More About Couples and Sex Therapy

Sexuality is a profound contributor to a healthy and dynamic  couple relationship.   Some couples experience a passionate connection from the first eye contact and others build toward a deep and passionate connection.  There is no right or wrong in being present to the differing ways of being together and types of lovemaking experiences. There are however, difficulties that may emerge from the first attempt at lovemaking to dissatisfactions or even dysfunctions that can arise at any point in the couple’s life.  These include loss of desire, difficulty with arousal or orgasm, sexual pain, among a list of clinical conditions.

The most recent sex therapy research suggests that often these sexual struggles have their roots in the couple’s relationship dynamics.  However, before making this assumption it is important for the Sex Therapist to do a comprehensive assessment:

  • the possibility of biological or chemical contributors (medical conditions, medications,  neurophysiological changes at different parts of the life cycle)
  • the relationship itself- couple dynamics; use of skills of emotional competence, interpersonal and problem solving skills
  • individual challenges- conscious and unconscious beliefs and attitudes regarding gender, sexuality, relationship, developed in family of origin; trauma history
  • stressors- financial, social, immediate and extended family
  • coping resources

A good relationship can be defined as one in which both members of the couple have their needs for safety (can be vulnerable and trust will be understood and not dismissed), affection, companionship,  presence, open and truthful communication, emotional intimacy, sex worth having and commitment to keeping the relationship alive and growing.

Following are some of the skills that each member of the couple needs in order to build a good and even great relationship.

  1. Awareness that I and my partner are separate and different people. We choose to be in a relationship with each other.
  2. Awareness of my emotional state. I can identify and name my feelings and am aware of the body sensations or physical state that correlates with the feeling.
  3. Awareness of my partner’s emotional state. I am interested to know my partner’s feelings, thoughts and concerns.
  4. I can express my feelings, needs and wants. This can often be difficult for a number of reasons. A common one is the myth that if you really loved me, you would know what I want and you would do it without my needing to tell you. Couples need to learn that no one can mind read. Feelings, thoughts, needs and wants must be clearly spoken in order for your spouse to know and understand you. Another reason that couples find it difficult to speak their feelings, wants and needs is growing up in a family where saying I need was not encouraged or actively discouraged and even called selfish. This may contribute to an undeveloped understanding of their emotional life. As a result a person will have difficulty articulating feelings, even though they are visible on their faces and in their bodies.
  5. I have developed the capacity to reflect. I understand that feelings are related to the meaning and perspective and that these effect verbal and behavioral expressions.
  6. I can attend to my partner’s reaction. This means that I have the capacity to be in my own shoes and my partner’s shoes and move comfortably between the two positions. It also means that I understand that my words and behavior effect my spouse and his/hers effect me and we can talk about this in a self regulated and respectful way.
  7. Self regulation is the critical skill. It is connected to the ability to tolerate emotional discomfort, which we experience during moments of conflict and difference. The field of neuroscience has helped us understand that when feelings are intense, one cannot think until we have returned to a calm space. This means that in order to build a successful and satifying relationship, one needs to practice and master self soothing skills. These enable us to avoid damaging interactions and empower us to make choices that promote happiness. They calm reactive emotional states and enable us to stay present during difficult moments.
  8. Awareness that in moments of difficulty, each partner contributes to the difficulty. Beware of blaming, shaming, attacking.

Couples and Sex Therapy is an important resource for couples who are struggling with dissatisfaction or unhappiness in their relationship and their sex life. Sex Therapists are skilled in diagnosing the roots of the difficulty and intervening in ways that will help the couple regain pleasure in being together and in using both verbal language and the non verbal language of sexuality to create an intimate and passionate connection.