If you're going to couple's therapy to address labor inequities in your relationship, like the unequal division of household labor, be advised, it wasn't built to do that.
Why Couple's Therapy Wasn't Built to Address Labor Inequity
"It is difficult to get a man to understand something, when his salary depends on his not understanding it." —Upton Sinclair
The diet industry is worth $20 billion.
The Couple's Therapy Industry is worth $22 billion.
TikTok Comment:
This was me 10 years ago. Loved my therapist but when she said "Well, what's so bad about making a list?"…I walked out on that session and never went back.
What if couple's therapists said this more often?:
It's not ethical for me to continue the couple's therapy because it's clear that the inequitable labor issues in your relationship are not going to change, given that they haven't changed yet. Given that we've explored this for a year with minimal progress, I see no reason to anticipate that it will change later.
We could keep talking about this, probably for years, but it would only be in service of me taking your money, allowing you (the man) to fool yourself into thinking you're "doing the work" without doing any actual work, and nothing changing or improving for you (the woman).
If you wouldn't expect what's above to be said in couple's therapy, or think it should have been said in yours and it wasn't, it's important that we ask ourselves why.[1]
Whenever I say things like what is in the box above, I look for the licensure Boards behind me and constantly worry I'm doing something wrong.
Which I now understand says more about the patriarchal heart of psychotherapy and couple's therapy, and the training culture involved in both, than it does about me.
Therapy having patriarchal roots means that such language or outcomes aren't commonly taught, explored, or discussed in therapy spaces.
In my clinical experience, that's a problem.
A problem for women, I should say.
Women, especially if they have children, come to couple's therapy by and large overwhelmed, exhausted, over-burdened, and stressed by the mental load of how much they have to do, with very little support.
Meanwhile, their male partners come asking the couple's therapist to make their wives less anxious and more "happy," or to want to have sex with them more, while doing nothing to counter-balance the load of what is actually making their wives anxious, unhappy and lacking in any interest whatsoever in sex.
I have realized this over the past few years due to my own lived experience and observations, support and conversation with feminist clinicians, podcasts by feminist thought leaders and parenting experts like Zawn Villines and Amanda Diekman; and, my own research into couple's work from a feminist lens.
Given what I've observed and experienced, it is difficult for me to not see what women often say occurs for them in couple's therapy as on par with what they get from diet culture in terms of its effectiveness and contribution to their actual wellness.
And just as diet culture has harms that extend beyond a financial grift, so can couple's therapy, which, depending on how it's executed, can trade women's mental health for patriarchal interests, including the institution of marriage.
Before You Start Couple’s Therapy for Labor Inequity.
If you haven't yet done couple's therapy and are seeking it out to address a labor inequity in your relationship, please ensure in interviews with the couple's therapist[2] that they see labor as a relevant issue within couple's therapy, and as a critical part of the mental health of both/all of the parties within the marriage.
Otherwise, the couple's therapy may go like this:
Woman: The labor inequity is the problem.
Therapist: No, your defenses and anger about the labor inequity is the problem. Or your lack of interest in sex as a result of the labor inequity is the problem. Or your irritability, due to the labor inequity is the problem. I recommend…more…couple's therapy. You have a lot of "work" to do, after all, on your reaction to the labor inequity.
Woman: But what about the work he needs to do at home so that things are more evenly distributed?
Therapist: Huh? What? Oh, wait, look over there! A defense mechanism!
And around and around you will go.
[Image: brown and white horse carousel. Photo by Phil Hearing on Unsplash]
It's not the labor inequity that's the problem, it's your reaction to the labor inequity.[3]
In one couple's therapy training demonstration led by a white, cis, male therapist, I observed a female trainee therapist present a case of a couple that had been "stuck" for five years.
The "problem" was that the woman was persistently angry about the unequal distribution of labor in the relationship.
The couple's therapist, a woman, had deemed herself a "failure" for not being able to "fix" this pervasive dynamic, and therefore was consulting with the Head Trainer, who did a demo session with the couple for the trainees to learn from.
The man became increasingly emotive and communicative in the session, while the woman remained stiff and withdrawn. As the Head Trainer applauded the man's vulnerability, the woman seethed.
As an observer, I seethed with her.
