Meet Dr. Megan Keyes

What Brings Couples to Therapy

Couples seek therapy for various reasons, and understanding these common challenges can help you see that you’re not alone in your struggles. Here are some of the most frequent issues couples face:

• Recurring arguments that never seem to get resolved. Many couples find themselves caught in a cycle of arguments over the same issues, whether it’s about household chores, communication styles, or differing priorities. These unresolved conflicts can lead to frustration and resentment, making it difficult to feel connected. Therapy can provide a safe space to explore the underlying issues behind these arguments and teach effective conflict resolution strategies, allowing couples to communicate more openly and constructively.
• Emotional or sexual disconnection from one another. Over time, many couples experience a decline in emotional intimacy or sexual connection. This disconnection can stem from various factors, such as stress, life changes, aging and evolving biology, or unresolved conflicts. Couples may begin to feel like roommates rather than partners. Therapy can help partners reconnect by fostering open communication about their feelings, desires, and needs, ultimately reigniting the emotional and physical connection they once shared.

• Rebuilding trust after a betrayal. Trust is fundamental to any healthy relationship, and a betrayal—whether it’s infidelity or a breach of confidence—can deeply damage that trust. Couples often struggle with feelings of hurt, anger, and confusion after a betrayal. Therapy provides a supportive environment to address these feelings and work toward rebuilding trust. Through guided discussions and exercises, couples can learn how to communicate effectively, express their emotions, and establish new boundaries and commitments for the future.
• Struggles with parenting, finances, or significant life changes. Parenting can be one of the most rewarding yet challenging aspects of a relationship. Couples often face disagreements on parenting styles, discipline, or balancing responsibilities. Similarly, financial stress can create tension, leading to arguments about spending habits, saving, or financial goals. Significant life changes, such as job transitions, moving, or caring for aging parents, can also impact a couple’s dynamic. Therapy can help couples navigate these challenges by enhancing their communication skills, fostering teamwork, and finding shared solutions that honor both partners’ perspectives.
• Feeling unheard, unappreciated, or overwhelmed. Many couples experience feelings of being unheard or unappreciated in their relationship, leading to frustration and emotional distance. One partner may feel that their needs or contributions are overlooked, while the other may feel overwhelmed by the demands of daily life. Therapy can help partners learn to express their feelings and needs more effectively, promoting a deeper understanding and appreciation of one another. By creating a space for both partners to share their experiences, couples can foster a more supportive and understanding relationship.

• Infertility or disagreements about starting or expanding a family. The journey to parenthood can be fraught with challenges, especially for couples facing infertility or differing desires about having children. These situations can lead to feelings of grief, frustration, and isolation. Additionally, disagreements about family planning—such as when to start a family or how many children to have—can create tension. Therapy can provide a supportive environment for couples to explore their feelings about parenthood, work through their differences, and develop a shared vision for their family’s future.
• Discernment counseling for couples unsure about their future together. For couples who are at a crossroads in their relationship, discernment counseling offers a space to explore their feelings and options without the pressure of deciding immediately. This type of counseling allows each partner to express their thoughts on the relationship, understand their individual needs, and consider whether they want to work toward reconciliation or if separation is the right path. Therapists guide couples through this process, helping them gain clarity and confidence in their decisions.
• Navigating divorce peacefully and respectfully when the decision has been made. When couples decide to divorce, it can be an emotionally charged and difficult process. Therapy can assist couples in navigating the complexities of separation while prioritizing mutual respect and understanding. This approach encourages open communication about the divorce process, co-parenting arrangements, and emotional support, helping couples minimize conflict and foster a more amicable transition. Therapy can provide the tools to cope with the emotional fallout and establish a foundation for healthier interactions moving forward.

Neurodivergent Couples Therapy

One of Dr. Keyes' niche areas of expertise is working with couples where either one or both partners are neurodivergent. Neurodivergence can encompass a range of conditions, including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), dyslexia, and others. Navigating a relationship in which one or both partners are neurodivergent can present unique challenges, as differing neurotypes may lead to misunderstandings, communication barriers, and differing emotional responses.

Challenges Faced by Neurodivergent Couples

• Communication Styles: Neurodivergent individuals may have different communication styles than their neurotypical partners. For example, someone on the autism spectrum may struggle with interpreting nonverbal cues, leading to misunderstandings in conversations. Conversely, a partner with ADHD might have difficulty staying focused during discussions, which can frustrate a neurotypical partner. These differing styles can create a communication gap that, if unaddressed, can lead to frustration and conflict.
• Sensory Sensitivities: Many neurodivergent individuals experience sensory sensitivities that can influence their daily interactions. For example, a partner with sensory processing issues may find certain environments overwhelming, which can affect their mood and ability to engage in shared activities. This can lead to feelings of isolation or resentment if the other partner does not understand these challenges.
• Emotional Regulation: Neurodivergent individuals may face difficulties with emotional regulation, which can impact the relationship dynamic. For instance, someone with ADHD might react impulsively or struggle with rejection-sensitive dysphoria during conflicts, while a partner with autism may have challenges processing and expressing emotions. These differences can lead to heightened tensions and misunderstandings if not addressed in a supportive manner.
• Expectations and Misalignment: Neurodivergent couples often have differing expectations about social interactions, household responsibilities, and emotional needs. These misalignments can create friction, especially if one partner feels overwhelmed by the demands of the relationship or if their needs are not being met.

Limitations of Traditional Therapeutic Techniques

While many traditional therapeutic techniques have been shown to be effective in neurotypical couples, they often do not fully address the specific challenges faced by neurodivergent couples. Most research in couples therapy has focused on neurotypical dynamics, which may overlook the unique experiences and needs of neurodivergent individuals.

Traditional approaches to couples therapy do not account for the distinct communication styles, emotional processing differences, and sensory sensitivities of neurodivergent partners. As a result, neurodivergent couples may find that traditional therapeutic approaches do not fully resonate with their experiences, leading to frustration or a lack of progress.

Dr. Keyes recognizes these nuances and tailors her therapeutic approach to meet the needs of neurodivergent couples. By integrating neurodiversity-affirming practices into her sessions, she aims to create a supportive environment where both partners can feel understood and validated. This personalized approach helps couples build stronger connections and navigate their unique challenges, fostering healthier relationships that honor each partner's neurotype.