The truth is that relationships involve hard work, and even the most well-suited couples sometimes need extra guidance to sort through issues that come up.

Rachel Sussman, a relationship expert and marriage counselor in New York City, is one such resource for people in relationships who need to talk things out. Here are five common issues that she often encounters and how she helps couples work through them.

Not spending enough time together

When one or both people have demanding jobs or busy schedules, especially if they have a child or children, Sussman finds that couples don’t end up having enough time to focus on each other and their relationship.

Disinterest in sex

Sussman often works with couples who aren’t connecting sexually.

To address the problem, she begins by learning more about the couple’s sexual history. She asks what sex was like when they were first dating, during the first year of their relationship, and when things changed.

Growing Apart

People are supposed to grow and change over time, Sussman says. But these changes can make couples feel like they don’t have anything in common anymore.

“The million dollar question is what happens when a couple changes [in a way that] makes them grow apart, if they were more aligned in an earlier phase of their relationship?” she said. “That’s an excellent use of couples therapy. What we try to flesh out is are there still areas where they are aligned and focus on that, and create some distance and space in a healthy way around areas they’re not aligned.”

Individual’s problems affecting the relationship

In therapy sessions, Sussman looks to distinguish between an individual’s problems that need to be addressed separately and problems that the couple can work through together.

“It takes a while to flesh out what the couples’ problem is versus what the individual problem is,” she said. “It’s usually two individuals with issues that are playing out and manifesting into a couples’ issue.”

On occasion, Sussman will recommend that one or both of the individuals see her or another counselor on their own.

“Sometimes the couples that I see are two pretty healthy people that are just having a hard time joining over something,” she said. “But oftentimes it’s each person’s personal demons and issues that are causing these problems.”

Communication issues

Sussman finds that when a couple tells her that they’re having problems communicating, it’s usually indicative of something deeper.

“They’ll say, ‘We have communication problems.’ They do, but they usually have a bigger problem and they’re not communicating well over it,” said Sussman. “That being said, couples that have a really good communication style – not being defensive, using active listening, which is when you don’t cut each other off and validate the other person’s perspective – those couples tend to have much healthier relationships and they really can talk about anything.”