By Mark Ryan, BACP Accredited Psychotherapist (MBACP Accred) and NCPS Accredited Relationship Therapist
Many couples wait a long time before seeking help. In my experience, by the time they do, resentment has often set in, communication has frayed, and one or both partners may have begun to emotionally check out of the relationship.
That delay is not a personal failing. It reflects something genuinely difficult about the decision to seek help. Couples therapy can feel like an admission that something is wrong, and most people are taught, implicitly or explicitly, to keep relationship struggles private. Many couples also assume therapy is for crisis situations, or that they should be able to work things out on their own first. By the time they decide otherwise, the work has often become harder than it needed to be.
This piece is for anyone who is asking themselves whether their relationship warrants therapy. The honest answer is that you almost certainly do not need to wait until things feel desperate. Below, I walk through the signs that suggest it is time, what the research I can stand behind says about each, and the question of whether you can afford to wait.
In brief
You do not need to be in crisis to start. Many couples come because something feels off or stuck.
Seven patterns I see most often: recurring arguments, withdrawal, fading connection, broken trust, a big life transition, thinking about leaving, and feeling like roommates.
Research on couple therapy is encouraging, including in everyday clinics and in studies that followed couples for five years.
Therapy is not right for every situation, and I explain when it should wait.
A free consultation is a low pressure way to find out.
Why couples wait
There is a quiet logic to waiting. The thinking usually goes something like this: things are not that bad yet, we have been through worse, we should be able to sort this out ourselves, and therapy is something you do when you are on the brink. In my experience this logic means couples often arrive at therapy later than they might have.
Research on help seeking fits that picture, at least in part. In a study that followed 213 couples through the first five years of marriage, 36 per cent sought some form of outside help during that period. Individual and relationship difficulties predicted increased use of relationship books and marital therapy in the following year, so couples tended to look for help after difficulties appeared and not before (Doss et al., 2009). This was a study of newly married couples in the United States, so I would be careful about applying it to every relationship.
Part of the reason is cultural. Therapy of any kind still carries traces of stigma in the UK, and couples therapy in particular tends to be associated with relationships that are already in serious trouble. That association discourages couples from seeking help at exactly the point when it may be easiest to use.
There is also a more practical reason couples wait. Many people simply do not know what counts as a good reason to seek therapy. They imagine they need a clear crisis, a major breach of trust, or an obvious breakdown in communication. In my experience, most of the couples I work with do not arrive in crisis at all. They arrive because something feels off, or stuck, or quietly wrong, and they have decided not to keep waiting. If you want a sense of what that initial conversation looks like, I have written separately about what actually happens in a first couples therapy session.
Signs it is time to consider couples therapy
Below are the patterns I see most often in couples who, in retrospect, wish they had come in sooner. None of these on its own means your relationship is in trouble. But if more than one feels familiar, that is usually worth paying attention to.
1. The same arguments keep happening
If you find yourselves rehearsing the same fight again and again, with no real resolution, that is a signal worth taking seriously. In my experience, recurring arguments are rarely about the surface issue. They tend to be the visible part of an underlying pattern, often involving unmet needs, attachment dynamics, or unspoken fears. Without intervention, these cycles tend to set rather than resolve.
There is research that suggests how a hard conversation begins is worth attention. In a study of 124 newlywed couples, researchers coded a 15 minute discussion of a marital conflict and found that it was possible to predict marital outcome over a 6 year period using just the first 3 minutes of the discussion (Carrère & Gottman, 1999). That does not prove the start causes the outcome. But it fits what I see: couples who keep opening the same conversation in the same way tend to get the same result. I have written more about this in how to stop arguing with your partner.
2. One or both of you has started to withdraw
Withdrawal can look like silence after a fight, avoiding difficult conversations, spending more time apart, or simply checking out emotionally. The Gottman Institute describes stonewalling, which means shutting down and withdrawing from a conversation, as one of what it calls the Four Horsemen, alongside criticism, contempt and defensiveness, and it describes the four as damaging when they become pervasive (The Gottman Institute, n.d.). Those are the Institute's claims about its own model.
