Maintaining a healthy relationship has its rewards and challenges. Life is full of change, and people in relationships must adapt to new circumstances: jobs change, priorities shift, finances fluctuate, loved ones die, moves occur, children are born. . . . Coping skills we have counted on in the past may not be effective in the present. A strained relationship may be marked by repetitive power struggles, unrelenting resentments, loss of desire, communication breakdowns, and isolation. Left unattended this strain can turn into a chasm. Couples begin to feel helpless or worse, hopeless. The relationship no longer provides energy, support, creativity or growth.

Couples Counseling can help us:

• Identify what may change and what may not change
• Broaden individual perspectives about ourselves and our relationships
• Alter the story we tell about ourselves and our relationships
• Create hope and flexibility where there was none
• Move away from past hurts and unresolved issues
• Identify new tools for coping with life’s challenges
• Increase understanding and deepen the connection between partners

Sexual Concerns and Sexuality

Sexuality is dynamic and fluid and includes our desires, fantasies, as well as how we gratify ourselves. Our sexuality is influenced by genetics, hormones, self-concepts, socialization, and external events. Concerns about arousal, desire, an inability to orgasm (inorgasmia), and painful sex (dyspareunia) affect many, but are often not discussed because of shame or embarrassment. Each of these concerns can frustrate and dishearten individuals as well as couples. Medical and psychological issues can be underlying causes. Therapy, both couples and individual, can help identify these underlying causes and facilitate proper treatment.

Similarly, concerns about sexual orientation, gender identity, and sex and gender _expression may arise during the life course and in the context of particular relationships. Therapy can provide an opportunity to explore these issues within a safe environment.

Grief and Loss

New losses can trigger old losses and stir up deep emotional pain from the past. Unresolved grief can create burdens that we carry in the form of depression, numbness, isolation, physical ailments (e.g. migraines, abdominal or gastro-intestinal distress), guilt, anger or despair. Grieving is a process of learning to live with loss, and learning we cannot necessarily fix it or force its resolution. Therapy can provide the safe space to experience strong feelings, to process the multiple layers of loss, and our perspectives about loss.

Stress

Stress can be a positive motivating force, like getting energized before a competitive athletic event and performing well, or a negative force that may lead to emotional and physical distress, such as witnessing a fatal accident. When stress becomes overwhelming, our bodies and emotions have difficulty managing our responses. These responses include anxiety, panic, lack of concentration, gastro-intestinal problems, and headaches. Well researched approaches can reduce stress responses and provide ways to manage stress. For instance, stress responses can be reduced by learning strategies to increase one’s sense of control under stressful circumstances.

Traumatic Stress

Any event outside the usual realm of human experience that evokes intense fear, helplessness, terror, or pain can cause trauma. Often these events are marked by an actual or perceived threat of death or a perceived threat to one’s physical integrity or the physical integrity of others.

When an individual experiences symptoms related to a trauma that don’t recede over time, Post Traumatic Stress Syndrome can result. These symptoms include recurrent recollections or dreams of the event, re-experiencing feelings and reactions related to the event (as if the event were re-occurring), avoidance of anything that is associated with the trauma, limited feeling states, anxiety and depression. Post traumatic stress overwhelms normal coping responses and causes feelings of helplessness. Cumulative stress can also cause post traumatic stress reactions. Therapy can assist in reducing the symptoms related to the trauma. It can help in healing and in regaining a sense of control over one’s physical and emotional life.