Schizophrenia symptoms are often classified as negative or positive symptoms. These symptoms are grouped based on whether they reflect diminished or excess function. Positive and negative schizophrenia symptoms have been seen ever since schizophrenia was first noted in medical literature over 100 years ago. (See: Schizophrenia Diagnosis and DSM IV Schizophrenia Criteria)

Schizophrenia Negative Symptoms

Negative symptoms in schizophrenia refer to a decrease or absence of normal function. An example of this is a loss of interest in everyday activities. Negative symptoms may be present years before positive symptoms in schizophrenia occur. Schizophrenia negative symptoms can be hard to diagnose as they can easily be mistaken for other disorders like depression.

Negative symptoms in schizophrenia include:^1,2,3

• Apparent lack of emotion or small emotional range
• Reduced ability to plan and follow-through with activities
• Neglect of personal hygiene
• Social withdrawal, decrease in talkativeness
• Loss of motivations

People with schizophrenia who have negative symptoms often need help with everyday tasks and with taking care of themselves. It can appear like the person with schizophrenia isn’t trying or doesn’t want help, but this is just a manifestation of his or her negative symptoms.

Schizophrenia Positive Symptoms

Positive symptoms in schizophrenia refer to an excess or distortion or normal function. Positive symptoms are the ones most typically associated with schizophrenia or psychosis. These include hallucinations,  which are often auditory (often hearing voices). These symptoms are the ones that generally cause people to lose touch with reality. Positive symptoms of schizophrenia can come and go and may not be noticeable at times (see 10 Early Warning Signs of Schizophrenia).

Schizophrenia positive symptoms include:

• Delusions – falsely held beliefs usually due to a distorted perception or experience. Delusions are the most common symptom of schizophrenia.
• Thought disorder – difficulty organizing and expressing thoughts. This might result in stopping mid-sentence or speaking nonsensically; including the making up of words.
• Disorganized behavior – unusual and inappropriate behavior. This might be childlike behavior or unpredictable agitation.
• Movement disorder – agitated or repeated movements. Catatonia (non-moving and non-responsive) is also possible.

Positive symptoms often respond more successfully to antipsychotic treatment.

Other Schizophrenia Symptom Types

Additional schizophrenia symptoms are also categorized as cognitive or affective. Cognitive symptoms can be very difficult to identify and include:

• Impaired memory and attention
• Difficulty thinking through complicated processes, making sense of information
• Impaired ability to organize
• Poor decision-making
• Difficulty in interpreting social cues

Affective symptoms are those that affect mood. This might be appearing gleeful or sad inappropriately. People with schizophrenia are often depressed or have mood swings.

article references

Pelvic floor exercises for men

Increasing the strength of your pelvic floor muscles through regular exercise will help you get the most from sex. Psychosexual therapist Paula Hall explains how to do the simple exercises and the benefits they could have.

Preparation

Before you start, you have to locate the muscles in question. You can do this by stopping your flow of urine next time you go to the restroom, as the muscles you use to do this are your pelvic floor muscles.

The benefits Regular exercise of the pelvic floor muscles - namely the pubococcygeus muscles that support the penis, bladder and rectum - has many health benefits, including:

• improved blood circulation to the genital area, which helps arousal
• stronger and more pleasurable orgasms
• a greater feeling of control and confidence over ejaculation
• improvement in the angle of erection
• avoiding urinary incontinence

The exercises

You can do these exercises any time, any place - no one will know you're doing them. Practice them while you're sitting, standing and lying down. The most important thing is to do them every day.

Squeeze and release the muscles 15 times. Don't hold the contraction.

Start with one set of 15 squeezes twice a day. Concentrate on squeezing your pelvic floor muscles only, not your stomach and thighs. This will become easier with practice. (Some people say that sucking their thumb while doing it helps.)

Over time, gradually increase the number of contractions until you can do 40 or 50 at a time.

Once you're comfortable doing this, vary the exercise by holding each contraction for a count of three before releasing. Again, slowly increase the number of repetitions until you can do 40 or 50.

