“We never have sex anymore.”
“He wants it all the time.”
“I think my wife is seeing someone.”
These are some of the common opening lines I hear from couples who have landed in my consultation office. Certainly, sex is not the most important component of a happy and healthy marriage. Yet it remains one of the primary signs of an unhappy or failing marriage. Some of the most common problems in the bedroom include infrequent or absent sex, extramarital affairs, and addictive cybersex. The presence of any of these will, over time, erode the foundation of even the strongest marriage.
A recent study indicates that 15% to 20% of marriages are “loveless” meaning that the couples have sexual intercourse less than 10 times per year. This occurs in recently wed couples nearly as often as in long-term partners. Many of these couples are anxious and reluctant to address the lack of sexual activity or to explore ways to build greater interest and excitement into their sex life. They are likely to rely on vague clichés such as “there’s no chemistry between us” or “we’re both just too tired.” These couples often make tremendous and rapid changes in therapy as they uncover ways to rekindle their relationship.
Historically, couples faced these sorts of challenges with denial or benign neglect. Some sought out specialized help in the form of sex therapy. In the latter instance, the focus of their work would have been almost exclusively on increasing sexual passion or encouraging more experimentation and playfulness in the bedroom. And, while for a certain percentage of people the presence of an underlying sexual dysfunction and/or a history of sexual abuse are truly the cause of a failing sex life, for most couples, problems in the bedroom stem from a much broader range of issues.
Some biological differences between the sexes can lead to misunderstanding and resentment in the bedroom. Many men, unaccustomed to exploring their feelings, think that through the act of intercourse they are reaffirming their love for their wife whereas women often need to feel emotional intimacy before they can experience physical arousal. It’s common for men to turn to sex as a way to relieve stress, unaware that their partners require a relaxed state of mind as a prerequisite for good sex. Couples who are willing to talk frankly about how timing and setting influence their readiness for and interest in sex often fare better than those who are reluctant to share their thoughts and preferences. The latter often are greatly assisted by a psychotherapist who creates a relaxed atmosphere and encourages, with a non-judgmental mindset, these exploratory conversations.
Certain couples, especially those who tend to avoid directly addressing other marital tensions, are prone to using sex as a weapon, both assaultive and defensive. A wife who feels hurt by her husband’s absence or angry outbursts may assert herself indirectly by refusing her husband’s advances. A husband who feels bullied by his wife in other domains, may reassert his masculinity by being overly aggressive in bed. These are common scenarios. Other examples include a wife becoming seductive towards other men as a means of retaliation for her husband’ s lack of support or admiration, or a husband retreating from sex when experiencing jealousy regarding his wife’s intense friendships. These struggles can be subtle; most often, they occur outside of the couple’s conscious awareness.
Extramarital affairs remain the most commonly cited cause of divorce. Affairs are one of the most painful events that couples encounter and yet, remarkably, nearly two thirds of marriages survive and even thrive following this traumatic experience. Recent studies reveal that 15-35% of married women and between 20% and 50% of married men engage in extramarital sex at some time or another during their relationship. These problems have been compounded in recent years with the use of the Internet for online affairs, which only 45% of men believe to be evidence of infidelity, or for online pornography addiction. Some couples remain together due to financial and religious concerns or because of their commitment to their children. For a good percentage of marriages, an affair is a powerful wake up call to address profound cracks in the foundation of the relationship.
Cybersex and internet pornography are recent additions to the challenges that couples encounter in the bedroom. The 2006 movie Little Children highlighted the destructive impact of Internet sex on marriage, with the depiction of a man compulsively masturbating online and displaying no interest in sex with his wife. The increase in pornography in recent years has been exponential: it accounts for 25% of video rentals and is the fourth most common reason people give for going online. Psychoanalyst and brain researcher, Norman Doidge, MD has written extensively on the causes of this hobby and, in some cases, addiction. As with other addictions, the brain, when exposed to increasingly hardcore sexual images, builds up a tolerance: in order for the pleasure centers of the brain to be activated and dopamine to be released, the intensity has to be ratcheted up a notch. The reality of one’s sexual relations with one’s real partner of several years cannot meet the brain’s need for ever-heightened stimulation. The challenges of trying to relate to a partner while trying to get their “fix”only makes things worse. Boredom, increased anxiety, and avoidance of sex with one’s mate then set in and the cycle perpetuates itself.
For many of these problems, couples therapy can provide a safe, structured, and supportive environment in which to explore unacknowledged grievances and to learn essential tools to promote affection, communication, and respect. John Gottman, the noted marital expert, believes that improving the friendship, promoting playfulness, and devoting adequate time to the marital relationship will set the stage for an atmosphere of sexual desire. Many therapists agree with this outlook and stress that rather than working on sex therapy techniques, couples will benefit most from working on broader issues. Some basic goals include improving listening skills, promoting an atmosphere of mutual appreciation, and scheduling time for the couple. Often, couples find that when they feel more valued and emotionally safe within the relationship, everything, including affection and sexual passion, begins to flow more freely.

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