Most couples don’t seek therapy when things first go wrong. On average, couples wait six years after problems start before they ask for help. But by then, patterns have set and resentment has built. Communication has also broken down a long time ago.
Unresolved conflict doesn’t stay contained. It spreads into parenting, work, and physical health. Research shows that chronic relationship stress is linked to measurably worse immune function and elevated cardiovascular risk.
The field of couples therapy has responded to this with dozens of competing models. But not all of them work equally well. And many therapists still treat couples as two separate individuals rather than as a system. That gap is filled by the work of Dr. Sara Spowart, a Licensed Marriage and Family Therapist based in Florida.
What the Research Says About Relationship Patterns
More often than not, couples fight something other than what they think they are fighting about. A disagreement over finances could be a disagreement about security. A conflict over time and attention is usually about connection and fear of loss.
This is what attachment science has documented for decades. When people feel emotionally unsafe in a relationship, they fall into predictable cycles: pursue and withdraw, attack and shut down, demand and disappear. These are nervous system responses.
This is why couples who addressed underlying attachment patterns, rather than surface-level behaviors, report higher relationship satisfaction.
Most people don’t know this when they go into couples therapy. They want communication tools, and when they leave without them, they wonder why nothing has changed.
How Dr. Sara Spowart Approaches Couples Work
Dr. Spowart, PhD, DMFT, LMFT, MA, MPA, trained extensively in attachment-based therapy, and her work with couples reflects that. She looks at the relationship itself as the client, not just the two individuals sitting in front of her.
“I believe in looking at couples and relationships as systems,” she explains on her website. “I work to assist couples and families in creating the healthiest dynamic possible.”
This means that the entire therapeutic process is changed. Instead of assigning blame or coaching communication scripts, Dr. Spowart focuses on the emotional architecture underneath the conflict. She helps couples understand the cycle they’re stuck in and interrupt it.
She draws on secure attachment theory as her clinical foundation, combined with Solution-Focused Therapy, Narrative Therapy, Dialectical Behavior Therapy (DBT), EMDR, mindfulness, and hypnotherapy.
A Boutique Practice Built Around the Individual Couple
Dr. Spowart runs what she calls a “boutique” practice. It means she doesn’t apply the same protocol to every couple who walks through her door.
Her services for couples include:
- Secure attachment-focused couples therapy (for addressing the emotional cycles and connection patterns that drive conflict).
- Trauma-informed work (for couples where one or both partners carry personal trauma that affects the relationship).
- Mindfulness-based interventions (including techniques from MBSR and MBCT) to help couples slow reactive patterns.
- EMDR and Safe and Sound Protocol (SSP) (for nervous system regulation when trauma is a factor).
- Hypnotherapy (as a complementary tool for deep-seated emotional patterns).
- Therapy (for personality disorders and abuse from personality disorders).
The Clinical Background Behind the Practice
Dr. Spowart holds a Clinical Doctorate in Marriage and Family Therapy, a PhD in Public Health with a concentration in mindfulness and well-being, and a Master’s in Happiness Studies. She has also taught graduate-level courses at the University of South Florida, New York University Medical School, and Carnegie Mellon University.
Her work spans more than fifteen years across trauma recovery, sexual violence response, global health advocacy, and clinical mental health. She has worked with survivors of human trafficking, taught mindfulness-based cognitive therapy to patients with chronic illness at NYU, and conducted on-the-ground research across West Africa and East Africa.
She has also been trained by the UC San Diego Medical School Center for Mindfulness, is certified in DBT, EMDR, and the Safe and Sound Protocol, and is a Certified Clinical Hypnotherapist.
Moving Forward Together
Couples therapy works when it addresses the right problem. Surface-level communication tools don’t fix deep attachment wounds. Dr. Sara Spowart’s practice is built on this: lasting change in a relationship comes from understanding the system, not just the symptoms. Her work offers couples a structured, evidence-informed path out of the cycles that have kept them stuck.
