Discrepancy in sexual desire. Some imbalances between husband and wife, “I want more, she wants less.”
With that it’s, it could be multiple things. One of the first things that we rule out is anything medical, for both the male and the female. Having them do a medical workup, either by a primary physician, a gynecologist, a urologist. If it’s not anything medical, and it’s more relational, then we have to look at what’s going on within the couple. A lot of times there’s a loss of interest, a lot of times there’s resentment. If a couple’s resentful or if one of the two are resentful, than they’re not going to want to have sex. They’re not going to want to be intimate in that way. Sometimes couples can use that as a way of getting back and they withhold sex. They feel like they’re in control if they do that. ADHD can play a big part in it. It’s not a priority. The anxiety that one of the two may experience can all lead to this discrepancy.
One of the first things is the assessment piece. Needs to be extensive, and then once we figure out where the discrepancy comes, then there’s different exercises like sensate focus. If they need medication they can go on medication. Sometimes it’s about, like we said, coming to a balance. If one person wants to have sex seven times a week, and the other one has one, or wants to have it once a week, then it’s about can we reach a middle ground. This goes into a lot of what I see again where couple have this resistance to things being planned. The reality is that in our busy schedules, sometimes we have to plan for sex. There’s absolutely nothing wrong with that. A lot of times we get caught up in the way it is in the movies, where it’s spontaneous, and it’s great if couples have that. A lot of the couples I see don’t have that.
It’s either, we’re not going to have that, or we’re going to schedule it and a lot of times once the couples engage in treatment and start scheduling it, they all say that it’s improved, and that they’re happy that they did it, and that the scheduling isn’t that bad after all. With the discrepancy in desire again, it could be multiple issues. A lot of times which can be surprising for some, we have this stereotype where guys always want more sex and women don’t, but I could say that three out of five of my couples, it’s the other way around where the women have the higher sex drive than the males. The way that they want it, they want to be seduced, they want to be grabbed, they want to be manhandled. These are all words that they use. The males want the same thing.
The initiation piece is also a big one. One of them wants the other one to initiate. We address that by having these scheduled nights where one night, one person initiates, the other night another person initiates. It’s really important also for people to understand that they are responsible for their own sexual needs and they create their own sexual desire. No one else is responsible for your sexual needs. If you want to be sexually active, then it’s your responsibility to tell you partner. A lot of couples have this idea that they should know, or, “I’m not desired if he’s not initiating,” or “I’m not desired if she’s not initiating.” A lot of times that’s the farthest from the truth. It’s about you owning your own sexuality and being comfortable with it to say, “I want to make love to you, I want to be intimate with you,” and not feeling the shame around it of it’s taboo, or women aren’t supposed to ask for sex, or women aren’t supposed to want more sex than men.
With the theme of sexuality and couples coming into therapy for sex therapy, a lot of these old ideas come into play that are passed down from generation, that are passed down from society, and a lot of the therapy is just dismissing a lot of those myths and educating both people on what sex is and what it isn’t, and what they’re comfortable with.