two people walking at sunset
two people embracing in silhouette at sunset

A clinical expert explains five signs of an unhealthy relationship.

I get often get questions about healthy relationships. What is normal? What should I be concerned about? Is this is my soul mate? As a clinical expert in Nursing, my role is to support healthy relationships while advising and educating my clients.

You see, I am a Nurse Practitioner. I have a clinical doctorate in Nursing and a Psychology degree. I am trained to assess and diagnose unhealthy relationships and other indicators of maladaptive behavior. I do this regularly with my clients. What most people don’t understand is how Nurses function professionally. This article integrates nursing concepts into a psychologic relationship framework.

There are five clinical indicators that your relationship is unhealthy. In order to understand the signs, you need to understand an essential framework for human development. Maslow’s Hierarchy of Needs is a good starting point.

Maslow’s Hierarchy of Needs

Abraham Maslow developed his motivational psychology theory in 1943. Maslow’s “Hierarchy of Needs” is one of many behavioral frameworks to understand relationships. Apply Maslow’s framework within an individual context of personal needs.

The hierarchy presents as a pyramid with five tiers of human need (see diagram). Each tier is progressively more important in order to develop the individual self. Not every person progresses through the hierarchy the same way.

Each level of the pyramid must be satisfied before an individual can take the next step. The bottom part of the pyramid the foundation. Love, friendship, and connections occur halfway up the pyramid. Individuals prioritize their progress, but physical and safety needs come first. The nursing paradigm is a partner in Maslow’s behavioral model.

Nursing recognizes safety as a foundational need as well. Personal safety includes identifying patients at risk for impaired self-perception and disrupted family or interpersonal processes.

Physiology and Relationship Needs

Physiology is the most basic component of human existence. It is a foundation of nursing practice. We look at the human within the context of their environment. Physiologic needs present before birth, in utero. Our mothers support and nurture us before we are thrust into the world.

Physiology is a branch of biology. It deals with the normal functions of living organisms and their parts. Physiologic needs, therefore, include the physical and primitive need for food, water, sleep, and warmth. Physical needs include a general reliance on health. Sexual activity is another basic need included in this area.

Physiology recognizes homeostasis as necessary for stability. Homeostasis is balance. The balance provides support that can be built on. This need for balance and support begins in human infancy. Disruption of homeostasis results in actual and potential problems in body systems (heart, lungs, and electrolyte imbalance among others), interpersonal attachments, and impaired maternal-child and other relationships.

Newborns are fully reliant on caregivers. They have raw needs to preserve comfort. Infants require support for all basic needs. This includes a roof over their head, restful sleep, and basic energy supply (food) for the proper body functions. Lack of these affects nearly every health domain including comfort, nutrition, and health promotion. Once basic needs are accomplished, humans can progress to the next level up the pyramid: Safety.


Safety is multifaceted. It has many components. Safety relates to your physical environment and financial situations. Job security is a component of safety. Having enough money in the bank and a means to continue growing the finances is a significant part of safety.

A lack of personal safety often leads to the potential for injury and risk of violence that is directed towards themselves or others. Financial and career instability reflect a risk of obtaining personal needs (food, shelter, and safety). These concepts are all related.

Once physical and safety needs are met, we can focus on love, relationships, and belonging. Lack of basic needs, or deficiency, is where things can get unpleasant. So how does this help understanding relationship needs?

Nursing considers the twelve specific domains as essential components of health. We diagnose and treat within each of the twelve health domains (look for another article about specific domains and how to understand them). By understanding relationship needs within the entire human context, Nurses can evaluate indicators of maligned relationships. We are attuned to manage physical deficiencies and safety issues to properly plan and intervene as needed.

Relationships that are deficient in any specific area are at greatest risk of being unhealthy or moving too quickly. If we lack basic physical needs, individuals might seek partners that are counterintuitive to their higher-level needs. So let’s review the common signs your relationship is unhealthy.

Inappropriate Trust

Giving too much trust, too quickly is an early warning sign of relationship health. Trust without fact is an indicator of naiveté. Often, this is due to a lack of personal experience and self-awareness. In nursing, this takes the form of hopelessness, disturbed personal identity, and risk of loneliness. The trust comes in different forms.

This misplaced trust can be a physical trust, such as with sex. It can also be an emotional trust: secrets, embarrassment, things you might feel will bring this person closer to you and fast. Trust inappropriately assigned to a new partner points to a potentially unhealthy dynamic. This directly relates to personal susceptibility and vulnerability to an unhealthy relationship. Underlying factors related to chronic low self-esteem, impaired perceptions of self or environment, and personal identity issues all impact who and how we trust.

Healthy relationships take time to develop. They are built on genuine communication and connection. The dialogue enables partners to learn about each other. The dialogue needs fluidity, a “give and take” between the partners. A healthy dialogue facilitates an understanding of how the relationship is evolving. Ultimately, trust experience and personal perspectives can answer “Why” someone is engaged in an unhealthy relationship.

Frequent sex, often unsafe and early in a relationship, is another warning sign that things are unhealthy. Intercourse in a healthy relationship includes connection and communication. An inability to communicate about sex with your partner occurs for many reasons. Ineffective communication, once properly addressed, highlights a need for heightened personal knowledge and respect.

