Episode 6 Coffee Chats: Katie Tesensky Conn, LMFT on couples and relationship therapy

In this episode of Coffee Chats, Sara talks with Katie Tesensky Conn, LMFT about her work as a couples therapist, why couples might consider going to therapy together and how it can be helpful, and offers her thoughts for practicing therapists considering working with couples.

Katie's client roster is full, but you can still reach out to her for resources and recommendations at Katie@RoomToBreatheChicago.Com

Resources mentioned in this episode:

Hold Me Tight by Sue Johnson
Come As You Are (book) by Emily Nagoski
Come As You Are (workbook) by Emily Nagoski
Eight Dates by John & Julie Gottman
We Can Do Hard Things (podcast) with Glennon Doyle

Interview transcript {edited for clarity}

Sara (she/her): Okay, we're here.

Katie (she/her): We're here.

Sara: Here with Katie Tesenskey. No. Katie Conn.

Katie: Yes, that is officially what it is. Yes.

Sara: We’re here with Katie Kahn, our couples therapist at Room to Breathe for, I’d say, 7 years.

Katie: I think it is. It's 7, yeah.

Sara: 7 years. 7 years! 

Katie: It doesn't feel like 7.

Sara: Because there's been many phases of that 7 years on both sides. All sides. Business, individual, me individual. But yeah, you are our LMFT who came 7 years ago, which would make that 2016. A lot has happened since 2016. 

Katie: Yes, yes. 

Sara: Your specialties are mainly couples. But you have seen families.

Katie: I’ve seen families, and individuals.

Sara: And you do see individuals. Obviously on relational stuff, and you do have quite the background in sex therapy - I would call it sex therapy. Or at least working with couples and intimacy and sex. 

Katie: Yes, yes, it comes up quite a bit.

Sara: Which is a beautiful thing. So yeah, that's like a really quick bio. But you're going to introduce yourself. And then we're gonna go from there.

Katie: Yes, so my name is Katie. I am a licensed marriage and family therapist.

Yes, I've been with Room to Breathe for 7 years, which is just wild to think about. But yeah, I work with a lot of couples, a lot of individuals. Yes, some families, some teenagers, too. But right, my degree is in marriage and family therapy. So couples work is sort of my bread and butter which I absolutely love. No day is the same. It definitely keeps me on my toes.

Yes, sex therapy, or just sex in general, intimacy, definitely comes up a lot as well as obviously communication issues, conflict resolution, trust, life transitions. Trying to think what else - those are probably the big ones. 

Sara: Separation? 

Katie: Yes, separation, right. Divorce. I'm sure I'm missing some. 

Sara: I feel like everything can fall into life transitions. 

Katie: Yes, I mean life itself is a transition every day. So!

Sara: Yes, but actually let's talk about that. Let's talk about your transitions. Because in 2016, when you started here you were also working at ComPsych.

Katie: Yes, I was working 2 jobs, and I had been doing that for quite some time. Which was exhausting, to say the least.

Yes, but I was working at a private practice, working at an employee assistance program. And probably did that for what? 5 months, maybe? Maybe less, maybe a little, I don't know, give or take. But then was able to finally make the jump to full time private practice at Room to Breathe. Yeah, and it was great. It's great. It was nerve racking. Don't get me wrong. Very nerve wracking, but really great. It helps too that I was able to get a lot of referrals from other clinicians at the practice, because obviously I see couples. So it's really nice when other people at the practice are able to refer their clients for couples, kind of keep everything under one roof which is just - it’s nice. It works out very well, for many reasons.

Sara: I mean - has there ever been a time where couples weren't knockin on your door?

Katie: No? 

Sara: Yeah.

Katie: Maybe early on. But I think…But no, I mean I still had couples then. 

Sara: Yeah. 

Katie: Yeah.

Sara: Yeah. Well. I mean, I don't know if you can speak to it. But is there anything that is like really obvious from 2016 to now in terms of your work as a clinician, or just how you approach work as a couple’s therapist?

Katie: Well, I think I've gotten - and this is good, I would hope this would happen to anybody -  much more confident, working with couples -

Sara: Sure, absolutely.

