Do you believe that all marriages are sexually active ?
Marriages in which the couple’s sex life has withered are much more
common than unconsummated marriages (see the previous myth).
Couples who have ceased being sexual altogether are referred to as being
in “no‐sex” intimate relationships, and couples who have sex once or
twice a month at most are referred to as having a “low‐sex” relationship.
If this describes your relationship, you have a lot of company. It’s estimated that there are more than 20 million marriages in the United States that meet the criteria of being no‐ or low‐sex marriages. Yet one would
not be able to tell this from the media. Just spend a little time watching
television and you will see married couples being sexually active, no matter how “sexually repellent” the husband may be (Hollywood still rarely
puts sexually repellent women on television; M. Feeney, 2005).
For some people, being in a no‐ or low‐sex marriage isn’t a problem –
or at least not a problem that they feel needs to be addressed in a forthright manner. Consider the following account from a woman who
responded to a questionnaire for the Hite Report:
Having sex isn’t very important to me for the most part. I lived with one man
for most of seven and a half years; our sexual relationship was only active
for about the first two and a half of those years. After that it dissolved
almost completely – I don’t think we fucked more than twice in the last
year of it. During all that time I never had or actively desired an affair with
another man (or woman), and the relationship with this one man was
otherwise sufficiently satisfying and nourishing that I was able to imagine
living with him for the rest of my life quite sexlessly. We were not unsensual –
we did kiss and hug, and this physical contact was (I now understand)
exceedingly important to me. I didn’t relish the idea of no sex forever,
but it seemed quite livable‐with, given the importance of the rest of the
relationship, to me. (Hite, 2004, p. 391)
I have heard many of my clients talk about their relationships in similar
terms. Many of the couples who are seeing me for problems in their relationship will tell me that they want to work on other issues.
For other couples, experiencing a loss of intimacy and vitality because of
the lack of sex or sexuality in relationship is of primary importance to
them. They talk wistfully about their sex life when they were dating or
before they had children. They use terms that evoke a longing to rekindle a
fire that they fear is down to the last embers. Partners who are especially
open and willing to be vulnerable will talk about the impact the decreasing
intimacy is having on them. These partners use terms like “lonely,” “hurt,” and
“unloved.” Other partners speak in more angry terms, even threatening to
have an affair or revealing that they have had some one‐night‐stands
because of their frustration with the lack of sex in the relationship.
Working with problems of sexual desire is difficult because there are
no easy answers and often those who turn to pills, potions, or lotions
as a solution end up disappointed and more frustrated than before.
My work with these couples is guided by the work of Barry McCarthy
who developed a program for integrating sexual therapy into couples
therapy (B. W. McCarthy, 2001). For those couples who seem ready to address the issue of desire directly, I recommend the book Rekindling
Desire: A Step‐by‐Step Program to Help Low‐Sex and No‐Sex Marriages
by McCarthy and his wife Emily McCarthy (2003). In their excellent
book, they write about the four components of sexual functioning as
being (1) desire, (2) arousal, (3) orgasm, and (4) satisfaction. While each
of these components influences the others, all of them play a role in how
couples can end up in a low‐ or no‐sex relationship.
Desire
When thinking about sexual desire in a committed relationship, people
often see a contradiction in the idea that one can maintain sexual desire
for the same person over the course of a long relationship. George Bernard
Shaw describes the vow of marriage as follows: “When two people are
under the influence of the most violent, most insane, most delusive, and
most transient of passions, they are required to swear that they will remain
in that excited, abnormal, and exhausting condition continuously until
death do them part” (Shaw, 1920, p. 25). While Shaw was writing about
marriage more generally, his words can easily be applied to sexuality
in marriage more specifically. In her book, Mating in Captivity, Esther
Perel (2006) writes about the difficulty of maintaining sexual desire when
a couple has deep affection for one another. As couples become more
caring for each other, their love becomes safe, affectionate, and comfortable, or as Perel puts it, “like a flannel nightgown” (p. 32). Others have
colorfully described sex in committed relationships as having the “flaccid
safety of permanent coziness” (Goldner, 2004, p. 388), whereas in essence
eroticism is about “otherness” and the need for distance to distinguish
that your partner is someone “other” than you (de Beauvoir, 1953; see
also Myth 20).
So, how can couples overcome this and keep the romance alive? The
process begins by owning the problem. By the time many couples have
arrived at the point where they want to work on the sexual desire in their
relationship, there’s usually been some blaming. It’s not always spoken
aloud. In fact, it’s often difficult to talk about it. Most people would like
to be seen as sexually alive, including by their partner. To talk openly
about one’s lack of desire or wanting to be more desirable puts one in a
vulnerable position. It can also be difficult to talk about it out of fear of
making matters worse or hurting the partner’s feelings. Think of all of the
one‐liners about the fragile male ego or endless jokes about women being
sensitive about their looks. These bits of comedy hit home because
one’s sexual self‐image is as delicate as a Fabergé egg. Nevertheless, the blaming – even if it’s self‐blame – starts early for no‐ and low‐sex couples.
Barry and Emily McCarthy (2003) make the point that it’s not his problem or her problem, but it’s “our” problem. By this, they mean that even
if the problem appears obvious, for example erectile dysfunction or vaginismus, it’s still a problem for the couple to work on together. Framing
the sexual issues in a relationship as a couple problem is likely to lead to
a better understanding and prognosis.