"He is STILL NOT HELPING ME AT HOME AND I HAVE BEEN ASKING FOR FIVE YEARS," she finally raged when asked about her response to the "work" her husband was doing with the male therapist.
The woman was diagnosed as having "grandiose defenses," and a "young" trauma response that had engaged the primitive defenses of "withdrawal and stonewalling," the deathknells of any relationship, if the literature and research are to be believed[4].
All attention was diverted by the white male therapist to the woman's defenses, rather than the labor inequity, which would remain unaddressed for her.
Again.
During the trainee debrief, a colleague asked about the man not responding to the woman's request and stated that her interpretation was that the woman was angry because her concerns were being dismissed.
The leader stated that the real issue meriting attention was the woman's trauma response of being "withdrawn," which was "unproductive." and "not relational."
The inequity of labor within the marriage? La la la la la!!!! I can't hear you! What? Huh?
If you've been in couple's therapy and it's felt damaging or painful to you beyond what seemed reasonable, ask yourself if it's possible that you were being gaslit, undermined, or dismissed.
Experiencing this kind of dismissiveness from an authority figure when you are profoundly stressed and have been chronically dismissed already by your partner for years on end is damaging to the mental health of women.
Given that people pursuing couple's therapy (often women) out of a wish that an authority figure can restore something in their relationship they cannot, woman are prone to believe that the authority figure in question is probably right, in which case, "There must be something wrong with me."
Not unlike how our culture consistently pounds a drumbeat of telling us that being in a big body is a criminally offensive act meriting of all kinds of acts of being gaslit, demeaned, bullied, and mistreated[5].
Someone trying to question if being in a larger body is really the cause of all their health conditions will be pummeled by information from the culture assuring them that even having that question is delusional.[6]
We now refer to the phenomenon of constantly telling people in big bodies that every medical condition is the result of their weight as medical gaslighting.
I think we need to seriously consider that couple's therapy is doing a form of gaslighting as well when it consistently tells couples, overtly, structurally, and covertly, that inequitable labor in relationships isn't that big of a deal and isn't a legitimate treatment goal of couple's therapy.
Or, that patriarchy or abusive dynamics are treatable in couple's therapy.
Just like someone in a big body being told that their broken arm is really related to their weight,[7] a woman wondering if her exhaustion due to carrying the entire mental and physical load at home is perhaps the issue in her marriage is commonly told, "No, no, that can't be."
The patriarchy, and sometimes the couple's therapist, assures her covertly and overtly that:
No, no, this is the way things are supposed to be;
There is something wrong with you that you're so angry about it;
You're lucky he does what he does to help out;
At least he's not cheating on you;
Well, he does earn more than you so isn't it fair that he doesn't do as much as home?; or,
It's not his fault he didn't learn all these skills growing up and it's so easy for you.
Standing up to the patriarchy is difficult, mentally and emotionally, and it makes it nearly impossible or much harder if you also have to also stand up to an authority figure telling you there is something wrong with you for being angry about what you are angry about and arming your partner with that information as well.
Couple's Therapy as the Diet Culture of Relationships
This is how I've come to see many forms of couple's therapy as the diet culture of relationships, promising an endless, infinite array of ways to waste time, money, energy on a "solution" that deflects, dismisses and ignores the reality of the actual problem.
While doing harm in the process.
Fat phobia and thin worship teach us that big bodies are an aberration, a state of existence that indicates poor character and can be solved with just more work.[8] Diet culture promotes the myth that we all have infinite control over the size of our bodies at all times, even though 95% of weight lost on a diet is gained back within two years.[9] We are told that we should all be the same size as we were at age 12, and that we will only be happy when we successfully shrink our bodies and keep them small.
Meanwhile, women are told that problematic and patriarchal men are an abberation, as are unhappy marriages, which we know is not true.[10]
Just as women are constantly told to contort, change and fix themselves to fit an arbitrary body mold, the patriarchy teaches women they need to accommodate, contort and adjust their expectations so that their marriage can work, while telling men they don't need to adjust anything at all.
Men are told they are entitled to happy and satisfying relationships, just as women owe us small, feminized bodies to look at.
