When something feels wrong, it isn’t always obvious where the work needs to begin.

You may be anxious, unhappy, overwhelmed or emotionally exhausted. Perhaps you’ve lost confidence in yourself, feel lonely within your relationship, are struggling after an affair, or have reached the point where you’re questioning whether you want to stay together.

Understandably, this can feel like an individual problem.

And sometimes it is. Individual counselling and psychotherapy can provide an enormously valuable space to understand yourself, work through difficult experiences and get support with something that is happening in your life.

But relationships can also create distress that doesn’t belong neatly to either person.

Sometimes the more useful question is:

Is this primarily something happening within me, or something happening between us?

Do I offer individual counselling or psychotherapy?

I no longer offer individual therapy.

My practice has evolved over the years and today I work exclusively with couples, with a particular focus on relationships experiencing significant distress, longstanding conflict, affairs and betrayal, emotional disconnection, trauma and relationships approaching separation.

My original training was in body-centred psychotherapy, and I spent many years working therapeutically with individuals. I am also trained in EMDR and trauma-focused work.

That background remains very much part of how I work.

Couples therapy isn’t simply about the relationship as though it exists independently of the people within it. There are two individuals in the room, each bringing a history, personality, vulnerabilities, fears, strengths and ways of protecting themselves.

Understanding the individual matters.

But so does understanding what happens when those two individuals meet.

When does an individual problem become a relationship problem?

People don’t always come to couples therapy saying, “We have a relationship problem.”

Sometimes one partner is anxious or unhappy. Someone is angry. One person has withdrawn. Sex has disappeared. There has been an affair. One partner feels desperately lonely despite sharing a home and a life with somebody.

It can become very easy to decide who has the problem.

But consider a common pattern.

One person feels disconnected and pushes for a conversation. Their partner experiences that approach as pressure or criticism and withdraws. The withdrawal creates more anxiety, so the first person pushes harder. The second retreats further.

Eventually both are exhausted.

Neither person’s experience, on its own, explains what is happening.

Individual therapy can help you understand your part of a pattern. Couples therapy allows us to bring both people into the room and work with the pattern itself.

Trauma and relationships

Trauma doesn’t always remain neatly contained within the person who experienced it.

Earlier experiences can influence how safe we feel with another person, how quickly we trust, how we respond to criticism and conflict, and what happens inside us when somebody we love becomes angry, distant or unavailable.

Someone who has experienced abandonment may find withdrawal particularly frightening. Someone who grew up around unpredictable conflict may shut down when voices are raised. Previous betrayal can make uncertainty extremely difficult to tolerate.

Our partners don’t necessarily create these wounds.

But intimate relationships have an extraordinary ability to find them.

My background in trauma psychotherapy and EMDR influences how I understand this part of couples work. Sometimes changing what is happening between two people also requires us to understand what each person is carrying into the relationship.

Can individual therapy and couples therapy happen together?

Yes.

For some couples, the best approach is couples therapy alongside individual therapy for one or both partners.

This may be particularly appropriate where there is significant trauma, anxiety, depression, addiction or another difficulty that needs its own dedicated therapeutic space.

Where individual therapy is needed, I generally recommend working with another appropriately qualified therapist while I continue to work with the relationship. This keeps the purpose and boundaries of each piece of therapy clear.

The two approaches are asking different questions:

Individual therapy: What is happening within me?

Couples therapy: What is happening between us?

Sometimes both questions need attention.

Individual therapy or couples therapy after an affair?

An affair is a good example of why this distinction matters.

Betrayal can create profound individual distress. There may be anxiety, anger, intrusive thoughts, difficulty sleeping, hypervigilance or an overwhelming need to understand what happened.

The partner who had the affair may be struggling with guilt, shame or questions about their own choices.

Individual therapy can be valuable for either person.

But an affair also creates an injury within the relationship.

If you are trying to establish accountability, understand what happened, rebuild trust and decide whether the relationship can recover, there is work that cannot easily be done by treating two people separately.

This is an area I regularly work with in couples therapy.

What about EMDR?

EMDR — Eye Movement Desensitisation and Reprocessing — is a trauma-focused approach that can be useful where distressing experiences or memories continue to have a powerful emotional impact.

I am trained in EMDR and it continues to inform my understanding of trauma within relationships.

Sometimes individual EMDR or other trauma-focused therapy with another therapist can sit alongside couples therapy. At other times, understanding the impact of trauma within the relationship itself becomes part of the couples work.

The important thing is not to assume that everything belongs either to the individual or to the relationship.

Often, the two overlap.

When weekly couples therapy doesn’t feel like enough

Some couples arrive after years of difficulty.

Others arrive because something has happened and the situation has suddenly become urgent.

There has been an affair. Separation has been discussed. Conflict has escalated. One person is close to giving up. Or perhaps you’ve tried couples therapy before, understood some of what was happening, but found yourselves gradually returning to the same place.

For couples in significant distress, an hour a week can sometimes feel too fragmented.

This is why my practice has increasingly moved towards Intensive Couples Therapy.

Intensive Couples Therapy in Galway, Ireland

My two-day intensive gives one couple dedicated time to work deeply with their relationship.

We have time to understand how you arrived here, identify the patterns that keep pulling you back into conflict or disconnection, explore what is happening underneath those patterns and begin working towards something different.

The intensive doesn’t begin when you walk through my door in Galway. We meet beforehand through a series of preparatory sessions, giving me time to understand both of you and the relationship we’re going to be working with.

Couples travel to my practice in Moycullen, Galway from across Ireland and internationally for this work.

Two days. One couple. Time to understand what keeps you stuck.