It may be six weeks before you start to feel the benefits listed above, but then you'll definitely notice them!

Related Information:

• Pleasing Yourself
• Learn to fantasize
• Sexual Exercises Men

The last thing you remember was sipping a drink at a party. Now you wake up in a strange place, possibly hours later, with a sense that you've been sexually assaulted. But no matter how hard you try, you can't remember exactly what happened. You may be the victim of one of a number of date-rape drugs.

Date-rape drugs are used to incapacitate you and make you vulnerable to sexual attack. They often leave you with no recollection of what happened to you while you were under the drug's influence. Health experts and law-enforcement authorities don't know exactly how often rapes involve use of such drugs. But these types of rape do happen. Help keep them from happening to you by learning more about what drugs are used in date rape and how to protect yourself from date or acquaintance rape

Drugs and rape: An old problem with a new face

Sexual predators have used alcohol and drugs to weaken their victims' resistance for centuries. Alcohol is the substance most commonly used for this purpose. Excessive alcohol consumption can induce blackouts and complete memory loss, while not necessarily impairing your ability to function.

Besides alcohol, at least 20 other drugs are used for purposes of sexual assault. Some of these include:

• Ketamine (Ketalan)
• Lorazepam (Ativan)
• Alprazolam (Xanax)
• Diphenhydramine (Benadryl)

Two drugs in particular - gamma-hydroxybutyrate (GHB) and flunitrazepam (Rohypnol) - are commonly implicated.

In a 1999 study, researchers tested more than 1,100 urine samples from sexual assault victims in the United States and Puerto Rico. They tested individuals who they suspected may have been the victim of a drug-related rape. Four percent of the urine samples contained GHB and 8 percent contained benzodiazepines, a type of sedative that includes Rohypnol.

The many faces of GHB

GHB depresses your central nervous system. Legal medications that also work as central nervous system depressants are sometimes used to treat insomnia or anxiety. Such drugs include Ativan, Valium and Xanax.

Depending on how much GHB you take, effects can range from sleepiness and drowsiness to seizures and coma.

GHB was available in some health food stores in the late 1980s, where it was marketed as a sleeping aid and muscle builder. Due to reports of its harmful effects, the Food and Drug Administration banned its sale in 1990. Ten years later the government classified it as a "Schedule I" drug due to its potential for abuse and its use in date rapes. This is the most dangerous class of drugs, which have no medical use. Heroin, for example, is another in this group.

Despite being illegal, GHB is relatively easy to make, with recipes available on the Internet, and is produced domestically in America and smuggled in from other countries. It's well-known as a club drug among teens and young adults, since it also can make the user feel euphoric and intoxicated. It's sometimes referred to as liquid ecstasy, Georgia home boy, and cherry meth. According to 2002 statistics from the Department of Justice, 1.5 percent of high-school seniors reported using the drug recreationally during the past year..

GHB also is a common drug in sexual assaults for several reasons. It's colorless and odorless and comes in powder or liquid forms, which makes it easy to mix in water, punch and alcoholic drinks. It also acts quickly. Within 15 minutes of drinking it, you become sleepy and lose the ability to control your muscles making you vulnerable to an attacker.

This drug also often causes a type of memory loss called anterograde amnesia, which means you don't remember anything that happened during the time the drug was affecting you. These effects are even stronger when GHB is mixed with alcohol.

Rohypnol: A sleeping aid outside the United States

Rohypnol (ro-HIP-nul) is also a central nervous system depressant that causes drowsiness and muscle relaxation. According to the Office of National Drug Control Policy, it's 10 times as potent as diazepam (Valium).

Rohypnol is sold legally in Europe and Mexico, where it's used as a sleeping aid, but it's not approved for manufacture or sale in the United States. In 1996, the Food and Drug Administration and the Drug Enforcement Administration banned its importation. Nevertheless, smugglers bring it into the country, where it's commonly used as a club drug among high-school and college students and other young adults. Other names for it include roofies, roches and the forget-pill.

