Dr. Steven Lazarus is a psychologist in Littleton, CO. He specializes in helping couples in premarital counseling, relationship counseling, and marriage counseling. This blog is dedicated to providing couples with resources to have healthy relationships.

Beat Stress with These Top Tips

If you’ve ever visited with a psychologist or therapist in Highlands Ranch, you know that we meet with people who are struggling with all sorts of different challenges. Sometimes people come in with specific concerns or life issues that they would like to work on, other times, they come with a simple request: “I’m stressed and I want it to stop!”

Stress is a normal part of life, and I have yet to meet anyone who has never experienced stress. Stress helps us to identify the need to take action, whether that is getting that big project done at work before your boss gets angry, helping your kids learn and behave effectively at school, or dealing with your romantic partner. However, if your life contains too much stress, you may find yourself becoming irritable, angry, and having more health problems! Fortunately, working with a psychologist in Littleton can help you to fix these stress areas and feel better. While you’re waiting for your next appointment, try these top stress busters.

  1. Get moving! If your idea of exercise is the long walk to the garage to get into the car, you’re probably not getting enough exercise. Walking for just 30 minutes a day has been found to improve mood and relieve stress. It can also help you to sleep.
  2. Budget your energy. You make a budget for your finances, why not your valuable time and energy? Lists or planners can be helpful for this, because you can write down what you need to do each day—and what you would “like” to do, if you have time. Focus on getting the needs done, and don’t feel guilty if you skip the “like to do” section—if you have budgeted your time and energy well, this will fit in another day.
  3. Read a book. The act of reading promotes quiet, calm, and focus—all stress-relieving things! Just 20 minutes of quiet reading can lower stress by up to 68%, making this classic leisure activity even more effective than listening to music or drinking a hot cup of tea.
  4. Embrace nothingness. Many American households operate like Times Square—always on, always bright, and always loud! If you feel like you can’t get a moment of peace, it’s probably because you can’t. Change that by dedicating at least 10 minutes a day to quiet. Whether you do this at night after the kids have gone to bed or make it a family tradition, taking just a few minutes to relax, breath, and think without the constant stimulation can reduce stress effectively.

If you have tried these things and they don’t work, or if you feel like your stress is unmanageable on your own, contact a psychologist. Dr. Lazarus and Zeke, his trained therapy dog, provide animal assisted therapy for clients in Littleton and Highlands Ranch. You can live a relaxing, fulfilling life in spite of stress!

Why You May Be Better Off Skipping Insurance for Therapy

No insurance?

As a busy psychologist in Littleton, I work to provide the best treatment at an affordable cost. For many, this means working with and utilizing health insurance benefits to pay for therapy costs. Especially since many new mental health and substance abuse treatment options have become part of “standard” healthcare packages in the few years due to recent federal policy changes, more and more people are seeking mental health providers in Colorado who take health insurance. While this does have the potential to save your family money on these costs, there are also some reasons why you might be better off skipping the insurance for therapy. Read on to find out the most common health insurance issues my patients in couples therapy and ADHD counseling in Littleton have experienced.

  1. Long waits. Many insurance providers are booked up, often for months! If you have a time-sensitive mental health need, waiting until the next season to get help may not work for you.
  2. Mental illness diagnosis. Unlike your physician or pediatrician’s office, your insurance does not allow you to head into a psychologist’s office for a “check up” or even “follow up.” In fact, without a diagnosed mental illness, your insurance won’t cover your costs. This can be very difficult for parents seeking to learn new parent strategies from a child behavior psychologist, or for couples who simply want to learn how to communicate better. Speaking of couples…
  3. …Only one person in the couple is the “patient.” The way that health insurance works is to code couple’s counseling sessions the same as an individual counseling session with a family member present—just like you might have if you were very depressed and needed a family member to help explain your current functioning. This means that one partner must be designated as the “patient,” while the other is simply “attending” the session.
  4. Pre-existing conditions. Mental health diagnoses can be considered pre-existing conditions. Something as simple as chatting briefly with a counselor in Highlands Ranch for ADHD counseling can indicate to your insurance company that you’ve had this problem—and may hinder you from getting competitive rates in the future.
  5. Time vs. money. With health insurance comes paperwork, phone calls, and a lot of time spent making sure you meet your deductibles, pay only your co-pay, and do not exceed your yearly limits. Some insurance companies may ask that you submit additional paperwork to “prove” that you still need services. At the end of the day, you may find that your health insurance covers so little that you may have been better using a Health Savings Account or Flex Spending Account to cover these costs.
  6. Confidentiality and Control. When you meet with a mental health provider, you are told that your information remains confidential, private, and protected by law… with certain exceptions, including compliance with health insurance requests and requirements. While your psychologist will work to keep your information as confidential as possible, we cannot control the actions of your health insurance company. For 100% peace of mind about your health information, self-pay protects you the best.

