Couples Therapy: Moving Beyond Labels Like “Narcissist” and “Gaslighting”

In couples therapy, we will often hear words like “narcissist”, “gaslighting”, “toxic”, or “red flags”come into the room.

These words have become part of everyday language now. They are used a lot on social media, in podcasts, in articles, and in general conversations about relationships. Sometimes they are being used because someone has finally found language for something painful and harmful that has been happening to them. And sometimes they are being used in a broader way, where the label can become a shortcut for describing hurt, disappointment, or conflict.

So I think we need to handle these words carefully.

If one partner says, “He’s a narcissist,” or “She’s gaslighting me,” it can be very tempting to either follow the label or challenge it too quickly. But in couples therapy, it is usually more helpful to slow things down and explore what is actually happening.

These words can be very evocative. They are associated with very negative characteristics, and once they are placed on a partner, it can be hard for that partner not to feel attacked or defined by them. The work can then quickly become about whether the label is true, rather than what is happening in the relationship.

Why Labels Show Up So Often in Couples Therapy

Many couples now come into therapy with a language already formed around their relationship. They may have read about narcissism, gaslighting, attachment styles, trauma responses, or emotional abuse. That can be very helpful at times. It can give people language for things they have struggled to name.

But in couples therapy, labels can also harden positions.

One partner may arrive feeling certain that they have identified the problem: “My partner is the narcissist.” The other partner may then feel shamed, blamed, or pathologised. Before long, the couple can become even more entrenched.

And then the therapist can be pulled into the position of judge.

Is this person a narcissist? Is this gaslighting? Who is telling the truth? Who is the problem?

That is rarely the most useful place for the work to sit.

The Risk of Staying With the Label

The difficulty with labels is that they can close down curiosity.

If we stay with the label “narcissist”, we may miss the behaviour. If we stay with the label “gaslighting”, we may miss the impact. If we stay with “toxic” or “red flag”, we may miss the relational process that is happening between the couple.

That does not mean we dismiss what is being said. It does not mean we minimise harm. It does not mean we treat serious behaviour lightly.

It means we bring the work back to something we can actually explore.

In couples therapy, behaviour and impact are often more useful than character labels. Behaviour gives us something concrete to look at. Impact gives us a way to understand what it is like for the other partner. Process helps us see what happens between them.

A label, on its own, often gives us very little room to work.

Moving From “They Are a Narcissist” to “What Is Happening?”

A useful therapist stance might be something like:

• “These words can carry a lot with them. Can we slow down and look at what you are seeing and what is happening?”
• “When you say narcissist, what behaviours are you referring to, and what impact are they having on you?”

This allows the client to feel taken seriously without the therapy becoming organised around proving or disproving the label.

It also gives the other partner a better chance of staying in the room. If they feel labelled as a narcissist, they may immediately become defensive or shut down. But if we begin to explore specific behaviour, there is more possibility for reflection.

For example, instead of staying with “He is gaslighting me,” we might ask:

• “What happens in those moments?”
• “What does he say or do?”
• “What happens inside you when that happens?”
• “Do you begin to doubt your own memory or your own sense of reality?”
• “Do you feel afraid to bring things up?”

These questions help us understand the seriousness of what is being described. They also keep us grounded in the work.

Staying Curious Without Dismissing Harm

This is where the balance is important.

Moving away from labels does not mean moving away from safety.

If a client uses words like gaslighting, coercive control, emotional abuse, intimidation, or fear, we need to take that seriously. We need to assess what is happening. We need to be alert to whether couples therapy is appropriate and whether one partner is safe enough to speak freely in the room.

Neutrality in couples therapy does not mean pretending that all behaviour is equal. It does not mean staying passive when harm is present.

But it also does not mean accepting a label without exploration.

The task is to stay curious and grounded enough to ask: what is actually happening here? What is the behaviour? What is the impact? Is there fear? Is there control? Is there accountability? Is there safety?

That is a much more clinically useful place to work from than simply accepting or rejecting the label.

Therapist Neutrality in Couples Therapy

I think neutrality is often misunderstood.

Neutrality does not mean we have no values. It does not mean we ignore harm. It does not mean we treat destructive behaviour as just another perspective.

In couples therapy, neutrality is about staying committed to understanding the relationship system, rather than becoming aligned with one person against the other. It is about being curious about both people’s experiences while also being very clear about safety, respect, and impact.

So if one partner says, “They’re a narcissist,” I would be cautious about either agreeing or disagreeing too quickly.

Instead, I would want to understand what the word means to them. What have they experienced? What are they trying to get me to see? What has felt painful, confusing, frightening, or impossible in the relationship?

And I would also want to understand what happens for the other partner when they hear themselves described in that way.

Not to create a false equivalence, but to understand the process that is unfolding in front of me.

What Therapists Can Say in the Room

There are some simple phrases that can help slow this down without dismissing the person who has used the label.

You might say:

• “Can we pause on that word for a moment and look at what it means to you?”
• “When you say gaslighting, what are you wanting me to understand?”
• “What is the behaviour you are describing?”
• “What impact does that have on you?”
• “What happens between you both after that?”
• “Do you feel safe to say what you think and feel in the relationship?”
• “Does this feel like a pattern where one of you feels controlled, silenced, or frightened?”

These kinds of questions help the therapist stay close to the client’s experience while keeping the work specific.

They also prevent the session from becoming a debate about terminology.

Why This Matters for Couples Therapy Training

This is one of the reasons couples therapy requires a different kind of stance from individual work.

In individual therapy, we may be listening primarily to one person’s experience and helping them make sense of it.
In couples therapy, we are holding two experiences and the relationship between them. We are listening for meaning, but also for process. We are listening for harm, but also for the cycle. We are listening for what is said, and what happens in the room as it is said.

When strong labels enter the room, it can be very easy to get pulled off centre. We may feel pressure to validate one partner quickly. Or we may feel pressure to protect the other partner from being shamed. We may worry about missing abuse, or worry about being unfair.

These are not small moments.

They are exactly the kinds of moments where couples therapists need training, supervision, consultation, and support.

Deepening your work in couples therapy

At the Institute of Couples Therapy, we support therapists who are beginning to work with couples, as well as couples therapists who want to deepen and strengthen their practice.

Our trainings focus on the real clinical moments that happen in the room: conflict, blame, stuckness, strong labels, resistance, safety, neutrality, and the challenge of staying steady while holding both partners and the relationship between them.

We also have the ICT Community, a supportive space for couples therapists that includes live case consultations, therapist discussions, and support from others doing this work.

Because couples therapy is deeply meaningful work, but it is also complex work. And it is not work we need to think through alone.