Read full article here: Don’t Wait for an Impending Divorce Date for Couples Counseling

Read full article here: Centenarian’s Marriage Advice to Obama: ‘Compromise!’

Read full article here: Sex therapist Dr. Ruth receives award from New Haven’s Yale School of Medicine

Read full article here: Marriage Maintenance When Money Is Tight

The short answer is that marriage counseling does work. Okay, it probably isn’t surprising that I would take this view. After all, what kind of a relationship therapist would I be if I didn’t believe that counseling is effective? But this isn’t just my personal opinion. I know it works because there is a considerable amount of scientific research that shows that it does (See Bergin and Garfield’s 2003 Handbook of Psychotherapy and Behavior Change for a thorough review of the literature). I also know that marriage counseling works because I see couples in my practice every day who are benefiting from it.

Research studies have shown that, overall, about a third of couples who participate in counseling benefit from it. A third might not sound like very much until you stop to consider the following:

1. Unhappy couples who don’t seek counseling are far less satisfied with their relationship, and far more likely to end it, than couples who participate in marriage counseling. In other words, the odds of things just getting better on their own are not good.
2. For those couples who go to marriage counseling, the ones who benefit are different in several important ways from those who don’t . Marriage counseling works best for couples who are: moderately rather than severely troubled; Committed to being in the relationship; willing to work on the relationship; and choose to work with a skilled relationship therapist. Under these circumstances, studies report marriage counseling success rates as high as 70% (check out the work of John Gottman and colleagues for more detailed research results). You don’t need me to tell you that these are much better odds. A couple doesn’t necessarily have to have all of these things in order for marriage counseling to work; however, the more of them they have, the better the odds it will work.

It is all well and good for you to know that marriage counseling works but let’s get to the real question. I would be willing to bet that what you really want to know is “how do I know if it will work for me?” If you are like most people, you may be reluctant to spend your time and resources on counseling without knowing if it will work for you. I wish I could offer you some kind of guarantee but I can’t. The reality is that not every couple will benefit from marriage counseling and, for those who do benefit, some will do better than others. what I can tell you with certainty is that Marriage counseling can give you and your partner a much better chance of staying together and being happy in your relationship. Give it a try and see for yourself if it works for you.

Bring up the issue when things are relatively calm. There is probably not an ideal time to bring up the issue of starting couples counseling but some times are definitely better than others. Your partner will probably be more receptive to what you are saying if you raise the issue at a time other than when you are in the middle of a heated argument. Emotions are often in overdrive during an argument, and this makes it more difficult for the other person to really listen to what you are saying. People are also more likely to dig in their heels and refuse requests during an argument.

Try to choose a time when you have some privacy, you are not rushed for time, and there are few distractions.

What to say. Focus on getting your message across rather than on choosing just the right words. Start by telling your partner that you care about them and your relationship. Let them know that you are concerned about the problems in your relationship, want things to be better between you, and believe talking to a couples counselor would be helpful. Ask them what their thoughts are about the two of you starting couples counseling. If your partner is receptive to the idea of couples counseling, then you can move forward with choosing a counselor and scheduling an appointment. If your partner does not agree, this does not necessarily mean that the conversation is finished.

Identify roadblocks. It may be tempting to attribute your partner’s reluctance to participate in couples counseling to a lack of commitment to the relationship or negative feelings toward you. This is, however, often not the case. Many people are afraid of being identified as the “problem” in the relationship or believe that all of the responsibility for fixing the relationship will be put on them. You can help change the direction of the conversation by encouraging your partner to discuss any concerns they have about couples counseling. Stay focused on your desire for the two of you to work together on your relationship rather than trying to persuade your partner that their concerns are somehow wrong.

Offer a compromise. The idea of participating in couples counseling can sometimes feel overwhelming to people. This is especially true when relationships are strained to the breaking point and/or there are many problems that need to be addressed. It might help to focus on taking a specific step rather than insisting on a larger commitment. Ask your partner to consider having one session with a couples counselor to get information and discuss options before making a final decision about couples counseling.

Respect your partner’s decision. Using these tips can help you and your partner get on the same page about starting couples counseling but unfortunately there are no guarantees. The reality is that you cannot make your partner start couples counseling If they really do not want to do it. Keep in mind that you still have options for working on your relationship even if this is the case. Individual counseling can help improve your relationship since what one person does can have a positive influence on the whole relationship.