Dr. Steve Lazarus provides counseling and couple’s therapy in Littleton and Highlands Ranch. While he does take some health insurance, he encourages all clients to weigh the pros and cons of using this sort of payment, and is open to discussing these concerns further in a free, 15-minute phone consultation.





Top Four Active Listening Tips for a Strong Relationship

Strong Relationship

What’s the number one reason why people seek counseling and couples therapy in Highlands Ranch? Based on my clients, communication is the main reason! Too many couples find themselves constantly on “different pages,” missing one another’s messages, and struggling to communicate about the good, the bad, or the in-between. Some of the past blogs on this website have addressed ways to communicate with your partner in a healthy way , but that only deals with one side of the equation. When people seek to improve communication, they must address both parts: “sending” the message, or talking, and “receiving” it—listening. This post will review the five basic steps of active listening and how they can help you to build a stronger relationship.

  1. Pay attention! Easier said than done, but reminding yourself to pay attention is key to listening actively. This includes not looking at your phone, eliminating distractions, and setting your mind intentionally to listen. This shows the listener that you value their time and their thoughts.
  2. Show attention. How does the speaker know you’re listening? It’s usually obvious. Your body language speaks louder than words, so make sure you show it. You can accomplish this by making good eye contact, nodding or shaking your head at appropriate times, facing your speaker, and using small gestures where needed. This lets the person speaking know that you are actively listening and valuing their statements, strengthening the bond between you and the speaker.
  3. Check for understanding. A good deal of verbal communication is missed or misunderstood—check with the person speaking to make sure you truly understand what they are saying by asking a clarifying question (“is this your friend, John, or your brother, John?”), rephrasing their comments (“I hear you saying that your car is having problems and you’re not sure if you want to sell it”), or reflecting their emotions (“you’re sad about the business loss, but still feel motivated”). These statements demonstrate your understanding and open doors to correct miscommunications.
  4. Be polite. Don’t judge, interrupt, or dismiss someone who speaks to you. Easily said, but remember, this requires active, mindful effort!

Active listening means that you are focusing your thoughts, energy, and attention 100% (or close) on the other person and what they are saying. It requires your brain to be working hard, not to think of your next statement or argument, but working hard to truly understand and hear the person you are speaking with. This is just a small sample of the various skills that you would learn in intensive couples therapy in Littleton. To find out more or develop a personalized plan to improve relationships and communication, set up an appointment with Dr. Lazarus today.



How Animals Help Couples Communicate

Many couples dread relationship counseling. While each couple is different, most present with one overarching concern: We can’t communicate! Fortunately, there is more to the office in Littleton than couple’s counseling—Zeke, a certified therapy dog, assists and helps people to express their feelings and communicate with one another. But how can a therapy dog help you communicate with your partner? Read on to find out more!

Fidget tool. Despite the popularity of fidget spinners in 2017, many people still struggle with a need to fidget with something, especially when the topic of conversation is otherwise tense. A therapy dog will happy sit and be petted, providing an outlet for both partners to fidget and experience sensory stimulation.

Emotional assurance. Therapy dogs, in general, promote calm and relaxation. Since our four-legged friends are non-judgmental and typically very present-focused, they can help humans feel the same way.

Welcome distraction. Sometimes, couples just need distraction. The depths of love you once shared may be disrupted by hatred, anger, jealousy, or resentment, and a pleasant distraction may be the perfect solution to help you feel better.

Nonverbal language. Dogs are experts at nonverbal language because they don’t speak with words. Instead, they are attuned to your body language, tone of voice, eye contact, and positioning. This can help reflect behavior back to the people demonstrating that behavior. For example, a dog who feels threatened by yelling or erratic behavior may move away from someone displaying these behaviors, even if the person does not realize they are doing it. A skilled couple’s therapist in Littleton can help you to interpret these animal communication signs and adjust accordingly.

