Relationships, Marriage and Family

pre-marital and marital counseling • couples therapy • divorce and separation • extramarital affairs (cheating) • online affairs or 'internet infidelity' • intimacy problems • communication issues • relationship ending • blended families and step families • codependency • family of origin issues • parenting issues

Relationships are the mirrors by which we experience ourselves. They can be a source of tremendous pleasure and awful pain. Considering all the things we learn about in formal education, it's interesting that most of us were never actually taught how to have relationships-- how to choose a partner, how to deal with differences and resolve conflict, and how to know when it's time to separate. We end up learning through trial and error, often accompanied by a lot of heartache and pain. One problem commonly experienced in relationships is placing unrealistic expectations on ourselves or our partner. Romantic relationships can be difficult to understand even in ideal circumstances--and can easily cause anxiety and despair when trust issues, conflict, and betrayal arise. Couples sometimes reach the point where they wonder if the relationship is worth saving. Counseling and therapy can help you sort through these issues and gain insight into having successful and healthy realtionships. Read more about marriage counseling.

One growing area of concern involves online cheating or internet affairs. Many spouses who get involved in internet affairs feel justify that having an online relationship isn't really cheating. They may claim it isn't real because there is no physical contact between the two parties. There are however, intimate discussions and talk of sex. Internet cheating can and often does lead to an in-person meeting for real sex. Online affairs can become 'addictive' for the cheating spouse, causing the person to spend increasing time on the Internet and away from the family. Some signs of online cheating include a spouse who closes the web browser as soon as you enter the room, signs up for multiple email accounts, insists on privacy while online and goes online while the rest of the family is asleep. Marital Counseling (relationship therapy) can help you modify this behavior and help couples repair damage to the relationship.

Substance Use

drug or alcohol problem • DWI or drug arrest • oxycontin addiction • loss of employment • failed a drug test • need a substance use evaluation • family member with a drug problem • counseling for people utilizing medication-assisted treatment (MAT) such as suboxone or methadone • 12-step recovery and alternatives to 12 step recovery

Substance use problems, or "addictions" as they are often called, can be overwhelming and devastating. If you are strugging with a substance use problem, whatever the substance is, you have come to the right place. It can be really difficult to reach out for help if you're feeling judged or "labeled" (i.e., "you're an alcoholic," or "you have a disease") or if someone is pushing you into seeking treatment against your will. My approach to therapy and counseling is to work with you where you are, without judging, labeling, or pushing you. Together we can take a look at the problem from your perspective, and review options.

Miller & Rollnick (2002) in their book Motivational Interviewing, Second Edition: Lessons Preparing People for Change eloquently explain:

We are suggesting quite a different understanding of motivation. Many of the clients we see have had no dearth of suffering. Humiliation, shame, guilt, and angst are not the primary engines of change. Ironically, such experiences can even immobilize the person, rendering change more remote. Instead, constructive behavior change seems to arise when the person connects it with something of intrinsic value, something important, something cherished. Intrinsic motivation for change arises in an accepting, empowering atmosphere that makes it safe for the person to explore the possibly painful present in relation to what is wanted and valued. People often get stuck, not because they fail to appreciate the down side of their situation, but because they feel at least two ways about it. The way out of that forest has to do with exploring and following what the person is experiencing and what, from his or her perspective, truly matters.

Take a look at the Stages of Change for more on this view of change.

Anger Management

hot temper • irritability • frustration • being overly sensitive • verbal arguments • feelings of rage • perfection and high expectations of self and others • short fuse • having to say you're sorry repeatedly • the need to be "right" most of the time • rigid "black or white" thinking patterns

If these things seem familiar to you, you may benefit from anger management counseling. Anger is a normal human emotion everyone experiences from time to time. However, when anger gets out of control, it can alienate friends and family. How you handle an anger impulse also has an effect on your health and well-being. Stress hormones are released, your blood pressures rises and things can get violent. Some people can develop a reputation as a "dangerous" or "angry person". When you express your anger in unhealthy ways, it can trigger others to become angry and defensive as well. People with an untreated anger problem often end up socially isolated because they have inadvertantly pushed people away. Learning to properly manage anger is relatively simple and can be acheived in a reasonable timeframe in counseling.

Anxiety

feeling tense and jumpy • persistent/intense worry & fear • restlessness and irritability • obsession & compulsion • intrusive thoughts • headaches and muscle tension • dizziness and nausea • trouble concentrating • insomnia and fatigue • sweating and pounding heartbeat • feelings of panic • feelings of dread or apprehension

Feelings of worry and tension or fear are normal when under pressure or dealing with a stressful situation. Anxiety is the body’s natural response to danger. However, when anxiety is overwhelming or constant, when it interferes with activities and relationships then it crosses the line into an anxiety disorder. Although there are several different types of anxiety disorders, they all share one common symptom: a severe or persistent worry or fear in situations where most people wouldn’t feel threatened. Through counseling and therapy, you can find relief and effective ways to cope with and reduce anxiety.

Depression

problems sleeping or sleeping too much • difficulty concentrating, focusing, can't seem to get things done • sudden loss of appetite or overeating • irritable and short-tempered • intrusive thoughts • overwhelming feelings of sadness, doom, or emptiness • thoughts of suicide or "giving up" • stop taking care of yourself • feeling hopeless or helpless • persistent restlessness or sluggishness • situational and clinical depression • counseling to enhance effectiveness of anti-depressant medications

Everyone goes through ups and downs and sadness is sometimes a normal reaction to life’s difficulties and disappointments. Clinical depression is more than just sadness, and if you're clinically depressed you can't just "snap out of it". Depression can be pervasive and devastating, and it can feel like you're “living in a black hole”. You lose interest in things that used to bring you pleasure, you can't concentrate, you feel hopeless and helpless and even worthless. Not everyone who's depressed feels sadness pe se. You may feel emptiness, lifelessness, like you don't care. Depression can interfere with your functioning and impair your ability to work, eat, sleep, and have fun. Research shows that the most effective intervention for clinical depression is a combination of anti-depressants and counseling/therapy. Even though you may feel hopeless, with support and counseling, you can get better. It is tremendously helpful to have someone who understands and cares.

Research has shown that cognitive behavioral therapy (CBT) is an effective treatment for depression and is comparable in effectiveness to treatment with antidepressants. The combination of cognitive behavioral therapy and antidepressants has been shown to effectively manage severe or chronic depression.

Perhaps you've been considering therapy and are wondering what to expect. Read my Frequently Asked Questions About Therapy for more insight into what therapy is all about.