I cannot overrecommend marriage counseling. (And if you have kids, make sure the counselor has their own kids. It matters a lot.) We tend to devise all manner of distortions about how our spouse really feels, and fear saying things that need to be said. It literally saved my marriage.

The reason it has a poor track record IMHO is what this guy is saying about the nail clipper: don't let the problems fester. Oncologists can only save people who are diligent about doing their cancer screenings to catch problems early.