I always ask the question “what do you want to have happen as a result of coming here?” at some point during my first meeting with new or prospective clients. The hands-down most common answer is “I (or we) want to be happy.” While one person’s idea of happiness may be very different from that of another, I recently came across a program that did a fantastic job of explaining some basic but important things we need to be happy in our lives, as well as what happens to us when these things are missing.

“This Emotional Life” is a three-part series that aired earlier this year on PBS and explores how and why improving our social relationships, learning to cope with depression and anxiety, and becoming more positive, resilient individuals can lead to greater happiness. I truly think this is the best program I have ever seen on mental health issues. The creators of the series kept things interesting by using a combination of compelling real-life experiences of “ordinary” people, insights from well-known celebrities, and current scientific research to illustrate their points. They also did a great job of explaining some complicated emotional issues and concepts in a clear, easy to understand manner that came across as genuine rather than condescending.

Since I earn my living by helping people have healthier, more satisfying intimate relationships, it’s probably no great surprise that I was particularly interested in the episode on social relationships (Episode 1). This episode emphasizes the fact that social relationships, more than any other factor, are the key to human happiness. To paraphrase a line from the show, “We are happy when our relationships are strong, we worry when they become weakened, and we suffer when they are absent or disappear.” This episode highlights how healthy attachment, effective communication, conflict resolution, respect, and trust are all necessary ingredients for people to be happy in their relationships with family, friends, and lovers. The best part from my perspective was that it took things a step further by consistently emphasizing the fact that we have to be proactive to achieve relationship happiness. To put it simply, being happy in our relationships takes work but the payoffs for our emotional and physical wellbeing are enormous and well worth it.

I definitely recommend watching this series. Whether you purchase a copy from PBS, DVR the rebroadcast, rent it from a video retailer, or check it out from your local library, it will be worth watching. If you are like me and don’t have six hours to devote to watching the whole thing all at once, try breaking it down into smaller more manageable pieces. Feel free to let me know what you thought of it or if you have questions.

Enjoy!

Erica stared at her husband Jim in shocked silence. “Was he serious?” She struggled to process what he had just told her.  Had he really secretly amassed a debt of nearly $10,000 that she did not know about? “No,” she thought “there’s no way.” They were barely making ends meet as it was and there was certainly no way they could afford that much extra debt. But Jim was crying now, something he never did, and telling her over and over again how sorry he was and she knew it must be true.

Erica’s hands were shaking so badly now, and coffee was sloshing over the rim of the mug she held clenched tightly between them. She could hear the blood pounding in her ears, her breathing was ragged, and she felt like vomiting. Then she exploded with anger. “How could you?!” she screamed at Jim. “How could you do this to me, to us? We’re going to lose everything we’ve got and it’s all your fault!”

“You have every right to be mad but please listen to me…” Jim began but Erica cut him off. “I have to get out of here, I can’t take any more!” she grabbed her purse and was out the door before he could stop her.

Financial infidelity is cheating

Jim committed financial infidelity by overspending family money without Erica’s knowledge. Like sexual infidelity, financial infidelity is a form of cheating. It’s cheating because it involves lying to and deceiving one’s partner. Lies and deception about money, no matter how seemingly small, can cause serious problems.

Lies destroy trust

In addition to the obvious financial problems they can cause, lies about money undermine the couples’ relationship. Lies erode trust, compromise the teller’s integrity, and make the person who was lied to feel really, really bad.

Why trust is so important

Trust serves as the foundation upon which healthy relationships are built. Knowing and believing that your partner will not cause you harm, emotionally as well as physically, leads to the development of true closeness, connection, respect, and intimacy. Without trust, these other important elements that make up a healthy relationship are not possible.

What you can do:

The good news is that relationships can and do recover from the damage caused by financial infidelity. Rebuilding trust is an essential part of healing your relationship when financial infidelity has occurred. If you and your partner are committed to working through financial infidelity, here are 5 things you can do to begin rebuilding trust.

