Someday, the Diagnostic and Statistical Manual of Mental Disorders will sit in a museum, next to a rotary phone and a butter churn.

The plaque will read: “Once believed to capture the human mind in tidy categories.”

Until then, we play along. Insurance companies demand DSM-5 categories. Schools want a formal mental health diagnosis before offering help.

The mental health system—like any bureaucracy—loves nice and easy paperwork.

But human beings nevah evah do anything nice and easy…

They ask me at barbecues. In parking lots. Sometimes, in a whisper, after two glasses of wine at their child’s back-to-school night:

“So… what’s really the biggest problem you see in couples?”

There’s usually a nervous laugh, like they’re bracing for me to say “sex” and make it a punchline. A quick laugh, and then we’re back to potato salad.

But I’ve stopped giving the polite answer.

Because the real answer is quieter. Slower. And much more important.

The biggest problem I see in couples—the one that quietly wears love down—is this:

At some point, people stop being willing to be changed by the relationship.

Let’s say the quiet part out loud.

Couples therapy is a strange ritual. You schedule your suffering in 50-minute blocks. You pay someone to ask hard questions.

You rehearse vulnerability, sometimes in the presence of someone who isn’t even making eye contact. And then you go home and argue about what was said—or what wasn’t.

It’s brave. It’s hopeful. But it’s also, at times, bewildering.

So when it doesn’t feel like it’s working—or worse, when it starts to feel like a weekly exercise in despair—you begin to wonder: Is this still worth it?

Let’s explore when it’s actually wise to quit couples therapy, and when the discomfort you’re feeling is exactly the thing you should be leaning into.

Couples therapy has a PR problem.

On Instagram, it’s all throw pillows, card decks, and holding hands on matching yoga mats. On Reddit, it’s stories of miraculous turnarounds:
“We went to three sessions, and he finally got it.”

Or: “She stopped bringing up 2017 after our therapist said I wasn't the villain.”

But let’s be honest. Sometimes it doesn’t work. Sometimes it’s 50 minutes of paid bickering, trauma-informed homework that nobody did, or one partner weaponizing every insight for rhetorical sport.

So: why does couples therapy fail?

Here’s the answer no marketing agency wants to give you:
because it’s not therapy that’s broken — it’s what we bring to it.

And often, what we bring has been shaped not just by childhood or trauma — but also, in part, by the particular psychodynamics of American culture.