The 3 Most Common Issues Couples Bring to Therapy

After years of working with couples, I can tell you that while every relationship is unique, the same three issues show up in my office again and again. Whether you're newlyweds or you've been together for decades, these problems don't discriminate - they can affect any couple at any stage of their relationship.

Here's what's interesting: most couples wait an average of six years before seeking help, according to research from the American Association for Marriage and Family Therapy. By the time they walk into my office, these issues have usually been brewing for a long time. But here's the good news - all three of these problems are absolutely workable when both partners are willing to put in the effort.

If you're reading this and thinking "that sounds like us," you're not alone. The American Association for Marriage and Family Therapy reports that over 98% of couples report experiencing at least one of these core issues. So let's dive into what they are and, more importantly, what you can do about them.

Issue #1: Communication Problems

Communication issues are hands down the most common reason couples seek therapy. But here's what's tricky - it's rarely about not talking enough. Most couples I see are talking plenty. The problem is they're not really hearing each other, or they've fallen into communication patterns that create more distance instead of connection.

What Communication Problems Actually Look Like

Maybe you and your partner have the same fight over and over, just with different details. Maybe one of you shuts down when things get heated while the other gets louder and more frustrated. Perhaps you feel like you're constantly walking on eggshells, or like everything you say gets twisted into something you didn't mean.

Research identifies what psychologists call destructive communication patterns - criticism, contempt, defensiveness, and stonewalling. These patterns are so toxic that they can predict relationship failure with startling accuracy. Criticism looks like attacking your partner's character instead of addressing specific behavior. Instead of "I felt hurt when you forgot our anniversary," it becomes "You never remember anything important because you don't care about me."

Contempt is even worse - it's when you start treating your partner like they're beneath you. Eye-rolling, name-calling, sarcasm, and mocking all fall into this category. This one is especially toxic because it creates an atmosphere of disrespect.

Defensiveness happens when you feel attacked and immediately try to defend yourself instead of listening to your partner's concern. While it's natural to want to protect yourself, defensiveness usually escalates conflicts instead of resolving them.

Stonewalling is when one partner completely shuts down and stops responding. They might physically leave the room or just emotionally check out. This usually happens when someone feels overwhelmed, but it leaves the other partner feeling abandoned and unheard.

How Emotionally Focused Therapy (EFT) Helps Communication

Emotionally Focused Therapy, developed by Dr. Sue Johnson, is one of the most effective approaches for helping couples break destructive communication cycles. EFT focuses on identifying the underlying emotions and attachment needs that drive these negative patterns.

In EFT, we help couples understand that beneath the criticism or defensiveness, there are usually deeper emotions like fear of abandonment, feeling unimportant, or fear of being controlled. When couples learn to express these vulnerable emotions instead of the surface-level anger or criticism, everything changes.

For example, instead of "You never listen to me!" a partner might learn to say "I feel scared that I don't matter to you when you look at your phone while I'm talking." This kind of vulnerable communication creates connection instead of defensiveness.