Geries Shaheen • May 13, 2017

Top 10 Couples Counseling Remarks

1) "It feels like we're roommates."
It's that feeling when you "just exist". When your identities become like two ships passing in the night. Sure you do your part; the chores, the wifely or husbandry duties, present with familiar responses and predictable retaliations. You become robotic. You become detached. When this happens and you have passed the threshold of detachment, it becomes easier to blame the other person. You may find yourself painting them in a darker light. Vilifying the individual becomes very easy.

Prompt : Considering you are aware of your portion, perhaps that is where you can start. Whether or not your partner is "just existing" or operating as a roommate does not mean you have to reciprocate. You are only responsible for your actions and reactions. The only thing you can truly control is your response to your environment.

2) "I cheated because my needs weren't being met."
Your needs are completely valid. Perhaps you have found yourself lost in the relationship, having to be left without fulfillment or satisfaction. You found yourself on a gradual path toward seeking to meet your needs elsewhere. While your needs are valid, at some point it causes pain for the other party. This leaves you taking on a role that is superior to your partner. It becomes a decision to split away from your commitment in order to have your own desires fulfilled. This also has left you, yourself, broken. A piece of you is now fractured considering you were willing to break a commitment. Much healing is required on both fronts and as a relational unit. The person who cheated requires healing, the person cheated against requires healing, the person cheated with requires healing, and the definition of the couple as a unit requires healing.

Prompt : Considering the past in now placed in a concrete and fixed position, we are not able to fully erase the occurrence. However, each person can focus on their process of healing, their own journey. At some point those two paths will merge back to one if truly desired. It may be beneficial to start off with an agreed decision, a solid rock decision of what each person truly wants or needs at this point. From there the message will be clear, and you can better focus on the method of those roads toward healing.

3) "He/ She always sides with the kids!"
If the mentality has now become so two sided that kids are thought of as a source of negativity, it may be time to take a step back and restructure your perspective. You are lying to yourself if you believe there are sides to chose from. This is usually a primitive response associated with blame. We begin to believe that there absolutely must exist a scapegoat in order for our feelings to be justified or considered. People tend to find the most vulnerable placeholder to target. When we point to innocence as being the scapegoat to our problems, rather than take ownership of our portion, we in turn became the very children we are blaming.

Prompt : If you find yourself saying something like "You always side with the children, you never consider me." perhaps look in a mirror for a few minutes and really think about what you are saying. After you have done so, start your conversation with your partner over again with something like "I often do not feel heard which in turn makes me feel unloved. Can you help me understand if this is true.". Use big people words, not grunts, huffs and puffs.

4) "I am not given opportunities to lead/ He is not leading me."
So you have found yourself not being given ample opportunities to take charge! Or perhaps the opposite, you are not feeling led. First question to ask yourself, "Have I made it clear that I desire to lead?", or " Have I made it clear I require leadership?". If not, perhaps what you are truly experiencing is a communication breakdown due to passivity rather than a deep desire to lead/ be led. The first step in either desire is to be courageous enough and humble enough to do something about it. The trick then becomes to merge courage and humility within the confines of your unique couple dynamic/ relationship.

Prompt : Begin by sifting through all the emotive words you have stored within yourself. Express them. Next sit down and jot out your identified fears and develop boundaries from those fears. This draft will be your charter within your relationship. A role identifier.


5) "I have lost my identity. I don't know who I am anymore"
Years can pass in what seems like days. One day you are at the wedding alter or on your first date, the next you find yourself 10 years into a relationship forgetting why you are even in love with that person. It happens. We tend to gravitate to the routine, the familiar. We end up floating down the river of life and finding ourselves operating on autopilot. We slowly and gradually lose pieces of ourselves. It becomes harder to remember, embody, and live out our true identities.

Prompt : Reflect on what parts of your life are Anchors. Those things that keep you grounded. The ultimate truths about your self that provide bumpers for who you are and who you are not. Not sure if you have those things? Then start developing them now and put them into practice! Slowly but surely a new structure to your identity will begin to solidify.

6) "This is our last resort before divorce."

So you have tried everything. You have run out of options. All is futile. Yes I believe that you have put in a great deal of effort and time in figuring things out. However, the first step is to truly decide to either be fully committed, or not. You can not begin walking down a road you haven't decided on. Many desire to walk a road and be effected by external factors. Treating external factors as indicators or evidences to validate their decision. The opposite is more beneficial.

Prompt : Make a committed decision, one road or the other, and have that decision impact the external factors rather than having the external factors impact you. You have to know the foundation rock on which you stand in order to make that initial decision. If you can't make one, then perhaps you must dig deeper and fully understand your identity before making a life altering decision.

7) "He/ She is always on their phone."

