What brings couples to therapy?

Couples rarely come to see me because of one neatly defined problem.

More often, several things have become tangled together. You may be arguing constantly but also haven’t had sex for months. An affair may have exposed difficulties that existed long before the betrayal. Parenting, work or money may be the subject of your arguments, while underneath them sits a much older feeling of not being heard, valued or understood.

Sometimes there isn’t even a great deal of conflict anymore. You have simply become distant. You organise the children, pay the mortgage, manage the week and function reasonably well together, but somewhere along the way you have stopped feeling like a couple.

At the other end of the spectrum are relationships in considerable distress. Arguments escalate quickly. One or both of you are exhausted. Separation has been mentioned, perhaps repeatedly. One person may be desperately trying to repair the relationship while the other isn’t sure whether they want to continue.

These are the relationships that make up much of my work.

I specialise in couples therapy for relationships that have become complex, highly distressed or difficult to shift, including couples on the brink of separation and couples who have already tried therapy but remain stuck.

Below are some of the difficulties that commonly bring couples to my practice.

Communication problems in relationships

“I think our problem is communication” is probably one of the most common things couples say when they first contact a therapist.

Sometimes it is. But communication difficulties can mean very different things.

Perhaps conversations quickly become defensive. One of you doesn’t feel listened to. One partner needs to talk things through while the other needs time before they can respond. You may interrupt, correct each other’s version of events or become so focused on establishing what actually happened that there is very little room left to understand how the experience felt to the other person.

Some couples communicate perfectly well about work, children and practical life but become almost incapable of talking when the subject is the relationship itself.

Good couples therapy isn’t simply about teaching two people to speak more politely. It is about understanding what happens between you when something important is at stake.

When you keep having the same argument

The details change, but somehow the argument feels remarkably familiar.

Last week it was money. This week it is sex. Before that it was your mother-in-law, parenting, work, the phone or who does more around the house.

Couples often arrive believing that they have twenty different problems. Sometimes they do. But underneath those problems there can also be a surprisingly consistent relationship cycle.

One person feels ignored and pushes harder to be heard. The other experiences that as criticism and becomes defensive or withdraws. The withdrawal leaves the first person feeling even less important, so they pursue harder. Both partners end up confirming precisely what the other was frightened of.

Identifying that cycle is an important part of the work. The problem gradually becomes something happening between you rather than simply something wrong with your partner.

Couples on the brink of separation

A significant part of my practice involves couples who genuinely don’t know whether their relationship will survive.

Sometimes divorce or separation has already been discussed. One partner may have emotionally begun to leave while the other desperately wants another chance. In other relationships, both people are simply exhausted and neither is certain whether enough remains to rebuild.

You do not need to come to couples therapy already united around the goal of saving the relationship.

My role isn’t to persuade two people to stay together, and it isn’t to assume that a relationship in serious difficulty should end. We need to understand what has happened, what remains between you, what would genuinely have to change and whether both people are willing and able to participate in that change.

Sometimes the work opens a route towards repair. Sometimes what a couple needs first is clarity.

Affairs, infidelity and betrayal

Discovering an affair can destabilise almost everything you believed about your relationship.

The betrayed partner may need answers and return repeatedly to the same questions. They may become highly alert to changes in behaviour, phone use, unexplained absences or inconsistencies. The partner who had the affair may feel ashamed, defensive or increasingly overwhelmed by conversations that seem never-ending.

This can create a painful cycle: the more one person needs reassurance and information, the more overwhelmed the other becomes; the more the other withdraws or becomes defensive, the less safe the betrayed partner feels.

Affair recovery involves more than deciding to put the past behind you. Safety, honesty and accountability matter. The injury itself needs attention, as does the question of what was happening within the relationship before the affair — without using relationship difficulties to excuse the betrayal.

Rebuilding trust after infidelity is possible for some couples, but it is a process rather than a decision.

Emotional disconnection

Not every distressed couple argues.

Some barely argue at all.

You may be good parents, manage a home together and look perfectly functional from the outside. Yet privately the relationship has become increasingly empty.