Rohypnol also has characteristics that make it particularly useful for sexual predators. It comes in pill form but dissolves in liquids, where it's tasteless and odorless. In 1997, its manufacturer revised the pill so that it would turn a drink blue when it dissolved. Still, some potential rapists may simply drop the drug into blue tropical drinks to get around this.

This drug is also fast-acting. Within 15 minutes after the drug enters your body, you may become sleepy and relaxed to the extent that you can't fend off an attacker. Rohypnol also can cause anterograde amnesia, rendering you unable to remember what happened while you were drugged. It, too, is even more powerful when mixed with alcohol.

How to protect yourself: Stay vigilant while having fun

Despite the advantage these drugs give to a would-be attacker, there are things you can do to protect yourself from becoming a victim of drug-related rape. One of the best things you can do is to stay aware of your surroundings, particularly at parties and dance clubs. Also follow these tips - recommended by health care providers and law-enforcement professionals familiar with this issue:

• Drink moderately so that you can keep your wits about you.
• Only accept drinks from trusted friends, and make a habit of accepting only unopened drinks and opening them yourself. This goes for alcoholic and nonalcoholic drinks. If you're drinking a mixed drink, always watch the bartender prepare it.
• Drink slowly, rather than gulping your beverage, so that if it has been drugged you may have more time to become aware of it.
• Don't drink from punch bowls and other large, open containers, which may have drugs already added to them.
• If your drink tastes or smells strange, avoid drinking it. Know that GHB has a strong, salty taste.
• Don't leave your drink unattended. Also, hold the drink with your hand covering the opening while your attention is diverted, for example when you're in conversation.
• If you must leave your drink, such as while dancing or using the restroom, get a new one when you return.
• In advance of going out to a club or a party, make plans with your friends to check on each other before leaving the event. Make sure they're alert.
• If you start to feel strange or unusually intoxicated, seek help from a friend. A stranger who offers to help you or escort you from the event could be someone who's slipped you a drug and plans to do you harm.

What to do if you think you've been sexually assaulted

If you think you may have been drugged and victimized, don't wait to seek help, and keep these tips in mind:

• Seek help from the police or a hospital as soon as possible. Tell the authorities that you think you may have been drugged. The sooner you report the incident, the more likely that laboratory tests of your urine may show evidence of any drugs. After 96 hours, such tests may be virtually useless because the drugs have passed from your system.
• Don't urinate before seeking help, if possible. The first urine that leaves your body is the most likely to contain evidence of drugs.
• Don't douche, bathe or change clothes before seeking care. Avoid these activities to help preserve other evidence of sexual assault.

By staying aware of your surroundings, watching what you drink and sticking close to your friends in social situations, you may reduce your risk of ever having to wonder, "What might have happened to me after that last drink?"

Sex and food have always been linked, and no more so than when it comes to aphrodisiacs. Sex counselor Suzie Hayman looks at which foods can get you in the mood for love and how to make the preparation of a meal fun and sexy too.

Preparation

• Set the table so you have a nice place to eat.
• Buy a range of small treats and finger foods.

Mood food

Certain foods have a reputation for putting you in the mood for love. For example, the sight, smell, and taste of oysters is reputed to put a woman's lover in mind of her intimate parts, while asparagus is equally suggestive to a man's partner.

Whether these foods are actually aphrodisiacs is debatable. It's not widely thought that they can affect your sexual organs or sexual desires to make you any more aroused, but using aphrodisiac foods or drinks as part of your seduction technique can bring something extra to your sex life.

Cupboard love

Spend time preparing your meal together. Simply sharing this task can bring you closer.Choose foods that have to be assembled by hand - either laid out on plates, or sliced, mixed and stirred.

Don't be afraid to get cream, peanut butter, tomato sauce or anything else all over you and your partner.

Treat each other

Tiny treats and special nibbles (peaches, figs, spears of asparagus, etc) are the best foods to choose. They don't have to be expensive or exotic, just things you can pick up and eat with your fingers.

As you prepare your feast, feed little bits of food to each other.

