• Couples therapist Priya Tourkow shares what questions she asks herself about the couple sitting in front of her, to help her understand their challenges

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I feel honoured when two people, struggling with their relationship, are sitting in front of me. This couple, in this particular relationship, becomes my client, even though it consists of two individuals. 

They have taken the step to come and see me, quite a challenging thing to do. The decision probably entailed a painful conversation about their difficulties and an agreement to do something about it, together. That will be the first thing I acknowledge to them as they sit down for their initial session.

Of course, it doesn’t always work this way. I sometimes hear from one member of the couple who may be desperate to get their partner to join them in therapy. However, for various reasons, this partner is not keen to attend. I always ask if they have discussed attending together as it is preferable for the couple to receive help since the problems belong to them both. If that’s not possible, I agree to see one of them. Often, after a session or two, the other one decides to join in. If they prefer not to join, I will continue to see the individual and help them with their situation, as it is for them personally.

I am always excited to see a couple. Initially, I’m very curious about their story, their dynamic and patterns, the issues they are grappling with. If they are coming regularly, I’m still curious: how are they doing with making change, connecting more and whatever it takes for them to move forward?

It is often an awe-inspiring experience to support and enable a couple to connect and deepen with one another and create their relationship afresh, going from despondency to hope and contentment.

It can also be difficult and hesitant, with two steps forward and one back on occasions. But, for me, it’s always absorbing and involving.

However, I’m fully aware that my involvement is not about being IN their relationship, which belongs to the two of them. My role is to be their coach and guide, from the outside, so to speak, paying attention to the dynamic of the two, how they cope with practical life, their styles of communication, expressions of empathy for one another, their patterns of intimacy and so much more.

How I came to specialise in relationships

You may like to know how I got to specialise in relationships, apart from the fact that I’m passionate about them! I became a holistic, integrative, mind and body psychotherapist almost thirty years ago. I trained with The Chiron Centre which, after many years, is now closed, though the body/mind movement is still active. I have always been drawn to the style of therapy that acknowledges that we are minds, bodies, emotions and spirit, all intertwined, with all aspects affecting one another.

As I worked initially with individuals, I was struck by the fact that most of their problems were deeply connected with and affected by their various relationships. I became more and more interested in studying and working with relationships themselves. Over the years, I have trained in various couple therapies, from emotionally focused couple therapy (EFT), to tantra (the ancient art of loving), to encounter based relationship therapy and psychosexual couple therapy.

I work with all kinds of couple issues: communication problems, intimacy and sexual issues, affairs, family difficulties, complications of re-constituted families, past abuse, body image, and troubles that one or both partners may be dealing with, which inevitably affects them both.

I specifically want to mention a speciality of mine: ADHD (Attention Deficit Hyperactive Disorder) or ADD (Attention Deficit Disorder). Many people are unaware that adults have this disorder as well as children. The fact is that if you had this as a child, you still have it! 

Sadly, this often goes unrecognised in adults as so many of us have some of the symptoms to a lesser degree. Bit, if traits like getting confused, overwhelmed, distracted, hyper-focussed, chaotic with practical tasks, lateness, telling lies are present in extreme degrees…PLUS the other partner is having a very hard time, it could well be that ADHD (ADD) is the problem. It’s challenging to discover that you have a named disorder, but it can also be a huge relief as there are many strategies that make it manageable for both partners in the relationship.

How each partner's background affects the relationship

Both individuals in every couple have naturally been raised by parent/s, with their cultural background, heavily contributing to who they are. This, sadly, may include the possibility of having suffered emotional/physical/sexual abuse. They may be highly vulnerable, sensitive, controlling, angry, have poor self-esteem and many other aspects of being human. This mix of personality aspects is what forms the essential dynamic between the couple, based on who they each are from the past and into the present.

Close relationships are renowned for triggering old patterns of fear, passivity, rage or anxiety to name just a few. 

