A recent study in Family Process caught my attention because it put some numbers to something I see regularly in my work with couples.
Researchers studied 1,014 Dutch heterosexual couples. Among those who had experienced serious relationship dissatisfaction, 36.4% considered professional relationship help and 19.5% eventually received it. Those who received help did so, on average, 3.7 years after the serious dissatisfaction began.
Why the delay? Interestingly, the most common reason was not cost or embarrassment. Nearly half said that things got better. Another common reason was that their partner did not want to seek help.
The 3.7-year figure sounds about right to me.
There are exceptions. Couples often come in much sooner when there has been a precipitating crisis – infidelity, a dramatic explosive argument or series of arguments, or discovering significant lies or omissions.
Absent something like that, couples can live with relationship difficulties for quite a while. I also wonder whether couples in which one or both partners are more attachment-avoidant tend to wait even longer before seeking help.
“But things got better.”
This part of the study especially interested me because I do not necessarily think that deciding not to seek therapy when things improve is a mistake.
Couples cannot be defined by their problems.
And I think couples instinctively know this.
Relationships have difficult periods. Couples disappoint one another. They argue. Sometimes they find their way through these periods without professional help. That is a good thing.
The problem comes when disappointment or poor behavior becomes a repeated pattern. Eventually, a couple can have difficulty defining themselves in positive terms and begin defining the relationship by its problems.
That creates a powerful negativity bias. It can also produce resentment and increasingly one-sided stories about what has gone wrong: I am trying. You are the problem.
At that point, something more than the latest argument is happening. The couple is developing a negative story about the relationship itself.
What if one person does not want couples therapy?
I see this frequently.
Often the reluctant partner is afraid of being blamed or ganged up on by the therapist. Men in particular may worry that, in a profession dominated by women, the therapist will quickly identify them as the problem – the uncaring, emotionally unskilled husband who needs to be fixed.
That is one reason I try to establish something very early in couples therapy:
The pattern is the problem, not the individuals.
Usually, what looks like two people behaving badly toward one another is also two people trying, unsuccessfully, to protect legitimate needs and values.
One pursues because connection matters. The other withdraws because peace, autonomy, or emotional safety matters. Their attempts to protect those things begin interacting in ways that make it increasingly difficult for either person to get what they actually need.
Seeing the pattern from outside can change the conversation.
Does our relationship have to be “bad enough” for therapy?
No.
I do not think couples therapy needs to be understood primarily as something medical or clinical. You do not need a diagnosis, and your marriage does not need to be on the verge of collapse.
Sometimes couples therapy is simply the wisdom of a third perspective.
When two people have been inside the same pattern for a long time, it can become extraordinarily difficult to see it clearly. A third person can sometimes see what neither partner can see from inside it.
And sometimes that is enough to help a couple begin telling a different story about themselves.
Research credit:This post was prompted by Henk Jan Conradi, Arjen Noordhof, and Jan H. Kamphuis, “Prevalence and predictors of help-seeking steps in a nationally representative Dutch sample of romantic couples,” Family Process 64, no. 1 (2025): e13074.
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