Heather Beeves, LMFT

Couples counseling, also referred to as couples therapy or marital counseling, can help people assess and better understand fractures in their relationships. A couples counselor may ask partners to determine what problems they are facing. Couples counselors may instruct each partner to describe their underlying emotions, experiences, and beliefs in detail. This process may be performed with both partners in the same room or just one at a time. The goal of this exercise is for partners to gain greater understanding of each other's needs and to create solutions for these needs to be met. For example, a couple may arrive at the conclusion that one partner's work schedule leads the other to feel neglected or overwhelmed. Then, couples might implement strategies such as increased communication and partner agreements. These strategies may address previous conflicts as well as prevent new ones from occurring.

In some instances, couples counselors may recommend individual therapy for one or both partners. Individual therapy can address mental health problems that negatively impact the relationship. With continued counseling, people can restore communication and may gain greater understanding of one another's needs, enabling them to better develop solutions for these needs to be properly met.

Anorexia nervosa, frequently referred to as anorexia, is a disorder where people severely restrict the types and quantity of food they eat. Those with anorexia have an extreme fear of eating and gaining weight and may repeatedly weigh themselves or engage in harmful behaviors such as excessive exercise or starvation. Those with anorexia often find themselves preoccupied with food, but unable to consume a healthy amount of it. This results in symptoms such as abnormally low BMI, vitamin deficiency, fatigue, fainting, and amenorrhea (lack of menstruation in women). Anorexia may cause bluish discoloration of the hands, brittle and falling out hair, yellowish skin, and lanugo (fine, downy hair). Left untreated, anorexia can lead to organ failure, brain damage, and even death.

Bulimia nervosa, typically called bulimia, is a disorder where people binge (eat large quantities of food) and purge the food that they just consumed by vomiting, laxative abuse, fasting, or excessive exercise. This behavior is usually motivated by a feeling of powerlessness over eating and a fear of weight gain or desire for weight loss. Bulimia can occur in underweight, normal weight, and overweight people. Symptoms of bulimia include acid reflux, intestinal distress, dehydration from purging, amenorrhea, and dental erosion from vomiting. Some people with bulimia have swollen parotid glands (salivary glands near the cheeks) and red scars and marks on the backs of their knuckles. Electrolyte imbalance from bulimia can be particularly severe and may lead to heart attack or stroke.

Binge eating disorder (BED) is the most common eating disorder. People with BED feel that they are unable to control the amount of food they eat and may continue to binge after reaching a point of fullness. BED binges (consuming large amounts of food) are often accompanied by feelings of sadness, guilt, and shame. Symptoms of BED include obesity, acid reflux, weight gain, and dissatisfaction with one's body. People with BED tend to experience cycles of negative emotions and binges. Binges or BED episodes can be provoked by stress, boredom, restrictive dieting, depression, and other triggers.

Other common eating disorders include:

• Pica, eating things that are not food, such as paper, ice, or soil
• Avoidant/Restrictive Food Intake Disorder (ARFID), disinterest in eating and avoidance of food
• Other Specified Feeding or Eating Disorder (OSFED), abnormal eating that does not fall under any disorder

Many people with eating disorders do not consciously develop them, and have difficulty seeking treatment. For this reason, it's important to detect and treat eating disorders as early as possible. Treatment for eating disorders can vary from therapy visits to inpatient treatment, depending on the disorder and its severity. Treatment aims to not only restore physical health and correct negative behaviors, but to also promote psychological well-being and self-confidence.

During sex therapy, individuals or couples will talk about their sexual issue and their background. It is common to be given exercises to work on outside of therapy to improve communication, intimacy, or physical response. Sometimes these exercises bring up strong emotions, and then those emotions can be discussed during therapy. The goals of sex therapy are usually to obtain reliable information about sex, to improve verbal and physical communication between a couple, and to improve sexual performance.

Because of the nature of sex therapy and how vulnerable it makes most patients feel to discuss their sex life, it is extremely important to choose a sex therapist wisely. Referrals can usually be obtained via physicians or clergy, but it is also important to seek a credentialed therapist. The American Association of Sex Educators, Counselors, and Therapists (AASECT) offers certification to sex therapists, which ensures proper training and education, as well as a strict code of ethics.