Save a couple: what sexologists and psychotherapists offer

In traditional couples therapy, which has been around for 50 years, sex often takes a backseat. Psychotherapists are trained to work with deep relationship issues such as guilt or communication, and many only discuss sex when they want to talk about it.

But in the last decade, psychologists have been increasingly talking about the importance of good sex in a relationship, about how couples should improve their sexual sphere before dealing with other problems. Other topics often covered by “apostates” from the principles of traditional couples therapy are love affairs, “gender oddity”, transgender identity, deviance, BDSM and pornography.¹

The leader of this new trend, psychotherapist Esther Perel believes that secrecy and distance promote long-term monogamous relationships. Her new provocative concept is that when discussing novels on the side, vocabulary associated with psychological trauma should be used sparingly.

“The romance on the side is a betrayal, but at the same time an experience of discovery and growth,” says Esther Perel. “This is a trauma to the relationship, but not a crime. Having survived this episode, the family often becomes stronger and more stable, and it also happens that the relationship takes on a second wind as a result. She usually works with couples, but sometimes she does individual therapy sessions with one of the partners. What she learns during these sessions remains a mystery to the second partner. The challenge is for them to be honest, if not with each other, then at least with the therapist.

And psychotherapist and sexologist Tammy Nelson recommends that couples write their own “monogamy code,” which can include a provision for side sex on the weekends or sex on the side, but only together. “I define monogamy as a kind of moral addiction,” Tammy Nelson says. “It can be whatever the couple wants it to be, but it must be fluid and flexible, and it needs to be renewed from time to time, much like a driver’s license.”

Psychotherapist Suzanne Iasenza is known for her bold approach to issues of gender, sexual orientation, and enjoyment. She introduces her clients to a model that contradicts the orgasm-oriented Masters and Johnson cycle (arousal, plateau, orgasm, normalization), arguing that one of the partners may initiate sex not only because of emotional arousal, but sexual arousal may precede desire.

This is an amazing idea for women who, after being married for more than ten years, feel that the wait for desire becomes endless. In addition, Susan Iazenza conducts individual sessions with each of the partners and gives them homework – to write a “sex menu” (a list of what turns them on). Then the partners introduce these lists to each other.

Why is sex-oriented therapy considered a departure from tradition? The fact is that the very concept of couples therapy appeared only shortly before the sexual revolution and developed in the early 1960s. Sex therapy, which was invented by William Masters and Virginia Johnson, developed in parallel, and its creators never dealt with couples. According to Esther Perel, when she was trained in psychotherapy, sex was only one hour in the curriculum. As a result, she received a diploma as a sex therapist two decades later.

And it’s not that she was just unlucky. Margie Nichols, who in 1983 founded the Institute for Personal Growth in New Jersey, one of the first mental health centers for gays and lesbians in the United States, did not have a single hour devoted to sexuality in the program during her training as a clinical psychologist. sphere. Today, her institute also offers psychotherapy to transgender people, but most clients are people of traditional sexual orientation.

According to Margie Nichols, homosexual couples have better sex than traditional couples who have been together for a long time: “Gay couples plan sex and languish in anticipation for several days. The quality of contacts is more important to them than their frequency. They are not afraid of diversity and experimentation. They do not evaluate the desires of a partner. They draw a clear line between “normal” life and sexual life, and this allows them to fully immerse themselves in the erotic space.

One of the most explosive issues for today’s couples, regardless of their sexual orientation, is Internet pornography. Marty Klein, a family therapist and sexologist, considers the problem of pornography addiction far-fetched and emphasizes that no one has the right to declare their home a pornography-free zone without discussing it with a partner.

“Many people can’t decide for themselves whether they are ready to take the fact that their partner is masturbating,” said Marty Klein. – If a person cannot come to terms with this, or with the fact that many adults have sexual fantasies, partners will not have a productive conversation about pornography. The problem is that people are anxious and secretive, because they receive a clear signal: “If you watch this, I will kill you.”

Marty Klein invites his clients to talk seriously about why people who love each other stop having sex. Clinical psychologist Sue Johnson, a developer of emotionally focused therapy working with couples, says that if pornography dominates life, it inevitably destroys relationships, like any other addiction. Romance on the side as a way to strengthen the connection between partners, she calls the craziest solution that can be offered, considering reliability, loyalty and affection as the basis of intimacy.

However, according to the “apostates”, strong affection does not ignite partners in bed. “Couple therapy is highly feminized,” says Tammy Nelson. – It is aimed at teaching a man to be like a woman. If she is unhappy, then something is wrong. We invite a man to treat a woman like his best friend, and then we’re surprised that she doesn’t want to have sex with him.” But the integration of sexology and couples therapy has already begun. “There are more and more good psychotherapists in sexology, and the area of ​​intersection of the two directions is increasing,” she says.

¹ For more on the current state of American sexology and couples therapy, read First Comes Sex Talk With These Renegades of Couples Therapy at nytimes.com