1. Be transparent. The first step in rebuilding trust involves both partners being fully accountable for their actions when it comes to finances. This means giving one another information about, as well as access to, all financial records, such as credit card statements, bank accounts, loans, etc.  While disclosing this information may be extremely painful for both of you, it is important for several reasons. Not only is this kind of transparency necessary to begin repairing the financial damage that has been done, it also demonstrates an openness that is necessary if trust is to be rebuilt.
2. Work together to create a financial recovery plan. Working together to develop and implement a recovery plan helps build trust in two ways: it allows both you and your partner to share the responsibility for the family’s financial wellbeing as well as makes each of you accountable to the other. A good financial recovery plan might include the specific steps for repaying the debt, creating and implementing a budget, and working with a debt consolidation agency.
3. Meet in the middle. It is not possible for both people in a relationship to always get their way when it comes to money. You and your partner both have valid points of view about spending versus saving that need to be acknowledged and incorporated into your financial planning. Try to understand your partner’s particular financial style and be willing to make some compromises. This will allow both of you to get at least some of what you want which, in turn, will lead to greater trust in one another
4. Actions speak louder than words. We’ve all heard this old expression but its absolutely true: people will give more weight to your actions than your words if there is a discrepancy between the two. Your ability to consistently follow through with what you say you are going to do when it comes to money can make all the difference in your partner’s willingness to trust you.
5. Give it time. The city of Rome was not built in a single day, and the same can be said for rebuilding trust between you and your partner. Rebuilding trust is a process that will occur gradually over time as you both follow the steps outlined in this article. Consider sitting down with your partner once a month to talk about how things are going between you so you can see the pattern of progress that is being made.

Objections:

Why do we need to work together to rebuild trust?

It is tempting for many couples to either give all of the responsibility for fixing the problems to the unfaithful partner since they were the one who made the mess, or for the deceived partner to take it all on themselves because they feel their partner is too irresponsible to fix it. Although both of these approaches may be understandable, the problem is that they further perpetuate the relationship dynamics that likely contributed to the financial infidelity in the first place (read “ Are You or Your Partner Guilty of Financial Infidelity?” for more information). The reality is that it will take both of you working together to repair the damage that has been done by the financial infidelity if your relationship is going to survive.

I’m not sure if I can ever trust my partner again.

Many people struggle with this issue, and it will be important for you to carefully consider whether your partner is deserving of your trust. While this is a very personal decision, here are some questions you can ask yourself to help you decide. Is the financial infidelity an isolated incident or is there a history of your partner keeping secrets (about money or anything else) from you? Has your partner accepted responsibility for his/her actions? Is he/she willing to make changes? Seek the help of a qualified professional if you want or need help sorting out this issue.

What if financial infidelity isn’t our only problem?

Sometimes people engage in financial infidelity to help hide other problems they do not want to share with their partner, such as sexual affairs or compulsive/addictive behaviors (i.e., drinking, drug use, gambling, shopping, etc.). These are very serious problems that will also need to be addressed in order for the relationship to recover.  Many people choose to seek help from a qualified professional since it can be difficult to resolve these kinds of issues on their own.

Erica and Jim, continued…

It took several days for Erica to calm down enough so she and Jim could talk about what had happened.  It was a painful conversation for both of them, but neither of them wanted to end what was otherwise a good marriage.  Jim and Erica knew that he would ultimately have to prove that she could trust him again but also recognized that she too had a part to play in rebuilding the trust between them. They came across this article and decided to follow the tips for rebuilding trust.

Jim and Erica started by  agreeing to make themselves accountable to one another and together went over all of their financial records. They decided to work with a credit counseling service so they could get help managing the large debt that Jim had amassed. Once they had a plan in place for repaying their creditors, they turned their attention to developing a monthly budget that would allow them to live within their financial means. They had anticipated that this would be difficult since they had different ideas about what to do with their money but, since both of them were willing to make some compromises, they were able to come up with a budget that met both of their needs. Erica and Jim both followed through with what they agreed to do and regularly talked with one another about their finances. As the months passed, Erica gradually began to trust Jim again and they both realized that they could handle their finances together without it being a battle between them. It has now been a year since Jim and Erica began the process of rebuilding trust and they feel their relationship is stronger than it has ever been.