Katie: And working with, right, like challenging conversations that, I mean, are on or about sex, even like finances. Boundaries with family members. That's another topic that comes up a lot of, you know, how to manage relationships with parents, inlaws, siblings, things like that. But I think trying to like answer your question more specifically. I mean, I've done a lot of my own kind of personal work. I could, I guess you could say, on learning more about emotionally focused therapy, which is to Johnson's theoretical model, which always, I mean, even in grad school, really resonated with me. So that has been super helpful just for, I think, how I work with couples and approach the therapeutic relationship, I guess you could say, but of course I kind of like, put some twists on it myself.

Sara: Totally. Yeah.

Katie: To make it more me. 

Sara: Yeah, well, I mean, I'm always fascinated by couples work, because obviously I'm just an individual therapist. Just a lowly individual therapist. That sends you couples! 

But I always think the most fascinating part of couples work, and I think of therapy in general is, people come in with what they think is the problem, and the problem is usually something else.

Katie: Yes, I mean a lot of things -

Sara: Or something different in terms of something bigger than what they think the problem is.

Katie: Yes. Well, a lot of people will come in saying, like, “We argue a lot.” or “We don't-” I don't know, “we don't see eye to eye.” Okay, which, that's a fine description. But - really hearing it from my couples therapist brain, it doesn't tell me a whole lot. Because in some ways it's like, okay, right. You're an average couple. It's not. I mean - we all fight with our spouses, our significant others like, no relationship is perfect. 

So let's say a couple comes in saying that. I kind of have to be a little bit of a detective in a way to figure out what – not only what is contributing to that, but also to your point, what are the underlying things that are going on that maybe are not being said initially, and also may not being said between partners too.

Sara: Sure, or not even in awareness. 

Katie: Right right right, and then that I mean…that could be anything.

Sara: But I think one of the biggest things that keeps couples from therapy is like. Who is the problem in the relationship?

Katie: Yes, people tend to want to point fingers a little bit. 

Sara: Yeah.

Katie: And it's also hard to like, sit in your own stuff, like your own emotional stuff. I mean, that's hard and humbling and difficult, and I always tell my couples initially when we're starting out like, I realize how difficult this is. I realize how difficult it is to sit on the couch. Bear kind of everything to someone that initially you don't know very well.

Sara: Yeah.

Katie: And usually people tend to…It's like a little bit of a collective sigh, because it is hard. And I'm asking difficult questions, but I try not to…I try to at least keep the first few sessions like a little bit more general, just as a getting to, and I mean I think all therapists do that, just a getting to know one another. But with couples it's just - I think it's harder because you're like, oh. This person is going to see all of the inner workings of our relationship, and that is anxiety inducing.

Sara: Yeah. So how do you level the playing field? Because it is a playing field with couples, I think sometimes, especially when they're coming in in the beginning with like, there's a problem that we need to fix.

Katie: Right, right, right. I mean, I will try and level set the best that I can. Most often just saying, you know, there may be times where questions will be more pointed to one person versus the other. It may feel skewed at certain points, but I'm just trying to get up to speed. I'm just meeting you two. I don't know… I don't know what I don't know. So I'm gonna ask questions. I'm gonna pause you. I'm going to say stop. I'm going to interrupt. I'm going to probably be slightly annoying about it. But I need to, like, catch up in a way.

Sara: Yeah. What gets in the way of that?

Katie: Well, if people aren't necessarily familiar with therapy, sometimes that can be a challenge. Also certainly, if people don't want to be there, kind of been forced or strongly encouraged to go. And just, I think, like general openness, sometimes people are really closed off, but I have to say, for the majority of people, are at least wanting to get something out of the process and wanting to, I don't know, like kind of put their best foot forward and make sure that they're getting what they want out of it.

Sara: Totally. So what are things that you could speak to for…let’s speak first to the couples out there, or the individuals out there in relationships. That…because I think one big myth of couples therapy is like if you're going to couples therapy, this isn't a good relationship.

Katie: Yes. yes.

Sara: So you might as well call the relationship off. Then you don't just spend the time and the money with a couples therapist. 

Katie: Yes, yes.

Sara: Is that true?

