Heart of the Matter - Page 4

Working with Rob and Jen

When Jen and Rob appeared in my office, they were a confused, demoralized pair, caught in a spiraling guilt-blame cycle. I typically adopt a problem-solving approach with such couples, focusing on helping them learn a new, mutually comprehensible sexual language and discover how to move out of their power struggle into being intimate and erotic partners and friends.

To begin, I use a four-session assessment model, which includes an initial couple session, two individual psychological/relational/sexual history sessions, and then a couple-feedback session to explore individual and couple strengths and vulnerabilities and propose a treatment plan. This model allows me to examine carefully and methodically the range of psychological, biological, and relational or social factors that shape a couple's sexuality.

My goal in the initial couple session is to send a powerful message that what the partners are facing, emotionally and sexually, is no one's fault: it's a product of their interaction. After taking the opportunity to see how Rob and Jen related, what they'd done previously to address their sexual problems, and how motivated each was, I gave them a chapter to read outlining the different sexual styles. This offers a framework for future discussion and introduces a vocabulary we can come back to when we next meet.

Before the couple-feedback session, Jen and Rob were asked individually to fill out a 36-item questionnaire examining their attitudes, experiences, and feelings about sexual initiation, intimacy factors, eroticism factors, sexual feelings and preferences, turn-ons and turnoffs, and values about couple sexuality. The questionnaire surveys each partner's feelings regarding the balance of autonomy/togetherness and intimacy/eroticism desired in their relationship. Sample statements for the questionnaire include:

- I value clear gender roles, especially the man's role to initiate intercourse.

- If I don't feel emotionally bonded at the moment, having sex is meaningless.

- Sex is a great way to make up after an argument.

- I need both verbal and nonverbal communication to feel sexually receptive and responsive.

The questionnaire is self-scored and gives each partner a total score for each of the four sexual styles, as well as a combined score to reflect their joint preferences.

After reviewing Rob and Jen's questionnaire scores and listening to their individual histories, I concluded that Jen had initially hoped for a soulmate couple sexual style, while Rob had favored a more traditional style. Over the past two years, each had fallen into the common trap of their hoped-for style: Jen felt frustrated and disappointed by Rob's emphasis on the erotic aspect of their sexual connection, and Rob found himself pushing more and more to claim his "rights" to be sexually satisfied when he initiated sex. They were caught in the kind of self-defeating sexual power struggle I often see in couples who seek my help in therapy.

In the couple-feedback session, I tried to show Jen and Rob that they were speaking different sexual languages, based on the styles of sexuality they preferred. Although the discussion of differing sexual styles in a therapy session is important in developing a common language, I often say to couples, "Half the therapy happens in this office and the other half happens in your bedroom."

I initially gave Rob and Jen two homework assignments: a nondemand pleasuring exercise to enhance sexual comfort (they'd later do an attraction exercise and a trust-position exercise to help rekindle desire) and an exercise to have a discussion based on items from the questionnaire about their major differences regarding sex. Discussion of such differences clarifies the key issues to be resolved, modified, or accepted.

For example, to the item, "I can offer a sexual option if I don't want to have intercourse," Jen answered "very much like me," while Ron answered that this was very unlike him, suggesting it was sexual intercourse or nothing as far as he was concerned. In clarifying this in their home discussion and in the next therapy session, we addressed Rob's fear that Jen was losing interest in intercourse altogether, to which Jen responded that her desire was enhanced by the freedom to make sexual choices, but squelched by sexual performance pressure.

 

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