Marriage and Couples Issues
A Sample of issues committed couples may experience.

CommunicationPoor communication is the single most prominent cause of friction between couples.  Love, understanding and trust are destroyed when problems, needs and emotions are not openly and freely expressed, and when what is heard is not accepted honestly and without taint of suspicion.  Without communication that is precise, there is too much room for misinterpretation.  Often persons use vague words, load down the meaning with qualifiers and generally don't communicate what they mean.  That leads to misunderstanding and conflict.
   The solution lies in learning to communicate.  Couples engage in exercises which begin to reveal to them where faulty communication is taking place.  They use assigned homework to practice in order to learn to communicate without arguing.  They learn how to avoid blaming the other partner, how to avoid having to decide who is right, how to be accountable for what they say, how to stick with the recent past, how to acknowledge the partner's feelings and points of view, how to negotiate so both win; and how to break the bad communication habits of the past.  Often, when couples learn to communicate, trust returns to the relationship and other issues causing problems between them disappear.

Dependency:  Persons who suffer from excessive dependency:  (1) Feel the need for lots of guidance, advice, and encouragement; (2) Expect others to take responsibility for them;  (3) Find it difficult or impossible to disagree with anyone for fear of disapproval;  (4) Have difficulty starting tasks;  (5) Constantly seek to please others; (6) Fear being left alone because of the belief that they can not care for themselves; (7) When one relationship ends, immediately replace it with another.  Problems for such persons include withdrawal from society and isolation from others.  They are also prone to become victims of persons who dominate them to meet their own needs.
    Treatment must be time-limited and goal-focused to prevent the client from developing a dependent relationship with the therapist.  Homework assignments usually include exercises to build self-esteem and assertiveness.  The earlier treatment can be begun, the better chances are for improvement. 

Financial Stress:  Money problems are a major cause of troubles in a marriage that very often end in divorce and a contributing factor in many other troubles.  The details of each person's situation may differ, but solutions to the problem are well known and can be learned.
    Not only are marriages threatened by financial stress.  Persons who feel financial stress tend to be in worse health and often experience insomnia, mood disorders, inability to concentrate and even cardiac problems.
    Often a psychotherapist will refer a couple to a financial counselor who will help a couple come to some firm agreements about how money is handled and assist them in developing a budget and a plan to get out of debt and begin to accumulate some funds to meet emergencies when they happen. 

Midlife CrisisIt doesn't happen to everyone, but when it does, it is a confusing and upsetting experience that can last from a few months to a few years.  It is generally thought to  result from a person's anxieties over growing older perhaps aggravated by reduction of certain hormones in the body.
    In any case, it is certainly no joke, and persons experiencing the crisis should seek help, and persons who are close to a person experiencing midlife crisis should find ways to be supportive through the transition. 
    It is helpful for the person in crisis and for persons close to him or her to learn to identify and express their negative feelings.  These often include: 
    Regret
- for losses of the dreams or their youth or regret for mistakes made; 
    Loss
- of youth, beauty, perhaps children or partners once a part of life;
    Meaning
- for the totality of life that is beginning to wind down;
    Change -
in the physical body, mental acumen, lost sense of being able to control the future.
    A counselor will help by leading the person experiencing midlife crisis in assessing and affirming the life he or she has had and beginning to move into a new phase of life with enthusiasm for new explorations and new relationships.  For many persons, this phase of life has become the most productive in developing strong spiritual links to God and to those around them.  It can also become a time for regeneration and creativity when a person is directed toward the realization of the purpose God still has for his or her life.

Obsessive-Compulsive Disorder:  A person with this disorder feels unable to control his or her repetitive thoughts or repetitive actions which seem to them intrusive, senseless, and disturbing.  Some examples are:  Obsessive neatness and order, excessive hand washing, checking and rechecking locks, repeated arranging objects, counting objects, saving or hoarding things, needing things to be done in a certain way.
    It is a serious condition causing excessive stress, requiring a lot of time and embarrassment and often interfering in developing close, intimate relationships with other persons.  The person realizes the obsessions and compulsions are excessive but feels unable to do anything about it.
    Treatment for the condition is a combination of medication and cognitive behavioral therapy.  One without the other may relieve the condition for a time, but relapse is probable. 

Separation and DivorceSeparation and Divorce take its toll in several areas: 
    Financial -
Divorce costs are high.  Two households cost more than one. 
    Career -
Divorce related requirements take time away from the job and make a person less focused.
    Logistics.
  Running a home, caring for children is more difficult than when there no longer is a partner to share the daily chores. 
    Emotional  -
Most people experience periods of depression, sadness, anger, fatigue and guilt - all debilitating.
    In addition to the toll on the divorcing partners, there is the profound impact on the children of divorce.  These are too many to categorize here but include: 
    Feelings of anxiety as the stability provided by the home is destroyed;
    Fear of abandonment,
    Feelings of rejection, loneliness, guilt and anger at all the adults that allow this to happen to them.
    All change in life circumstances create stress.  Persons without children need help from professionals to get through it:  Financial Specialists, Lawyers and also Counselors who can guide divorcing persons through the stress related issues.  Parents who divorce have special needs related to minimizing the stress that divorce causes for children.  Marriage and Family Counselors can work with parents and with children to plan ways for dealing with the stress-causing issues of divorce. 

Sexual Abuse Being sexually abused involves both physical and psychological assault.  Victims are often unable to develop close, healthy sexual relationships with a committed partner.  Victims experience a range of emotions including fear, shame, anger, and depression.  Emotional and physical reactions include: 
   Shock - The victim feels disbelief, fear and anger: may also experience flashback and sleep disorder;   
   Adjustment
- Feels life beginning to return to normal and may deny the impact of the assault. 
   Resolution
- Feels closer to resolving the issues, but may continue to be depressed, experience mood swings, feel cut off from others or the need to isolate herself or himself. 
    During the Resolution phase of recovery, the patient can be assisted by individual counseling and/or group therapy.  Group therapy is an excellent way for victims to talk about their experiences with others in a supportive, nonjudgmental atmosphere.  

Sexual Dysfunction: Any condition which prevents persons from experiencing enjoyment in normal sexual relationships with their partners is a dysfunction. 
    Male dysfunction includes these conditions:  Erectile dysfunction, painful intercourse, delayed ejaculation, premature ejaculation, orgasmic disorder, and inhibited sexual desire.
    Female dysfunction includes:  Lack of sexual desire, arousal disorders, orgasmic disorders and painful intercourse.
    Treatment varies between the sexes and depends on the nature of the dysfunction.  Initial determination needs to be made to discover if the dysfunction is physical and will respond to medical treatment, although most sexual disorders are psychological in origin.  Best results are obtained when therapy involves both individual therapy and counseling with both partners together and may include sensate-focus exercises.   

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