Gaps and Discrepancies in Desire
Our team believes in closing any gaps that may arise in clinical treatment delivery by providing continued education to our team. Recently, we had the opportunity to sit down with Barry McCarthy for the first session in our Sex Plus Symposium series and gain insights on gaps in desire and desire discrepancies in couples. Couples with mis-matched desire is one of the most common presenting problems in a sex therapy practice.
Barry is a professor emeritus of psychology at American University and a diplomate in both clinical psychology and sex therapy. Barry has published 110 papers, 33 book chapters, and 23 books. He has also received the Masters and Johnson award for lifetime contributions to the sexuality and sex therapy field.
He provided helpful guidelines and suggestions for what can be helpful and not helpful during sex therapy practice, and we’d like to share some of these with you.
Many people view desire arising from specific things that a person within a couple gets turned on by; this isn’t always healthy as the expectation.
Desire is complex and thinking more broadly, what’s actually more inclusive is the concept of sexual responsive desire that as you give and receive pleasure-oriented touching — that’s when you feel desire.
Read on to learn more.
“One size never fits all sexually.”
Myths in Sexuality
Barry began the presentation by walking through different myths in sexuality. Many myths are based on past experiences and unrealistic expectations propagated through a variety of sources including religion, upbringing, lack of sexual education or poor sexual education.
The most important myth to understand is rather than the belief that everybody is doing sexually better now than they were in the past; the reality is that the rates of sexual problems have not gone down.
Primary sexual problems, or problems that could be considered pre-existing, have trended down, but there is a rise in secondary sexual issues that have been brought on by unrealistic sexual expectations.
One of the most prevailing secondary sexual problems that bring people into sex therapy is low sexual desire, which can be common among men and women.
Roles in Sexuality
While low sexual desire can occur with either partner in a relationship, it is more common in women.
One of the primary dysfunctions affecting men within a sexual relationship is premature ejaculation, while low desire is a secondary issue. Let’s focus on the desire.
A pervasive myth is that loss of an initial erection means you are sexually uninterested or turned off. It is a natural physiological process for erections to wax and wane during prolonged pleasuring.
The main thing to keep in mind is that each person is responsible for their sexuality, but ultimately, sex is a team sport.
“Sex is best understood as a symptom of an individual or couple problem.”
Sex Therapy Treatment and Relapse Strategies
The key to healthy sexuality is communication. Better communication leads to better intimacy which, in turn, leads to better sex.
From a psychologist's point of view, any overarching mental issue — anxiety or depression, bi-polar disorder, alcoholism, trauma, family of origin issues — needs to be addressed first before moving on to resolving sexual dysfunctions.
Once the sexual issue is being managed and a healthy sexual relationship has been established, the next key step is to determine a relapse prevention strategy. Relapses with sexual desire are common.
When a relapse happens, an individual often looks for somewhere to place the blame if no strategy has been put in place. Barry provides a full look at helpful relapse prevention strategies in his book, Sex Made Simple. This is a nuanced practice that the majority of therapists we know don’t practice — which is promoting “booster” therapy interventions to maintain gains. A couple or individual may not always realize that ongoing booster check-in’s with your therapist is part of a successful treatment strategy.
At a high level, set aside quality couple time and discuss what you need to do individually and as a couple to maintain a satisfying and secure sexual relationship with regular follow-ups either by yourselves or with a therapist.
It’s also important to accept occasional lapses, but do not allow a lapse to become a relapse. A relapse means giving up and reverting to the cycle of anticipatory anxiety, pass-fail intercourse performance, frustration, embarrassment and avoidance.
There is not “one right way” to be sexual. Each couple develops a unique style of initiation, pleasuring, eroticism, intercourse, and afterplay. Be open to modifying or adding something new or special each year.
Work on developing a range of ways to connect, reconnect, and maintain connection. These include five dimensions of touch:
Affectionate touch (clothes on) — kissing, hand-holding, hugging.
Non-genital sensual touch (clothed, semi-clothed, or nude) — massage, cuddling on the couch, touching before going to sleep or on awakening.
Playful touch (semi-clothed or nude) — mixing non-genital and genital touch — romantic or erotic dancing, touching while showering or bathing, “making out” on the couch, whole body massage.
Erotic, non-intercourse touch — using manual, oral, rubbing, or vibrator stimulation for high arousal and/or orgasm for one or both partners.
Intercourse — view intercourse as a natural continuation of the pleasuring/eroticism process, not a pass-fail individual performance test.
Maintain a flexible sexual relationship that energizes your bond and facilitates desire and desirability. Barry goes into greater detail on the five dimensions of touch in his book Enhancing Couple Sexuality.
Couples who share intimacy, non-demand pleasuring, erotic scenarios, and planned as well as spontaneous sexual encounters, have a vital sexual relationship. The more ways in which you maintain an intimate sexual connection, the easier it is to avoid relapse.
In part two of Barry’s presentation we’ll cover how to balance intimacy, pleasure, eroticism and satisfaction in addition to ways you and rebuild your sexual attraction and find the sex style that’s best for you and your partner.
Learn more about sex therapy and how our team can help determine a treatment plan.