As a family therapist, I've seen many couples over the years whose presenting complaint revolves around sex. Usually it's because the sex is too infrequent, too lackluster, or at the male parter has some kind of sexual dysfunction. (I've only seen one case where the complaint was too much sex!) As usual, unless there's a biological problem, the sexual relationship is embedded in the larger emotional/psychological dance of the couple.
Here's a snapshot of a couple where the wife worried about their lousy, uninspired sex life: (Identifying data are disguised)
Sarah and Alan initially came to see me because of Sarah's distress over their extremely lukewarm sex life. Sarah described feeling "turned off" to Alan, and when he did attempt any kind of sexual overture, she described his efforts as "half-hearted," without any enthusiasm or "oomph." She felt both frustrated and bored.
A little background: Sarah and Alan have been married about 15 years, with 3 kids. They met while visiting mutual friends in Europe. Alan is from Moscow, and his mom and sister still live there. Sarah's parents were born in Russia, but they moved here many years ago, and Sarah and her two brothers were born here. Alan speaks good English, with an elegant-sounding Russian accent. He's a handsome, intellectual kind of guy with a tender quality. He works at a prominent, progressive graphic design firm, where he says he gets to indulge his artistic inclinations. Sarah looks like an ex-hippie; natural looking, without make-up, she doesn't appear to care about clothes or "girly" things. She works part-time in investment banking, what she describes as a real "boys club."
I could see the relationship inhibition as soon as I met them. As usual, sexual inhibition --premature ejaculation, and its relatives -- is symbolic of a broader inhibition. Typically, especially in an ongoing relationship, the "inhibition" doesn't belong to one person, but rather, can be found embedded in the couple's duet. And, in this case, I observed that Alan was scared of his wife. Not the kind of "scared" that's visible to the naked eye. He spoke with authority, but in a controlled manner, cautious and correct in his responses to Sarah, seeming careful not to upset her or challenge her perceptions.
And, though Sarah came across as bold and opinionated, she also had great humor and conveyed an openness and willingness to look at EVERYTHING -- herself included. Though her tendency to be "in charge" was very much in evidence in the way she talked to and about Alan, she also seemed willing to relinquish control; her life did not depend on it. She was not brittle. I saw an opening.
As we met over several months, I approached their unsatisfying duet in a couple of ways. As we talked, I wanted to enlarge their narrow view of their dysfunction as merely sexual. First, I invited Alan into some conversational play. I wanted to get him out of his box, and the one of the best ways I know how to do that is through play. I talked to him about his artistic vision, we talked about jazz, I admired his quirky and creative responses to my questions. If fact, as I suspected, this guy had a much wider range than his overly correct version of himself.
I kept my eye on Sarah as Alan and I played. During those sessions, Sarah commented repeatedly how she "enjoyed" this guy she saw in my office. She said she wanted to take this guy home with her, not the other, dryer version. Sarah's open enjoyment of this new, looser, husband gave him confidence to take a few more risks with her. Over the months, Alan's expanded, more playful self began to slowly work it's way into the relationship. They had sex slightly more often, with, according to Sarah, slightly more enjoyment. Not perfect, but better.
We also addressed what emerged as Sarah's overly vigilant, controlling approach to sex. She had fantasies about how other people must be having "wild" sex, but was afraid to apply these fantasies to herself and her husband. With Alan, she was often worried about their sexual dance, anticipated "failure" and somehow needed to diminish the power of their sexuality as a couple. She seemed both eager to be "wild" and afraid of it.
A little exploration into Sarah's background proved helpful: Her father, a well-known painter, was apparently a demanding, tempestuous kind of guy. Sarah's mother catered to him, and both Sarah and her brothers were convinced that Sarah's mom should not be such a "doormat" for her husband. When Sarah tried to bring this to her mom's attention, the mother claimed she loved "doing things" for her husband, and felt happy in this relationship.
Sarah's parents had (and apparently still have) a passionate relationship, but it felt psychologically dangerous for Sarah in some ways. Apparently her parents occasionally had noisy sex within the earshot of Sarah and her brothers, horrifying them and leaving Sarah feeling "disgusted" and "dirty." Sarah felt too "embarrassed" to bring these incidents to her mother's attention.
Though Alan knew this history, somehow I think it felt different hearing it in my office. Sarah clearly came into this marriage with a toxic association to "wild" sex. Passion became associated with being out of control, not in a good way, but where someone gets hurt. Alan had clearly picked up on this early in their marriage, and this helped shape his cautious approach to his wife sexually. Clearly, Sarah needed to be rid of this past burden, and she needed her husband's help. As she said at the end of one session, "It's not easy being me." Meaning, always "in control."
Alan's second-guessing himself with his wife reinforced her control in the relationship. This interfered with their freedom as a couple. Alan's status as an immigrant -- not being "from here", not always being sure of the cultural rules -- operated covertly but powerfully in keeping Sarah on duty. I discovered that Alan would run his emails by Sarah before he sent them out. Since his English was excellent, I took this to be an artifact of their caution/control duet. I laughed when I discovered his use of Sarah as his email editor. I intended this as a therapeutic laugh, like..."Are you kidding? With your excellent English and articulate speaking style?" I knew that if Alan was going to help free his wife from her sexual fears, he needed to stop constantly asking for her approval.
After about six months, Sarah commented on how their relationship felt "much better" -- sexually and otherwise. During this time, I had also seen them with the kids several times, to get a sense of how they operated as a family. This appeared to help the couple as well. As the therapy was winding down, Sarah reflected on what had been helpful: She said "It really helped when you said it has nothing to do with chemistry". When I initially saw them, Sarah was convinced that the problem was "lack of chemistry" between her and Alan. I politely rejected this explanation, and offered an alternative way of looking at their cautious sexual relationship.
Chemistry, of course, is a purely subjective response. From my perspective, my "it's not chemistry" approach is a way to introduce a dynamic approach to a couples' problem. "Chemistry" is immutable. Not feeling loved, or anger at being criticized, you can change. Always, with couples and families, I try to convert a static idea about a problem, i.e., She "has depression", into a problem that's more alive..."(To husband) Your calm indifference feels like abandonment to her."
My intention with this couple was to loosen their frigidity with each other, to give them more freedom to play. They came to me emotionally polarized, under the symbolic heading of "sexual dysfunction." Sarah had labeled Alan as sexually boring/inept, which I viewed as being an artifact of their relationship, rather than qualities possessed by Alan. Alan, in fact, had much more to offer, but his overprotectiveness prevented him from using what he had with his wife. As Alan grew bolder and less approval-seeking, this helped Sarah to trust him. She learned to lean on him, sexually and otherwise. This was a different kind of sexual liberation -- a whole-person freedom that could, with any luck, develop and grow over the course of a lifetime.