Tools can be used to create and destroy. What more powerful tool than your phone. It transcends individuals to a place of power. Individuals become omnipresent. With a skype, or google hangouts call you can be in multiple places at once. Individuals become sovereign entities, having full control over their online domains. With the ability to control who engages with them and what is being discussed. Individuals become imminent, actively and immediately engaging with their social circles. Individuals become semi omnipotent, being able to make things happen, will their realities. They increase in omniscience, googling just about any question they may have. Gradually finding our identity in these god like attributes can leave people chasing after the wind.

Prompt : Work on finding a balance in life. Draw or write out your spheres of influence. How and where do you devote your time? Technology is not a "bad" thing. It is incredible! But what is more incredible is the person siting right next you, looking down at their screen. What does finding a balance in life look like? I'll give you a hint. It has less to do with screen time and more to do with physical face time.

8) "I don't trust him/ her. "

Trust is the hardest thing to build. It takes so much effort and time. It can quickly be destroyed. You don't want to be "walked all over" but you also understand the other person's struggles. You have positioned yourself to give half of yourself, knowing at any given time you could pull away and be fully broken. So much effort for something that is a facade of trust. If you think about it, all the work and effort that is placed in NOT trusting someone, could be calibrated to begin a path ending in trust. Because we are human and require visual stimulus to engage our mind and our heart, we tend to desire evidence for change. We want enough evidence of non painful experience to overshadow the past or potential pitfalls.

Prompt : Instead of being half in half out, mentally decide one or the other for a short while. Test drive your emotions and see how you respond. Does giving the cold shoulder actually get you the healing you desire? Does engaging in sex with your partner alleviate the pain? More often than not, the story is deeper than that. Develop opportunities of evidences. Structure your relationship to intentionally include moments of trust building. At the end of the day trust is a mix of chemical and spiritual ingredients. Start writing the cookbook to your relationship.

9) "How do I know they wont hurt me again? "

The short answer to this is that you wont. You wont know if your husband, boyfriend, girlfriend, father, mother, sister, uncle, wont hurt you again. You will never know how external factors and variable will operate because we truly do not have full control over those factors. The only true factor we have control over is our self, our responses, our minds. Not knowing if you will get hurt again places you in a nebulous and fearful position. You begin to live in the unknown and paranoia may kick in. Anxiety will increase, and you will feel debilitated. Not a very healthy quality of life.

Prompt : Don't live in fear. Live in truth. It can be easy to allow others to structure your responses. Allowing someone's actions, or your past hurts to control your current and future reality strips you of your dignity. It makes something else in control of you. You no longer become autonomous. Rid yourself of this mentality. Don't feel safe? Seek safety. Don't feel heard? Be heard. Don't feel accepted? Dialogue through the why. If it's too much for that someone to accept you and love you, then find acceptance elsewhere. You are too valuable and precious to live any moment of your life in fear.

10) "This experience has been helpful. Not horrible, or amazing, but beneficial."

Experience makes up the gritty work of counseling. It can be hard, sometimes even messy. The experience, the process sheds off the layers leaving people vulnerable if they are willing to be. By the time the process is over there is a realization. No one was the good person, no one was the bad person. Every behavior, maladaptive or not, is an attempt to meet a very real need. This reality helps to not vilify one another during the counseling process. It makes the dialogue beneficial. Its not good, not bad, but helpful and beneficial. It's not static but dynamic.

Prompt : Prior to going to counseling, understand that there will not be any taking sides. It is not a venture to prove yourself right or the other wrong. Prepare yourself to dive into the depths of your vulnerabilities in order to come out stronger.

-For more detailed prompts and directives, read through the book "How To Have That Difficult Conversation You Have Been Avoiding" by Henry Cloud and John Townsend. It offers tagged scriptures and specific examples of how to put into words what you are feeling. -



Geries Shaheen is a Provisionally Licensed Professional Counselor operating in and around St. Louis Missouri. Geries teaches psych classes as an Adjunct at Saint Louis Christian College and offers Adolescent/ Family Therapy through Preferred Family Healthcare . Geries holds his BA in Intercultural Studies from Lincoln Christian University, and his MA in Professional Counseling from Lindenwood University. Holding a certificate in Life Coaching, Geries provides life coaching services to clients online throughout the nation.

