Most couples who call me still care about each other. They have gotten stuck somewhere, and the conversations that used to fix things have stopped working.
I'm Dr. Elissa Hurand, a licensed psychotherapist with a PhD in clinical psychology. I provide couples therapy and marriage counseling at my office in Ballard and by video for couples anywhere in Washington or California. My work is attachment-based and trauma-informed, which means we spend most of our time on what is going on underneath the arguments.
If the two of you have been circling the same problem for months, or have tried couples counseling before and came away feeling like nothing really shifted, I'd like to hear what that was like. A complimentary 20-minute call is a low-stakes place to start: you can ask how I work, tell me what has and has not helped, and go from there.
Couples Therapy & Marriage Counseling in Ballard, Seattle
Signs it may be time for couples therapy
You don't have to be in crisis to start couples therapy. These are the patterns couples most often describe when they first reach out.
Same Fights
The same fight keeps coming back in different forms. The dishes, the calendar, money, sex, the in-laws. It never gets settled.
Damaged Trust
Trust has been damaged, whether by an affair, a secret, or a long run of small letdowns, and you don't know how to repair it.
Feeling Alone
One of you wants to talk it through and the other goes quiet or leaves the room. Afterward you both feel alone.
Intimacy Issues
Physical or emotional intimacy has faded and it feels risky to bring up.
Feeling Like Roommates
You feel more like roommates or co-parents than partners.
Big Changes Have Happened
A new baby, a move, a job change or a death has changed the relationship and you have not caught up to it yet.
If some of this sounds familiar, you are probably caught in a pattern. That is different from being in a bad relationship. Patterns like this are hard to see from the inside and very hard to change without help.
How I work with couples
Most couples can predict how a fight will go before it starts. What is harder to see is why the pattern has so much pull. In couples therapy the topic on the surface is usually less important than whether each person feels safe with the other and able to reach them when it counts.
My training is in attachment-focused and experiential therapy. That includes the Masterson Institute's work on attachment and neurobiology, Accelerated Experiential Dynamic Psychotherapy (AEDP), and Somatic Experiencing. In couples sessions, that training shows up in a few ways.
We slow the cycle down. We name the pattern you fall into, who pursues, who pulls back, and what each of you is protecting. Once you can both see it, it becomes something you can work on together.
We get to the feeling under the reaction. Anger, defensiveness and shutting down usually cover something more vulnerable, like the fear of not mattering, of being controlled, or of being left. When one partner can say that plainly and the other can take it in, the conversation changes.
We pay attention to the body. Conflict is physical. Part of the work is noticing when one of you has gone into fight, flight or freeze, and learning to settle enough to stay present with each other.
We look at what each of you brought in. Early relationships, past partners and old injuries shape how you handle closeness and conflict now. Understanding that with some compassion lets couples stop taking each other's reactions so personally.
I welcome couples of all orientations and relationship structures, including LGBTQ+ couples.
Trauma-informed couples therapy
When one or both partners carry trauma, from childhood, a past relationship or something more recent, it shows up in the relationship in ways that are easy to misread. A partner who shuts down during conflict may be protecting themselves. A partner who needs a lot of reassurance may be reacting to an old fear of being abandoned. Neither of those is about the person in front of them.
A large part of my individual practice is trauma treatment, including EMDR, Somatic Experiencing and Cognitive Processing Therapy. I bring that experience into couples work so trauma responses get recognized for what they are, and so both partners learn how to help each other settle instead of escalate.
Premarital counseling
You do not need a problem to benefit from premarital counseling. Couples who are engaged, moving in together or making a deeper commitment often find it is the best time to do this kind of work, before patterns harden and before the stakes go up.
Premarital sessions give you a structured place to talk about the things that are easy to skip while you are planning a wedding: how you each handle conflict, money and household roles, sex and intimacy, family involvement, faith and values, whether and how you want to raise children, and what commitment means to each of you. The point is to walk in with a clear picture of each other's expectations and to have practiced the hard conversations at least once already.
What to expect
We start with a free 20-minute phone or video consultation. You can ask questions and get a sense of whether I am a good fit. Fit matters a great deal in therapy, and I would rather you find that out before you invest.
In the first sessions we go over your relationship's history, what brought you in now, and what each of you wants to be different. I will want to hear from both of you, together and sometimes one at a time.
Most couples begin weekly. We revisit that as you make progress, and we talk openly about duration and estimated total cost at the start and along the way.
Sessions are in person at 5306 Ballard Ave NW in Seattle, or by secure telehealth for couples anywhere in Washington or California State. Partners can join from the same room or from separate locations.
Fees and insurance
Couples therapy sessions are $250 for 50 minutes. Payment is due at each session by credit, debit or HSA/FSA card, and a card is kept on file.
I am an out-of-network provider. After each session I provide a superbill you can submit to your insurance for possible reimbursement, and many PPO plans cover a meaningful portion of out-of-network mental health care. Insurers usually only reimburse couples work when it is billed under one partner's diagnosis, so it is worth calling your plan and asking specifically about couples or family therapy. HSA and FSA funds can be used directly.
Frequently Asked Questions
Is couples therapy worth it?
It is when both of you are willing to show up and be honest, including about your own part in the pattern. It does not go well when the goal is to have a referee declare one of you right. If you are unsure whether therapy fits your situation, the free consultation is a good place to ask me directly.
What kind of therapist should we see for couples work?
Look for someone with clinical training in attachment and relationships who is licensed in Washington and can explain plainly how they work. I am a licensed psychotherapist (PhD in clinical psychology, LMHC, LPCC) with attachment-focused and trauma-specialized training. If we are not the right fit, I will tell you and help you find someone who is.
How long does couples therapy take?
It depends on what you are working on. A couple coming in to strengthen a solid relationship or to prepare for marriage may only need a handful of sessions. A couple rebuilding after a betrayal will need longer. We set expectations at the start and check in on them as we go.
What if my partner does not want to come?
It is common for one partner to be more ready than the other. You are welcome to start with an individual consultation, and I can also work with you one-on-one on your side of the relationship. Sometimes that is what makes it feel safe enough for a partner to join later.
Do you offer online couples therapy?
Yes. I see couples by secure video anywhere in Washington & California State, and in person in Ballard.
Do you work with LGBTQ+ couples?
Yes. I welcome couples of all orientations, genders and relationship structures.
How early should we start premarital counseling?
Earlier is better than the month before the wedding. Couples who start several months out have room to work through what comes up instead of rushing it.