Just as women must do work to stay small and attractive, we're also told over and over that the task of making relationships work depends on us. To negotiate, to cajole, to beg, or to change our expectations around the state of cleanliness of our home, labor distribution, and the amount of care and nurturing we receive.
Everyone will be happy when her body is small.
Everyone will be happy when she adjusts to what he's willing to offer in the relationship.
Bodies cannot be coerced into being a a certain size most of the time; and, women cannot be coerced into being happy in uneven, disrespectful relationships.
The math does not math.
It never has.
There was not some magical time when marriage as domestic servitude was satisfying for women or made them "happy."
There was a time when the consequences of a failed marriage motivated them to fake happiness more effectively.
Before women could divorce or earn their own money, they survived their unhappiness by numbing it with valium[11] and wine or often killed themselves.[12]
It wasn't that recently that we stopped the practice of men being able to institutionalize their wives for almost any reason they want, including protesting their husband's affair.[13]
And yet, If you have a heteronormative relationship problem, even though a lot of data points to the issue likely being caused by the construct of marriage itself, and its negative impact on women, you are likely to be prescribed the solution of infinite communication.
In the same way that if you are in a big body and have a medical problem, a dating problem, a self-esteem problem, or a mental health problem, it's possible you will be prescribed, or have been prescribed—especially of you are a woman—the solution of losing weight.
A solution which, in many cases, will make the original problem worse.
Somehow, with both frameworks, the majority of the labor and responsibility falls onto women, while men sit passively by and wait for the complaints, and the size of the jeans, to decrease.
Women are instructed to use up precious mental capacity, time, and effort to research, read about, become experts in, absorb, talk about, worry about, ruminate about and try to figure out how to solve the riddle of how to extract love, respect, validation, internal happiness and health from society via weight loss and/or how to extract love, respect, mutual partnership, validation, internal happiness, and health from a man by communicating better.
And guess what, both are fools' errands, because the locus of control is misplaced and there are multiple fundamental flaws with the entire premise that are identical, whether you're talking about "communicating better" or "losing weight."
It's the same game, different distraction.
The experience of patriarchy for women manifests as a one-track train ride to Self-Doubt and Exhaustion.
It's almost as if the whole point of everything is to make women constantly exhaust and doubt themselves.
If the patriarchy is lucky, it can distract you with both perpetually, and have you never thinking about yourself or your own fulfillment ever.
[Image: People stand inside a clock on the water. Photo by Galina Nelyubova on Unsplash]
Capitalism will love it, too, because both distractions cost a lot of money. The diet industry is worth $20 billion. The couple's therapy industry is worth $22 billion.
The "communication skills" red herring: For women labor is work. For men, labor is talking about working.
In one of the training groups I went to to improve my group therapy skills, the leader advised a clinician nervous about starting a new group, "As long as they're talking, the first session is going great."
While this may be true for the first few sessions of a therapy group, this is the pervasive idea behind couple's therapy that is problematic, because it serves to substitute talk for actual labor, which has been well documented by Zawn Villines.
Many couple's therapists will tell you that most inquiries start with, "We need to work on communication issues," and invariably the "communication issues" are often about shared labor in the home or some other concrete problem.
Often, the pattern is that "the problem" bothers the woman, but it does not bother the man, whether it's his drinking, his depression, his anger, or his lack of interest in helping her around the house or with the kids.
The communication issue therefore really could be boiled down to: She is not an effective enough communicator to convince him that her needs or perspective, or reasonable household tasks, matter or should be taken seriously. She is therefore hoping that the couple's therapist is a skilled enough communicator to do what she cannot.
One TikTok comment states:
Yes! I'm told that I am too direct. I'm too quick to process. I'm too pushy with him. Yet I've softened, reframed, praised him, avoided asking for too much…I've made myself sick and exhausted doing these things. He hasn't changed, he hasn't met me in the middle, and he continues to disrespect me if I express any need or feeling he disagrees with. Yet it feels like our couples therapist is still framing this as a communication issue. As if she absolutely has to say here's your fault, and here's his.
Someone replied to her, saying:
Oh, that's because they both hate you. he doesn't think you're a person and she thinks a woman is supposed to be a service for men. escape immediately.