The proof's in the pudding

One couple who found their relationship took a turn for the better when they started making their evening meals together are Mick and Siobhan.

Mick, who'd been brought up to expect men to stay out of the kitchen, found a whole new meaning to the term 'food lovers' as he and his partner Siobhan got into the habit of slicing and dicing, stir-frying and sauteing together.

Related Information:

• Aphrodisiacs
• Blind tasting
• Get to Know Your Body

If you have unprotected sex or your normal contraceptive method fails, there are two methods of emergency contraceptive that might still prevent a pregnancy. Find out more from this fpa factsheet.

What is it and how does it work?
Emergency contraception can be used if your usual method of contraception has failed, or if you've had sex without using contraception (unprotected sex). If you act quickly, emergency contraception usually prevents pregnancy.

There are two methods:

Emergency contraceptive pills contain the hormone progestogen. They must be taken within three days (72 hours) of unprotected sex. The intrauterine device (IUD) must be fitted within five days of unprotected sex. The IUD used to be known as the coil.

The emergency contraceptive pill
Emergency pills are more effective the sooner they're taken after sex. If taken within 24 hours, they prevent more than nine out of ten pregnancies that would have happened had no pills been taken. The IUD is 98 per cent effective if inserted up to five days after sex.

Emergency pills must be taken as soon as possible after sex.

The pills work by:

• stopping an egg being released (ovulation)

• delaying ovulation

• stopping an egg settling in the womb

Usually, your period arrives within a few days of when you expect it.

The IUD
IUDs must be fitted in the womb by a trained doctor or nurse. They work by:

stopping an egg being fertilized stopping an egg settling in the womb

It can be removed during your next period if you want.

Advantages

• Neither method has any serious side effects, and most women can use emergency pills.

• IUDs are helpful if you're too late to take pills, if you don't want to take hormones or a long-term method of contraception.

Disadvantages

• With emergency pills, some women experience headaches, breast tenderness or abdominal pain. A few feel sick or vomit.

Can anyone use emergency contraception?
Not everyone can use an IUD. Check with your doctor.

General comments
Some prescribed and over-the-counter medicines can affect the way the emergency pills work. Ask your doctor, nurse or pharmacist for advice.

Emergency pills can be taken more than once, but they are not as effective as using a regular method of contraception. If you don't want to get pregnant, use contraception.

Where to get it
Call or visit a family planning clinic or see your doctor.

Related Information:

• Sexually Transmitted Infections
• Why Practice Safer Sex?

next: Why Practice Safer Sex?

• What Is Self-Confidence?
• Suffering From Lack of Self-Confidence? Learn Why
• How to Get and Gain Self-Confidence
• How To Improve, Increase Self-Confidence
• 5 Self-Confidence Tips that Provide Powerful Results

Ending a relationship can be emotional painful and hard to accept. Find out what you can do to cope with a relationship breakup.

When you have been in a meaningful relationship, you and your partner have usually made an investment in the relationship and in each other.

When your partner decides that the relationship is no longer working for them, that they would rather be with someone else or with no-one at all, it can be a very difficult time.

The person leaving may:

• feel guilty about leaving or their reasons for leaving and consequently may not want or be able to give clear 'reasons' for going.
• be dealing with their own issues that make it difficult for them to stay in the relationship.
• be unwilling or unable to make a longer commitment to you or the relationship.
• have developed different goals which would preclude them continuing in the relationship.

If you still want to be in the relationship, then you may find it hard to accept any of the 'reasons' your partner gives for wanting to leave the relationship. You may keep trying to get a proper 'reason' out of them with no success and increasing frustration for both of you.

Your reactions may include:

• Denial/disbelief - they're not serious, they just need some 'space', there's been a misunderstanding, they can't mean it, they are just stressed/drunk/tired and will feel different tomorrow/next week/after the project is completed.
• Negotiating - if I do this, my partner will come back, "I promise to...," "I won't nag about... anymore."
• Anger - "How dare they! After all I've done. They owe me an explanation!" "They will have to hear what I have to say. It's so unfair."
• Depression and Despair - "I'm no good." "There's something wrong with me, I can't live without them," "I'll never meet anyone else," "I'm too fat."

