Four telltale signs you may be in need of couples therapy

Relationships expert Karen Doherty tells Sara Keenan why couples counselling can offer a safe space to air issues, and lists the indicators that therapy is required

Breaking point: 'A therapist can create a space that is safe enough for people to hear each other,' says Karen Doherty

Netflix’s eight-part reality series Blue Therapy follows seven couples as they navigate their relationships with the help of therapist Karen Doherty.

The fly-on-the wall documentary, which centres on therapy sessions and the couples’ interactions in the real world, covers issues including infidelity, dishonesty, financial difficulty, and parenting.

Couples therapist and relationship coach Doherty said the show was exactly like her day job.

“I had no contact with them [the couples] other than the six hours of therapy that I did with them,” she says.

“The whole show is based on the premise that the therapist gets to know what she finds out in that moment and responds appropriately there and then. We all stuck to that format.

“I didn’t really have to do anything with them outside of therapy and the production team was so brilliant. The room they created was even just like one of my consulting rooms.”

“I think everybody involved was surprised,” Doherty says. “The contributors had come in and had these issues, but I don’t think they really expected to be so vulnerable. 

But once the three of us got going in what felt like a very safe space, the magic happened and it worked. You didn’t hear or see the cameras. It was just like my day job.

“It’s about getting couples talking to see each other, see what’s going on, unpacking resentment, then getting them communicating and connecting again.”

Couples therapy is effective, adds Doherty.

“It creates an opportunity for couples to hear each other and a therapist can create a space that is safe enough for people to hear each other, not just move to their patterns of fighting or bickering or falling back on old arguments,” she says.

“I don’t tolerate that in the room. It’s actually a great space and I think the show democratised therapy and the idea that anybody can go to therapy and get something out of it.”

Here are the signs that couples may need therapy.

Constant arguing

“If you’re constantly arguing, it will eat away at everyone’s patience,” Doherty says. “It eats away at the willingness, the empathy, and the compassion, so constant arguments have to be arrested.

“Bickering that goes on over the same things, all these superficial bits, they are all indicators of something much more profound going on underneath.”

Lack of communication

“There is this constant battle that couples seem to have between the reality and their scripted narratives, based on assumption,” Doherty says.

People don’t hear each other and they don’t communicate effectively, and the assumptions one makes about the other can be so offbeat and wrong.

Inability to communicate is especially common among people who are neurodivergent.

“It happens where somebody who is overwhelmed and can’t speak is thought of as ignoring or rejecting somebody, or stonewalling them. But, actually, they’re just so emotionally dysregulated and they can’t actually put words together because their executive function [mental processes] is compromised.”

Living separate lives

This is a common problem, Doherty says. “People can start living alongside each other, rather than together,” she says.

“Once the couple becomes deprioritised like that, there’s an issue, because you’re never bridging that gap.”

Intimacy issues

“You have to look at intimacy,” Doherty says. “If that is broken down, what is going on?

By intimacy, I mean in a range of different connections. But if sex and intimacy is broken down, you need to ask: Did you sign up to be flatmates or is there something missing?

“This is a key sign a conversation needs to happen.”

A common theme within Blue Therapy was the reluctance among some couples to attend therapy, but there are ways to approach this, too.

“Your partner may not want to go, but, realistically, it’s not going to get better. That’s the first thing to remind them of and then ask them: ‘Do we want to stay like this?’,” she says.

“Then, what you can do is simply have an introductory call with a therapist.

“Lots of them do these initial consultations and, I can guarantee, you and your partner will both take something out of that. “

Doherty says many couples really need help at the moment: “It’s a very complex time for modern relationships. They’re navigating new environments that have never been navigated and the old models are not necessarily equipped to deal with the new challenges that couples are facing.

“You’ve got this hyper-connectedness and confusion over identities. You’ve got men in crisis everywhere. It’s a completely different environment, where roles are up for discussion.

“I’m, hopefully, one of those therapists looking at it through that lens,” Doherty says.