Pioneer Counseling Blog

By Geries Shaheen August 11, 2026
Conversations about DSM-6 are growing louder in professional spaces . Industry leaders, researchers, and clinicians are sharing insights about what the next revision of the Diagnostic and Statistical Manual of Mental Disorders may look like. Some projections suggest a potential release window around 2029 to 2030 , though the American Psychiatric Association has not formally confirmed a publication date. For Licensed Professional Counselors, it is important to distinguish between confirmed information and thoughtful speculation. What follows is a grounded overview of both.  What Is Officially Confirmed There has been talks of the next DSM potentially being names something totally different, as well as potentially being a living breathing document housed online rather than a printed material. This has led to thoughts that it will include a full structural overhaul as it aims to find a balance between psychiatric insight as well as lived experience data. At the moment, there has been no official announcement of: A finalized DSM-6 release date A confirmed structural overhaul A change in name Adoption of biomarkers as diagnostic requirements The APA has historically used multi-year committee processes for revision, as documented during the development of DSM-5 (Regier et al., 2013, American Journal of Psychiatry). Any specific timeline, including projections of 2029 to 2030, remains speculative unless formally announced by the APA. Documented Criticisms of the DSM Many of the concerns you listed are well documented in peer-reviewed literature, including in the American Journal of Psychiatry. Historically cited critiques include: • The DSM uses a categorical model, which may not fully capture dimensional or nuanced symptom presentations. • Emphasis on diagnostic reliability has sometimes been prioritized over diagnostic validity. • Limited integration of biological markers despite advances in neuroscience. • Heavy reliance on expert consensus panels. • Concerns about Western cultural bias in diagnostic framing. These critiques have appeared in academic discussions surrounding DSM-5 and broader psychiatric nosology debates (Hyman, 2010; Regier et al., 2013). What is important to note is that these criticisms are part of ongoing scholarly dialogue. They do not automatically predict specific DSM-6 changes. Themes Being Discussed in Professional Circles While not formally confirmed, several themes are widely discussed among researchers and leaders: 1. Greater Dimensional Integration DSM-5 already introduced cross-cutting symptom measures and severity scales. Continued movement toward dimensional models is supported in academic literature (Krueger & Markon, 2014). A future DSM may further integrate dimensional frameworks alongside categorical diagnoses. 2. Stronger Alignment with ICD There has been ongoing effort to harmonize DSM diagnostic codes with the International Classification of Diseases, maintained by the World Health Organization. Future revisions may continue this integration to improve global diagnostic consistency. 3. Inclusion of Biomarkers Despite significant neuroscience research, no current psychiatric diagnosis relies on validated biomarkers. The National Institute of Mental Health developed the Research Domain Criteria (RDoC) framework to explore biologically informed models. However, RDoC remains a research framework and is not a diagnostic manual. Any integration of biomarkers into DSM-6 would require strong empirical validation, and no official confirmation currently exists that biomarkers will be required for diagnosis. 4. Cultural and Social Determinants DSM-5-TR expanded cultural formulation tools and updated language related to gender and diversity. Ongoing discourse suggests future editions may further incorporate cultural, socioeconomic, and environmental determinants of mental health. 5. Lived Experience Input There is broader movement in healthcare toward incorporating lived experience perspectives. While stakeholder feedback has been part of past revisions, there has been no formal announcement detailing the extent of lived experience integration for DSM-6. The direction of greater inclusivity aligns with contemporary healthcare standards but remains under development. Autism and Potential Diagnostic Shifts Speculation regarding updates to Autism Spectrum Disorder criteria reflects ongoing research around gender differences, masking, and underdiagnosis in women and people of color. Research literature supports the idea that autism presentations may differ across populations. However, there is currently no official confirmation that DSM-6 criteria changes will create a diagnostic surge. Any future criteria updates would require field trials and empirical validation before implementation. Committee Structures The APA historically forms workgroups and task forces organized by diagnostic categories and thematic areas. Planned improvement committees include the "Structure and Dimensions committee", "Functioning and Quality of life committee" "Biomarkers and Biological factors committee" " Socioeconomic, cultural, and environmental determinants of mental health committee". What LPCs Should Do Now Continue practicing under DSM-5-TR standards. Strengthen dimensional assessment skills and measurement-based care. Stay informed through official APA channels and peer-reviewed publications. Approach social media claims with professional caution. :) It is reasonable to expect that DSM-6 will aim to reflect scientific advances, cultural responsiveness, and improved diagnostic validity. However, until the American Psychiatric Association releases formal statements, timelines, or draft criteria, any detailed structural predictions remain speculative. For Licensed Professional Counselors, preparation is less about anticipating dramatic changes and more about maintaining strong assessment practices, cultural competence, and evidence-based treatment planning. Geries Shaheen is a Licensed Professional Counselor and Nationally Certified Counselor operating in and around St. Louis Missouri. Geries holds his MA in Professional Counseling from Lindenwood University, BA in Intercultural Studies from Lincoln Christian University, and holds a certificate in Life Coaching, Geries provides life coaching services to clients online globally. Geries is EMDR trained and DBT Certified, practicing from a TIC lens.