A pattern researchers have studied for decades is the one where one partner pushes for change and the other pulls back. In a study of 31 couples, the partner wanting a change pressured the other through emotional requests, criticism and complaints, while the other retreated through defensiveness and passive inaction. Both partners were more likely to demand when discussing a change they wanted, and more likely to withdraw when discussing a change their partner wanted (Christensen & Heavey, 1990). In my experience withdrawal is often misread as the absence of conflict, when it is really a form of it. A small study suggests why shutting down matters. Couples whose bodies showed a broad pattern of high physiological arousal during a conversation about their relationship went on to report a greater decline in satisfaction over the next three years. The study followed 30 couples, and 19 of them were traced three years later (Levenson & Gottman, 1985). I cover the dynamic in more detail in my piece on stonewalling and emotional shutdowns.
3. The emotional or sexual connection has faded
Sexual and emotional disconnection often go together. In a study of 108 couples seeking therapy at a clinic in Montréal, the most common problems they reported were communication, emotional affection or distance, specific areas of the current relationship, and lack of physical affection or sex (Boisvert et al., 2011). That was a single clinic and a fairly small sample, so it describes those couples and not all couples.
A drop in physical intimacy is rarely just about sex. It usually reflects something happening in the relational foundation underneath, whether that is unspoken resentment, accumulated stress, changes in life stage, or a slow drift in closeness. Couples often wait years to address this, hoping it will resolve on its own. In my experience, it rarely does. One area where research gives some hope is talking about it. A meta analysis of 93 studies, covering 38,499 people in current relationships, found that sexual communication was positively associated with both relationship satisfaction (r = .37) and sexual satisfaction (r = .43), and that the quality of the communication mattered more than how often couples talked (Mallory, 2022). These are associations, not proof of cause, but they suggest that learning to talk about intimacy is worth the effort. I have written separately about desire discrepancy and about why couples stop having sex.
4. Trust has been broken
This is the one situation where couples often do come to therapy promptly, particularly after infidelity. But trust can be broken in less obvious ways too. Repeated dishonesty about money, secret addictions, emotional affairs, or a pattern of broken promises all erode the foundation of safety in a relationship. If you are sitting with a sense that you cannot quite trust your partner, or that they cannot trust you, that is worth bringing into a therapy room.
The research on infidelity and therapy is small, but it points towards hope. A small exploratory study followed 19 couples who had experienced an affair, within a larger trial of couple therapy. It found that couples who revealed the affair before or during therapy showed greater improvement in relationship satisfaction than couples who had not experienced infidelity (Atkins et al., 2005). It shows what is possible, not what is likely. And in an interview study of 13 people who had completed a treatment trial for distress following romantic betrayal, participants described the betrayal as shocking and destabilising and found it hard to understand the intensity of their own reactions. When they encountered a trauma framework to explain the effects of betrayal, they described clarity, validation and relief (Lonergan et al., 2021). I have written separately about how couples heal from infidelity and rebuild trust and about the first two weeks after finding out.
5. You are facing a major life transition
Marriage, moving in together, having a baby, redundancy, illness, bereavement, retirement, blended family dynamics: all of these put pressure on a relationship in ways that are not always visible at the time. One transition has been studied closely. In a study of 218 couples followed through the first eight years of marriage, parents showed a sudden deterioration in relationship functioning after the birth of their first child, which was small to medium in size and tended to persist. Mothers and fathers showed similar amounts of change, and couples without children showed a more gradual decline without the sudden change (Doss et al., 2009b). That tells us about one transition in one group of newly married couples, so I would not generalise it to every transition. But it fits what I see: couples often assume they should manage transitions on their own, and therapy during a transition is not a sign of weakness. It can be preventative. If you have a new baby, I have written about why the first two years are so hard on a relationship.
