This is not couples counseling. This is individual therapy for the person who has started to notice that no matter who they are with, something familiar keeps happening. The same arguments. The same distance. The same feeling of being too much or not enough. The same ending.
Relationship problems are the most common reason people seek therapy, and most of the time, the real work does not require both people in the room. It requires one person willing to look at the patterns they carry into every connection they form. At Turning Leaf Therapy in Old City Philadelphia, 15 of our therapists specialize in relationship-focused individual therapy. We are a relational, psychodynamic, and trauma-informed practice, which means the way you relate to other people is not a side topic in our work. It is the center of it.
Start Your JourneyWhy Individual Therapy for Relationship Issues
You might be wondering whether you should be looking for couples counseling instead. Here is the distinction that matters.
Couples counseling works on the dynamic between two specific people. It addresses communication, conflict resolution, and the particular patterns of a particular relationship. It requires both people to show up, participate, and be willing to change.
Individual therapy for relationship issues works on you. It addresses the relational templates you carry into every relationship, the ones that were set long before you met your current partner or your last one or the one before that. It does not require anyone else to participate, because the work is about understanding what you bring to connection, why you bring it, and how it can change.
If you keep finding yourself in the same kinds of relationships, if your friendships follow similar patterns, if you struggle with the same dynamics at work, the common denominator is not bad luck. It is the relational blueprint you are operating from. And that blueprint can be rewritten. But only from the inside.
The Patterns That Bring People to This Work
You may recognize yourself in one or more of these descriptions. Most of our clients recognize themselves in several.
You Keep Choosing the Same Person in Different Bodies
The faces change but the dynamic does not. You are drawn to people who are emotionally unavailable, or controlling, or intermittently attentive in a way that keeps you off-balance. Friends point it out. You can see it in retrospect. But in the moment, the pull feels automatic, almost magnetic.
Psychoanalytic theory has a name for this: repetition compulsion. It describes the unconscious tendency to recreate the emotional conditions of early relationships, not because you want to suffer but because your nervous system gravitates toward what it recognizes. Familiarity registers as safety, even when what is familiar is painful. The person who grew up with an emotionally distant parent may find themselves drawn to partners who are just out of reach. The person who grew up managing a volatile caregiver may find themselves attracted to intensity and unpredictability, mistaking adrenaline for love.
This is not a character flaw. It is how the human attachment system works. And it is one of the most important things therapy can help you understand and interrupt.
You Lose Yourself in Relationships
When you are in a relationship, you mold yourself to fit. You adopt the other person’s interests, preferences, even opinions. You say yes when you mean no. You suppress your own needs to keep the peace. You do not know what you want for dinner, let alone what you want from your life, when there is another person’s feelings to manage first.
An estimated 40 million Americans carry codependent traits (Hughes-Hammer et al., 1998). Among women being treated for depression, 36 percent were found to be moderately to severely codependent. This is not a personality defect. It is an adaptation, often rooted in childhood environments where a child’s own needs had to be subordinated to a parent’s emotional state.
Pete Walker, who identified the fawn response as a fourth trauma response alongside fight, flight, and freeze, describes it as seeking safety by merging with the wishes and demands of others. The fawning person acts as though the price of admission to any relationship is the forfeiture of their own needs, preferences, and boundaries. It is the hardest trauma response to identify because it is socially rewarded. Kindness, agreeableness, and selflessness are valued. The cost is invisible, mostly to the person paying it.
You Pull Away When Things Get Close
Intimacy feels dangerous. Not logically, but in your body. When a relationship starts to deepen, you find reasons to withdraw: picking fights, going quiet, suddenly noticing flaws you had not noticed before. You may tell yourself you value independence. From the outside, you may appear self-sufficient and emotionally contained. From the inside, the avoidance may feel less like choice and more like necessity.
Roughly 23 to 25 percent of adults carry a dismissive-avoidant attachment pattern. It develops when early caregivers were consistently emotionally unavailable or dismissive of the child’s needs. The adaptation: stop needing. If expressing vulnerability leads to disconnection, then suppressing it becomes the strategy for maintaining whatever connection is available. In adulthood, this shows up as discomfort with closeness, difficulty identifying emotions, and a tendency to withdraw precisely when a partner is reaching for connection.
You Cannot Stop Scanning for Signs of Abandonment
A delayed text spirals into a narrative about being left. A partner’s quiet mood triggers panic. You need reassurance, and when you get it, the relief lasts minutes before the anxiety returns. You know it is disproportionate to the situation. You cannot make it stop.
