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Couples therapy

Couples therapy is one of the hardest things to finally reach for. Not because the work is scary, but because getting here usually means you've already tried a lot on your own. You've read the books. Maybe you've even done therapy before. But the same fight keeps showing up, or worse, you've gone quiet and the distance is starting to feel permanent. The word "divorce" has been said out loud. Not because either of you actually wants to leave, but because something has to change.

Couples therapy in my practice is built around one central idea: the conflict you keep having isn't really about what you think it's about. The argument over finances, the shutdown after a hard conversation, the silence that stretches into days — all of it is pointing to something deeper. Unmet needs. Old wounds. Attachment patterns that were formed long before you ever met each other. And sometimes, a neurodivergent dynamic that nobody has ever named out loud, where one partner's ADHD is quietly driving the cycle and neither of you fully understands why. My job is to help you slow down, name what's actually happening beneath the surface, and build a new way of showing up for each other that actually sticks.

You don't have to keep running on empty

A lot of the couples I work with look like they have it together on the outside. Careers, community, a full life. But privately? They're exhausted. The conflict is escalating, or they've swung the other direction and checked out completely. Neither one feels like the relationship they signed up for.

This is especially true for couples carrying layers that most therapists never think to ask about. BIPOC and interracial couples navigating not just their relationship but also what it means to build a life together across different cultural identities, family expectations, and lived experiences of race in America. Inter-political couples, one partner Democrat, one Republican, who fell in love before the political climate made every dinner table conversation feel like a minefield. And couples where ADHD is in the room, whether it's been diagnosed or not, where one partner feels like they're managing everything alone and the other feels like they can never do anything right no matter how hard they try. These aren't small things. They shape how you fight, how you shut down, and how safe you feel being fully honest with the person you love.

If any of these sound familiar, you're in the right place:
  • You keep having the same argument and it never fully resolves
  • You're walking on eggshells or shutting down to avoid another blowup
  • You feel more like roommates than partners
  • One partner has ADHD and the dynamic has quietly become parent-and-child instead of equals
  • Cultural or political differences are creating distance you don't know how to bridge
  • You have real insight into your patterns but still can't seem to break them
  • The emotional distance is growing and you don't know how to close it
  • You're privately wondering if this relationship can actually survive

Insight alone doesn't change behavior. That's where the real work comes in, and that's where I can help. Every couple I work with gets something built around their specific relationship, not a generic road map applied to everyone who walks in.

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Interracial and BIPOC couples carry a particular kind of weight that doesn't always get named in therapy. You might be navigating family disapproval that's never fully gone away. Differences in how race, identity, and belonging were experienced growing up. One partner who has lived with the everyday reality of racism and one who is still learning how to show up for that. One partner whose cultural background comes with expectations around gender roles, family loyalty, or communication styles that feel completely foreign to the other.

These aren't just cultural footnotes. They are live wires in your relationship, and they deserve to be worked through with care, not glossed over.

The same is true for inter-political couples. You didn't choose your partner's voter registration. You chose them, their values, their humor, their presence, the life you were building together. But somewhere along the way, the political became personal in ways that feel impossible to separate. Conversations that used to be theoretical now feel like identity-level attacks. What started as a difference of opinion has started to feel like a difference in who you fundamentally are as people.

And then there's ADHD. When one partner has ADHD and it has never been properly understood or addressed, the relationship often develops a quiet imbalance that builds resentment on both sides. The non-ADHD partner starts carrying the mental load, managing schedules, tracking details, following up on things that were supposed to get done. They feel abandoned and alone in the relationship. The partner with ADHD feels constantly criticized, like they are always failing, always disappointing, never enough. Neither one is wrong about what they're experiencing. But without the right framework, both partners keep paying the price for a dynamic neither one created intentionally.

I work with couples who are living inside all of this. You don't have to leave the complicated parts of your relationship at the door. That's exactly where we start.

The layers that don't get talked about enough

What we actually work on together

I'm not the kind of therapist who nods and stays silent while you talk in circles. I'll challenge you, gently but honestly, to say the thing underneath the thing. We move toward what's real, not just what's comfortable. And for couples navigating real differences in culture, race, politics, or neurotype, that directness matters even more.

