Difficult Relationship Breakups
While sadness is common after a break-up, there are times in which a break-up can trigger a more intense depression or anxiety. People who hold beliefs about themselves centering on an inability to be alone (e.g., I am worthless without a boyfriend), or people with unresolved issues around loss (e.g., the early death of a parent, divorce of parents) are particularly vulnerable to experience depression or anxiety when a relationship ends. The person might not be able to identify these underlying dynamics; they just know that they can’t seem to get over the break-up.
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Chronically Falling for a Partner Who Doesn’t Treat You Well
We learn about relationships from those around us, our earliest influences being our parents. When raised in a healthy environment, we learn to expect and are attracted to healthy partners. When raised by a parent who was unable to be a healthy, predictable, and stable presence, our expectations in relationships become skewed. We might think we want a “normal” partner, yet seem to keep falling for people who don’t treat use well, or otherwise let us down. Psychotherapy can be an extremely powerful tool to understand the resolve those past hurts and learn to love in healthy ways.
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Chronically Rejecting what Seem To Be Good Relationships
A variation of the above theme, people who didn’t learn early on to feel safe in a stable, healthy relationship, will often have difficulty committing to one in adulthood. They may constantly end relationships with seemingly great people, “just not feeling a connection,” they may sabotage the relationship through infidelity, or may have trouble allowing relationships to move forward (e.g., exclusivity, engagement, marriage). Again, psychotherapy can extremely useful in understanding and changing these patterns.
For more information about how psychotherapy can help, please see "Learn about Psychotherapy with Dr. Susan Cook Maytorena" or feel free to contact me.
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Helpful Resources for Individuals
--HELPGUIDE.ORG (See especially article on “Attachment and Relationships.”)

For Couples
Signs that Couples Help is Needed
All couples have disagreements or conflicts at times. There is simply no way that two people can both have the same needs, wishes, and desires at all times. For this reason, the couple who says, “We never argue,” is likely to be in more trouble in their relationship than those who argue, but are eventually able to resolve the conflict. There are signs, however, that disagreements aren’t being resolved in a healthy manner, and that professional help might be needed. Some of these signs are:

• The same arguments keep coming up over and over again, often with increasing resentment.
• Arguments tend to escalate to hostile put-downs and name-calling.
• One or both partners tend to withdraw during the argument, such that the issue never gets resolved.
• The arguments stop, but the unhappiness, resentment, or contempt hasn’t.
• Finding yourself having a growing emotional attachment towards another person outside your relationship. You are just “friends,” but you find yourself disclosing more and more to this friend and less and less to your partner.
• Contemplating or having an affair.
• Any emotionally abusive words or physical violence.

The Couples Therapy Process and Goals
Before working on the specific problems you would like addressed, it is important to get a thorough assessment. When I meet with a couple for couples therapy, I typically see them both together once, then each separately once. During this time, I collect a thorough history of the relationship, its strengths, its difficulties, and the couple’s goals for therapy. Meeting with each member of the couple individually helps me understand how past background experiences may be influencing how a person interacts in his or her current relationship. Occasionally, I will give couples worksheets to fill out in between sessions to help collect information. After these conjoint and individual sessions, we come back together to clarify goals and discuss my recommendations for treatment.

My approach in couple’s therapy is eclectic, drawing from behavioral, psychodynamic, and emotionally-focused approaches to help you meet your goals. Please note that I have a special interest and expertise in helping clients discuss and address issues in their sexual lives that have become unsatisfying. While the overall goal is a happier, healthier relationship, specific skills often addressed include:

• Improvement of listening and communications skills.
• Improving each partner’s ability to understand each other’s perspective.
• Improving the couple’s ability to resolve conflicts in a way that is respectful of each person’s needs.
• Exploration and resolution of unresolved conflicts that are contributing to the current difficulties.
• Exploration of unresolved family of origin conflicts that are contributing to the current difficulties. When unresolved issues predating the current relationship seem to be a significant contributor to the current difficulties, a suggestion will likely be made for individual therapy.

If you are feeling stuck in your relationship, please consider couples therapy. Research by Dr. John Gottman, a leading marital therapist, found that couples wait an average of seven years after initially feeling dissatisfied before seeking help. That is a long time to allow happiness to erode and dissatisfaction to sink in. There are effective interventions to help you gain back satisfaction in your relationship. For more information on how couples therapy can help, please feel free to contact me.
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Helpful Resources for Couples

--The Gottman Institute

--HELPGUIDE.ORG