How therapy can rescue couples whose relationships are heading for the rocks
Domestic strife can have an enormous impact - so why don't more of us avail of support?
When things go wrong with our health, we visit a doctor. When the washing machine's on the blink, or the car's failing to start, we call the experts - but when it comes to the health of our relationships, seeking support doesn't seem to come as naturally.
Nearly one in five UK couples admit their relationship's 'distressed', a report by Relate found last year - yet a recent poll by Tavistock Relationships (TR) found 64% of people in long-term relationships/marriages/civil partnerships would be 'unlikely' to seek counselling if their relationship was in difficulty.
The biggest reason cited for this was scepticism over whether couple therapy works (43%). But it seems most are well aware of the impact relationship troubles can have on mental health (53% acknowledged addressing mental health concerns as one of the main probable benefits of couple therapy), and TR CEO Andrew Balfour thinks it's time "to start a national conversation about the importance of getting help for our couple relationships".
"A substantial body of research shows that couple therapy improves relationship distress and mental health," says Andrew. "( And) when you consider that 71% of people coming to TR for couple therapy have depression, the provision of couple therapy clearly has a huge role to play in the alleviation of depression.
"The idea that couple therapy doesn't work is simply not true - and the evidence is clear on this. It's important we get this message across," he adds. "I think we're at a point where the issue of mental health was a few years ago - where the stigma kept many people from getting help and left them suffering in isolation."
He'd like to see the "substantial strides" society's making in recognising mental health problems in general - and providing relevant support - echoed in the context of relationships.
Relate chief executive Chris Sherwood agrees there might be a lack of awareness of the role and effectiveness of relationship therapy: "Good quality relationships are fundamental to our mental health and wellbeing but, as these statistics show, there's a great deal of stigma attached to seeking support.
"It seems the public are uncertain about whether couples counselling actually works, yet 95% of Relate's clients said their relationship was 'better' after attending relationship counselling, and 85% felt able to cope with any difficulties they may face in the future. Our work helps to prevent loneliness, depression, homelessness, debt and many other life-shattering events that can happen when relationships go wrong."
The Hollywood effect
The old cliche of stiff upper-lipped, don't-make-a-fuss Brits - as opposed to our American cousins whom, if Hollywood's anything to go by, are just as likely to go to therapists as the gym - might also be a factor in our reluctance.
But Dr Kathryn Hollins, a consultant psychiatrist and psychotherapist who heads up the Parenthood, Pregnancy and Family Life Service at Priory's Harley Street Wellbeing Centre in London, thinks things are shifting. "In the UK, we value our independence and privacy, but sometimes this is to the detriment of our own, and our family's, health and happiness. Reaching out for tips, support and even help takes courage. It also means believing there are solutions for the 'overwhelming' problems we face.
"As a nation, we have been slow to accept that an experienced and well-trained therapist can support us to improve our relationships and, in the process, change our lives. But this is changing. More and more of us recognise that being in unhappy or destructive relationships is bad for our physical and mental health."
Doing it for the kids
Relationship difficulties can, of course, also have a significant impact on children's mental health. Andrew notes that 'family relationship difficulties' is the "leading presenting problem reported by children being assessed by Children and Young People's IAPT services", and "family relationship problems" appears in the top three reasons for all age groups who call ChildLine.
It was parenthood that eventually led Samantha and Richard* to seek counselling through Tavistock, after 15 years together. "When we became parents, our frame of reference turned out to be so different that it became hard to work as a team. We lost a lot of our friendship and fondness of each other," Samantha recalls. "We were at breaking point. Our views had become very polarised and we were both hurt and disappointed about the state of our relationship and family life."
She admits it was initially "uncomfortable and awkward", but adds: "The counsellor helped us communicate and think about things in a constructive way, and avoid the trap of, 'I am right and you are wrong'. It took the sting out of the situation... We can't change the actual things going on in our life, but have become much better at supporting each other and talking about our difficulties."
Richard agrees that the experience "took some of the edge off of what we were feeling towards each other", and says it was a "positive learning experience".
They also participated in a Tavistock 'Parenting as Partners' programme; therapist-led group sessions with other couples. Despite being worried about "sharing dirty laundry", Richard says it "a useful outlet for sharing thoughts and experiences, in a supportive environment... It's helpful to know the challenges you face are not yours alone."
Not just a crisis solution
It's not always just about 'saving' relationships, either. "There is a myth that it is best to 'stay together for the children'. We know from research that children do best when their parents are happy and not in conflict with each other, so separation and divorce can be a healthy decision for all the family," says Dr Hollins.
However, counselling can still play an important role in managing the emotional fall-out of a break-up, and helping maintain positive communication between separating couples who have children. Similarly, therapy doesn't just have to be just a last-chance-saloon. While supporting couples at 'crisis point' is a big focus - and, evidence attests, can still be effective at this stage, Dr Hollins says it isn't just a make-or-break solution.
"Couples therapy can make a difference at any stage of a relationship. It can shift a longstanding or complex problem at the beginning, middle or end of a relationship," she says. "Perhaps you are convinced you will mess up a new relationship, and you're keen to make it work as you've met someone special. Or you and your partner are both convinced that separation is necessary. In both scenarios, therapy can make a real difference."
Access for all?
Cost can be a barrier for seeking therapy too, especially as some private therapists can easily cost hundreds of pounds. Charities like Tavistock Relationships and Relate, however, aim to help improve access, with some therapy sessions offered on a free or subsidised, means-tested basis. Tavistock's Parents as Partners group sessions are free.
For more information, visit tavistockrelationships.org, relate.org.uk, and priorygroup.com * Names changed for purposes of this article