They will each have a kind of view or template, often unconscious, about what makes a relationship good or bad. This is based on their family of origin, mainly how their parents did their relationship, both as a couple and as parents. Their individual templates may well be the opposite of each other’s, or they could be quite similar.

When I begin to explore what is going on with this couple sitting in front of me, I have lots of questions in my mind, in no particular order:

  • What is their communication like? Do they listen or interrupt one another?
  • How do they organise the practicalities of life together? Is one doing most of the tasks?
  • Can they tell each other what they are feeling, or do they project onto or blame the other one?
  • Do they openly appreciate one another or are they over critical?
  • Are they made up of two adults or is one more of a “parent” and the other the “child?”
  • Are they affectionate with one another? Is emotional and physical intimacy present in their relationship? Do they both create this?
  • Are they empathic, kind, caring, supportive and basically interested in one another?
  • What happens when they disagree?
  • Is one of them a “victim” and the other a “persecutor?”
  • Are they able to talk openly about intimacy and sex?

My main approach is to support the couple to “encounter” each other as fully as possible in the sessions.

I get them talking together face to face (and far less to me) about what’s going on between them: what hurts, what is good, what they want more of, or less of, and so on. I ask them to slow down their dialogues, as couples often communicate very fast and are not totally engaged. I coach them in listening to each other with focussed attention and affirming what they are hearing. This fully engages them with one another and creates feelings of connection, closeness and empathy. This doesn’t necessarily happen as easily and gently as it may sound. Sometimes they get triggered by each other in all sorts of ways. We look together at all of this, finding out what the triggers are about and where they come from.

We often go deep, through layers not previously addressed. Many couples tell me, regretfully, they have never really heard each other like this before. It’s as if a new territory of possibility starts to open up for them.

What has changed for couples

Over many years of working with couples, I have noticed more and more relationships negatively affected by the pace of their lives speeding up. It takes a lot of focused attention to slow it down and simply spend uncluttered valuable time together as a couple.

I encourage them to deeply see and meet with one another practically, emotionally and physically. Many couples have lost that sense of bonding after the initial romantic stage has faded somewhat, or after having children. Their couple-ness may have become inaccessible and they’re out of touch with expressions of love and appreciation of one another. It’s all gone rather dead.

In this disconnected atmosphere, irritations and arguments can all too easily take over. The intense focus on the content of these disagreements and differences can feel like dealing with life and death scenarios at times. I help them see that the process happening between them is much more valuable than getting stuck in the content. They gradually learn to speak to one another about their own feelings, the recurring sadness or pain or anger from a place of wanting to make sense of it for themselves, rather than blame the other person. They gain a personal language to share with one another, which can release a new communication style for them both. Arguments hold less power then.

With intimacy and sexual issues, it is vital that they feel able to personally communicate with one another. Mostly, they have not had the safety to talk about these things, let alone say what they would really like from each other. My ease with talking about sex relaxes them and supports them in building a journey for themselves in increasing their intimacy.

Often, sex has been put on a pedestal, with one or both pressurising for it to happen and feeling guilty if it isn’t.

When they become able to focus on everyday expressions of loving connection eg warm hellos and goodbyes, hugs and stroking, cuddles on the sofa, the pressure and guilt drops away. The intimacy grows, the loving connection strengthens and sexual enjoyment seem to flow more naturally. Again, this is not always straight forward or easy, but therapy rarely is!

Every relationship needs to be fed and nurtured by both partners as equally as possible. This is probably the beating heart of my offering to them; the key to this ideal being through their journey of emotional and physical intimacy. I am passionate about enabling couples to create and build this together because deep love and happiness can often ensue!

Priya Tourkow is a verified welldoing.org couples therapist in Kent and online

Priya is running an online course for couples starting on the 3rd March 2022 – more information here

Further reading

The main challenges polyamorous couples face

What a therapist thinks of TV's Couples Therapy

What are the origins of tantra?

MAFS UK and how to really be successful in relationships

Relationship therapy saved our marriage