Whatever your concerns, all of your relationship issues stem from communication issues. As you can see, the face and context of issues might look different, but no one escapes relationship issues. Human beings are very diverse and complex at times. Now throw in generational differences, gender, cultural, racial, familial, educational, financial, and so on....
Differences can lead to relationship issues when you do not know how to address
differences through effective communication. Are there other factors such as biochemical, emotional, mental, and psychosocial factors that can contribute to relationships issues, ABSOLUTELY! Having awareness and insight of more complicated concerns that require in-depth professional care can make a huge difference in understanding each other and healing wounded relationships.
In my practice, all things are considered because all things are important and can serve as grist for the mill when helping individuals to live their most amazing life.