Katie: My opinion is that a lot of people who get to that, or to have that mind mindset of, “Oh, we go to see a couple of therapists when things are really bad” is actually detrimental over all, because I'm of the opinion that a lot of things can be done, I guess, more proactively to then prevent. 

Sara: “Preventative care.”

Katie: No, yeah, it is preventative care. But, as I said earlier, I mean, no relationship is perfect. And I mean, you're going to argue, you're going to fight. But how is anybody doing that in a productive, healthy way, knowing that - Okay, it isn’t, I don't know, our relationship is not doomed if we have a really big argument. This is how we recover. This is how we repair from those more challenging moments. Because I think a lot of people who do think that, “Right, we'll go. We go to couples when things are really bad.” It's just a lot harder to work with, because you may be kind of set in your ways a little bit, and more damage may have been done. Essentially. It might, it may be much harder to get to that repair/recovery if it's been years and years of resentment in the making between.

Sara: Well, I think it’s the same with individual like, “Oh, I can't go see the therapist. That means I'm crazy.”

Katie: Right, right. 

Sara: But repair. If you want to repair something. Then you can go repair it.

Katie: Right, right.

Sara: So, is it ever too late to see a couple’s therapist?

Katie: No, it's never too late.

Sara: Yeah.

Katie: It also - caveat with this - but like, it may not be too early, though, too. Granted it's like, okay, right. If we've been dating for a week. You're not gonna see a couples therapist, but if you - and this is kind of where some of the life transition topics come in. Yes, where it's - okay, we're thinking about moving in together. That's a great time to come in. Your relationship… I mean, people just may be excited about it. That's great. But this is taking, in my opinion, taking the relationship a step further. There's another level of commitment that's happening, and it's sometimes helpful to talk through in some ways like, okay? Well, how are you joining? I mean, there's financial component here. 

Sara: How are you sharing?

Katie: Right. How are you sharing? How are you - this is a big one that comes up - how are you making decisions together?

Sara: Hmm.

Katie: How are you communicating in a way that is collaborative so that you, you know, you both feel like your voices are heard and understood by the other person. This also comes up with people who are newly engaged, or even people who are newly married. Thinking of having kids, even making big financial decisions, of buying a house, or moving out of state, things like that where it can be, everything could be perfectly fine, and the relationship feels good, and we're committed. And yet it's sometimes nice to talk about these things with a third party.

Sara: Yeah. But then also the case of like, I don't know, we're healing generations, right, starting with like GenX on, I feel like. I mean, I love the baby boomers that are in therapy, too. And healing. And then also being in relationship with somebody else who's either healing newly, not healed/healing yet doesn't even know it looks like, right, stages of change, wherever you want to put them.

Katie: Yeah.

Sara: That's where I see couples therapists being so important because you're also sharing a space with somebody that has reactions and…

Katie: Yes.

Sara: …life that they're living outside of just inside the 4 walls that you're living with them, or inside the table you're at while you're dating. And how are you navigating political stuff, financial stuff, like all the economical things? So yeah, whether it's, maybe it's not ever too late, but in terms of too early I think there are a lot of fears or doubts around, “How do I bring this up with my partner that I wanna go see a couples therapist?” 

Katie: Right, because it goes back to what you said before, I think still, of that stigma of like - Oh, you want to go to couples therapy? That must mean something's wrong, or that must mean you're unhappy, or you want to break up, or something of that sort.

Sara: Or you have a big secret that you don't know how to share with me. 

Katie: Yes, yes.

Sara: Which is also a great reason to go to couples therapy!

Katie: Right, right. 

Sara: But yeah, I guess that kind of gets into then…it has been a - is it a barrier? Yeah, a barrier of entry for clients in the past to get into couples therapy because their partner doesn't want to do individual therapy. And ideally you have both partners in therapy.

Katie: Right, right, I think, for some…and granted I am always very…sounds so nerdy, but very excited when I have a couple, and both partners are in therapy. It's like - great! 

Sara: It’s a luxury. 