Children. Animals can reflect the world of children. You and your partner may try to keep your words civil or may even plaster on a fake smile all day, but your children may sense your emotional distress. Like our animal friends, children, especially young children, often pay more attention to body language and unspoken signals. How the therapy dog reacts, particularly to arguments, can signal the same sort of distress for your child.

To start experiencing the benefits of animal assisted couple’s therapy in Highlands Ranch, give Dr. Lazarus a call today. He and Zeke will be happy to happy to help!

How to Help a Loved One with Depression

Those who are familiar with pop psychology know the trend: People get more depressed and even suicidal around the holidays. Unfortunately, this pop-psych trend is based in reality. People do report increasing rates of depression around this time of year, and for a variety of reasons. For some, the short days, cold weather, and lack of sunlight can contribute to seasonal depression; for others, all those images of happy friends and family can be a reminder of what is wrong in their lives. At the time when the media is screaming at everyone to be happy for the holidays, those who are depressed only face constant reminders of the fact that they cannot be happy. One of the most common questions that people ask their Littleton couples therapist is how they can help. Here are some ways to help your loved one with depression this holiday season.

  1. Remember, depression is a mental health condition, not a mood or temporary state. Telling someone to “cheer up” or “smile” will not change their depression. It may make them act happier or look happier temporarily, but they are only putting on this happy mask to make you feel better. Inside, they likely feel worse for having to “fake it.” Instead, acknowledge and respect their feelings while offering to engage. Consider a statement such as: “I know the holidays are hard for you. If you need someone to talk to, or if you want to spend some time together to take your mind off of it, I’m here.”
  2. Keep inviting them, even if they don’t show. People get frustrated with depressed friends and family members because they often decline invitations or fail to show up. While this is hurtful to the person doing the inviting, most people who are depressed see these messages, wish they could go, but ultimately do not feel well, similar to how someone with the flu might respond. However, the invitation (and reminders!) shows them that you still want them to be there, even if they can’t make it. Besides, they might show up!
  3. Learn the warning signs for suicide. While they are different for different people, some common ones talking about feeling hopeless and helpless, feeling they have no purpose, feeling they are a burden to family and friends, sleeping all day or not at all, withdrawing from others, using substances more than usual, or becoming edgy or reckless. Most importantly, those who talk about wanting to die, wanting to kill themselves, or exploring means of suicide are at high risk. Never fear asking your friend or family member directly: “Are you thinking of killing yourself?” You will not “give them the idea,” you will give them the chance to seek help and sort through their feelings. If you feel that your loved one is in immediate danger of hurting themselves or others, you can always call 9-1-1 nationwide or call/text the Colorado Crisis Services at 844-493-8255 for help.
  4. Assist in getting help. While many people with depression are already in treatment or not interested, many people benefit from it but are unable to access it. If your loved one is depressed and you are worried, it is not inappropriate to ask if they need help finding, setting up an appointment with, or even getting to a skilled psychologist. Seeking counseling in Highlands Ranch or attending animal assisted therapy can bring major, positive changes to the life of someone with depression.

If you are feeling depressed, or if your loved one is depressed and would like a skilled couples and animal assisted therapist in Littleton or Highlands Ranch, consider giving Dr. Steve Lazarus a call at 303-267-2194. He has helped many people recover from mental health problems and live a full, healthy life.

When Loss Strikes: What is Normal and When to Seek Help

For better or worse, loss is a part of life. Not only is it inevitable, it is necessary—if nobody ever died, we would simply run out of room for new life to be born. However, this does not make the process any easier, especially when the loss is someone whom you love dearly. When does grief become something else, and when should you seek help? Read on to find out!

Immediate reaction

One of the best ways to think of immediate loss is of devastation. Whether you have lost a loved one unexpectedly or after months of declining health, the final realization that they are gone can be rough. It is normal to cry, feel sad, or even feel angry—at the person who is gone, at yourself, and at the whole world. Your emotions may feel overwhelming, and that’s okay. Allow yourself time to feel these emotions and seek the support of others in your life.

Signs you need help

While loss is difficult to bear, there are some signs that you should seek professional help. If you consider harming yourself or others, you should always call 9-1-1 or visit your nearest emergency room.