Shortly after, another woman wrote:
I could have written this about my experience in couple's therapy with my ex husband. Thankfully I had a great individual therapist who kept me from self abandoning. We later found a better couples therapist but my ex still wouldn't do any of the work the therapist recommended.
Can Couple's Therapy Be Ethical in a Patriarchal Society?
It is not entirely shocking to imagine that a therapy modality designed only by straight, heterosexual married people, who profit from people's investment in the construct of marriage, would not necessarily view the patriarchy or the structures and assumptions we have about marriage itself as part of the problem when marriages break down.
It's not hard to imagine that couple's therapy was designed to uphold the patriarchy, just as therapy in general serves to keep people fit for work on behalf of capitalism.[14]
While making people money! Bonus!
It is important that women understand this before embarking on pursuing couple's therapy.
One TikTok comment, from someone who states she is a therapist:
Working with het couples hurt my soul…trying to gently pull out in the session that there was more subtle emotional abuse happening and doing that "and how do you feel about that" and validating men's experience of their partner when they're coercively controlling her…excruciating. I got more direct over time but it almost always ended in the couple not coming back.
Whether couple's therapy can be done ethically in a patriarchal society is an open question.
There also remains the question of if men can, do and will tolerate couple's therapy when conducted with a genuinely feminist, anti-patriarchal framework without an anti-divorce or pro-marriage bias.
What I do know is that just like medical practice is dubious when providers do not own and address the ways that weight stigma plays into every level of our medical care and thinking, no couple's therapy is ethical unless the patriarchal biases, myths and harms within the institution of marriage and romantic relationships are addressed in a straightforward and obvious manner.
When facing any framework that exhibits power or authority over us, or aims to teach us "how to be," the question must always exist, "Who does this way of being that is being promoted serve?"
Couple's therapy is absolutely no exception, on many, many levels.
Reprinted with edits and updates from the What If Nothing's Wrong With You? Substack (now combined with this one). Originally posted: May 13, 2025.
Thinking about couples therapy?
Learn more about couples and relationship therapy at Shift Happens Collective or schedule a free intro call.
For Therapists:
Lisa Kays and Lisa Sherper are co-facilitating Deconstructing Couple's Therapy: Ethical Approach to Gender Inequity & Its Impact on Mental Health, a virtual CE workshop on January 8, 2027 (3 Ethics Cat I CEs). Learn More →
Footnotes
Despite my usual recommendation that we ask ourselves "why" less.
Part 3 of this series will cover screening questions for couple's therapists.
This is a tactic of coercive control and emotional abuse, by the way, in the macro/political sphere and in the interpersonal sphere. It is a form of DARVO designed to deflect attention from the original harm/issue and onto the victim's reaction to the original provocation/act of harm/neglect, etc..
Gottman Four Horsemen. Note: This was not a Gottman training.
Farbman, D. (2014 May 28) "Weight bullying: Large size people are often targets." Psychology Today. Last accessed July 16, 2026: link
Morgan, K. "Understanding weight bias and medical gaslighting." WebMD. Last accessed July 16, 2026: link
Paine EA. "Fat broken arm syndrome": Negotiating risk, stigma, and weight bias in LGBTQ healthcare. Soc Sci Med. 2021 Feb;270:113609. doi: 10.1016/j.socscimed.2020.113609. Epub 2020 Dec 14. PMID: 33401217; PMCID: PMC7920326.
Or now a GLP-1, but that's a whole other story.
Carter, J. (2022 Feb 1). "That diet probably won't work long-term: here's what to focus on instead." The Ohio State University Health & Discovery. Last accessed July 16, 2026: link
There is documentation and evidence of this in this post, and Zawn Villines has effectively documented it for years, as have many others.
Taggart, S. "Prescription sleeping pills and women." Clemson University. Last accessed July 16, 2026: link
Fersch, P. (2025 Apr 9). "Does No Fault Divorce help or harm women?" Forbes. Last accessed July 16, 2026: link
Thorpe, JR. "Women who defied gender roles were once imprisoned in asylums." Bustle. Last accessed July 16, 2026: link
Sarmiento Verano, L. (2024 March 7). "Therapy and the capitalist ethos." South of Therapy. Last accessed July 16, 2026: link