Summary

Trust is an essential part of a healthy relationship. Financial infidelity severely damages trust, but it can be rebuilt if both you and your partner are willing to work on it. 5 things you can do to begin rebuilding trust are:

1. Be transparent when it comes to money
2. Work together to create a financial recovery plan
3. Be willing to make some compromises
4. Back up your words with your actions
5. Give it some time

Next steps

Take what you have learned in this article and use it to rebuild the trust in your relationship that has been damaged by financial infidelity. Consider working with a qualified professional or marriage counselor if you want or need help following these steps.

Jim “solved” the problem by secretly taking out a credit card so Erica wouldn’t know how much money he was spending. Now he could have a little fun and it wouldn’t cause more problems between them. Jim’s plan worked great at first. He stored his arsenal of state-of-the-art paintball gear at a friend’s house and paid the minimum amount due on the card each month. Then he gradually started secretly buying more and more things he felt sure Erica would consider to be frivolous. As time went by, both his debt and sense of guilt began to spiral out of control. Now he had amassed almost $10,000 in credit card debt and could no longer manage it on his own. What was he going to do?

Financial Infidelity is Cheating

Jim committed financial infidelity when he overspent family money without Erica’s knowledge. Their story is by no means unique: financial infidelity has become a rampant problem among couples in the United States. Surveys have consistently shown that between 25-30% of respondents admit that they have lied to, or been lied to by, their partner about finances.

Like sexual infidelity, financial infidelity is a form of cheating. It’s cheating because it involves lying to and deceiving one’s partner. Lies and deception about money, no matter how seemingly small, can put the family’s finances at considerable risk. Perhaps even worse, however, is that they undermine the couples’ relationship by eroding trust, compromising the teller’s integrity, and making the person who was lied to feel really, really bad.

How could this happen?

It can be extremely difficult for many people to comprehend how someone could be financially unfaithful. While the person who was deceived is in no way responsible for their partner’s infidelity, the reality is that the interactions the couple has about money can create a situation where, for whatever reason, one person feels justified in secretly overspending family funds. Financial infidelity often occurs in relationships where:

1. The members of the couple have different spending habits – one is a “spender” and the other is a “saver;” and
2. one or both partners adopt negative and potentially destructive attitudes about these differences in spending habits- the natural saver sees the freer-spending partner as childish and irresponsible whereas the spender partner views the saver as a miser and a kill-joy.

Why keep it a secret?

Financially unfaithful partners may choose to keep their infidelity a secret for several reasons. They are well-aware that their partner will not approve of their actions, often fear that they might lose their partner if they tell, and/or feel deeply ashamed of what they have done.

Although it may seem totally illogical, these feelings of fear and shame often make it more difficult for the unfaithful partner to confess and face the consequences of their actions than it does to just ignore the money problems or attempt to deal with them secretly. This approach, of course, does not work in the long run and the situation inevitably escalates to the point where the financially unfaithful partner gets caught or has no choice but to disclose what they have done.

What you can do

Your relationship is in serious jeopardy if either you or your partner are keeping financial secrets from one another. Relationships that involve lies and deception will not survive in the long run.

This does not, however, necessarily mean that all is lost when it comes to your relationship if either you or your partner have committed financial infidelity. You can give your relationship the best possible chance of surviving by first revealing the truth. It is imperative for the financially unfaithful partner to fully disclose the extent of their infidelity. Only then will the two of you be able to work together to address the financial problems and rebuild trust in the relationship.

There is no good way to tell or confront your partner about his/her financial infidelity. Here are some suggestions for how to make this task as easy as possible.

1. Choose a time and place where you will have privacy and when there will be minimal distractions and/or disruptions.
2. Tell your partner directly and honestly what you have done or what you know or suspect has been happening. Beating around the bush or holding back information will not help at this point. Take responsibility for your actions if you are the partner who has committed the financial infidelity.
3. Recognize that your partner will most likely be angry or upset. Give her/him some time and space to come to terms with what has happened.

Objections

I’m too scared to tell/confront my partner.

While telling or confronting your partner about financial infidelity is certainly not pleasant, the anticipation of doing so is worse than the reality for many people. If, however, you feel you cannot raise this issue with your partner or feel your physical safety would be at risk if you were to do so, you should seek the help of a qualified therapist before taking any action. Working with a therapist can help you explore your options and determine the best way to handle the situation.