Katie: Yeah, exactly like you sort of know the individual therapeutic lay of the land, great. We can really dive in there and get some good work done. Not to say that you can't. I mean, obviously, you can do that with people who have not been in therapy before, but it's a little bit different, because there, as I said earlier, there may be some nervousness around it, there may be some kind of guarded uncertainty of how this is gonna go. Also too, how introspective has someone been about their own emotions? Their upbringing, different traumas, little t traumas that have happened, or big T Traumas where it's just like, oh, yeah, this impacted me in this way, and this is also how I’m carrying this with me throughout my life. So it's definitely helpful when people are in individual therapy, too. And oftentimes there comes a point where it's actually helpful, I mean so helpful, for the couples work to also have the individual space to not only process what's happening in couples, but I mean hopefully through couples therapy you're growing, you're changing both within the context of your relationship. But as an individual, too. And sometimes it's nice to have a space to process all of that.

Sara: Yeah.

Katie: Because couples, an hour goes by really fast.

Sara: Sure does. Yeah. And sometimes it has to be focused on one individual in the hour, especially if they're not in individual therapy. But then I think it's also important to talk about like equity, and some folks are coming to couples therapy and they get to, because their partner has insurance.

Katie: Yes.

Sara: And they can't, because they don't have insurance. So I think that's where we have to be mindful. But I think you do a good job at having resources to give couples. So like, in that case how do you help that individual navigate healing and getting, you know, the help or the space they need?

Katie: Mhmm. Well, I certainly…if therapy is accessible. Then I will, I mean, I have a pretty large network of people that I can reach out to, that, as you know, like all different kinds of specialties, too. So that is nice. If therapy isn't accessible…I mean still, even, I know other clinicians at different practices, but who have clinicians that can see folks at a sliding scale. Right? I mean. So it's still very possible, even if, again, financially insurance-wise, it doesn't seem accessible. It may be. Even if it’s not…

Sara: Well, it's also that conversation of finances, too, of like - well, what are we spending money on?

Katie: Yes, that is always a big one that comes up because everybody has their own relationship with money. 

Sara: Yeah.

Katie: It is oftentimes quite different from their partner.

Sara: Yeah.

Katie: Yeah. But there's -  and to go back to the accessibility piece - there's also so many groups, support groups, different…again, kind of even like different, like books and podcasts and things like that that I think, are also I mean so much more accessible, obviously, but also so much…I don't know. There's so many of them which is a wonderful, great thing. So it's like. If I recommend one, that it's not your cup of tea, we can find another one, too.

Sara: Yeah, which it then speaks to how hard it can be to be in couples therapy and be on the same schedule and figure it all out. 

Katie: Yes, yes, but that's I think, I don't know, in some ways kind of laying down the groundwork and foundation at the beginning of like, hey okay, what is it that you both really want to work on? And you know, kind of…

Sara: …the intention all about?

Katie: Yeah. Yeah, exactly. Exactly.

Sara: Okay. So not just couples. You also do other relationship work. So what would you say is like a big - outside of intimate relationships - a big relationship thing that comes up in your work? Is it friendships? Is it colleagues? Is it family?

Katie: I mean, I would say it's a lot of…I mean definitely some friendships. But something that comes to mind is the relationships that adults have with their parents. So adult children have with their parents. 

Sara: Adult children, yes.

Katie: Yes, that comes up, I mean certainly comes up with couples, but comes up a lot with the individuals that I work with, too. That can be difficult to navigate. Especially going back to the life transitions thing of - okay. I just got married. How do I begin to, in a very natural, healthy way, prioritize my family that I'm building, and not be so connected to my parents or to siblings. It can be, yeah, that can be very difficult to navigate. It also comes up then too if a couple decides to have children. And that's where boundary work can be very, very important and necessary.

Sara: Yeah. But you are speaking to something that I think is not newer, but louder, in the space of adult children and kind of something I alluded to before, like we're all on these healing journeys, and we're like very intentional about healing, “we” as these generations, right, and a lot of our parents are not, or they're very offended by our healing journey.

Katie: Yes, or it brings up a lot within them about - oh, what do you need to heal from? What does that mean about me as a parent and all that?

Sara: Yeah. So is that coming up a lot with your - I mean with individuals and couples, perhaps? 