Sex by itself is a primal action. It is a basic biologic need. It also provides a connection with a partner when it is viewed through higher mammalian brain functions. Serious sexual communication reflects an awareness of the action itself.

Unhealthy sexual engagement typically results from feelings of impaired self-perception, ineffective knowledge and ineffective self-health management. If you can discuss sexual preferences, likes, and dislikes Congratulations! That is a good sign of relationship health. If you cannot talk about sex, be concerned you are moving too fast.

Loss of Space

Quickly combining spaces and moving in together is a concerning indicator of relationship health. People need their space to decompress, grow, and evolve. When someone quickly meets, and moves in, with their partner or otherwise combine spaces on a shortened timeline, it can demonstrate a need for connection. It is not normal to move in with someone soon after meeting. Recall that Maslow’s Hierarchy reflects physical space and safety as more basic needs than intimacy, love, and self-esteem.

A lack of individual separation is unhealthy. Spending all your time with one person early in a relationship is detrimental to psychology and overall health. This also negatively impacts the highest personal needs for self-fulfillment needs.

In order to fulfill your potential, you need space to do that. This includes the ability to be creative and be yourself. This self-actualization cannot be accomplished if an individual is not permitted space to grow. Often times, moving in together with a lack of individual separation occurs concurrently with emotional intensity.

Extreme Intensity

Extreme relationship intensity presents as severe arguments and inappropriate professions of love. Let’s review each.

Extreme arguments are vocal, aggressive, and unsettling. These are couples that begin arguing over seemingly insignificant conditions. It might be relationship-oriented or unrelated to the relationship itself. One or both of the members are easily triggered in disagreements. These arguments devolve into verbal altercations and insults. One or both may be emotionally abusing towards the other. These relationships may devolve with signs of physical violence such as hitting, punching, and throwing objects.

Emotional abuse and physical violence are always indicators of unhealthy relationships. The scope of physical and emotional abuse is beyond the scope of this article but a recognized concern for unhealthy relationships. Readers concerned about abuse issues are encouraged to seek out local medical and law enforcement resources to help. If they are in immediate danger, contact 911 or your local emergency resource.

These deep professions are equally detrimental to a healthy relationship. Professions of love are the opposite of intense arguments. These are the “swooners”, professing their “undying love” after recently meeting. This is not to say that you cannot find and identify as a soul mate. It just means you need heightened self-awareness, the ability to effectively communicate, and assurance you are not displaying patterns of ineffective relationship dynamics.


Relationships that demand you isolate yourself are unhealthy. Family, assuming they are themselves healthy (that is a whole other topic) typically provide your physical and safety needs. They also provide external perspective and validation of your personal concerns as well as specific circumstances.

Family and friends are part of Maslow’s psychological needs related to belonging and accomplishment. These are the people that helped you before you met your new partner. These are your closest confidants and best friends. If you are asked to give that up, leave. This puts you at risk of hopelessness, loneliness, and disruption in your personal identity. Anyone that forces you to stay away from healthy relationships in your prior life causes concern.

The same is true in relationships where you find yourself alone, despite having a partner. You drift away from family and friends or they comment that they “don’t know you anymore”. You may lose yourself, your focus, or your direction. Mental health issues are underlying factors for unhealthy attachments. They are also side effects of unhealthy relationship dynamics. If you see any of these indicators, you need to look at the relationship with a professional.


Communication is the essence of a healthy relationship. Much of what is discussed in this article comes down to communication. Impaired communication is a health concern. Unhealthy relationships reflect a breakdown in communication.

Before you can create a personal action item, you need to understand the ‘why’ of your specific communication deficiencies. If you are not able to express your needs, wants, and desires for whatever reason, the relationship is unhealthy. The reasoning behind an unhealthy relationship can dictate the next steps.

Fortunately, the ability to fully appreciate the depth of your personal needs correlates with healthy relationships. Healthy relationships depend on both personal safety and awareness for proper communication. Finding your personal voice is the first step in recognizing unhealthy relationships.

Recognizing triggers behind unhealthy adaptations can make a huge difference in finding and maintaining healthy relationships. Ultimately, physical and emotional abuse automatically indicates you need to leave the relationship. This is true for all genders and sexual orientations.


There are many signs of unhealthy relationships. An ability to recognize underlying motivations is essential. These thoughts are grounded in Maslow’s Hierarchy, which explains behaviors that occur and the changes that are necessary to improve yourself. These thoughts are also supported in the nursing paradigm of health. When individuals are able to see that their physical and psychological needs are met, they are capable of healthy relationships.

The five indicators of unhealthy relationships include trust, space, extreme intensity, isolation, and communication. Individuals must have a healthy personal balance to accomplish relationship health and stability. Any of these five signs can mean your relationship is unhealthy. Your soul mate match won’t come with an instruction manual but will meet all the basic guidelines for healthy engagement in a relationship. What you do next is up to you. Contact me if you need professional guidance in your relationships, communication, personal growth, or other concerns.

Dr. Kirsten Turkington, NP is a unicorn clinician with Turkington Medical. She is an expert Nurse Practitioner, Educator, Coach, and Advocate. She is a published author who has earned degrees in Nursing and Psychology. Follow Turkington Medical at LinkedInFacebookInstagram, and Twitter.