Approximately 11 to 20 percent of adults carry an anxious-preoccupied attachment pattern. It develops when caregiving was inconsistent: sometimes responsive, sometimes absent. The child learns that amplifying distress increases the odds of getting a response. In adulthood, this becomes hypervigilance to relational cues, protest behaviors designed to pull a partner closer, and a chronic sense that you are one misstep away from being abandoned.
Our Anxiety Therapy page addresses the broader anxiety picture. But when the anxiety lives primarily in your relationships, when it is specifically about connection, closeness, and the fear of losing it, the work belongs here.
You Stay in Relationships You Know Are Not Good for You
Friends have told you to leave. Part of you agrees. But something keeps you attached in a way that does not respond to logic. It is not weakness. It is often a combination of attachment system activation (under threat, humans seek increased closeness, even with the source of the threat), nervous system conditioning (the cycle of tension and relief creates a neurochemical pattern that feels like love), and familiar dynamics (if your childhood included similar relational patterns, abuse can feel “normal” in a way that genuine safety does not).
We do not judge anyone for staying. We understand why leaving is not as simple as it sounds. And we are here when you are ready to explore what has been keeping you in place.
You Are Processing Infidelity, Divorce, or a Breakup
The end of a relationship involves genuine grief, and our Grief and Loss Therapy page goes deeper into that work. But relationship endings also surface patterns that existed long before this particular relationship. Why you chose this person. What you tolerated and why. What you gave away and what you held back. Individual therapy after infidelity, divorce, or a breakup is not just about healing from this loss. It is about understanding what this relationship revealed about the relational templates you carry, so the next chapter is built on something different.
Research estimates that 20 percent of men and 13 percent of women report extramarital sex (General Social Survey/Institute for Family Studies). The divorce rate for first marriages is approximately 41 percent (APA). In Philadelphia County, 1,837 divorces were recorded in 2024 (Pennsylvania Department of Health). Behind every one of those numbers is a person trying to figure out what happened and what comes next. That work is best done in individual therapy, where the focus is entirely on you.
Your Relationship Patterns Show Up Everywhere, Not Just in Romance
The people-pleasing you do with your partner also shows up at work. The conflict avoidance you practice in your marriage also shapes your friendships. The difficulty trusting a romantic partner mirrors the difficulty trusting a supervisor. Relational patterns are not situation-specific. They are templates that travel with you into every connection you form. If you are noticing the same dynamics across multiple areas of your life, that is important information. It means the pattern is yours to understand and yours to change.
How Relational Psychodynamic Therapy Works With Relationship Patterns
Our clinical approach is grounded in relational psychodynamic and psychoanalytic theory. This is not incidental. Relational psychodynamic therapy was built to do exactly this work.
The core insight is that your sense of self, your capacity for connection, and your relational patterns were all shaped within your earliest relationships. The way your caregivers responded to your needs, your emotions, and your bids for closeness created internal working models, unconscious blueprints for how relationships are supposed to work. Those blueprints now operate automatically in every significant relationship you form.
Cognitive approaches to relationship difficulties focus on changing thoughts and behaviors. They can be useful for developing communication skills or managing conflict. But relational psychodynamic therapy changes patterns at the level where they operate: in relationship. The therapeutic relationship itself becomes the space where your patterns become visible, not as abstract concepts but as lived experiences happening in real time between you and your therapist.
You may notice that you perform for your therapist the way you perform for everyone else. You may notice that you withhold your real feelings because expressing them has never felt safe. You may notice that you are scanning your therapist’s face for signs of judgment or disengagement. These are not distractions from the work. They are the work.
Research consistently supports this approach. Jonathan Shedler’s landmark 2010 review found that psychodynamic therapy achieves effect sizes of 0.97 for symptom improvement, growing to 1.51 at long-term follow-up, a “sleeper effect” where benefits continue deepening after therapy ends. For interpersonal problems specifically, effect sizes reach 1.56 (Leichsenring and Leibing, 2003). This growing-after-therapy pattern makes sense from an attachment perspective: once new internal working models are established, they continue to shape relational experience long after the last session.
Our therapists also draw from EMDR, IFS, DBT, ACT, and somatic approaches when they serve the work. But the relational psychodynamic framework is the foundation, because relationship patterns were formed in relationship and can only transform in relationship.
