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PMDD Couples: The Art of the Apology

In a recent couples counselling session, a couple shared they had been fighting for days over a relatively minor issue. When digging deeper, I realized the husband had felt ignored and dismissed by his partner, a PMDD sufferer. For him, this cut particularly deep, given how much work he’s done with her to support her symptoms and understand this disorder. In session, she apologized, stating, “I am sorry you feel so insecure about this. I thought you were more confident.”

Unsurprisingly, he didn’t accept her apology.

Apologies are a bit of an art, and we have to understand when communicating how important they are. While it’s natural for couples to fight or disagree over little and big things, it’s not the argument that matters; it’s the repair. And repair lies in the careful art of the apology.

Famous people have gotten into hot water over this time and time again, with half-baked apologies that typically state, “I’m sorry if you were upset…” These do NOT work, and nowadays, it’s rare for an actor/singer/athlete to not be called out for the approach to an apology.

Most often, we just near to hear that our partners are sorry when they do something (either on purpose, or more commonly, accidentally) wrong. A sincere apology is one of the most powerful tools for connection, healing, and trust-building in relationships. Yet, many of us never learned how to truly apologize. We offer a quick half-hearted “I’m sorry,” defend ourselves mid-apology, or skip it altogether.

Why Apologizing Is So Hard

In my time in the corporate world, I heard repeatedly to never apologize, as “it makes you look weak.” Early in my career, I had a boss who pounced when I apologized, yelling more when I took responsibility for a mistake. So, I stopped. I suppressed my urge to apologize, particularly when I messed up, in favour of excuses or blaming others. It did not make me better at my job, but it did mean I got called out at times for never taking responsibility. Hence, I started to appreciate the importance of apologies.

We often struggle to apologize due to:

  • Ego and defensiveness: Apologizing can feel like admitting failure or weakness (see my example above). It challenges our self-image and can feel threatening to our sense of self.
  • Fear of blame: Some fear that taking responsibility means being blamed for everything or that it will be used against them (again, my example above).
  • Not understanding the impact: We often focus on our intentions rather than the impact of our actions, making it hard to see why an apology is needed. This is very important, as it’s easy to know what we meant without understanding how it made the other person feel.
  • Unresolved shame: If we carry unresolved shame or trauma, even small criticisms can trigger big reactions, making apologizing feel unbearable.

But avoiding apologies—or offering poor ones—keeps couples stuck in cycles of resentment and disconnection.

The Anatomy of a Real Apology

An effective apology goes beyond the words “I’m sorry.” It’s a relational act—a bridge between two people that says: “I see how I hurt you, and I care enough to make it right.” A meaningful apology includes the following elements:

  1. Acknowledgment of Harm

Name the specific behavior and its impact. This shows your partner that you understand how they were affected.

“I realize that when I raised my voice and walked out of the room, it made you feel abandoned and dismissed.”

Apologies should address what was done in the moment. Don’t say “I’m sorry I’m the worst husband in the world, and I’m making you miserable.” Instead, say, “I’m sorry I didn’t listen when you needed me to listen.”

  1. Taking Responsibility

Avoid minimizing, justifying, or blaming. Focus on your role. Do not surmise or assume (like “I didn’t realize you couldn’t handle this,” or “I’m confused by your low self-esteem.”)

“That was wrong of me, and I take full responsibility for it.”

  1. Expressing Regret

Let your partner know you feel genuine remorse, not just for the consequences, but for causing pain.

“I truly regret hurting you.”

  1. Commitment to Change

Apologies lose power without change. Offer a concrete step toward doing better.

“I’m working on pausing when I feel overwhelmed instead of shutting down. Next time, I’ll ask for a break rather than walking out.”

  1. Invitation to Talk

Apologies are part of a conversation. After apologizing, give your partner space to share how they feel.

“Is there anything you’d like me to hear or understand more about how that affected you?”

Now, in the heat of the moment, this type of approach can be very tough. This is why apologies often come after we’ve had a chance to cool down.

Not Great Apologies

Again, apologies are needed to address the wrong you’ve done in a situation. Try to avoid:

  • “I’m sorry you feel that way.” (This evades responsibility and shifts blame to your partner’s emotions.)
  • “I didn’t mean to…” (Intent matters less than impact. Focus on their experience.)
  • “I’m sorry, but…” (Anything after “but” usually cancels out the apology.)


When an Apology Isn’t Enough: Betrayal and Infidelity

While apologies are a core part of relationship repair, situations involving betrayal — such as infidelity — call for a deeper level of healing. In these cases, trust has often been significantly damaged, and rebuilding it takes far more than words. Alongside a sincere apology, recovery typically requires consistent accountability, transparency, and ongoing actions that demonstrate commitment to the relationship over time. As discussed in this article on ‘How To Get Over A Cheating Husband And Move Forward‘, our couples counselling supports the recovery process after a betrayal — whether that means working to rebuild trust, or finding a way to emotionally navigate the end of a relationship.

A good, effective apology can diffuse an emotional situation and make the other person feel heard. For PMDD Couples, where one partner is suffering from symptoms, emotions can run high for both parties. When we learn to apologize when we’re in the wrong (or if we have unintentionally caused harm), we can repair our relationships and feel better overall.

About the Author: Nadine Evans
PMDD and ADHD therapist - Nadine EvansNadine was diagnosed with PMDD nearly a decade ago and subsequently left her corporate career to become a therapist. She and other therapists at Impart Therapy all focus on PMDD treatment and therapy, and her book, Mastering the Monthly Madness, provides a DBT-focused guide to help with PMDD. 

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