A man and a woman look away from each other because they're arguing
Psyche

When is couples therapy really worthwhile?

When a deep love begins to crumble or a marriage is on the verge of failing, it’s painful for the couple. pme couples therapist Gisela Backes uses the example of Jessica and Daniel to explain when conflicts turn into a genuine relationship crisis and how you can manage to make a fresh start. Just a heads-up: You’ll most likely have a lot of work ahead of you.

Expert: Gisela Backes, couples therapist; Editor: Christin Müller
 

What causes love to fall apart? 

According to couples therapist Gisela Backes, a lack of communication and misunderstandings are often the main causes of crises in relationships.

She recommends that couples actively work on their relationship, communicate openly and consciously make time for each other in order to reconnect.

Professional support can help to discover new paths, develop solutions and strengthen the partnership - provided both are willing to engage in this process.

 

The Jessica and Daniel case: When accusations keep repeating themselves!

Jessica and Daniel have been a couple for twelve years. The two met at university. They moved from Münster to Berlin together - lucrative jobs were waiting for them in the capital. Jessica worked as a project manager in a PR agency, Daniel as an engineer at a technical institute. With their wedding four years ago and their little daughter Mia, their private happiness seemed perfect.

But problems soon began to arise. Jessica , who was now primarily taking care of her daughter, found it difficult to cope with no longer being able to do her old job, where she had often worked overtime. She had bitten the bullet and taken a lower-paying job as a team assistant—a part-time position wasn’t an option at her old job.

Daniel now saw his main task as earning money. He worked whenever he could. The earnings were also too good and the opportunities for promotion were within reach. Although the two of them had no financial worries, that one strange feeling soon crept in - that they simply no longer functioned as a couple.

Relationship crisis when the children arrive

Gisela Backes is a couples and family therapist at pme Familienservice. In recent years, she has helped many couples through a crisis, including Jessica and Daniel. "A child is a wonderful thing for a couple. It turns a relationship between two people into a small family. It inevitably has an impact on the parents' relationship." The mother often takes over the care and upbringing of the child.

1. How changes after childbirth put a partnership to the test

Just like Jessica. After her year of parental leave, she primarily took care of Mia. She kept track of all the vaccination appointments, stayed home with her when Mia had a fever, and did all the shopping after work. She slept in her daughter's room so that Daniel could sleep peacefully.

A drastic change: “When a mother has to give up her old life, dissatisfaction can quickly set in,” says Gisela Backes. She may also miss the appreciation and validation she received in her old job. That can be frustrating. But the change didn’t leave Daniel unscathed either. He longed for more time together with his wife.
 

"Poor communication and misinterpretation of situations and statements are the most common causes of crises in relationships."
Gisela Backes, couples therapist, pme Familienservice
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2. When parenthood displaces togetherness

Jessica wouldn’t let it happen. She was too exhausted from her day with the little one, and secretly, she blamed her husband for her unhappiness. Physical closeness with a child is often the top priority during the first year of life and shortly thereafter. When Jessica spent many hours in close physical contact with Mia, her need for physical closeness was met. This requires Daniel to be understanding and patient, but also to persistently court his wife as a partner.

Be sure to check out our podcast on the topic: What happens in couples therapy?

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A lack of communication and misinterpretations strain a relationship

The same applies to recognition at work. “When you have children, daily routines don’t necessarily leave room for conversation,” the couples therapist points out.

Often, a lack of communication between partners is the reason for misinterpreting situations and statements: “The couple believes they know each other inside and out, and the words ‘never’ and ‘always’ are frequently used,” says Backes. But if the couple does not work together to find solutions to their dissatisfaction or stress, this often triggers a serious crisis.

Important are discussions about:

  • job
  • Childcare
  • Personal needs for sleep, rest, and physical closeness
  • Distribution of tasks in the household
  • Leisure activities
  • Staying in Touch with Friends and Hobbies
     
Technical Presentation for pme Clients

Why we love the way we love: Recognizing attachment patterns in couple relationships

September 25, 2026 | 12:00 p.m. – 1:00 p.m.

This presentation provides in-depth knowledge about the classic attachment styles (secure, anxious-ambivalent, anxious-avoidant) and shows you how to recognize your own patterns as well as those of the person you’re interacting with. Through concrete strategies and practical examples, you’ll learn how to consciously navigate these patterns.

Registration: Recognizing Attachment Patterns in Couple Relationships


​​​​​​​When Silence and Arguments Define the Relationship: Positions Harden

Things had gotten more tense between Jessica and Daniel. Normal communication had long since seemed impossible. At first , they argued every day; eventually, they just stopped talking to each other.