How do I cope with this?

• Feeling hurt and upset is natural - most people take some time to recover from a broken relationship. You can't decide on when you'll start feeling better, but you can take steps to start moving in that direction.
• People often go through a range of strong feelings and have a lot of confusing thoughts. It is as if the jigsaw that was your life has been thrown up in the air and one significant piece is missing. Now you have to readjust and create a new life and it takes a while for the pieces to land and fit together again.
• Cry, punch the pillow, talk out loud, and do what you need to do. You have "lost" something important and tears are an important way for men and women to express their sorrow.
• Talk to your friends or family, have a cry on their shoulders. Build a supportive network of people who are comfortable discussing feelings. Don't be afraid to ask for help, we all need help sometimes.
• Try and keep your sleeping, eating and exercise programs running, although some disruption to these may occur. See your family doctor or counselor if you are concerned or not coping.
• Pamper yourself. Long bubble baths with a good book, a coffee/glass of champagne, soft music, candles, etc. work well for some.
• Your concentration may be affected, so make lists, take breaks, give yourself some leeway to do things (don't try and do things at the last minute or take on new responsibilities).
• Minimize and monitor your use of alcohol, smoking, caffeine, and drugs to avoid the added complication of addiction issues. We sometimes use these substances to escape and help block out the pain.
• Keep the routines in your life going - work, play, sport, interests, friends. Avoid making big sudden decisions about your life.
• Draw, paint or write poetry or a journal to get the feelings out and express yourself creatively. Look back on this when you feel stuck and remind yourself of how far you really have come.
• See this as a good opportunity to think about what's important to you, adjust and refocus on long term goals. This may not have been your choice but how you respond is.

What may I be doing to make things worse?

Avoid excessive promiscuity or rebound relationships; don't start a new relationship before fully working through the issues around the ending of this relationship. People choose this because it is often a time of intense and painful feelings, including loneliness, and the wish to avoid these can be strong. You take your unresolved grief as 'baggage' to complicate the new relationship and slow your healing.

Refusing to accept your partner's decision and their right to make it will prolong your grief.

Self-check

You may like to check out what you are doing or can do to manage your loss and take care of yourself.

I am:

• Eating, sleeping and exercising well.
• Talking to supportive friends frequently/daily
• Keeping the routines of my life going - work, sport, interests, and friends
• Not making any big sudden decisions about my life
• Accepting this situation and making choices for myself
• Taking special care of myself in ways I value
• Minimizing and avoiding drugs, alcohol, and smoking.
• Avoiding extra responsibilities during this healing time
• Treating my partner respectfully
• Expressing myself creatively through art or writing
• Considering going to counseling or therapy.

Do you worry about the state of your body in bed? Don't let a poor body image blight a potentially glorious sex life.

Imagine the scene. The kisses are getting steamier, touches more intimate. Passion is rising fast. Yes, yes, yes! Then his hands reach for your tummy and you freeze. No, you're not off sex, but when it comes to certain areas, you just can't relax.

It may be your stomach you dislike, or your breasts, your bottom, your cellulite or stretch marks. Whatever it is, you're not alone. In my survey Women on Sex, a staggering 98% of women expressed worries about their bodies, and 22.2% said they weren't comfortable naked in front of anyone, particularly their lovers. In short, all our insecurities flare up when it comes to sex.

The key to good sex is confidence - feeling good about yourself, your looks and ultimately your body. Yet so many women's sex lives are hampered by body insecurities. A positive self-image leads to a glorious sex life. Start beating your body image blues and feeling like a sex goddess. You can do it and here's how.

Cosmetic camouflages
Do what you can to improve your looks - smooth legs, painted toenails, clean shiny hair, glowing skin. These strategies may be cosmetic but they do make you feel better about yourself. Choose beautiful lingerie - rather than big faded knickers - to boost confidence too.