Katie: Yeah, I don't know I wouldn't say it comes up a lot, but it comes up frequent enough where it is, you know, kind of figuring out: okay, what would you like the relationship to look like given…I don't know, like given the circumstances that are at play right now. Because I always want to give people, especially I mean, if I'm seeing someone individually, and we're talking about their mother. I don't know their mother. I'm not gonna know their mother. But knowing, you know, trying to hold space for okay, this is still a human being. They're still capable of growth and change, and all those good things. And yet if the relationship is going to stay as it is right now, what can a client do to kind of work within those parameters.

Sara: Right and protect themselves almost.

Katie: Yeah. Right. Right right. But it is I think a, I don't know, kind of newer I suppose topic, where some older generations may be, may not necessarily understand it. So that's also too kind of a challenge in and of itself. And then you know, of course, like any cultural differences that may not be as independent. That can be just another thing to kind of keep in mind as you're working on some of this boundary stuff, too.

Sara: Right which I also is like, I think, where grief comes in.

Katie: Yeah.

Sara: And I think you as a couples therapist, support people in grief more than just the like grieving the loss in terms of the way we typically think of grief, 

Katie: Right, right. Yes, because it's the loss of essentially what I thought this was going to be, or what I thought this would look like.

Sara: Yeah. And hopefully, I'm not changing the subject too much. But for some reason it just brings up like grief of what I thought love was.

Katie: Yeah. yeah.

Sara: And losing something because I didn't realize that wasn't the love that I needed, or the love I deserved, and the love that was love for me.

Katie: Yes, well, and that gets into what I call, and I referenced it before. But some of like some of the little t traumas that can happen throughout someone's life where, no, they didn't lose a limb. But there are emotional wounds. That maybe have been repaired. But also maybe haven't.

Sara: Or can't be. In their own control or their own capacity.

Katie: Right. Which to your point there's a loss.

Sara: Which brings me to your good old “Yoga for a Broken Heart.” 

Katie: Ah. Yes, yes.

Sara: Because I can't talk to you about grief without thinking of that lovely program that you and Serena did. But something to speak to about it is how do you feel you've incorporated somatics work, or encouraged folks towards that in your practice, because I think that's so huge. Especially maybe you can speak to some of like the integration with the intimacy work, and sex work and being in bodies.

Katie: Yeah, yes, that's exactly where my mind went to. I mean. Certainly I will have individuals go to yoga classes, or we'll even do a meditation in a session. But right when it comes to couples work it's very much: okay. I mean so much of our life is top down. How are we incorporating a bottom up approach to include everything that is happening here below. And when it comes to relationships, I mean, physical touch is a big part of them. 

Sara: Yeah.

Katie: And a lot of people have a lot of thoughts and feelings about physical touch, too. So not only is it exploring what those thoughts and feelings are from a cognitive perspective. But it's also okay. What does this actually look like in your day to day life? Are you touching one another? Are you kissing, are you, I don't know, sitting next to one another on the couch while you watch Ted lasso? Yes… and all of those things don't have to necessarily lead to sex. They can just be - this is how I'm enjoying your company right now. This is how I’m showing you some affection because I love and care about you.

Sara: Right. Or showing myself affection because I love and care about myself.

Katie: Mhmm. Yeah. 

Sara: Which is huge. Yeah, and it makes me think of…I mean some of our yoga teachers are very well trained in like, self touch and self massage, which I think is huge in that sense, but also just like being able to sit and experience in a moment with the therapist and be really uncomfortable in it. 

Katie: Yes, yes, I mean there have been times where I have told the couples, “Okay. Turn towards one, you know, physically towards one another. Grab the other person's hand, look them in the eyes. Tell them what you just told me.” Essentially. Because so often people are just talking straight forward.

Sara: Especially now that you’re in a box. On a screen. 

Katie: Exactly exactly. But it's powerful. Granted, people say they're a little uncomfortable, because I'm watching them. But it's powerful, and so often that's what a lot of people are looking for, even if physical touch is not one of their top love languages, too.

Sara: Or needs.

Katie: Yeah.

Sara: Or things they haven't been able to work through in their own healing journey. 

Katie: Yeah. But it's helpful.

Sara: So much.

Katie: I know. Couples work is so dynamic and complex and wonderful and beautiful. I just love it. 