There were days when the two of them didn't say a word to each other, and when they did, it was only to yell at each other. The love that had once begun seemed to have vanished—let alone any kind of romantic life.

And somehow, neither of them really cared. At that point, divorce seemed more likely than a reconciliation. There was still one more attempt left—one last-ditch effort before taking the final step. Because they knew things couldn’t go on like this. The couple came to see Gisela Backes for counseling. The 62-year-old couples therapist helped them overcome their crisis.
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Couples therapy can uncover dynamics within the relationship and help partners rediscover respect and love for one another (Photo: pme Familienservice).

When couples go to couples therapy

“Couples come to me whenever they can no longer see a way out of a critical situation on their own. This can happen at the onset of a crisis or even after years of an ongoing crisis.”

"A reason to seek counseling can be a life-changing family situation , such as a birth, a death, a serious illness, a job change, infidelity, but also disrespect, lying, hurt feelings, childlessness, frustration, a lack of sexual desire, or cultural differences," explains the therapist.

In Germany today, one in three marriages ends in divorce. Very few people seek professional help. Gisela Backes knows why that is: 
 

"In most cases, at least one of the people involved feels embarrassed about seeking outside help, or at least one person does not believe that therapy will bring about any change."
 

What characterizes successful partnerships and how therapy can help

Gisela Backes can't say for sure how many couples she was ultimately able to help. She advises: “It's important to work on your relationship as a couple, to really want it, and not to just give up.”

"Successful partnerships are characterized by a mutual positive choice (the partner is the absolute No. 1), by mutual love, by mutual trust, and by respect and esteem for one another."

Even though some therapies are more difficult than others, Gisela Backes has never advised a couple to separate: “The decision is always made by the couple—or at least by one person in the relationship. Anyone who is willing to accept help or support can be helped.”

"However, if one person decides they no longer want to continue the relationship, we can also support the couple through the separation process."

Goals, methods and process: How does couples therapy work?

The approach in couples counseling depends on the goal of the counseling. "This could be, for example, improving communication, regaining trust after infidelity, reviving sexuality, or growing together as a second family," Backes continues.

There are preparatory questions for couples counseling that look back at the beginning of the relationship, at the here and now, and at hopes for the future. These questions serve as a guide during the counseling session, from which exercises for the couple can be derived as needed.

 

How couples can strengthen their relationship after a crisis

1. Find more time for each other

Therapy has helped Jessica and Daniel. They've made a commitment to be more attentive to each other as a couple and to invest time in their relationship.

So now there are times when they’re just there for each other. In the evenings, the TV often stays off, and sometimes the housework gets put on hold. Over a glass of wine, they reflect on the day. One date a month is firmly marked on the calendar.

In the meantime, a babysitter is watching over little Mia. For a weekend trip to celebrate their wedding anniversary, they even brought in the grandparents—who live far away—to look after the child.

“Spending time together can help. Even if it’s just 15 minutes a day, during which everyone can express themselves without judgment and work together to find understanding or solutions,” says the therapist. “It’s not always possible to find answers that satisfy everyone involved. In that case, temporary solutions should be found, and the issue should be revisited after a certain amount of time.”

2. Maintain open communication: Keep the conversation going!

Daniel will try to reduce his workload so that his wife can pursue new career plans. Everything seems to be turning out well.

However, it's important to keep the lines of communication open! Gisela Backes summarizes: "Many people find it difficult to talk to their partner about their wishes, longings, and fears. But that's precisely what keeps a relationship vibrant."

When asked why she thinks it's worth fighting for an existing partnership, she has a very simple answer: "Because it's a wonderful feeling to love and be loved and to have a partner by your side."

Couples and individual counseling from experienced therapists

At pme Familienservice , we offer couples and families support in talking openly about their needs and clearing up misunderstandings.

Find out more: EAP consulting

 

Literature tips

Hans Jellouschek How partnership succeeds

 

FAQ: Couples therapy, relationship crisis and family life

When is couples therapy really worthwhile?


Couples therapy is worthwhile when couples can no longer find a way out of a difficult situation on their own – regardless of whether they are at the beginning of a crisis or it has been ongoing for some time. Professional help is particularly beneficial when children are involved, to protect family happiness and enable a fresh start. Accepting help takes courage, but it can bring about real change.

What is the most common reason for the breakdown of a relationship?


According to couples therapist Gisela Backes, a lack of communication and misunderstandings are the main causes of relationship crises. Open, honest conversations and consciously spending time together help couples to reconnect and address problems.

How do children affect a relationship crisis?


When parents argue or are unhappy, it puts a great strain on children's emotional well-being. Having a child brings many changes to daily life and the relationship. Especially after the birth, responsibilities and traditional role models shift, which can lead to dissatisfaction if partners don't communicate openly about it.

