This paper describes the process of couple therapy with a client who has a mild learning disability and cerebral palsy, and her partner, who also has cerebral palsy (all information has been anonymised and pseudonyms are used throughout). Informed consent was gained from both individuals for the purposes of writing about their case. Therapy spanned twelve sessions and was informed by systemic and psychodynamic ways of thinking. Formulations are discussed, and psychological theory is linked to what happened in the therapy room. The current study takes a reflective stance and discusses the process of therapy, which includes successes as well as pitfalls. Pertinent issues for people with learning disabilities are discussed in terms of power dynamics, the impact of physical disability, capacity to consent to therapy and the effects of abuse. (Contains 2 figures.)