There's a lot you can do with simple camouflage. Keep that wonderful teddy on until the last moment when you slide between the sheets. Candlelight, or a soft bulb, create a flattering light and enhance the intimate mood.

Be conscious of your body language. Walk (or sit, kneel or recline) tall, by pulling in that stomach and rolling shoulders back so your breasts stand proud.

Talk yourself confident
Beneficial as all these strategies are, they all still buy into the same old belief - that you have to have a perfect body to be confident in bed.

A more useful, longer-term strategy, is to change your mind rather than your body. It was Jennifer Lopez - voted the world's sexiest woman - who said that her looks are unimportant. It's the way she feels about herself that makes her a killer beauty. Sexiness comes with confidence.

You may be muttering, 'It's all right for her, she's got the looks'. But she's right, if you feel bad, you'll look bad. If you feel good about yourself as a person, you will look beautiful. Your partner will see you as beautiful. He'll pick up on your self-belief.

So concentrate, in bed and out, on the parts of your body you are happy with. Do you love your hands, your hair, your eyes? Be aware of your assets, flaunt them and believe it when people pay you compliments.

Your man cares about you, not your insecurities

Always believe your partner's compliments. Women's belief that men want bodily perfection is a purely female hang-up. When men are young, and before they've experienced a real relationship, they love to ogle sex symbols - just as we fancied Brad Pitt.

No survey has ever recorded man's requirement for a flat stomach in his partner. Very few men specify their preferred breast size - those who do being almost equally divided between the large and the small.

By the time you've gone to bed with a man, you've almost certainly had a hug or a cuddle. He already knows what size you are, how slim your waist is or whether you're well rounded, and he still wants to go to bed with you.

He is so overwhelmed by the touch and feel and smell of you - and the fact that you're willing to go to bed with him - that he doesn't give a damn about your perceived lack of perfection.

Get your man in on the act
You can do a lot to raise your self-esteem by asking your man to tell you what he likes about your body.

Tell him your insecurities - gently and seriously describe what you dislike about your body. Ask if he can give you positive but genuine feedback about what he feels. You might hate your 'too big' bottom, but he - and I speak from personal experience here - may adore its shape and cuddliness.

Don't go on and on about how you hate yourself, as that would turn off any lover. Do encourage your man to celebrate, with words, with touches, with kisses, the bits you don't feel too good about.

If your man won't play ball with this exercise and can't bring himself to compliment you, then think seriously about whether your relationship is sound. Never put up with a partner who criticizes and nags you about your body. This will not enhance your self-esteem.

Let sex make a difference
A good sexual relationship can blow all your body issues away. So use what happens in bed to build up your confidence.

On a basic level, choose moves and positions that hide the bits you feel bad about. If you feel your bottom is the size of Texas, then get him to hold you round your waist rather than gripping your buns.

As you start to feel more secure, use sex to focus attention on the body parts you like most. If you love your bottom, then encourage your man to fondle it, lick it and use rear entry positions. If your breasts are your best feature, climb on top.

Most importantly, shift the emphasis from the way you look to the way you feel. This is what men do. They are so turned on by the feel of sex that they forget their beer bellies. Go for sensuality, massage, deep long kisses, lots of foreplay, extra oral sex - by the time you're ready for full frontal, you're so turned on you don't worry about how you look.

The more energy you put into sex - giving and receiving pleasure - the more you'll enjoy it and forget your angst.

Finally...
Most of us don't feel 100% confident about the way we look, and that won't change overnight. If women can accept their body shape - not perfect perhaps, but nevertheless wonderful - then we can all begin to feel happier about ourselves and better about our sex lives. Isn't that what we all want?

Resources:

• Sexual Intimacy by Anne Hooper
• How to be a Great Lover by Lou Paget
• Hot Sex by Tracey Cox
• Guide to Getting it On by Paul Joannides

Communication problems, sex, anger, even illness can contribute to problems in a marriage or relationship. To manage conflicts and stress, couples sometimes turn to marriage counseling or couples counseling to help heal the relationship. Learn more about marriage counseling.