By Geries Shaheen August 11, 2026
In behavioral health, we spend a significant amount of time discussing medical necessity. We complete assessments, symptom inventories, risk scales, progress reviews, treatment plans, and utilization documentation designed to justify levels of care to payors, agencies, and federal grant programs. Those systems are important. Accountability matters. Evidence-based care is crucial. But there is another clinical variable that often determines outcomes more than any assessment score alone: Cadence. The frequency and consistency of therapy can profoundly impact stabilization, insight development, emotional regulation, therapeutic alliance, and long-term outcomes. Yet cadence is often treated as an operational scheduling issue instead of a clinical intervention in itself. The reality is that not all clients need the same rhythm of care. Some clients benefit from: Daily therapy for intense instances. Twice-weekly sessions during periods of crisis stabilization or acute symptom escalation Weekly therapy for active trauma processing, emotional regulation development, or skill acquisition Biweekly sessions during maintenance phases Monthly sessions for relapse prevention, accountability, and long-term support after sustained improvement Research increasingly supports what many clinicians already observe in practice: matching cadence to client need improves outcomes. A 2024 meta-analysis published in the Journal of Affective Disorders found that increasing psychotherapy frequency from one session per week to two sessions per week was associated with significantly stronger treatment outcomes for depression, particularly during the acute phase of treatment. Researchers noted that session frequency appeared to matter more than total treatment duration alone. ( https://www.sciencedirect.com/science/article/pii/S0165032724008061? ) Additional longitudinal research comparing weekly and biweekly therapy found that clients receiving weekly therapy demonstrated higher rates of early improvement and shorter durations of suffering compared to biweekly treatment schedules. The study also emphasized that therapy frequency should be individualized because client response trajectories vary considerably. ( https://pubmed.ncbi.nlm.nih.gov/37870790/ ) This aligns with what clinicians see every day: Clients in early trauma work often need tighter therapeutic containment Clients learning emotional regulation benefit from repetition and proximity Clients with attachment disruptions frequently require consistency before depth Clients in relapse recovery may need increased contact before symptom escalation becomes visible in formal assessments Therapy does not occur only during the 53-minute session. It unfolds between sessions , in how quickly a client can reconnect after dysregulation, revisit a cognitive distortion before it hardens into avoidance, process a triggering event while it remains emotionally accessible, or practice a coping strategy before disengagement returns. The interval between sessions can either sustain therapeutic momentum or unintentionally interrupt it. This is where the tension between clinical reality and administrative structure often emerges. Many large agencies rely heavily on standardized assessments and federally guided documentation frameworks to determine treatment frequency and level of care recommendations. These tools create accountability, consistency, and measurable outcomes across systems. As they should, but Measurement-based care has become increasingly important in behavioral health. Some recent findings suggest that structured measurement-informed care can improve patient outcomes by as much as 24%, while psychiatric treatment incorporating routine symptom monitoring has shown remission rates up to 75% higher than treatment without ongoing measurement practices. (https://www.twochairs.com/blog/two-chairs-publishes-first-of-its-kind-study-showing-measurement-based-care-training-improves-outcomes-by-24-at-scale) Thus, assessments are snapshots. Cadence is relational. An assessment may capture symptom severity at a single point in time. Cadence captures the pace of support a client clinically requires to sustain progress between those moments. Two clients can present with similar PHQ-9 or GAD-7 scores yet require entirely different treatment frequencies based on: emotional regulation capacity environmental stressors trauma acuity relapse history attachment dynamics coping skill generalization safety concerns psychosocial support systems Strong clinical work requires balancing measurable data with clinical judgment . (and often, clinical judgment comes from building clinician autonomy).( https://www.psychiatrictimes.com/view/measurement-based-care-in-psychiatry-clinical-outcomes-and-practical-applications ) Sometimes the most important question is not: “Can we justify this frequency to insurance?” Sometimes the more important question is: “What cadence gives this client the best opportunity to succeed?” Approximately 50% of clients discontinue therapy prematurely, with poor therapeutic fit, inconsistent engagement, and treatment structure often contributing factors. ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5600065/ ) As mental health systems continue evolving toward outcome-driven care, there is an opportunity to broaden how we define treatment effectiveness. Frequency of contact, continuity, relational consistency, and therapeutic pacing deserve greater recognition as active components of care. Otherwise they will be thrown to the wayside as mere operational details. In our industry, timing truly matters. And cadence is part of the treatment itself.  Geries Shaheen is a Licensed Professional Counselor and Nationally Certified Counselor operating in and around St. Louis Missouri. Geries holds his MA in Professional Counseling from Lindenwood University, BA in Intercultural Studies from Lincoln Christian University, and holds a certificate in Life Coaching, Geries provides life coaching services to clients online globally. Geries is EMDR trained and DBT Certified, practicing from a TIC lens.
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