I feel certain my partner will leave if I tell him/her that I have been financially unfaithful.

You are not alone if you feel this way. It is true that some relationships do not survive following a disclosure of financial infidelity; however, it will ultimately not survive if you continue to hide this information from your partner.

I suspect my partner is being financially unfaithful. I confronted him/her about it and he/she denied everything. How do I know if he/she is lying?

It can be difficult to know if someone is being truthful. Begin by considering what you know about the situation. Does what your partner said match up with his/her actions? What is your partner willing to do to show that he/she is trustworthy? Is the current situation an isolated incident or a recurrent pattern? The answers to questions such as these can help you decide if you think your partner is being truthful or dishonest. Working with a qualified therapist can also help you with this issue.

What happened to Jim?

Jim told Erica everything. It was the hardest thing he had ever done in his life, but it was also a relief to finally tell his secret. Erica was furious and told him she wasn’t sure if she could forgive such a betrayal. They both took some time to consider whether their relationship could recover from Jim’s infidelity or if they should call it quits. They decided to try again and, with the help of their therapist, are doing much better.

Summary

Financial infidelity is a form of cheating that can destroy relationships in which it occurs. Relationships can, however, recover from financial infidelity when the infidelity is revealed and the couple works together to resolve the financial difficulties and rebuild trust. This article described three ways to help someone tell or confront their partner about financial infidelity:
1. Pick an appropriate time and place
2. Be honest and direct
3. Give your partner time and space

Next Steps

If financial infidelity is happening in your relationship, consider telling or confronting your partner about it.  Use the suggestions given in this article to help make this task as easy as possible. Seek assistance from a qualified therapist if you want or need help doing this.  Then read the next article in this series to learn how to begin repairing the financial and emotional damage caused by the infidelity.

Don’t be afraid to get help in therapy.  Wichita Falls residents (or those nearby) can make a phone appointment for a free consult with me.

Why are sexual side effects such a problem?

Unlike many other side effects that tend to resolve or improve with continued antidepressant use, sexual side effects can persist for many months or even throughout the duration of treatment without improvement. Sexuality is an important part of many people’s lives, and sexual side effects can have a significant negative impact on one’s emotional wellbeing and intimate relationships.

What kinds of sexual side effects can antidepressants cause?

• Decreased libido –Both women and men can experience a loss of interest in sexual activity but it is more common among women.
• Erectile dysfunction – This includes Difficulty achieving and/or maintaining an erection.
• Orgasm difficulties –This includes absent orgasms in women, premature ejaculation in men, and orgasms that are less intense or “muted” in both sexes.

Which Antidepressants cause sexual side effects?

There are several different types of antidepressants, and all of them can cause sexual side effects. Selective serotonin reuptake inhibitors (SSRI’s), such as Paxil, Prozak, Zoloft, Celexa, and Lexipro, have a higher incidence of sexual side effects than do either tricyclic or atypical antidepressants. Atypical antidepressants, such as Wellbutrin, Remeron, Cymbalta, and Nefazodone, are associated with the lowest rates of sexual side effects.

Why do medications cause sexual side effects?

Researchers are uncertain as to exactly how antidepressants interfere with sexual functioning. Some popular but still unproven theories suggest that sexual side effects are due to the increased bioavailability of the neurotransmitter serotonin, the sedating effect of many antidepressants, or neurochemical changes in parts of the brain responsible for sexual functioning.

What you can do about it

Here are four things you can do to help if you are taking (or considering taking) an antidepressant and are concerned about sexual side effects.