Conversations are mostly practical. Affection has reduced. You rarely ask each other meaningful questions. Perhaps you spend your evenings in different rooms or sitting beside one another looking at separate screens.

Couples sometimes describe themselves as housemates, co-parents or friends rather than partners.

Emotional disconnection can happen gradually enough that neither person can identify when it began. Therapy gives us an opportunity to understand how the distance developed, what has happened to friendship and intimacy, and whether emotional connection can begin to be rebuilt.

Sex, intimacy and differences in desire

Sexual difficulties rarely exist in complete isolation from the rest of a relationship.

Some couples have stopped having sex. Others have very different levels of desire. One partner may feel repeatedly rejected while the other experiences sex as another source of expectation or pressure.

For some couples, sex becomes the place where years of resentment, emotional distance, body-image concerns, stress, parenthood, hormonal changes, trauma or difficulties around vulnerability become visible.

The question isn’t simply “How often should we be having sex?”

We need to understand what sex and physical intimacy have come to mean within this particular relationship, what happens when one person reaches towards the other, and what has made closeness difficult.

Where a sexual difficulty requires specialist medical or psychosexual assessment, I may recommend appropriate additional support rather than assuming every sexual problem can be resolved through couples therapy alone.

Parenting and the stress of family life

Having children can place enormous pressure on a relationship.

Sleep deprivation, competing demands, loss of time together, different parenting styles, household workload and the sheer logistics of family life can gradually move the couple relationship to the bottom of the list.

Arguments may centre on discipline, screens, bedtime, schooling, who carries the mental load or whether one parent is sufficiently involved.

Often there is another conversation underneath the practical one:

I’m doing this alone.

You don’t trust me as a parent.

There is never any space for us anymore.

Nothing I do seems good enough.

Couples therapy can help separate the practical parenting disagreement from the relationship injury that has become attached to it.

Money and financial conflict

Money is rarely only about numbers.

For one person, saving may represent security. For another, spending may represent freedom, enjoyment or generosity. One partner may experience the other’s spending as irresponsible; the other experiences their partner’s caution as controlling.

Differences become particularly difficult when couples are under financial pressure, when one person earns substantially more, where there is secrecy around spending or debt, or where assumptions about money were never properly discussed.

The objective isn’t for a couples therapist to tell you how to manage your finances. It is to help you have the conversations that money has made difficult and understand what financial behaviour means to each of you.

Autism, ADHD and neurodiverse relationships

I work extensively with couples where one or both partners are autistic, have ADHD or are otherwise neurodivergent.

These relationships can contain considerable strengths, but differences in communication, emotional processing, sensory experience, routine, attention, executive functioning and the need for predictability can also create persistent misunderstandings.

One partner may experience withdrawal as rejection when the other is actually overwhelmed. A request for space can feel like abandonment. Forgetting something important may be interpreted as not caring. A neurodivergent partner may feel constantly criticised for things they are already struggling to manage, while the other person feels that their needs repeatedly disappear.

Generic relationship advice can be particularly unhelpful when it assumes that both partners experience and process the world in broadly the same way.

The objective isn’t to make a neurodivergent partner more neurotypical. It is to understand the relationship in front of us while helping both people take responsibility for their impact on one another.

Trauma, attachment wounds and relationship triggers

Sometimes the intensity of what happens between two people cannot be fully understood by looking only at the present-day disagreement.

A partner becoming distant may touch an old experience of abandonment. Criticism may activate a powerful sense of failure or shame. Following an affair, something as ordinary as a phone notification can bring the shock and fear of the original discovery rushing back.

Our histories enter our relationships with us.

That doesn’t mean that every strong emotion is a trauma response, nor should genuinely hurtful behaviour be dismissed as somebody else’s “trigger”. But where earlier experiences are contributing significantly to what happens between a couple, trauma-informed therapy can help us understand what is being activated within each partner.

Where appropriate, I can also draw on EMDR as part of the wider couples therapy work.

Resentment and years of accumulated hurt

Some relationships aren’t dealing with one enormous rupture. They are carrying hundreds of smaller ones.