What can I do when accusations and arguments become part of everyday life?


Recurring accusations and constant arguments are warning signs of a deep crisis. In this situation, the couple should seek professional counseling to learn to communicate respectfully with each other again and to find solutions together.

When does couples therapy become beneficial?


Couples therapy is helpful in cases of persistent dissatisfaction, recurring arguments, communication breakdowns, or after significant life events such as childbirth, job loss, infidelity, or illness. It supports couples in openly discussing their desires, needs, and fears and in addressing potential changes.

What happens during couples counseling?


The approach in couples counseling is individualized, but always tailored to the couple's goals: often it involves improving communication, rebuilding trust after conflicts, strengthening sexuality, or growing together as a family. Couples receive guiding questions and practical exercises to actively shape their relationship.

What makes for successful partnerships?


Successful relationships are based on mutual love, respect, trust, and a genuine desire to work on their shared lives. It requires the willingness of both partners to remain open, listen, and make each other their first choice.

What if only one person is ready for change?


If one partner doesn't want to change, the therapist encourages them to seek help anyway. The decision to separate or start over should be a conscious one. Counseling can also provide support during a separation.

How can couples strengthen their relationship after a crisis?


It's important to make time for each other as a couple – small rituals, regular date nights, and everyday conversations help you reconnect as partners. Support such as babysitters or grandparents allows for shared time out, even if it's short.

Why is open communication crucial?


Only by talking about desires, fears, and longings can a relationship be kept alive. Many difficulties arise from unspoken expectations. Open communication makes closeness and understanding possible.

zero Postpartum tips: How to make the first time with baby a success

Father sleeps with baby in his arms
Parent & Child

Postpartum tips from emergency midwife

The postpartum period is one of the most important phases in the lives of parents and newborns. It is a time of physical regeneration, emotional adjustment and intense bonding. But it is precisely in these first weeks after the birth that many new mothers face challenges that are often underestimated. 

In this article, midwife Katharina von NotdienstHebamme explains the challenges that often arise during the postpartum period, dispels myths and gives valuable practical tips on how to organize the postpartum period in the best possible way.

Your postpartum timetable helps you to better understand the individual phases of the postpartum period and to prepare yourself. 

Katharina, what exactly is the puerperium and why is this time so important for mother, parents and child? 

Midwife Katharina: The postpartum period begins immediately after the placenta is delivered and usually lasts around eight weeks. A lot happens during this phase - both physically and emotionally. The body undergoes involution, the uterus contracts again, the birth wounds have to heal, milk production has to get going and the hormones change dramatically. All of this serves the regeneration and the new role as a mother. 

At the same time, the postpartum period is a crucial time for building a deep bond between parents and child. The first touches, breastfeeding or feeding and getting to know each other significantly shape the baby's sense of safety and security. 

This time is often underestimated because society often expects "everything to return to normal quickly".

"The postpartum period is much more than just a time to rest—it lays the foundation for life with your child. Just like building a house, if the foundation is solid, it will last."Midwife Katharina from NotdienstHebamme

What typical challenges do women face in the first few weeks after giving birth? 

The challenges are manifold:

  • Physical pain can be caused by birth injuries, afterpains or a caesarean section. This pain can significantly restrict everyday life and mobility. 
  • Breastfeeding often requires more practice than expected. Problems such as sore nipples, engorgement or uncertainty when latching on are not uncommon. Professional support can bring a lot of relief here. It is even better if women have had the opportunity to acquire a lot of knowledge about breastfeeding before giving birth.
  • Emotionally, many women move between feelings of happiness and exhaustion. The so-called baby blues - with mood swings and sudden outbursts of tears - are hormone-related and completely normal.
  • Lack of sleep is another major challenge. Caring for a newborn requires constant attention and radically changes the daily rhythm. [Reading tip: Understanding baby sleep: How much sleep does my baby need?]
  • Organizational issues such as household management, visiting times and errands can also cause stress if they are not planned well. Many women overestimate what they can achieve during this time and become overloaded as a result. 

How do midwives support mothers and families during this sensitive phase? 

Midwives work holistically. Medically, they monitor the recovery, check the healing of birth injuries or scars and pay attention to the course of the postpartum flow. The baby's weight gain, drinking behavior and umbilical healing are checked. 

A central component is breastfeeding support. Midwives provide support with latching on, give tips on comfortable breastfeeding positions and help with difficulties such as engorgement or sore nipples. 

Midwives are also important contacts for emotional support. They encourage women to listen to their body's signals, respect boundaries and take time to adjust to life with a newborn.

