Nothing is more frustrating than trying so hard to make your relationship better only to find it hasn’t changed at all. You love your partner and have a vision of a relationship that really works but no matter what you do that reality remains out of reach. So often when people hit this stuck place they find the true definition of insanity, doing the same things over and over again expecting different results and never finding them.

One of my wisest mentors and a well-seasoned couples therapist, Steve McManus, LMFT, shared with me years ago that when couples are truly stuck, at minimum one of four issues might be occurring in their relationship. Throughout my work with couples, I have witnessed how not addressing these four critical issues inhibits partners from working with each other toward positive change and creating experiences of insanity. (As you read through this list listen to your gut and if any of these issues stir you, don’t be afraid, you may have finally found the answer you have been searching for.)

These are the four critical issues:

  1. Active addiction states of one or both partners. This can include addiction to alcohol, drugs, sex, gambling, exercise, eating, and other such addictions that consume an individual and make them unavailable to their partner. Addiction is painful and takes an enormous toll on a couple’s connection while creating negative generational implications for the whole family. There are so many good places to get help. Please don’t wait any longer.
  2. Active and/or untreated mental health disorders. This can include mood disorders (e.g., depression, anxiety, phobias, bipolar disorder, etc.); pervasive personality disorders (e.g., borderline, dependent, paranoid, narcissistic, etc.) and/or other mental health concerns (like ADD/ADHD). When undiagnosed and/or untreated, not only do individuals suffer unnecessarily, but so does the relationship. Due to the stigma that still exists around mental health, many people delay treating manageable disorders. Go see a mental health professional and stop your struggle.
  3. Active infidelity. This includes emotional and physical affairs, both in reality and in virtual environments (i.e., online, texting, etc.). If you or your partner’s head and heart are somewhere else, your relationship isn’t going to be the first priority. There are a variety of reasons partners may choose to have an affair, but they all have one thing in common—they are an indicator that the committed primary relationship needs help. The result of an affair is deception and betrayal. Both of these experiences are painful realities to live in that take a toll on your body, mind, and spirit. Deciding to end the affair game is good for everyone involved.
  4. Active and/or untreated domestic violence. This includes physical abuse, sexual abuse, emotional abuse, and psychological abuse that is ongoing and/or has never been addressed. Being hit, threatened, forced, manipulated, used, yelled at, and depreciated are forms of abusive and unacceptable behavior. Domestic violence affects men and women of all cultures and social economic status. It is not healthy, and it is never a form of love. If you are experiencing abuse in any form and need help, contact



If you haven’t been feeling right about what’s going on in your relationship or have been looking for help in multiple ways and trying to self-diagnose and treat these issues on your own without any success, go to the right professional today. If you have vacillated between feeling like you are crazy or wondering if something is really wrong, you’re not crazy—go with your gut, advocate for your relationship, and get an expert opinion.

And, if you are experiencing any of the four critical issues in your relationship, it is recommended that you attend first to treating and resolving these primary concerns before entering into work on your couple relationship. This doesn’t mean you ignore your couple relationship, it just means that until you and/or your partner is fully available for the relationship, positive, sustainable change is going to be difficult to obtain.

Making a consultation call to get some direction on how to pursue help for these concerns is an excellent reason to contact a couples therapist. Do not hesitate.

Until we meet again—Love each other well

Jen Elmquist