Your partner comes home from work, makes a beeline for the liquor cabinet and then sulks off silently. You haven't had a real conversation for weeks. A few arguments over money or late nights out, sure, but no heart-to-hearts. Sex? What's that?

Your relationship is on the rocks, and you both know it. But you aren't sure how to fix things — or if you really want to.

It may be time for marriage counseling. Marriage counseling can help you rebuild your relationship. Or decide that you'll both be better off if you split up. Either way, marriage counseling can help you understand your relationship better and make well-thought-out decisions.

What is marriage counseling?

Marriage counseling, also called couples therapy, helps couples — married or not — understand and resolve conflicts and improve their relationship. Marriage counseling gives couples the tools to communicate better, negotiate differences, problem solve and even argue in a healthier way.

Marriage counseling is generally provided by licensed therapists known as marriage and family therapists. These therapists provide the same mental health services as other therapists, but with a specific focus — a couple's relationship.

Marriage counseling is often short term. You may need only a few sessions to help you weather a crisis. Or you may need marriage counseling for several months, particularly if your relationship has greatly deteriorated. As with individual psychotherapy, you typically see a marriage counselor once a week.

Who can benefit from marriage counseling?

Most marriages and other relationships aren't perfect. Each person brings his or her own ideas, values, opinions and personal history into a relationship, and they don't always match their partner's. Those differences don't necessarily mean your relationship is bound for conflict. To the contrary, differences can be complementary — you know the saying about opposites attracting. These differences can also help people understand, respect and accept opposing views and cultures.

But relationships can be tested. Differences or habits that you once found endearing may grate on your nerves after time together. Sometimes specific issues, such as an extramarital affair or loss of sexual attraction, trigger problems in a relationship. Other times, there's a gradual disintegration of communication and caring.

No matter the cause, distress in a relationship can create undue stress, tension, sadness, worry, fear and other problems. You may hope your relationship troubles just go away on their own. But left to fester, a bad relationship may only worsen and eventually lead to physical or psychological problems, such as depression. A bad relationship can also create problems on the job and affect other family members or even friendships as people feel compelled to take sides.

Here are typical issues that marriage counseling can help you and a spouse or partner cope with:

• Infidelity
• Divorce
• Substance abuse
• Physical or mental conditions
• Same-sex relationship issues
• Cultural clashes
• Finances
• Unemployment
• Blended families
• Communication problems
• Sexual difficulties
• Conflicts about child rearing
• Infertility
• Anger
• Changing roles, such as retirement

Strengthening bonds

You don't need to have a troubled relationship to seek therapy. Marriage counseling can also help couples who simply want to strengthen their bonds and gain a better understanding of each other. Marriage counseling can also help couples who plan to get married. This pre-marriage counseling can help you achieve a deeper understanding of each other and iron out differences before a union is sealed.

How does marriage counseling work?

Marriage counseling typically brings couples or partners together for joint therapy sessions. The counselor or therapist helps couples pinpoint and understand the sources of their conflicts and try to resolve them. You and your partner will analyze both the good and bad parts of your relationship.

Marriage counseling can help you learn skills to solidify your relationship. These skills may include communicating openly, problem-solving together and discussing differences rationally. In some cases, such as mental illness or substance abuse, your marriage counselor may work with your other health care professionals to provide a complete spectrum of treatment.

Talking about your problems with a marriage counselor may not be easy. Sessions may pass in silence as you and your partner seethe over perceived wrongs. Or you may bring your fights with you, yelling and arguing during sessions. Both are OK. Your therapist can act as mediator or referee and help you cope with the emotions and turmoil. Your marriage counselor shouldn't take sides in these disputes.

You may find your relationship improving after just a few sessions. On the other hand, you may ultimately discover that your differences truly are irreconcilable and that it's best to end your relationship.

What if your partner refuses to attend marriage counseling sessions? You can go by yourself. It may be more challenging to patch up relationships when only one partner is willing to go to therapy. But you can still benefit by learning more about your reactions and behavior in the relationship.