About couples therapy
Couples therapy helps partners improve communication, handle conflict, rebuild trust after a crisis or make decisions together, including separation. Sessions are usually joint, sometimes with individual meetings. It is not about deciding who is right but about understanding the patterns between you.
Psychoanalysts work with psychoanalytic or psychodynamic therapy, which explores how past experiences and unconscious patterns shape present feelings and relationships. It is usually a longer, in-depth process. Training and titles vary by country: check each professional’s background.
Getting mental health care in North Macedonia
Public health system · Public health system (Ministry of Health and Health Insurance Fund): community mental health centres and hospital psychiatry
Public mental health care is delivered through community mental health centres and hospital-based psychiatric services, with referral between primary, secondary and tertiary care. The national strategy for 2018-2025 aimed to decentralise care and reduce reliance on psychiatric hospitals. According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines. More information
How to check that a professional is licensed
- Chamber of Psychologists of North Macedonia (Комора на психолози). Only psychologists who hold a general and/or special licence issued by the Chamber may provide psychological services. A general licence requires a year of practice, a professional exam and entry in the Register of Psychologists, and a special licence requires additional specialised training. The Chamber publishes a list of licensed psychologists. Search the official register
- Doctors' Chamber of Macedonia (Лекарска комора на Македонија). The Chamber issues doctors' working licences and publishes a register of doctors and a list of doctors with valid licences. Search the official register
Insurance and coverage
According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines in the public system.
Urgent help in North Macedonia
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 112 · Emergencias
Information reviewed in November 2026 · Sources: who.int, borgenproject.org, komoranapsiholozi.mk, lkm.org.mk
Signs to look out for
All couples argue. It may be time to seek help when the same arguments repeat without resolution, conversations quickly turn into criticism or silence, you feel lonely within the relationship, affection or sex have faded and that worries you, trust has been broken, or a big change such as a baby, illness or a move has unbalanced things. Considering separation is also a reason to talk.
What helps: treatments and professionals
Couples therapy approaches with good evidence include emotionally focused therapy, integrative behavioural couple therapy, cognitive-behavioural couples therapy and the Gottman method. Couples therapists, psychologists and psychotherapists with couples training usually lead the work, and a sex therapist can help when sexual concerns are central. Therapy can help couples reconnect, or separate with less damage, especially when children are involved.
When to seek urgent help
If there is physical violence, threats, sexual coercion, or you feel afraid of your partner, your safety comes first: contact your local emergency services if you are in immediate danger, and seek specialised support for domestic violence. Couples therapy is not recommended in these situations. Seek urgent help too if anyone has thoughts of suicide or harming others.
What you can do in the meantime
Choose calm moments to talk about difficult topics, rather than in the middle of an argument. Try to describe how you feel and what you need, instead of criticising. Take a break if things escalate and agree to come back to it. Make time for small moments of connection. Reading reliable information on relationships together can also open useful conversations.
What does a psychoanalyst do?
A psychoanalyst works with people who want to explore how early experiences, desires, conflicts and unconscious patterns influence how they feel, relate and choose today. Day to day they listen closely, help connect present difficulties with personal history, and pay attention to dreams, repetitions and the relationship with the analyst. Sessions are usually frequent and the process tends to be long-term.
When to see a psychoanalyst
Psychoanalysis or psychodynamic therapy may suit you if you notice repeating patterns in relationships, a persistent sense of emptiness or dissatisfaction, or want to understand yourself in depth and are open to a longer process. If you need quick relief for a specific symptom, such as panic attacks or a phobia, a structured approach like CBT may be more appropriate first.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in North Macedonia cover psychological care?
Public mental health care is delivered through community mental health centres and hospital-based psychiatric services, with referral between primary, secondary and tertiary care. The national strategy for 2018-2025 aimed to decentralise care and reduce reliance on psychiatric hospitals. According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines.
How do I check that a psychoanalyst is licensed in North Macedonia?
Chamber of Psychologists of North Macedonia (Комора на психолози): Only psychologists who hold a general and/or special licence issued by the Chamber may provide psychological services. A general licence requires a year of practice, a professional exam and entry in the Register of Psychologists, and a special licence requires additional specialised training. The Chamber publishes a list of licensed psychologists.