"Sometimes men seem like rocks and maybe she really doesn't know how deeply this issue is hurting your R and M. If she really loves you and has really HEARD what you are saying and doesn't want to lose you then she'll do SOMETHING to make it better. Even if that means talking! That is the truth in a nutshell."
I think she understands the effect that this is having - I've certainly told her (again and again), and she recognizes that it's a problem. It just doesn't seem to be one she is willing to work on solving. When I ask her to tell me what she thinks I should be doing, she always says that she doesn't know, or she doesn't have the answers. It just gets old and frustrating.