For a few weeks or months following the loss, you can expect to still feel pain quite vividly. You may notice that your pain subsides somewhat, or that it “rears its head” with vengeance every now and again. Reminders of the person you have lost, such as their clothing, favorite TV show, or perfume may bring back vivid and unsettling memories. However, at this stage, you should be able to start recovering and moving on. Try thinking of the positive memories you have of this person and what they would want for you—chances are, they would encourage you to keep living your life!

Signs you need help

Immediately after a loss, it is perfectly normal to “shut down” for a few days. However, if weeks or months have passed and you still find yourself unable to go to work, maintain hygiene, or feel happiness or enjoyment, you should seek the help of a grief counselor in Littleton. Loss can take a huge toll on relationships as well. Your partner might not understand your grief, or why you’re so sad, and attending Littleton couples therapy sessions might help you to see eye to eye.


After a few months, you may feel guilty that you do not think of your lost loved one that often. Don’t despair—this is a normal part of moving on. In addition, you may find yourself doing great most days, but receiving an occasional “blow” when something reminds you of your lost loved one. This, again, is perfectly normal. Holidays and anniversaries tend to be the hardest, but you can turn these moments of sadness into moments of celebration by honoring the lost person’s favorite activities and sharing them with others. The person you lost will always be a part of you.

Signs you need help

If you still feel the same intense pain as you did when you first realized your loved one was gone on a daily basis, or if you still feel limited in your work, social life, or personal life because of the loss, you may benefit from working with a therapist. While there is no “time limit” on grief, it is important to differentiate grief and loss from depression. In addition, working with a trained professional can help you to clarify your feelings and values and develop effective coping skills to keep yourself going.

While your loved one may be gone, you know he or she would never want you to get “stuck” as a result. Live your life to the fullest and give Dr. Lazarus a call if you’re feeling stuck!

Am I Having a Mid-Life Crisis?

Many clients come in asking a common question: Am I having a mid-life crisis?

Interestingly, many of the clients who are asking this aren’t even mid-way through their lives—which has promoted a tongue-in-check trend of referring to a “quarter-life crisis” or even “third-life crisis.” What do these terms mean, and how can you tell when you need help? Read on to find out some answers from Dr. Steve Lazarus, a psychologist in Littleton.

What is a mid-life crisis?

A mid-life crisis is not a formal diagnosis—just like the “terrible twos” or “irresponsible twentysomething” phases that people tend to go through, a “mid-life crisis” is a pop psychology concept that has been embraced and promoted in the media, showing people in their 40s and 50s rejecting their “boring, adult lives” and engaging in activities such as buying new sports car, ditching the spouse for a younger paramour, or going on a months-long road trip—all while ignoring the daily routine of bills, healthcare, and responsibility. For some, a little fun now and then is normal. For others, big and reckless decisions might signify a deeper crisis. Further, many people who feel like they are having a mid-life crisis report that they are concerned about their own aging, mortality, health, and future. They may feel bored, restless, careless, or rushed to accomplish a “bucket list” of events.

So, am I in a crisis at all?

If you’ve carefully budgeted, expanded your garage, and pre-purchased insurance for your new sports car, you’re probably doing all right. However, if you feel like nothing matters, if you are spending beyond your earnings, or if your new activities in life are alienating friends and family, these are all signs that something is wrong. While it is okay, and even healthy to have fun, when your “fun” starts taking a toll on the other areas of your life, it’s time to re-evaluate.

How can a state of crisis affect my life and relationships?

Most often, by the time people show up in a therapist’s office, they are truly in a state of crisis. They might confess that their spouse no longer wants to engage in intimate activities, or that their kids are avoiding them. Some have even lost jobs. After the initial excitement, many people find themselves “crashing” and regretting their decisions, leaving them with feelings of depression, anxiety, and regret. Many seek counseling in Highlands Ranch, couples therapy, or other help from professionals.

What can I do to feel better?

The upside to a midlife (or quarter-life, or existential) crisis is that it lets you know that something is wrong. Maybe you never bothered to have fun as an adult, so you’ve made up for twenty years of unflinching responsibility with a month of irresponsible partying. Maybe you and your spouse have grown apart, and you finally had the motivation to make a change. Explore the reasons why you needed these drastic changes in your life to find insight into what you might want to change in the long-term. Of course, if you are feeling depressed, anxious, or just don’t understand what is going on, consider seeking help from a professional. Dr. Lazarus has helped many people navigate their or their spouse’s mid-life crisis, coming out stronger on the other side. To set up an appointment, call 303-267-2194.