What myths about the postpartum period do you often encounter and what do you think should be corrected?

1. a widespread myth is the idea that women should fully recover after just a few days. In fact, the body needs several weeks to recover from pregnancy and childbirth. 

2. also misleading is the assumption that breastfeeding always works without problems right from the start. Breastfeeding is a learning process in which support is not a sign of weakness, but of care. 

3. the view that lots of visitors are automatically good for you should also be viewed critically. Especially in the first few days, rest and privacy are often more helpful for recovery and the start of breastfeeding. 

4 The baby blues are also sometimes mistakenly interpreted as weakness. However, it is a normal hormonal reaction that many women experience. 

All these myths lead to moms being under a lot of pressure. However, this stress is not at all good for postnatal recovery, breastfeeding and the start of parenthood. 

What tips do you have for making the most of the postpartum period?

1. it is helpful to organize support in advance - for example for housework, shopping or meals. Visits should be consciously planned and dosed in the first few weeks. 

2 A balanced diet, sufficient fluid intake and regular rest breaks are crucial. Household chores should take a back seat during this time to allow for physical recovery. 

3. skin contact, cuddling together and closeness promote bonding and have a calming effect on parents and child. 

4 In order to reduce the uncertainty after the birth to a normal level, it is important to prepare not only for the birth but also for the time with the baby. Breastfeeding courses, baby care courses and first aid provide important knowledge and support during this uncertain time. 

5. warning signs such as heavy bleeding, fever or persistent depression should be taken seriously and discussed immediately with a midwife or doctor.

"The postpartum period is not a time to prove resilience, but a phase to heal, grow and arrive in a new life." - Midwife Katharina

The postpartum timetable: Overview of the first weeks

Week 1: Arrive and relax 

The first week is characterized by physical regeneration and emotional adjustment. The menstrual flow is heavy and contractions can occur. Mood swings often occur during this phase. Rest and support are particularly important at this time. 

Practical example: A mother who felt exhausted on the third day after giving birth benefited significantly from reducing visiting times and adhering to a fixed rest schedule. 

Week 2-3: Gain confidence 

The menstrual flow becomes weaker, pain subsides. Breastfeeding or feeding often becomes more routine, but challenges can still arise. Walks in the fresh air support the recovery process. 

Practical tip: Pain when breastfeeding should not be ignored - even a small change in position can often help. 

Week 4-6: Gathering strength and shaping everyday life 

Postnatal recovery is well advanced. Light postnatal exercises can begin if it feels good. Everyday life is becoming more structured, but overloading should still be avoided. 

Example: Many women report that they feel more energy again from the fourth week onwards, but are still clearly aware of their physical limitations. 

From week 7: Transition to everyday life 

Physically, most women feel more stable and sporting activities are possible again if there are no complications. Emotionally, the new family routine stabilizes and the focus expands to other areas of life again. 

Thank you so much for the interview, Katharina! 


 

Midwife service before and after the birth 

In cooperation with NotdienstHebamme , pme Familienservice offers professional support and supplementation to outpatient midwife care. 

1. tested online courses: With the tested tips and practical instructions, new parents and pregnant women receive comprehensive support in the online courses from NotdienstHebamme that can be accessed at any time - ideal for preparing for the new addition to the family. 

Online courses are available on the following topics: Birth preparation, baby care, regression, baby massage, breastfeeding. 

2nd midwife consultation hour: With midwife advice from NotdienstHebamme via video chat, telephone or e-mail, parents receive quick answers and support, even with psychosocial stress such as mood swings and baby blues. 

You can find more information about the cooperation with NotdienstHebamme in our service portal My Familienservice. Not yet a customer of pme Familienservice? Please contact us!   

 Frequently asked questions (FAQ) about the postpartum period

1 How long does the puerperium last? 

The puerperium begins immediately after the birth and usually lasts around eight weeks, during which the body and mind recover from the birth. 

2 What helps with breastfeeding problems in the postpartum period? 

Breastfeeding problems such as sore nipples or engorgement can usually be solved with the professional support of midwives. Patient latching on and the correct breastfeeding position are important. 

3 When should I contact a midwife in the postpartum period? 

Midwives should be contacted immediately if you have any questions about postnatal recovery, pain, breastfeeding problems or emotional stress. Quick help is particularly important in the event of warning signs such as heavy bleeding or fever. 

4 What is the baby blues, and is it normal? 

The baby blues is a hormone-induced mood swing with sadness and exhaustion in the first few days after the birth. It is completely normal and usually temporary. 

5 How can I best organize the postpartum period? 

A deliberate rest period, support in the household, good nutrition and patient handling of the baby are important factors. Planned visits and emotional support also help.