Couples Sex Therapy: A Team Game

When a couple decides to begin a course of therapy, the phrases that emerge most frequently at the beginning of the process are: “My wife no longer has sexual desire” , “My partner suffers from impotence/premature ejaculation” , “We used to do it more often, but now we don't, I'm convinced that he/she is cheating on me” .

A very important fact to take into consideration is that today's couples have undergone evolutions compared to the past : the "couple of yesterday" responded more to a need for social and economic security, the roles within it were more rigidly distinct and romantic love could be there or not. The "couple of today", unlike the past, does not necessarily originate from a marriage contract, the roles and rules that characterize it are transforming following cultural changes, and the choice of partner is no longer guided by the achievement of a status, but by the realization of a desire .

The American psychiatrist Stephen B. Levine, in 2003, stated that desire "is the result of all the forces that push us to the sexual act and that push us away from it" . We note how this definition includes a double polarity that includes different qualitative levels. Therefore, not only sexual aspects are considered, but also everything that concerns the relationship with the other, from communication to the emotional relationship we have with the other person.

A fundamental aspect that characterizes the couple is sharing . A couple finds themselves sharing both relational aspects such as projects, values, physical and mental spaces, daily life/routine, families of origin, sexuality, and aspects "external" to their entity as a couple, such as work activity, economic management, passions and hobbies, political ideologies.

At the basis of sharing is communication , which can be expressed both in verbal exchange and in action, and which, when problems arise in the couple, is often the first to not be understood and/or used effectively . Communication difficulties easily lead to the onset of periods of crisis, and it is here that therapy can help to offer new keys to understanding and solutions.

Therapy does not aim to fill a void, but to enhance existing resources . Since a couple also communicates sexually, therapy does not aim to eliminate or minimize certain dysfunctional symptoms, but rather to facilitate openness to sexual desire and to understand the role of sexual expectations .

When and why should you undertake couples therapy?

The crisis can become so deep that it creates lasting discomfort in the members of the couple and calls into question the bond built over time. The same dynamics can be triggered and repeated between partners, which fuel misunderstandings and create a vicious circle in which sexuality is one of the first to suffer, with the first symptom being a decline in desire .

According to the systemic-relational psychological approach, the couple does not live only in the present, but is also the result of previously lived interpersonal experiences: crises can therefore arise from situations in the past . Memory, according to this perspective (but not only!), is not received passively, but is actively constructed over time, giving shape to a story rich in meanings, which influence the present.

Communication is not something simple, on the contrary, it is full of facets: first of all, both partners communicate not only explicitly, but also implicitly; furthermore, both have both a shared communication and a non-shared personal communication . We can easily imagine how among the most common factors that trigger couple crises there are precisely the different communication methods and the lack of attention and care towards the needs of the other .

The fact that conflicts may emerge at a certain point is not the core of the crisis: this arises from much older and more nuanced roots and ultimately finds only its own expression in the conflict, which therefore becomes a symptom, not the problem to be fought.

At the same time, it is also true that conflict can generate further problems. The more the members of the couple close themselves in their sexual differences by relating only to the "lowest common denominator" of the sexual relationship and the more they reduce sexuality exclusively to the principles of "consideration and care", the more they become dependent on harmony and therefore avoid sexual communication, both verbal and emotional. This also affects the quality of sexual life.

How does it work?

Therapy does not aim to teach people something completely new, but rather to help bring out resources that they already possess but are not aware of .

First of all, a therapeutic contract is agreed upon , in which the objectives , meetings and frequency are defined together. Working with the couple means working with both people who compose it, but there could be some individual meetings at the beginning , aimed at knowing and deepening the past stories that have built the identity of its individuals.

Both partners must be willing to commit and invest their energy . Everything that happens during the meetings is explored in a private space where they feel safe and comfortable.

The duration of the process naturally varies depending on the complexity of the situation and the number of aspects on which the couple wishes to intervene. There are several factors that can affect the duration, including: communication and relational dynamics, the nature of any conflict between partners, subjective interpretations of the couple's situation, perceived prospects for change and the willingness to implement the prescriptions assigned by the therapist in both the sexual and relational fields.

How to behave if your partner does not agree?

Often in couples therapy it can happen that one of the two partners is more motivated than the other: especially when working on sexuality, it can happen that there is a tendency to avoid responsibility for the problems that have emerged.

Couple therapy can be a winning help for those who want to cooperate and do what they can to solve the problems in their relationship: if one partner is against starting the process, forcing him or her is not the right way to start, as the right motivation would be missing.

Instead, you can try to communicate your needs in a non-judgmental way and gradually approach the possibility of receiving external help , thus helping your partner to recognize the need for external support.

The therapist has a neutral role with respect to the couple and their expectations, and it is important that both partners try to establish with him as constructive an alliance as possible.

The role of the therapist within therapy

The therapist acts as a listener to the issues raised by the couple, without giving explicit advice or judgments. His listening is “active” and generates spontaneous reflections in the people who are in therapy, without him taking any position.

Sometimes couples start counseling with a lot of confusion and upset because of the difficulties they are going through and the role of the therapist is to make what is happening more concrete and clear. The problems brought by members of the couple will always be welcomed with understanding and never minimized or judged in any way. Therapy is a safe space in which it is important to bring out what you really think and feel, in order to work on it effectively.

We can conclude with an important consideration: in couples therapy, the therapist will never decide the future of the couple. The purpose of therapy is to bring out the communication and relational skills of the partners that, over time, may have become obscured, as well as to welcome the fears and emotions of the other in a protected space free from judgment, with the aim of rediscovering sexual pleasure and well-being.

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