Your Attachment Style Can Change
If you have read our Attachment Therapy page, you know that roughly 40 percent of adults carry an insecure attachment pattern. You may also know that attachment researchers have identified a category called “earned secure attachment”: adults who experienced insecure childhoods but have developed the capacity for secure, satisfying relationships through later corrective relational experiences.
Earned secure individuals represent approximately 20 to 25 percent of securely attached adults. The research finding that matters most: earned secure individuals are statistically indistinguishable from continuously secure individuals on measures of relationship quality, emotional regulation, and parenting. The security is real.
Long-term relational psychodynamic therapy is the most studied pathway to earned security. The mechanism is straightforward: the therapeutic relationship provides consistent attunement, reliable responsiveness, and non-retaliatory engagement. Over time, this repeated experience contradicts the old blueprint and builds a new one. It does not happen in 12 sessions. But it does happen.
Focus
Individual Relationship Therapy. Focuses on your patterns and the blueprints you carry, rather than couples counseling.
Format
In-person at our Old City Philadelphia office (123 Chestnut St) or telehealth for anyone located in Pennsylvania.
Insurance
Aetna, BCBS plans, United Healthcare, and Optum Behavioral Health. Out-of-network support offered.
Fees
$130 to $200 per session for self-pay clients, depending on the therapist. Superbills provided.
Frequently Asked Questions
Couples counseling focuses on the dynamic between two specific people. Individual relationship therapy focuses on you: the relational patterns you carry into every connection, where those patterns came from, and how they can change. You do not need a partner present to do this work. In many cases, individual therapy is more effective for lasting relational change because it addresses the underlying templates rather than the surface-level dynamics of one particular relationship.
Yes. You do not need your partner’s participation to do meaningful work on your relational patterns. In fact, individual therapy often produces changes that positively influence the relationship as a whole, because when one person changes how they show up, the dynamic between both people shifts.
Repetitive partner selection is driven by internal working models, the unconscious relational blueprints formed in your earliest caregiving relationships. Your nervous system gravitates toward what it recognizes, even when what is familiar is painful. Therapy helps you become conscious of these patterns so you can begin making different choices from a place of awareness rather than automatic pilot.
Relational psychodynamic therapy is an evidence-based approach that understands your relational patterns as shaped by early attachment experiences and maintained through unconscious processes. It uses the therapeutic relationship itself as the primary vehicle for change. Research shows it produces effect sizes of 0.97 for symptom improvement, growing to 1.51 at long-term follow-up (Shedler, 2010).
Yes. When you understand the patterns you bring to your relationships, and when those patterns begin to shift through therapy, the way you relate to your partner changes. You become better able to communicate needs, tolerate conflict, set boundaries, and receive closeness. These shifts often improve the relationship even when your partner is not in therapy.
Early attachment experiences create internal working models that function as unconscious blueprints for all future relationships. A child who experienced inconsistent caregiving may develop anxious attachment patterns in adulthood. A child who learned that expressing needs leads to rejection may become avoidantly attached. These patterns operate automatically until they are made conscious and worked through in therapy.
Common signs include repeating the same relationship dynamics with different partners, difficulty setting or holding boundaries, chronic people-pleasing or conflict avoidance, fear of abandonment or fear of intimacy, staying in relationships you know are not good for you, losing yourself in relationships, or recognizing that the same relational struggles show up across multiple areas of your life.
Yes. Relationship difficulties are among the most common reasons people seek therapy. You do not need to be in crisis or in a failing relationship to benefit. Many of our clients come to therapy because they want to understand their patterns before entering their next relationship, or because they are tired of the same cycle repeating.
Relational patterns took years to form and are deeply encoded. While you may experience relief and insight early in therapy, lasting change in how you relate to others requires sustained work. Many of our clients engage in this therapy for a year or more. The depth of that commitment is what produces the kind of change that does not fade when life gets stressful.
Yes. Betrayal shatters the internal working model of safety in relationships. Individual therapy provides a space to grieve, to process the specific meaning of the betrayal in the context of your history, and to gradually rebuild the capacity for trust. This is not about forcing yourself to trust prematurely. It is about understanding what trust requires and rebuilding it at the foundation level.
Take the First Step
Every relationship you have ever been in has taught you something about the relational patterns you carry. Some of those lessons have been painful. All of them have been informative. Therapy is where you take what you have learned, make sense of it, and begin building something different. Not with the next person. With yourself, first.
Start Your Journey