Sara: I know. So now I want you to speak to clinicians, because I can't not speak to the fact that being, I mean for you, being a full couples therapist, meaning you have no space in your schedule. You've had many times where you've had no space in your schedule. We need more couples therapists. We need more therapists willing to see couples.

Katie: Yes, yes.

Sara: What's one thing you would want people to know with your 7 years of experience, of seeing couples and your I don't know how many years of training, I mean at least like 2 and a half 3, solid years of like straight licensed marriage and family therapist training.

What do you have to say to the clinicians that's like, I want to see couples because I love relational work, but holding space for 2 people feels like a lot.

Katie: Well. Start small. Start with one.

Sara: Okay. Start with one couple.

Katie: Also too maybe even before that take a training. Talk to other people. Talk to or or just get some consultation, peer support from a couples therapist. Because that's something, certainly, that I did early in my career was like, hey, I am in this field - also was looking for a job, too. But like I wanted to be able to -

Sara: Where are my people at?

Katie: Yeah, I wanted to be able to network and to learn and to kind of utilize the people like these other clinicians that have been doing this work for a bit to be like, hey? Can I pick your brain for a little bit, because I think it is having that -  and I'm biased because this is important to me - but having that type of peer support is really important, and I think is especially important if you're wanting to kind of dip your toe in the couples pond but may be nervous about it, or right, scared, or you know there's some type of barrier. But there's - I mean certainly me! You can contact me. I'm happy to support people in that way, because it is, I mean, I don't know, with pandemic, economy, political, like all of these things, more and more people are seeking out couples therapy. And it's great. We just have to be able to provide the support for it. 

Sara: Yeah, for sure.

Okay. One last thing that I want you to leave us with for the couples or the individuals out there that are looking for resources before going to couples therapy. Name a few. I won’t give you a number. 

Katie: But you mean books, podcasts, things like that? 

Sara: Books, podcasts.

Katie: Well, you probably know of some of them.

Sara: I know some of them.

Katie: “Hold Me Tight” by Sue Johnson. It is amazing. I've read it several times. I've read it several times with couples. It's very accessible. There's different exercises. Case studies in there. Also, like, she's pretty funny, too, so that helps.

So that's more so just for, like, general I want to enrich or strengthen my relationship. Or we had this big thing that happened. How do we repair? That book is great for that.

For sex specific topics, “Come As You Are”.

Sara: And the workbook.

Katie: And the workbook! The workbook is great. Some of it does overlap, but the workbook is great. If you're not necessarily a reader you can get by with just the workbook. But highly recommend the book. 

Sara: Or listen to it. 

Katie: Yes, or listen to it. Looking at my bookshelf right here. Oh, another thing to strengthen your relationship and do it in a kind of fun, maybe…I mean it's not non traditional, but “Eight Dates” by John and Julie Gottman and Doug Abrams and Rachel Carlton Abrams. This book is really great, because they lay out 8 dates for you and your partner to go on, and it's all kinds of questions to ask. I mean it's it's a little…you have to do some work ahead of time, but it's really great, because it will give you a lot of more pointed questions, because a lot of times people will say, okay, we go on date night, but we just talk about our jobs, or the kids, or I don't know, surface level stuff. This book is going to get you diving a little bit deeper into things.

Sara: Cool.

Katie: Also too, Glenn Doyle. Podcast things. And now the name is completely…

Sara: “We Can Do Hard Things”. You can do hard things.

Katie: We can all do hard things. They…well, that's not always focused on couples, but the ones that I have listened to that are on couples are amazing so.

Sara: Or even their own relationship I think they talk about.

Katie: Yeah.

Sara: Well, thank you.

Katie: You are welcome.

Sara: This was fun. We'll try to get those resources from you, too. Just so that we can write them out.

Yeah, you're lovely and refreshing, and then people want to get in touch with you, they can even though you’re full.

Katie: I'm not accepting any new clients. But I am here for resources for couples or individuals. I can also help make some good referrals too, and certainly for other clinicians, too. If you're interested in couples work and want to know more feel free to reach out too.

Sara: Yeah, okay, you're the best.

Katie: Thanks.