should he see a medical doctor as well as a counselor?
It can never hurt to see a doctor and rule out any medical conditions. From what you've described it sounds like it is more of a psychological issue, which is why I initially recommended a counselor. A counselor should also be able to recommend whether or not he should see a doctor, if he does not see a doctor first. The best place to start may be wherever he feels most comfortable. Chances are that whether he starts with the doctor or the counselor, he will get referred to the right person, and either way you know that he has started to take the first step in getting this resolved. All the best,