Relationships - whether with family, friends, or partners - will have had a marked impact on our sense of self and how we relate to others. They can provide us with security, affection, excitement and hope, but our closest relationships are often the playground - or battleground - upon which our deepest vulnerabilities, our most damaging behaviours, and our unresolved past hurt can be revealed. 

According to Relate, 25% of people are in distressing relationships, characterised by issues around sex, money, trust and communication. Only 1 in 3 people report being satisfied with their sex life with their partner, with many others detailing issues around loss of libido and intimacy. Studies have shown that our relationship health is intimately related to our individual mental health: Relate's research found that those who reported being happy in their relationship were less likely to report experiencing emotional and mental health difficulties, such as depression

Here, therapists explore common relationship problems and how couples counselling might help:

1) Trust, intimacy, and infidelity 

Research carried out by Relate shows that 67% of people view trust as the most important factor in a relationship. But trust can be hard to build, and even more difficult to maintain. "When two people become uniquely involved in a relationship, each brings with them generations of aware and unaware culture and norms. These can manifest as problematic symptoms such as withdrawal, arguing, infidelity or simply loss of energy and interest," says Gestalt counsellor Tania Tuft

"One of the learned behaviours is our management and tolerance of intimacy. We have all acquired our own relationship with intimacy. What many couples don’t realise is that we all need to moderate intimacy and that the ideal is to be able to move in and out of intimacy freely, becoming fixed neither in isolation or confluence. Because couples are concerned about rejecting or feeling rejected they develop strategies, and ‘play up’. Many relationship problems can be seen as misguided strategies to moderate intimacy, ranging from ‘hiding’ in work or tech-use to jealousy, infidelity, or arguments which function to rupture or distance.

If our early relationship was with someone who found intimacy and vulnerability terrifying, our own intimacy needs will have been locked away behind thorny brambles of fear and trepidation. One unwitting breach by our partner, who has their own history, and the portcullis slams down, fearing and rejecting the perceived and possibly unwitting perpetrator. This sounds extreme, but most of us operate at a level where this primal drama is not fully available to us, only the repertoire of behaviours we reach for.

Our partner, with their own material, is often unequipped to heal our wounds, even though we long for them to do so, and much of our hurt, resentment and anger arises from this unrealistic expectation. The therapist equips us with awareness which enables us to change in better relationship with ourselves, and in becoming free, we experience our relationships change."

2) Sexual problems

Selena Doggett-Jones, a psychosexual therapist working in London, often sees clients with sexual problems in relationships: "Most people suffer sexual problems at some point in their lives. Unfortunately, especially in the UK, people often feel ashamed about being sexual in the first place let alone sexual problems. We snigger about sex, rarely talking directly about it to friends or family. This shame can prevent people from seeking help.  

Working with a therapist who is trained in psychosexual therapy can be very helpful in normalising peoples' concerns, in educating them about sexuality and listening to them in an accepting and non-judgmental way. These therapists talk about sex in detail on a regular basis so there is no need to be embarrassed and often by naming the concern out loud to an empathetic listener it can be disempowered. Clients can be concerned about so many aspects of sex, sexuality, gender, sexual fantasy and what they perceive to be strange sexual interests and practices. Religious and cultural influences can prevent them from enjoying sex or be in conflict with their partner’s or family’s beliefs. When this is the case couples therapy can be so helpful in guiding the couple to listen to each other in an active and empathetic manner leaning to understand from where some of the misunderstood behaviours may derive.  

Sometimes clients seek help because they are fearful and have never been able to have an intimate relationship. There maybe a history of abuse and trauma that has left them ashamed and terrified. They may never have experienced affection or intimacy within their family or for some other reason struggle with making relationships. These clients can be supported into exploring their fears and encouraged to recognise they have choices and autonomy."

3) Difficulties involving family and friends 

Our position in the family, the roles we played growing up, and our relationship with our parents may all affect our current relationships. Therapist Francis Atkinson explains: "We are often (unconsciously) attracted to someone because of who they might represent in our family of origin. A father, mother, brother, or sister. Sometimes this works, and there are no problems, and everyone gets on fine. But it can also the case that the partner ends up being part of a ‘family drama’ that they don’t (consciously) realise they are in. but in being part of it, end up contributing to unresolved issues of their partner’s family, without realising it.

This can also happen with friends of a partner, where, as with your family, your partner, and/or you, have friends who in some way also represent part or parts of your own family, and then you end up being part of a drama that you don’t realise you are in.

These patterns, which are mostly unresolved developmental relationship dynamics from childhood, can be worked on and understood with a couples therapist. In doing this, you can hopefully ‘unpick’ the part or parts of your family/friends that your partner has been immersed in, and uncouple the past from the present, and see each other for who you are now." 

4) New parenthood 

"When two become three or more, the dynamic in an intimate relationship changes," says therapist Judith Chamberlain. 

"For the new mother, the focus is not only on the baby but also on her own changing body and mind, on how she must adapt psychologically to motherhood. With each stage of pregnancy and with each day of the baby’s life there is an ever-evolving state of mothering and state of mind.