6. You are thinking about leaving
If one of you has started to seriously consider whether the relationship has a future, that is a clear signal. It does not necessarily mean the relationship is over. Many couples come to therapy specifically to find out whether what they have is worth saving, and that is a legitimate reason to seek help. In the Montréal study mentioned above, couples who came to resolve ambivalence about the relationship reported more problems with commitment or security and with infidelity or flirting than couples who came to relieve distress (Boisvert et al., 2011), which suggests that these are different reasons for coming and may need different kinds of help.
It is also worth knowing that a good outcome in therapy does not always mean staying together. In a study that followed 134 seriously and chronically distressed couples for five years after therapy, both therapies produced substantial improvements in marital satisfaction. About a quarter of the couples (25.7 per cent and 27.9 per cent) were separated or divorced at follow up (Christensen et al., 2010). The honest answer often emerges through the process itself. What matters is that you give the relationship a real chance to be examined before making a decision that cannot easily be undone. I have written about how to know when a relationship is over and about whether a trial separation can save a relationship.
7. You feel more like roommates than partners
This is one of the quieter signs and one of the most overlooked. The relationship is not in crisis. There are no big fights, no breaches of trust, no obvious problems. But the closeness has gone. You manage the household, raise the children, get through the week, and end up living parallel lives. Couples in this state often do not seek help because nothing feels urgent enough. In my experience, the slow erosion of intimacy is one of the most common reasons relationships end, and it often responds well to therapy when it is caught early. If this is where you are, my piece on when you have nothing left to say to each other may speak to it.
Many people simply do not know what counts as a good reason to seek therapy.
What the research says about couples therapy
I want to be careful here. The studies I can stand behind show how couples seek help and how well couples therapy works overall. I have not been able to confirm a study showing that going earlier produces better results, so my belief that earlier is easier comes from my clinical work and not from research.
On the overall evidence, a review of a decade of research on couple therapy concluded that it positively affects about 70 per cent of the couples who receive it, that its effectiveness is comparable to that of individual therapies and far better than no treatment, and that couple distress is closely linked with depression and anxiety (Lebow et al., 2012). A later review of the research on Emotionally Focused Therapy concluded that it meets or exceeds the guidelines for classification as an evidence based couple therapy (Wiebe & Johnson, 2016).
It also works in ordinary clinics. In a UK study of 877 people who completed at least two sessions of psychodynamic couple therapy, individual psychological distress fell with a large effect size and relationship satisfaction improved with a medium effect size, and the authors described effect sizes similar in strength to those reported in randomised trials (Hewison et al., 2016). And benefits can last. In the five year follow up of 134 seriously and chronically distressed couples, effect sizes remained large and about half of the couples showed clinically significant improvement (Christensen et al., 2010).
There is one more finding worth knowing, because it bears on how to use therapy once you start. In a randomised trial of 410 people at a community family counselling clinic, couples whose therapists received regular feedback on their progress and the quality of the alliance achieved nearly four times the rate of clinically significant change compared with treatment as usual (Anker et al., 2009). That is a good question to ask any therapist: how will we know whether it is working?
If you want a fuller and more cautious picture, I have written separately about whether couples therapy is worth it.
When therapy might not be the right answer yet
It is worth saying that couples therapy is not the right intervention for every situation. In my view, if there is active domestic abuse in the relationship, conjoint therapy is generally not appropriate and may even be unsafe. If one partner has an active and untreated addiction, couples work often has to wait until the underlying issue is being addressed individually. And if one partner is unwilling to engage in good faith, therapy will struggle to help. If your partner is reluctant, I have written about what to do when your partner won't go to couples therapy and there is a companion piece, an honest guide for the sceptic.
There are also situations where individual therapy is the right starting point. If one of you is struggling with significant unaddressed mental health issues, or is processing trauma that predates the relationship, it can be helpful to do that work individually first, or alongside couples therapy. A good couples therapist will tell you honestly if they think individual work is needed first.
Taking the next step
If you have read this far and something has resonated, the most useful thing you can do is have a conversation about it, ideally with your partner, but also potentially with a therapist. Most couples therapists, including me, offer a free initial consultation in person or online. It is a low stakes way of finding out whether therapy might help and whether the therapist feels like a good fit, without committing to anything. If you are comparing therapists, I have written a guide to how to choose a couples therapist in London.
