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Cynthia countered by pointing out that he not only avoided intercourse, but any physical intimacy or touching. Both looked sullen and defensive at this point in the session. They didn't project any sense that they belonged to the same intimate team, although they'd have to work together as a team if they wanted a sexually satisfying marriage.
Teaching the Concept of Sexual Teamwork
At heart, the problem was the disabling, but very common, belief held by both Bill and Cynthia that sex was zero-sum game, a win-lose athletic performance, measured entirely by the "success" or "failure" of the male arousal-intercourse-orgasm sequence. So the first step was to educate the couple to the amazing possibility that they could develop a new sexual style, replete with desire, pleasure, and mutual satisfaction—one that completely bypassed the old up-in-and-out model of sex that Bill (and, implicitly, Cynthia) believed was normal.
The advantage of the individual assessment sessions that followed is that they provided an opportunity to take a detailed sex history, which helped reveal each person's emotional and sexual strengths and vulnerabilities. Cynthia valued the special bonding and energy generated during sex. She missed this now, but felt powerless to influence Bill to reengage. The most striking thing revealed in Bill's individual history was how narrow his view of sex was.
The couple feedback session that came next offered a chance to help Bill and Cynthia create a new relational and sexual narrative based on a good-faith commitment to a sexual life focused more on intimacy, pleasure, and satisfaction than on intercourse per se. We gave them a psychosexual exercise to take home—a playful touching experience involving both nongenital and genital stimulation—saying that intercourse wasn't allowed for the time being. This introduced a new approach to lovemaking. Cynthia was enthusiastic when she heard about it, but Bill was dubious. He said he wanted intimacy and touching back in their marriage, but continued to be dominated by fear of intercourse failure.