The traditional model of sexual problems was that sex was a symptom of an individual or couple problem. The belief was that once the core problem was resolved that sexuality would easily become functional and satisfying. In reality, sexuality is complex-multi-causal, multi-dimensional, with large individual, couple, cultural, and value differences. In most cases increasing intimacy and communication does not improve sexual desire and function. In fact, in some cases it increases the sexual problem because there is so much focus on intimacy and mutuality that the couple “de-eroticize” each other and their relationship. The challenge for couples, married or partnered, straight or gay, is how to integrate intimacy and eroticism. Sexual problems need to be addressed directly by recognizing that the new sexual mantra is desire/pleasure/eroticism/satisfaction. Rather than hoping for a bio-medical stand-alone intervention, a comprehensive couple psychobiosocial approach is utilized for assessment and treatment. Challenge the cultural expectation of perfect, predictable sex. Embrace the Good Enough Sex (GES) model which emphasizes the value of variable, flexible couple sexuality, acknowledging the value of both synchronous and asynchronous sexual experiences.
A motivating, empowering learning is that the couple’s sexual style is usually different than their relational style. The couple sexual style balances each partner’s autonomy (“sexual voice”) with being an intimate sexual team who create the right fit for intimacy and eroticism. A crucial concept is the need for an individualized relapse prevention plan to maintain and generalize sexual gains.
- Implement the four-session assessment model for understanding sexual problems.
- Utilize a comprehensive couple psychobiosocial model for assessment and treatment.
- Assign and monitor psychosexual skill exercises to build sexual comfort and confidence.
- Utilize a new model to make genuine meaning of affairs and focus interventions to rebond the relationship or move toward a good divorce.
- Create an individualized relapse prevention plan to reinforce desire/pleasure/eroticism/satisfaction