To give an example of how this can work, I will describe a couple I
treated. Andy and Erin were in their mid‐sixties. Erin had been retired
from her job as a hospital nurse for about a year. Andy still worked as a
partner in a successful accounting firm. As always, I asked about their
family (they were empty‐nesters), their stresses outside the marriage
(his job required long hours and lots of stress), and what initially attracted
them to each other (they both seemed stable and caring). They didn’t
seem to be in serious distress, but they said they were arguing more. Erin
was the more upset of the two, while Andy seemed shocked that, after
nearly 40 good years of marriage, he found himself in my office. After
successfully launching their children and seeing their parents through
terminal illnesses, he thought things were now settling down, so why
was Erin upset? After a few sessions discussing some seemingly minor
incidents, Erin started talking about how much she missed “being
intimate” with Andy.
“By intimate, you mean …” I asked, knowing the answer but wanting
her to say it rather than me.
“I mean sex,” she answered. “I go to bed while he’s still watching TV –
or more likely while he’s sleeping in front of the TV – and I lay there
thinking about when we used to have sex. I miss it.” She started crying,
paused, and continued softly. “I miss Andy.”
Andy looked distraught and bewildered. He was clearly a loving
husband, a good father, a pillar of his community who went to church
and volunteered his time. Now he was realizing that he had been hurting his wife. Worse still, he was hurting her by relaxing in the evening
after a long day of work. During the silence, he seemed to be working
on how to understand it all. If he was angry or sad, those were secondary to a feeling of confusion and helplessness. Finally, as my gaze told
him it was time for him to say something, the accountant in him
reviewed the books:
“It has been a long time since we had sex.” I could almost see him sifting
through the ledger in his mind to see how he ended up in debt to his wife.
“We really haven’t had much of a sex life since the kids were born.”
“I know,” Erin said softly. “Let’s change that.”
Over the course of the session, we came to realize that Erin, having
retired from her hospital job, discovered what it was like to not feel
fatigued all the time. In the last year, she started sleeping normal hours;
consequently, she regained her energy and, with it, her interests in new
activities. She wanted one of those new activities to be sex with her husband. The problem was Andy was still working as hard as ever. They both
felt he should be able to pull back at work, but it never seemed to happen.
In addition, they had developed different sleep schedules over the years,
so they had little time in bed together when they were both awake.
By looking at the problem from the perspective of it being “our” problem, not Andy’s because he falls asleep watching TV and comes to bed
after Erin is asleep and not Erin’s because she was the one who changed,
it became their issue to work on together. Happily for them, they were in
good health and had no physiological challenges to overcome.
Arousal and orgasm
Although it was not the case with Andy and Erin, many couples experience problems with arousal and orgasm. As discussed in the previous
myth, there are a variety of treatments for particular issues of arousal and
orgasm that have demonstrated efficacy. Whether the treatments include
working with a therapist, a medication and a therapist, or just a self‐help
book, they usually will involve tackling the issue as a team. In my experience, the couples who are the most successful are the ones able to approach
sexual challenges with an open mind and a lot of humor. There is a lot that
can be awkward in working on sexual problems with a partner. Accepting
that and being ready to laugh and have fun with lowered expectations
seems to be how couples are able to stick with programs to treat issues like
erectile dysfunction, premature ejaculation, and vaginismus.
Satisfaction
Barry and Emily McCarthy (2003) talk about finding bridges to sexual
desire. In the case of Andy and Erin, I learned that they had a standing
date night on Saturday nights. They both enjoyed that time together. It
was often the only night of the week that they went to bed at the same
time. They used that as a bridge to include time in bed to reacquaint
themselves with each other’s bodies. I made a point of forbidding sexual
touching. At this point they were to simply get used to the feeling of being
together and attending to each other. While my motive was genuine, I had
an alternative motive as well. I wanted to take the pressure off. Nothing ramps up performance anxiety like saying “OK, on Saturday at 10:35
p.m. you need to engage in coitus.” Rather, I wanted there to be no pressure
so I forbade sexual touching. It’s not that having your therapist forbid
sex turns you into Mr. and Mrs. Casanova, but it allows space to begin
the process of feeling less awkward and having more fun. If the couple
doesn’t break the rules by having sex (they often do – making my job
easier), I will work through the stages of change in McCarthy and
McCarthy’s book in an effort to improve their sexual satisfaction.
Erin and Andy’s date nights started to include sex on a regular basis.
This feeling of closeness permeated their relationship, which led to more
shared interests and joint activities. They seemed to remember that they
not only loved each other, but that they really liked each other too.
Eventually, they were planning for Andy’s retirement and discussing their
shared goals. They both seemed hopeful and happy.
Conclusion
There is an adage that a good sex life can add 15–20% to relationship
satisfaction and a bad sex life can detract 50–70% from relationship
satisfaction (B. W. McCarthy & McCarthy, 2003). I’ve not found that to
be quite true in my practice. Instead, I’ve found that sexual satisfaction
and relationship satisfaction are moderately correlated (e.g., Sprecher &
Cate, 2004, found a correlation of .45). A moderate correlation means
that for some couples an unhappy sex life goes hand‐in‐hand with an
unhappy marriage, but for other couples there may be dissatisfaction
with their sex life while being generally happy in the relationship (I’ve
also known couples who seemed deeply distressed and dysfunctional
while enjoying an active and satisfying sex life). In any case, there are
effective treatment options available to those who want to improve their
sexual functioning.
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