My approach draws on several evidence-based frameworks woven together based on what your relationship actually needs. Here's what that looks like in practice:
  • Slow the cycle down (EFT). Instead of watching the same argument escalate in real time, we step back and look at what's triggering each of you and why. Emotionally Focused Therapy maps the pursue-and-withdraw pattern that most stuck couples are living inside of, whether they know it or not. For couples where ADHD, cultural differences, or political tension are a factor, this step is especially important because the trigger is almost never what it appears to be on the surface.
  • Build real communication tools (Gottman Method). Not just "use I statements." Skills for navigating conflict when you're flooded, repairing after a rupture, and having hard conversations without the whole thing going sideways in the first two minutes. For couples managing ADHD dynamics, this includes tools for addressing the mental load imbalance and rebuilding a sense of partnership.
  • Get honest about your part (RLT). Relational Life Therapy pushes for real accountability, not blame. Each partner looks at what they're contributing to the dynamic, and that's usually where the biggest shifts happen. This includes examining the ways ADHD, cultural conditioning, racial identity, or political beliefs may be showing up in how you relate to each other.
  • Understand your history (Attachment). The ways you learned to connect, or to protect yourself from connection, in early relationships shape how you show up with your partner today. For BIPOC and interracial couples, that history often includes experiences of racial trauma and intergenerational patterns worth understanding together. For individuals with ADHD, early experiences of rejection, shame, and emotional dysregulation often run deeper than most people realize.
  • Practice between sessions (CBT). Cognitive Behavioral Therapy gives you concrete tools to use in your actual life, not just in the therapy room. This is especially useful when ADHD is part of the picture, because building new relational habits requires structure, repetition, and practical strategies that actually hold up outside of a therapy session.
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Before anything else, I offer a free 20-minute consultation. It's a real conversation, not a sales call. We talk about what's going on, what you're hoping for, and whether I'm the right fit for your relationship.

If we decide to move forward, here's what the process looks like:
  • Electronic onboarding. All intake paperwork is completed online and includes detailed assessments that give me real insight into your relationship dynamics before our first session. For couples where ADHD may be a factor, these assessments help surface patterns that are often invisible until they're named.
  • First couples session. I want to hear your story from the beginning — how you met, what drew you together, the good memories that are easy to lose sight of when things are hard. That foundation tells me what you're both fighting to protect. For interracial and inter-political couples, this often includes understanding what the early days felt like before the differences became friction. For couples navigating ADHD, it means understanding when the dynamic started to shift and what each partner has been carrying since then.
  • Individual sessions. I meet with each of you separately to build rapport and understand each person's personal history, cultural background, neurodivergent experience, family-of-origin patterns, and past experiences that may be shaping how they show up in the relationship today.
  • Alignment session. We come back together, review the assessment results, align on what's actually happening between you, and build a clear plan for interrupting the cycles and rebuilding the connection.

How we get started

Some couples can't do weekly. The schedule doesn't allow it, or the level of support needed is more than once-a-week therapy can offer right now. That's where couples intensives come in.

An intensive is an extended, focused format that creates real momentum in a compressed period of time. Instead of spreading work across months of weekly sessions, we go deeper together in a way that breaks through faster.

Intensives work especially well for:
  • Couples at a crossroads who need clarity now, not in six months
  • Partners navigating a significant rupture or breach of trust
  • BIPOC or interracial couples who want dedicated time to address the layers that often get skipped in standard weekly therapy
  • inter-political couples who need a structured, safe space to work through values differences without it becoming a fight
  • Couples where ADHD has been driving the dynamic for years and both partners are ready to finally understand it together
  • Busy schedules that make consistent weekly sessions unrealistic

After an intensive, we schedule a follow-up session to review the gains you've made, identify what still feels challenging, and acknowledge the shifts that have already started to take hold.
Once we've done the initial phase of work, how you continue is flexible and shaped around what fits your life. There's no single format that's right for every couple.
  • Future intensives for couples who want a reset or want to go deeper on something specific
  • Monthly or as-needed 90-minute sessions to maintain momentum without committing to a weekly schedule
  • Weekly sessions when ongoing support is appropriate and availability allows
The goal is never to keep you in therapy indefinitely. It's to give you what you need to keep going without me.

Not ready for weekly sessions? There's another way.

What support looks like after care is established

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I offer both in-person and online sessions. For couples in the Pleasanton, CA area, meeting in person creates a contained, focused space that a lot of couples find grounding for this kind of relational work. Online sessions offer the same quality of care with the flexibility to meet virtually, which works well for busy schedules and couples across California, including those managing the daily realities of ADHD where reducing friction in getting to an appointment actually matters.

Either way, the intention is the same: help you slow down, speak honestly, and find your way back to each other.

In-person and online couples therapy in Pleasanton, CA

Frequently Asked Questions

If you have questions or need help deciding if this is the right fit, feel free to reach out using the link below—we’ll sort it out together.

When do you know you need couples therapy?