Categories: Relationships and Marriage

How Noise Increases Your Stress—and What to do About It

What can you hear right now?

Take a moment to focus, perhaps close your eyes, and consider the sounds around you. Is there a fan in the background? Music playing? Do you hear the cars from the highway outside? Is it loud enough that you are distracted, or are you surprised by all the noise you can hear?

All living beings who are capable of hearing sound use these sounds to detect information about the environment, including cues for danger. While this has served an important role throughout human development, in today’s world, people are exposed to far too much noise. Chronic exposure to noise, especially at high levels, can greatly increase stress, making you more irritable and increasing the chance of a major fight with your family or friends. Many clients who seek couples therapy in Highlands Ranch admit that environmental stress and noise have an effect on their relationship. This stress can result in negative health outcomes including decreased sleep, increased risk of heart disease, and lower mental performance. Have you ever been driving a car, looking for an address, and turned down your radio? Talking GPS devices aside, people have been doing this instinctively for decades to help them “see” better—but it’s more accurate to say that it helps your brain than your eyes. That’s right, you really can think better when you turn down that noise!

Unfortunately, in many areas of our lives, we cannot “turn down” the noise. While you wish you could, you probably cannot “mute” your chatty coworkers, and your children cannot “mute” their classmates—no matter how much it could help you to focus and concentrate. People aren’t the only source of problem here; environmental noises have been compared to smog, “polluting” the air in the same way as a black factory smokestack can pollute a city. With the constant interruption of dinging cell phones, people living in increasingly close quarters, and tiny little Bluetooth devices delivering social media right into our ears, sound can be almost impossible to avoid!

Fortunately, you have some options. While a Littleton ADHD Counseling expert can help you learn tips to stay focused, that noise will still be there! One of the best is to simply assess your personal environment for noise level. If you always leave a TV or radio on by habit, consider trying a day without noise. You may find that your stress levels are lower, or that you can be more productive. At night, noise-cancelling headphones or earplugs can be a lifesaver—those same tools can also help you get some peace and quiet at work. Reducing or removing noise, even on a temporary basis, can help promote mindfulness and relaxation. You can address noise through structure as well, such as placing carpet or rugs in your home, using doors or curtains to separate rooms and serve as noise barriers, or fixing or oiling squeaky doors, fans, and other appliances throughout your home. In a noisy world, few people appreciate silence, but it can be a positive addition to your life.

The Parent’s Guide to Strengthening the Husband-Wife Bond

For many couples who commit their lives to each other, having children is often the next natural step in the relationship. And while some couples assume that having kids will automatically smooth over any rockiness in the relationship, the opposite is usually true. Raising a family can be just as stressful as it is wonderful, and often that stress can lead to even more problems. But having kids doesn’t have to mean the end of a couple, and it is possible for couples to strengthen their bond while still being parents, it just takes a little extra effort.

Have Alone Time Together

Finding time to spend alone together as a couple can be challenging when you have kids, especially for new and first-time parents. When a couple first gets together, the dating process is all about getting to know each other. After a couple has kids, this process begins anew, because people and relationships change when children come along.


Time alone with your spouse, therefore, is important for many reasons, including that it lets you relax together, allows you to enjoy each others company without the stresses of home getting in the way, and it keeps you connected as you grow as individuals and a couple on the new path of parenthood. On top of scheduling regular date nights, have a list of trusted babysitters on-hand in case you want to arrange an impromptu night together or if one sitter falls through on plans. Feel free to use grandparents if you are lucky enough to have them nearby.

Make Time for Intimacy

After having a child, intimacy can take a backseat for a while as you recover from the birth and adjust to the routine with a new baby in your life. But when it’s comfortable again, it’s very important for couples with children to make time for intimacy. A good rule is when on a date, don’t talk about the kids. Looking forward to time spent together keeps your connection strong and makes parenting easier. Many couples learn how to your marriage healthy and strong during a busy lifestyle with techniques addressed at Highland Ranch couples therapy by Dr. Lazarus


Schedule a parent business meeting

Since you are planning dates where the rule is to not talk about the kids, you need to have a set time when you can talk about the kids. Leave the home if possible and meet for coffee or lunch. Plan on spending about 30 minutes a week going over schedules, appointments, kid activities, and any issues or concerns you are having with a child. Develop a plan together as partners for addressing these concerns and then regroup next week to discuss how things went.

