defenses, or getting pulled into a replay of an early emotional scenario that goes on to take on its own life. 

Our sense of possibility can start to dwindle, and our deepest fears begin to run the show.
The office of Oakland therapist Andrea Baxter, featuring several throw pillows and a blanket draped on a wicker chair with a houseplant with red leaves on a side table

When couples arrive in my office, they are often bravely seeking to find a new way through one of these predicaments.

Our work begins by starting to map out the different components of your relationship, with lots of space for me to learn about what is and isn’t working between you and how you’ve been handling that.

I’m listening out for ways you learned to secure connection in relationship early in life, and the types of feelings that are allowed and those that are taboo. I’ll get a sense of the main channels your couple system is using to communicate - such as the chores list, the bedroom, or your respective families of origin (and in laws!).

And we’ll also start to get a deeper sense of past hurts and ruptures within your relationship and what is needing to be addressed and potentially repaired.

As we’re having these conversations, we’ll start to pay increasing attention to what it’s like to talk about these issues and the feelings that are most alive between you. Depending on where your system is expressing the most strain, we might focus more on one partner for some time, or do an individual break out session to help bring support to something specific. 

Core Issues in Couples Treatment

  • Doubts About Compatibility

    We may find ourselves in a relationship with somebody quite different from us. You might connect to the world through feeling and be with a partner whose style is more analytic. Introverts pair with extroverts, doers with dreamers.

    This might be novel and delightful initially, but the confrontation may stir up different feelings over time. This can lead to doubt and distrust about compatibility, fostering withdrawal and disconnect.

    I enjoy helping couples find the right balance between appreciating each other in their unique differences and being able to compromise and connect. Often, this work can help locate early attachment wounds around individuality and heal beliefs we may be carrying about whether we can be both individuals and remain connected.

  • Loss of Intimacy or Desire Discrepancy

    You might be arriving at couples therapy with a lot of distance in your relationship, with both physical and emotional intimacy at a major low. From this place even the idea of couples therapy probably seems daunting, and you may have been putting this off for a while and be at some kind of breaking point. Under the conditions of the emotional desert, one partner might be pulling more for sexual connection, with the other feeling little to no desire.

    I honor how fraught it might feel to address this situation with one another and with me, and am especially spacious and gentle in finding pathways to reconnect and understand what the feelings and experiences the disconnect has been protecting might be.

  • Communication Breakdowns & Patterns of Conflict

    Some couples are most distressed by the way they communicate with one another, and especially the ways conflict is handled.

    Teaching communication skills is rarely enough to meet this challenge alone. We will work to discover the underlying patterns and feelings that are leading to conflict and to particular ways of trying to be heard, whether through attacking the other or shutting down. 

  • Impact of Early Trauma on Relationships

    We learn from our earliest days what it means to be in relationships, and particularly the ones in which we feel most vulnerable.

    If you were badly or continually hurt or let down early in life, the expectations you bring into partnership are likely that you have to brace against more of the same disappointment. We are skilled as humans in finding all kinds of ways to manage this predicament, but coping mechanisms have an expiration date, and you might be held back in your partnership because of wounds that are decades old.

    Often a combination of individual and couples therapy is ideal for those of us facing early trauma.

    I welcome folks in my practice who have experienced childhood sexual trauma as well as neglect, physical and emotional abuse.

  • Strain of Parenthood

    We are in a societal moment where parents are facing huge stressors, to the degree that the US Surgeon General issued an Advisory around parental mental health and wellbeing in August 2024. Parents in the Bay Area face additional challenges around cost of living, and oftentimes pressures to be highly engaged and emotionally attuned in parenting style.

    Even the most robust couples can begin to crack under these conditions, which might lead to arguments around how to parent, work-life balance, and oftentimes a global sense of unfairness and resentment.

    My work with parents generally seeks to strengthen your base as much as possible, both emotionally and pragmatically. We will make space to acknowledge the reality of the impossibility of the job description, and look for places to release tension and gradually replace brittleness with flexibility. 

Book a Consult

My approach is highly personalized and tailored to each specific couple and your needs.

This is why I spend careful time getting to know you and to get a sense of what is going to be most helpful and effective. I draw both on humanistic and emotionally focused therapies as well as psychoanalytic ways of understanding relationships that also include awareness of power, socio-cultural, and intergenerational layers that may also be in the room with us.

I bring to my work as a couples therapist an ability to hold multiple and often contradictory perspectives and threads. Sessions are equal parts light and deep, and I find that toggling between an intense emotional experience and pulling out to think together is an effective way to build flexibility and resilience.

I also offer gentle directness and a sense of humor, which can be helpful in facing the complexity of being human in relationship.

I hold with great honor the work of being witness and guide to the way your unique partnership expresses itself.

Couples Therapy

Frequently Asked Questions

  • I believe that everyone can benefit from couples therapy and that you don’t need to be at a breaking point to have somebody help you take care of your relationship. If you want to deepen your connection with your partner, talk over life decisions, or simply have time built into your week to tend to your relationship, couples therapy can be of great help.

    Additionally if you are in a place where you are feeling stuck in a pattern of conflict, withdrawal, or facing life challenges together, couples therapy is a wonderful way to have somebody on the outside help you hold and face this moment.

    Given the wide range of circumstances under which couples therapy can be supportive, I invite you to reach out and discuss your specific situation and I can give you more of a sense of whether I can be of help.

  • I strongly prefer to offer couples therapy in person, in my office in the Rockridge neighborhood, Oakland.

    If there are mitigating circumstances, I am happy to discuss virtual or hybrid options on a case-by-case basis, but my strong recommendation for getting the most out of couples therapy is to make it work to meet in person. 

  • For the vast majority of couples, I recommend beginning with a weekly 60-minute session. We will find a regular time that works for us all, and commit to meeting at that same time for some period.

    Some couples transition to meeting alternating weeks for either a 60- or 75-minute session once the initial work is done and things feel more consolidated in the relationship.

    I will occasionally agree to biweekly 75-minute sessions from the beginning if we together determine that is adequate to meet your situation.

  • While it’s hard to answer this question because sessions are so varied and specific to your relationship and situation, you can rest assured that we won’t just do the things you are already doing that aren’t working — by which I mean this doesn’t just look like your usual fight with a referee.

    If you want to get more of a sense of couples therapy, I recommend checking out Dr Orna Guralnik’s show “Couples Therapy,” or Esther Perel’s podcast, “Where Should We Begin?”

  • Yes. Please reach out to talk more about intensive couples treatment, which might consist of several longer sessions over a condensed timeframe followed by maintenance therapy, or a smaller discrete set of longer sessions. I also can integrate ketamine assisted therapy for couples into bespoke intensive work or into ongoing treatment. 

  • I am able to provide a monthly statement which you can submit to insurance for any out-of-network reimbursement for which you are eligible. Pease check with your insurance to confirm the specifics of your mental health coverage. 

The therapeutic relationship is so much about alchemy.

Oakland therapist Andrea Baxter uses a match to light a stick of incense, which is held upright in a green incense holder with a gold candle in the background

I invite you to reach out for a call, and to schedule an initial meeting so can we feel into the fit together.