Counseling Couples in Crisis

Therapy for Wounded Relationships

At The Family Recovery Institute (FRI) in San Rafael, CA, we specialize in helping couples through some of the most painful and defining moments of their lives together.

Couples come to us feeling hopeless, resentful, or shut down. Common difficulties involve problematic parenting, worsening disdain for one another, substance abuse, relapse, or addiction, infidelity, emotional disconnection, lack of intimacy, or current separation, we offer compassionate counseling creating a space in which both partners are heard and supported. We’ll interrupt disabling and dissonance-promoting patterns to determine whether shifts toward new possibilities can create the conditions under which a closer, warmer, and more sustainable coupleship can be developed.

Non-binary, LGBTQ+, and alternative lifestyle couples are welcome.

When a Relationship is Experiencing Existential Crisis

Every relationship has challenges—but sometimes those challenges become overwhelming, even existential. Crises can rupture trust, erode intimacy, and trigger long-standing personal wounds. Without intervention, couples spiral into destructive patterns that feel impossible to escape. At FRI, we help couples face and work through a wide range of relationship crises that may include:

  • Parenting difficulties particularly involving a troubled teen or stuck young adult

  • Sexual problems including infidelity, changes in sexual preferences, performance problems (medical workup always essential first), or loss of sexual interest with or without “bed death”

  • Financial situations resulting in emotional difficulties

  • Substance overuse or addiction in one partner

  • Recent tragedy or loss causing partnership discord or estrangement

  • Partners deciding whether to remain together or separate thoughtfully

  • Mood problems in a partner causing deterioration of partnership’s meaning or value

  • Specific difficulties deriving from LGBTQ+ or alternative lifestyle partnerships

Common relationship issues that we treat include:

Addiction and Substance Abuse

When substance overuse or addictive disorders are present—whether related to drugs, alcohol, or “process” addictions like gambling, spending, or sex—it deeply impacts both partners. The non-using partner may feel betrayed, abandoned, or trapped in a caretaker role. The partner struggling with addiction often feels shame and responds with denials or defensiveness. We provide trauma-informed, relationship-focused support to help couples move from simply surviving and tolerating their intolerable situations to recovery and happiness.

Infidelity and Betrayal

Whether a physically intimate (romantic) or emotional betrayal, trust is broken and extreme suffering ensues particularly in the early period during which the infidelity or deception has occurred. We help couples process the pain, understand the “why” beneath the affair, and explore whether trust and connection can be rebuilt and how.

Divorce, Separation, and Breakups

For some couples, therapy is about ending the relationship with clarity and respect. Others want help navigating the uncertainty of whether to stay or leave. We support couples in separation or divorce to minimize conflict, protect children’s wellbeing, and define the parameters that will support healthy communication.

Intimacy Issues

Disconnection—emotional or sexual—can erode long-standing relationships. Partners may feel rejected, ashamed, or alone and abandoned . We help couples explore and resolve blocks to intimacy, reconnect emotionally, and rebuild emotional and physical trust and comfort whether or not actual sex will be resumed.

Chronic Conflict and Emotional Shutdown

When couples are locked in chronic conflict—or avoid each other entirely—it’s often a symptom of one or some of the issues mentioned above. Therapy helps couples break out of these patterns and develop healthier, more productive ways of relating.

Our Therapeutic Approach

Every couple’s journey is different. Some come in on the brink of dissolution while others wisely just want get out ahead of a brewing issue or issues and reconnect. We tailor our work to individual needs and situations, drawing from proven therapeutic modalities including psychodynamic and attachment-based approaches, cognitive-behavioral and mood stabilization methods.

Our therapists are neutral, nonjudgmental, and skilled at holding space for both partners. We help couples slow down reactive cycles, speak from vulnerability, and explore repair—even after serious harm has occurred.

Therapy Options for Couples in Crisis

Individual Therapy

In many cases, relationship struggles reflect individual challenges—trauma, attachment wounds, low self-worth, or anxiety. We offer individual therapy to help clients process their experience in the relationship and gain insight and clarity. Whether you’re in crisis, healing from betrayal, or uncertain about staying, individual therapy offers a private, supportive space to work through issues.

Couples Therapy

Our couples therapy sessions are structured to reduce blame, build empathy, and promote understanding. We work collaboratively with both partners to:

  • Rebuild trust after infidelity

  • Improve communication and emotional regulation

  • Address physical and emotional disconnection

  • Develop healthy boundaries and shared goals

We also offer counseling for couples who are unsure whether to stay together at all, facilitating a short-term process focused on decision-making and mutual safety.

Family Therapy

When a couple is in crisis, the entire family feels the impact—especially older children or young adult dependents. Our family therapy services help families navigate transitions like separation, blended family formation, or recovery from addiction. We support parents, co-parents, and extended family systems in creating new relational structures that are clear, respectful, and supportive.

Why Choose FRI for Couples Counseling?

Located in San Rafael, CA, The Family Recovery Institute is a renowned and trusted provider of couples counseling serving people from Marin, San Francisco, Alameda, San Mateo, and Sonoma counties. Remote (video-based) sessions can be conducted with people anywhere in California. Our therapists are experienced in navigating sensitive emotional work and helping couples reconnect, redefine, or peacefully and safely dissolve their partnership.

Ready to Get Support?

With more than 35 years of experience, Dr. Perlmutter and the experienced team of clinicians at FRI combine psychodynamic, family systems, cognitive-behavioral therapy, peer support, and spiritual methods to help our clients achieve their goals. This is often long-term challenging work. We pride ourselves on our ability to help people with complex conditions navigate and find approaches to best managing even the most difficult circumstances.

Please call 415-322-0939 for a phone consultation or complete our form to schedule an appointment.