My practice, Rise and Grow Therapy™, offers couples therapy across central London from rooms in Kensington, Pimlico and Angel, Islington. I work with couples of all configurations, including same sex and consensually non monogamous relationships. If you are weighing up whether the time is right, the consultation is the easiest way to find out.
The thing I most want to leave you with is this: in my experience, the biggest mistake couples make is not whether they choose the right therapist or the right approach, it is waiting too long. If you have been wondering for months or years whether you should do something, that itself is worth listening to.
About the author
Mark Ryan is a BACP Accredited Psychotherapist (MBACP Accred) and NCPS Accredited Registered Relationship Therapist based in central London. He runs Rise and Grow Therapy, with rooms in Kensington, Pimlico, and Angel, Islington, and works with individuals and couples on relationship difficulties, intimacy, communication, and emotional connection. He has particular experience working with diverse clients and couples in consensually non-monogamous relationships. To book a free consultation, visit riseandgrowtherapy.co.uk.
References
Anker, M. G., Duncan, B. L., & Sparks, J. A. (2009). Using client feedback to improve couple therapy outcomes: A randomized clinical trial in a naturalistic setting. Journal of Consulting and Clinical Psychology, 77(4), 693 to 704.
Atkins, D. C., Eldridge, K. A., Baucom, D. H., & Christensen, A. (2005). Infidelity and behavioral couple therapy: Optimism in the face of betrayal. Journal of Consulting and Clinical Psychology, 73(1), 144 to 150.
Boisvert, M., Wright, J., Tremblay, N., & McDuff, P. (2011). Couples' reports of relationship problems in a naturalistic therapy setting. The Family Journal, 19(4), 362 to 368.
Carrère, S., & Gottman, J. M. (1999). Predicting divorce among newlyweds from the first three minutes of a marital conflict discussion. Family Process, 38(3), 293 to 301.
Christensen, A., Atkins, D. C., Baucom, B., & Yi, J. (2010). Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology, 78(2), 225 to 235.
Christensen, A., & Heavey, C. L. (1990). Gender and social structure in the demand/withdraw pattern of marital conflict. Journal of Personality and Social Psychology, 59(1), 73 to 81.
Doss, B. D., Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2009). Marital therapy, retreats, and books: The who, what, when, and why of relationship help seeking. Journal of Marital and Family Therapy, 35(1), 18 to 29.
Doss, B. D., Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2009b). The effect of the transition to parenthood on relationship quality: An 8 year prospective study. Journal of Personality and Social Psychology, 96(3), 601 to 619.
Hewison, D., Casey, P., & Mwamba, N. (2016). The effectiveness of couple therapy: Clinical outcomes in a naturalistic United Kingdom setting. Psychotherapy, 53(4), 377 to 387.
Lebow, J. L., Chambers, A. L., Christensen, A., & Johnson, S. M. (2012). Research on the treatment of couple distress. Journal of Marital and Family Therapy, 38(1), 145 to 168.
Levenson, R. W., & Gottman, J. M. (1985). Physiological and affective predictors of change in relationship satisfaction. Journal of Personality and Social Psychology, 49(1), 85 to 94.
Lonergan, M., Brunet, A., Rivest Beauregard, M., & Groleau, D. (2021). Is romantic partner betrayal a form of traumatic experience? A qualitative study. Stress and Health, 37(1), 19 to 31.
Mallory, A. B. (2022). Dimensions of couples' sexual communication, relationship satisfaction, and sexual satisfaction: A meta analysis. Journal of Family Psychology, 36(3), 358 to 371.
The Gottman Institute. (n.d.). The four horsemen: Criticism, contempt, defensiveness, and stonewalling. Retrieved 5 October 2026.
Wiebe, S. A., & Johnson, S. M. (2016). A review of the research in emotionally focused therapy for couples. Family Process, 55(3), 390 to 407.