Part of this process is affected by the cultural and societal expectations of how to be a ‘good’ mother. From psychoanalytic literature to neuro-scientific research there is so much written about the crucial role of the mother and her effect, good but all too often bad, on the developing psyche of the infant. In contrast, very little is written about the partner’s role and even less is written about the parental relationship.

Clients I see can be suffering hugely because on the path to and through motherhood they have “lost” themselves and a sense of being in a couple. Memories of what they experienced as a baby and child themselves in being mothered are frequently heightened at this time. In many ways they become strangers to themselves and their partners.

Talking about and seeking help before breaking point for sexual and emotional changes in relationships with partners is taboo. The expectation, after all, is that the baby has brought you closer, is it not?

Couples therapy can be an incredibly supportive way to process what can be overwhelming feelings. Talking to someone who is not emotionally involved or judgemental, who can see the bigger picture at a point when you can only see risks and feel anxiety or despair, can be immensely grounding."

5) Mid-life and menopause 

Veronique Briant, a couples therapist working in St Leonards-on-Sea, sees many couples who experience difficulty in mid-life: "My experience suggests that couples usually do have some strengths working as a team but they have sometimes forgotten their shared experience and strength. For mid-life couples, the scenery is often different. They are likely not to be experiencing the earlier demands of their marriage with younger children, work, making a home, etc., but now other issues come into focus. I don't want to be too gender-specific here, but menopause can be confusing and can play havoc with moods and sex drive. Men often start to focus on retirement but don't necessarily discuss changes in feelings of self-worth. In mid-life, couples might see themselves mirroring aspects of their parents. Health becomes a factor and medication can have affects on the body and mood.

Couples in mid-life may have often developed a certain stamina and sometimes forgotten how to access a relationship connection. In this instance, investigating well-worn routines can be useful - counselling can provide a relationship MOT of sorts - a checklist and reminder on the whole person and the relationship."

6) Changing values, behaviours, and opinions 

'Opposites attract' is a well-used adage, but why is it that so many of us find ourselves drawn to partners who embody such different characteristics to ourselves? This could be the influence of our unconscious, explains Albertina Fisher: "We have to remember that we are usually not aware of lost and disavowed aspects of ourselves. These aspects are usually ones we were taught by parents or by experience to see as negative, and can include anger, ambition, emotional needs and many, many other things.

Being with someone different to us offers the possibility of re-integrating lost aspects of yourself that the other has, but that can only happen if we can face the fact that we, too, possess these aspects, mourn the fact that they were lost to us for so long, and begin the painful process of change that allows us to become more rounded versions of ourselves. Where this happens, both partners grow and develop. But where lost aspects of the self cannot be accepted and re-integrated, they slowly become more and more irritating to see in the other. 

Psychodynamic couple theory gives us a way to think about this phenomenon, based on the concept of 'unconscious partner choice'. This suggests that we choose our partner because, unconsciously, they remind us of parts of ourselves that we have lost touch with, often to such an extent that we can deny that they are a part of us too."

7) Substance abuse and addiction 

"Alcohol and substance abuse, where one person is consuming and the other is not, is significantly damaging to the relationship and to the health and wellbeing of one or both partners," explains therapist Gurpreet Singh

"With the passage of time, emotional and financial concerns can start to become real. As the habit continues, you might start to feel alienated and think that your partner does not understand you. Feelings of isolation create an environment of distrust which rock the pillars that the relationship is built on. This will intensify the anger and isolation you already feel. Inevitably, this will give rise to arguments and may lead to violence if not managed and contained. 

Therapy offers you both the ability to understand each other and create a supportive environment in which you can deal with the issue that led to this behaviour. Whilst it is accurate that substance abuse can lead to an increase in arguments, it is also possible that the perceived state of the relationship is causing the habit. Couples therapy helps you develop honest communication with each other, create a mutually supportive environment and deal with the issues that might underpin some of the substance abuse behaviour."

8) Feeling under-appreciated

Feeling that a relationship, whether in terms of domestic responsibilities or emotional input, is one-sided is a common relationship problem. "Sometimes you might feel undervalued by someone who is important to you. There could be many reasons for  a relationship seeming one-sided: a lack of appreciation or perhaps lack of motivation to continue the relationship," says therapist Bhavna Jaiswal.

"Sometimes people are not able to identify the reason and might need an expert who can help. At this stage couple / relationship counselling will be helpful. Couples therapists can help both partners understand the needs, thoughts, emotions of the other and try to bring you back to the same page. In some situations, where a partner is unable to express their feelings, therapy also can help to provide a platform to do this. 

Therapy also can help you discover whether the relationship is genuinely one-sided or there is a lack of communication. If this problem is rooted in poor communication, relationship therapy provides a platform where couples can express their hidden or real feelings can be explored in a non-judgemental environment." 

Further reading

Depression is harming my relationship – what can I do?

How negative self-talk damages relationships

5 rules for fair fighting in relationships

How therapy helped me find the right relationship

Relationship therapy saved our marriage