There are certain criteria by which psychology judges mental health. For example, signs of good psychological health include 1. adaptability, 2. living in the present, 3. the capacity to be affected by input from outside of one's own self and own mind (e.g. other people, rules or principles, realistic response to circumstances, etc.) and 4. the ability to grow.

Obviously, a person 1. who is rigid, 2. who lives in the past or future (e.g. present-day neurotic associations stemming from childhood dysfunction, or overpowering anxieties about what might happen in the future), 3. who is closed to or is unaffected by input from another person (needs, feelings, opinions, requests, etc.) or is callously indifferent about another person or who fails to deal with circumstances or principles as they really are, or 4. who refuses to grow as a human being... does not show signs of good psychological health.

These being the case, when a couple comes in and one or both spouses show any of the above signs, I have "tools" or "data" that help to define what the situation is. All of these unhealthy signs indicate that there is serious work to be done in the counseling process. When a person has psychological difficulties which stem from abuse, emotional trauma, dysfunction, a neurotic parental role model, etc., the person's relating patterns are essentially 1. continuations of their "psychological training" and/or 2. defenses against the damage, fright or suffering they went through or against what they presently associate with it. This makes their relating very complicated because present behavior is very enmeshed with nasty and complex origins in the past. Since such people tend to be somewhat blind to the meaning or impact of their behavior, and are generally judgmental and defensive, it is difficult to get them clear or anchored in what the issues are, or what they have to do, to not do and/or to change. They always have an explanation. What is tragic, of course, is that the person, regardless of denial, is causing "human damage" by abuse or emotional harm to family members. Their refusal to recognize the reality outside of the "private reality in their mind" does not help those whom they are damaging. It is critical that they come to deal responsibly to repair their personality, behavior and perceptions. If the person is "reachable" I work to increase awareness of the hurtful, destabilizing and disruptive impact of behavior on others, to accept his or her responsibility to shield spouse and children from harm and to gradually bestow good on other family members while working out the inner turmoil, conflict, pain, anxieties, tension, frustrations and confusion. If the person is not reachable, the road is more difficult and slow. I'll strategically work around the resistant individual by changing the other spouse; for example, build self-esteem, teach "emotional self-defense," increase the sense of value in the marriage (to maneuver the offender to having more fear of losing the marriage and more motivation to change) or make the offender's behavior be ineffective or backfire. Then, we can bring the partner into the counseling process. This, of course, does not apply if someone is "closed tight" or dangerous. It's always a case-by-case question.

Sometimes psychological or emotional problems stem from early in life. Sometimes the problems originate in the marriage or are brought to the surface in the marriage. To the extent that the marriage originates or triggers psychological or emotional difficulties, the marriage itself must provide repair (deeper or earlier problems have to be dealt with using different therapeutic processes). As Rambam writes, to fix a bad extreme you must go to the other (good) extreme. The couple must be emotionally supportive, nurturing, sensitive and understanding to create together an environment of emotional comfort, stability, responsiveness, fulfillment, cooperation and security. This is crucial to gradually building a wholesome, calm, trusting and satisfying relationship.