Schedule a Daily Check-in

Life with kids can often be so busy that it seems you never have a moment to yourself. But when it comes to you and your partner, you need to make time. Even if you just have a quick chat each night before bed, a talk in the morning before the kids are up, or a lunchtime phone call to check in, it’s important that you talk to each other about your days, your goals, your feelings, and anything that might be bothering you. This will keep the lines of communication open and provide you both with a safe space to talk, open up, and ensure nothing is getting bottled up or ignored.

Stay Active Together

Raising kids often takes most of your time and energy as a parent, but that doesn’t mean you should neglect your own physical health. Staying active together is a great way for you and your partner to stay connected, and it can give you family time or alone time doing something fun and new together. You don’t always have to follow the same routine, either: you can go for a family walk one week, out dancing alone together the next, then for a family bike ride, followed by a couple’s hike the week later.


Dr. Lazarus’s Highlands Ranch couples therapy sessions focus on the need for parents to make an effort to spend more time together as a husband and wife and to separate out the parenting piece of the relationship. It can be difficult for parents to find time for these things, but connectedness, communication, and time spent together are crucial for couples who want to strengthen their bond, especially when children are involved.

To find out more about how you can make the most of your time together and learn to communicate more effectively,

call today to schedule an appointment or fill out the contact form.


3 Ways Couples Therapy Can Significantly Help Your Relationship

Couples Therapy

Nothing is perfect. We accept this in everything we experience in our lives, including our relationships. But when it comes to the people that matter the most in our life, even though we shouldn’t seek perfection, we shouldn’t let problems and conflicts harm a relationship. There are small problems, which over time cause harm, and then there’s big problems which can really feel impossible to solve. Whether you are struggling with small issues, or big problems, it may be time to step back, assess the situation, and bring in a third party, such as a couples therapist


This is where an experienced Littleton couple’s therapist comes in, and if you’re considering getting some help, here are three ways that couples therapy can improve your relationship.

1 – Better Communication

Communication is the absolute bedrock of any successful relationship, and, unsurprisingly, can often be the biggest causes of problems. Depending on the personal situation, there can be any number of reasons for a breakdown or difficulty in communication. One partner may be naturally introverted and less prone to speaking up. Another partner may have simply never had an opportunity or vehicle to safely express their emotions, and subsequently doesn’t know how. Not feeling heard or understood can cause a person to shut down, or get very frustrated and angry.


By bringing a neutral mediator into a discussion, clear channels of communication can be established, and, through couple’s therapy, better techniques can lead to increased communication between couples to use in everyday life, not just in a therapeutic setting.

2 – New Coping Tools

For many, when an argument or disagreement occurs, unhealthy coping mechanisms are potentially unpleasant and often unproductive. Simply walking out of an argument, giving “the silent treatment,” or even separating and sleeping in separate rooms—or other locations entirely—are closer to retaliatory actions than a means of resolving a problem.


Couples therapy can introduce new tools to a couple to use when there’s a problem that needs to be resolved. Yelling, arguing and similar reactions don’t fix things. Working together with a sincere desire to make things better is easier to do when couples have better coping strategies to deal with life when things aren’t working out.

3 – Gain an Understanding of Each Other

One of the biggest obstacles to couples being in a harmonious relationship is often basic misunderstanding. Couples therapy gives a couple a safe, carefully controlled environment in which to explore the heart of certain issues. Understanding each other is critically important in being able to successfully resolve problems.


This is a chance for couples to say what matters, explore unrecognized feelings and honestly confront what they really want or don’t want. By being honest, loving, and patient, couples have a much greater chance of working together to develop win/ win solutions.


Littleton couples therapy doesn’t have to be just for troubled marriages. Any couple, whether it’s a new relationship wanting to start off on the right foot, or a couple simply wanting to improve what’s already there, can experience real, powerful, lifelong benefits by taking the time to strengthen a relationship through couples therapy.


Additional Article: Do we need to see a couples therapist?

Dr. Steven Lazarus can help you work through any couples therapy issues you may have.