Couples therapy when the job takes everything.
For partners in tech, finance, law, medicine, and startups, where work has become the third person in the relationship.
What it looks like
Most couples who come to me aren't in crisis. They're two capable people who've been running the relationship like a logistics operation and can't remember the last conversation that wasn't about scheduling. Things I hear:
- You manage the household over text and haven't had a conversation that wasn't logistics in months.
- One of you is on call, or in a deal, or on service, and the other has stopped asking when it will end.
- The company, the fund, or the practice comes up in every argument, and neither of you can say that out loud.
- One of you got laid off, and the other is carrying it and doesn't know how to say that either.
- A relocation, a return-to-office mandate, or a new role is forcing a decision you keep postponing.
- Money is fine and still stressful, because equity, bonuses, and one large income make fairness hard to talk about.
- You're good at solving problems together and bad at being in the same room without one.
You don't have to be close to separating to come in. Plenty of couples start because things are fine and they'd like them to stay that way.
Why demanding careers strain a relationship in a particular way
A demanding job doesn't only take hours. It takes the best of your attention, and what's left for home is the tired, irritable version. Both of you know this, and neither of you can fix it by trying harder, which is what high performers do by default.
There's also the asymmetry. Often one career is louder than the other, and the quieter one adapts until it doesn't. Or both careers are loud, and the relationship gets handled in the gaps like a low-priority ticket.
I've spent years working with people in tech and other high-pressure fields individually. For the past two years I've also worked with couples as a small, deliberate part of my practice, with consultation from a couples specialist. I know these jobs from inside the room, so we can skip the part where you explain what a deal cycle or an on-call rotation does to a week.
How I work with couples
Sessions are 50 minutes with both of you, sometimes with a mix of joint and individual sessions when that helps. I draw on the same frameworks I use in individual work, with particular attention to how each of you ended up in the role you play in the relationship and whether you'd choose it.
Early sessions map what's happening: where the conflicts recur, what each of you does under pressure, and what the job has been standing in for. Then we work on the specific things, which for most couples means how you fight, how you decide, and how you get back to each other after a bad week.
I don't take sides, and I don't treat the career as the villain. The job is usually the easiest thing to blame and the hardest to change, and the work that helps is mostly elsewhere.
More About MePrivate, out of pocket, and simpler than the individual side.
I don't bill insurance, and for couples work that changes little, since most plans wouldn't cover it anyway. It also means neither of you ends up with a diagnosis on file. Nothing about your therapy reaches an insurer, an employer, or a background check. Sessions are $250 and HSA and FSA eligible.
In person in Midtown Manhattan, or by secure video from anywhere in New York State. See fees.
Questions people ask before reaching out
Usually not. Most plans don't reimburse couples work because there's no individual diagnosis to bill against, so couples therapy is generally paid out of pocket whoever you see. Sessions are $250 and HSA or FSA eligible. If your plan looks like an exception, I'll say so.
That's common. Often the hesitant partner is worried about being ganged up on, and the first session usually settles that. If your partner won't come at all, individual therapy focused on the relationship is still useful, and I do that too.
My couples work uses the same person-centered, cognitive-behavioral, and acceptance-based frameworks I use in individual therapy, applied to two people at once, with ongoing consultation from a couples specialist. If you're specifically looking for a Gottman or Emotionally Focused Therapy practitioner, tell me on the consultation call and I'll point you to one.