1. Timing – it really might be everything. Sexual side effects are sometimes less pronounced when the medication is not at its peak level in your bloodstream. Try timing sexual activity so that it is as far away from your last dose as possible. Some men in particular also find it helpful to plan sexual activity for the mornings when testosterone levels in the bloodstream are naturally higher.
2. Learn to adjust to your “new normal.” This process begins by coming to terms with the fact that your sexual functioning is, at least for the time being, not what you would like for it to be. Sex might not feel like it once did, but it can still be good in different ways. Learn more about the new way your body responds to sexual stimulation by experimenting with different kinds of touch, using different positions, and engaging in sexual play.
3. Consider participating in psychotherapy. Medication is not the only option for treating depression: it is well documented that psychotherapy alone or in combination with medication is as effective as medication alone. If maximizing your sexual functioning is important to you, one advantage of psychotherapy alone for treating your depression is that it does not cause sexual side effects. Psychotherapy in combination with an antidepressant, in addition to helping improve your depression, can also play a useful role in helping you adjust to the sexual side effects caused by the medication. All treatments have benefits and risks that you should carefully consider before choosing the option(s) that is best for you.
4. Talk to your prescriber about your concerns. While health care professionals are becoming increasingly sensitive to the importance of sexual functioning for their patients, many still do not discuss sexual side effects when prescribing or monitoring antidepressant medication. This means that you as the patient must often take a more active role in making sure that these issues are addressed. One thing you can do is talk to your provider about whether it might be possible in your particular situation to minimize or reduce sexual side effects by making changes to your medication. This might involve adjusting the dosage of your antidepressant, prescribing a different antidepressant that has fewer sexual side effects, or prescribing an additional medication to help counteract sexual side effects. Please remember to always consult your health care provider before making any changes to the dosage of or stopping your antidepressant medication.

But wait…

I just spent 2 years finding a med that seems to really be working for me. I’m afraid to make any changes, even if my sex life is a problem, for fear that my depression will get worse.
Only you can decide if you can live with the sexual side effects you are experiencing. If they are tolerable, then there is something to be said for leaving well enough alone. If not, then using some of the behavioral suggestions given above could help you manage or reduce the sexual side effects without making any changes to your medication.

This feels really unfair. My relationship suffered because I was depressed, so I got on meds. Now my relationship is suffering because I have no interest in sex! I feel like I can’t win.
You are absolutely right: it often seems like we end up trading one thing we want in life for another and this can feel very unfair. The good news is that you do not necessarily have to give up your sex life in order to improve your mood. Using the tips given in this article will hopefully help you find a balance that works for you.

Jessie’s story

Jessie was taking Paxil to treat her depression and anxiety. It did a great job of improving her mood but unfortunately made it almost impossible for her to have an orgasm. She had been satisfied with her sex life before beginning the Paxil and found this sexual side effect to be both annoying and distressing. She decided to try some of the tips given in this article to see if they helped. Jessie made a point to time sexual activity whenever possible so that it occurred first thing in the morning before taking her daily dose of medication with breakfast. She also grudgingly accepted the fact that her body responded differently to sexual stimulation than it did before she started the Paxil and began learning more about her body’s new way of responding. Jessie found that making these changes allowed her to resume having orgasms. Although they were less frequent and intense than they had been previously, she was thrilled to be having orgasms again and was satisfied with her level of sexual functioning for the time being.

After being on Paxil for a year, Jessie decided it was time for a change. She had recently become involved in a serious relationship and, although she was still managing the sexual side effects of the Paxil reasonably well, she was becoming increasingly frustrated with her body’s response and wanted to experience sex with her partner the way she knew it could be. She consulted with me because she wanted some guidance figuring out what to do. I helped her identify all of her available options, consider the relative advantages and disadvantages of each one, and come up with a plan that would work well for her particular situation. Jessie decided that she needed to continue taking medication to treat her depression. She talked to her health care provider, who decreased her dosage and prescribed an additional medication to help counteract the sexual side effects she was experiencing. We also discussed a few other specific things she could do to enhance her sexual relationship with her partner. Jamie reported when I last spoke with her that she had noticed further improvement with regard to her orgasms and was pleased with the results of the changes she had made.

Summary

Sexual side effects are an unfortunate consequence for many people who take antidepressant medication. There are, however, many things you can do to minimize and manage these sexual side effects so that they do not ruin your relationship or your sex life.

• Time your sexual activity to maximize your sexual functioning
• Learn to adjust to your “new normal”
• Consider psychotherapy as a treatment option
• Talk to your prescriber about your concerns

Next Steps

• Try some or all of the suggestions given in this article and see if they help you better manage the sexual side effects you are experiencing from your antidepressant.
• Consider working with me or another qualified professional if you need or want someone to help coach you through the process of making these changes.