If you're having the same argument on repeat, feeling more like roommates than partners, or privately wondering whether the relationship can survive, that's usually a sign it's time. For interracial and inter-political couples, that signal sometimes sounds like a single conversation about race or politics that cracked something open and never fully healed. For couples navigating ADHD, it often sounds like one partner finally saying "I feel like I'm doing this alone" and the other saying "nothing I do is ever good enough." You don't have to be at rock bottom to reach out.

How soon is too soon to start couples therapy?

There's no such thing as too soon. Waiting until things are in crisis makes the work harder, not easier. If something feels off, if the communication has gotten tense, if ADHD is quietly running the show, or if differences in culture or values are building distance, that's a good enough reason to start. Early support tends to produce faster, more lasting results.

How often should a couple go to couples therapy?

It depends on where you are and what you need. Weekly sessions work well for couples in active conflict or at a critical point. Monthly or as-needed sessions are a good fit for couples maintaining momentum after an initial phase of work. I also offer intensive formats for couples who can't do weekly but want concentrated, meaningful progress. For couples managing ADHD, the structure and consistency of a regular session format often makes a real difference.

What should you expect when starting couples therapy?

We start by getting to know your relationship from the beginning, not just the problems. I'll want to hear how you met, what drew you together, and what you're both hoping to rebuild. For BIPOC and interracial couples, that often means understanding the cultural contexts each person came from. For inter-political couples, it means getting curious about how values differences are showing up in day-to-day life. For couples where ADHD is part of the picture, it means naming the dynamic that's been quietly running underneath everything else. The process is structured, personalized, and designed to give you clarity early.

Can therapy actually help a inter-political couple stay together?

It can. Political differences become relationship-threatening when they stop being about policy and start feeling like an attack on who you are as a person. What therapy does is help you separate the political from the personal, find the shared values underneath the differences, and build the skills to disagree without the conversation becoming a referendum on the entire relationship. A lot of couples are more aligned on what actually matters than they realize.

How does ADHD affect a relationship, and can couples therapy help?

ADHD in a relationship often creates a dynamic where one partner ends up managing most of the mental load while the other feels perpetually criticized and misunderstood. Over time, this can quietly erode the sense of partnership and equality that the relationship was built on. Couples therapy helps both partners understand what ADHD is actually doing to the dynamic, not as an excuse but as a starting point for building something more workable and fair. When ADHD is understood and accounted for, the resentment tends to drop significantly on both sides.

What are the top relationship problems couples bring to therapy?

The most common ones I see are communication breakdown, emotional distance, recurring conflict that never fully resolves, and the quiet fear that you're drifting apart. For interracial and BIPOC couples, unaddressed racial dynamics and cultural misalignments often sit underneath the surface conflicts. For inter-political couples, it's frequently values-based disconnection that started small and grew. For couples navigating ADHD, it's usually an imbalance in responsibility that neither partner knows how to fix on their own.

What should you not say during couples therapy?

Avoid using the session to build a case against your partner. Statements like "you always" or "you never," blame-based narratives, and shutting down when things get uncomfortable all slow the process down. For inter-political couples, leading with political labels rather than personal feelings tends to close doors rather than open them. For couples navigating ADHD, framing everything as a character flaw rather than a neurological reality tends to keep both partners stuck. Couples therapy works best when both partners come in willing to look at their own part.

What is the No. 1 rule for saving a relationship?

Stop trying to win. The moment you're more focused on being right than being connected, the relationship loses. This is especially true for inter-political couples, where being right can feel like a matter of moral conviction. And for interracial couples, where one partner's lived experience gets dismissed in the name of keeping the peace. And for couples navigating ADHD, where the scorekeeping of who does more and who drops the ball keeps both partners locked in resentment instead of repair. The couples who make it through are the ones who learn to see each other as teammates. That shift from adversaries to allies is often the turning point, and it's exactly what we work toward together.

Can couples therapy work when partners have very different cultural backgrounds?

Yes, and it's some of the most meaningful work I do. Cultural differences don't have to be a dealbreaker. They do need to be taken seriously. In our work together, we look at how each partner's background, family expectations, and lived experiences are shaping the dynamic between them, and we build a shared language for navigating those differences with care and honesty.

Reach out to schedule your free 20-minute consultation. For information about session formats, scheduling, and availability, contact me directly. Let's figure out if we're a good fit, and if we are, let's get to work.

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I'm Alanna Esquejo, a Licensed Marriage and Family Therapist based in Pleasanton, CA, and I work with couples who are high-functioning everywhere except, it seems, with each other. My practice, Therapy With Alanna, specializes in helping BIPOC, interracial, and neurodivergent couples break out of survival mode and start actually talking again. If you're tired of the same fight or the suffocating silence, this is the place to start.