Promises weren’t kept. Important moments were missed. One person repeatedly felt unsupported. Sex disappeared. Parenting became unequal. Attempts to talk ended badly. Apologies didn’t seem to change anything.

Over time, couples can begin interpreting even neutral behaviour through the history of everything that has gone before. Today’s interaction is no longer only about today.

Part of couples therapy can involve deciding which injuries genuinely need to be revisited and repaired, which patterns need to change in the present, and what each partner needs to take responsibility for if the relationship is going to feel different.

Different values, cultures and ways of seeing the world

Couples don’t need to agree about everything to have a strong relationship.

But differences can become increasingly polarised around religion, culture, family expectations, politics, lifestyle, parenting, money, where to live or what each person believes marriage and partnership should look like.

This can be particularly significant in intercultural relationships, where assumptions that seem completely obvious to one person may not be obvious at all to the other.

The goal isn’t necessarily to eliminate difference. Sometimes the more important task is learning how two genuinely different realities can exist within the same relationship without either person needing to defeat the other’s.

When one person wants more closeness and the other wants space

This is one of the most common patterns in couples therapy.

One person wants to talk, reconnect or obtain reassurance. The other feels overwhelmed, criticised or pressured and needs distance. Unfortunately, each person’s attempt to feel safer tends to make the other feel less safe.

The more one pursues, the more the other withdraws. The more one withdraws, the more urgently the other pursues.

Neither partner necessarily created the pattern deliberately, but both eventually become caught inside it. Learning to recognise what is happening before the cycle takes over can change the conversation considerably.

When previous couples therapy hasn’t worked

Many couples who come to me have already tried couples counselling.

Sometimes it helped for a while. Sometimes you gained considerable insight but struggled to translate that understanding into change at home. Perhaps sessions repeatedly became consumed by the latest argument, or just as you reached something important, the hour was over.

Previous therapy not producing enough change does not necessarily mean that your relationship is beyond help. It may mean that you need a different therapeutic approach, a different therapist or simply more uninterrupted time to work with what is happening.

This is one reason my practice has increasingly moved away from conventional weekly couples counselling and towards extended and intensive sessions of three hours, one day or two days.

When a relationship crisis is time-sensitive

Sometimes couples therapy cannot comfortably be treated as an open-ended process.

A decision needs to be made. Someone is considering moving out. An affair has just been discovered. A wedding is approaching. A baby is coming. One partner has said that they cannot continue as things are. Or there is a narrow window in which both people are still willing to try.

These situations can create urgency, but urgency doesn’t mean rushing towards a predetermined outcome. It means creating enough focused space to understand what is happening while there is still an opportunity to do something meaningful with it.

When you love each other but can’t seem to make the relationship work

Perhaps one of the most painful situations is when there is still love between two people, but being together has become extraordinarily difficult.

You may both care deeply and still hurt each other. You may understand each other’s histories and still become caught in the same conflict. You may have promised countless times that things will be different and genuinely meant it.

Love matters. But love by itself doesn’t always tell us how to create a workable relationship.

Sometimes couples therapy is about helping two people understand why something that matters so much to both of them has become so difficult to live inside.

You don’t need to know exactly what the problem is

You don’t need to diagnose your relationship before contacting me.

You may recognise yourselves in several of the difficulties above, or none of them precisely. Most complex relationships don’t fit neatly into one category anyway. An affair may coexist with years of disconnection. Parenting difficulties may sit alongside ADHD. Sexual distance may be connected with resentment. Trauma may amplify conflict that already has legitimate causes.

That complexity is part of the work.

My practice is based just outside Galway City. I work with couples from Galway and across Ireland, as well as couples travelling internationally for focused intensive work. My practice is built around extended sessions and one- and two-day intensive couples therapy rather than conventional weekly appointments.

If you aren’t sure what kind of help your relationship needs, you don’t need to work that out before getting in touch.

We can start with the relationship you actually have.

Tuesday to Friday: 17:00 – 22:00

(Max. of 4 appointments per day)