Mismatched Desire is a Relationship Problem--Not An Individual Problem

Mismatched desires in a relationship problem between both people--not just a problem for the individual with lower desire (see my article: What is Desire Discrepancy?).

Desire Discrepancy is a Relationship Problem

So, why do many individuals "send" their partner to sex therapy instead of joining them to resolve the relationship problem? 

The "Identified Patient" Dynamic

There can be many reasons why a partner might not want to join their partner in sex therapy, including sexual shame. But one of the main reasons is because Partner A, the one with the higher desire, tries to convince Partner B, the one with the lower desire, that something is wrong with Partner B and B should go so the therapist can "fix" them.

As a certified sex therapist, I see this so often in my New York private practice and I know that most of the time there is a misunderstanding about why they're having sexual problems.

Desire Discrepancy is a Relationship Problem

Partner A, the one with the stronger sexual desire, pathologizes Partner B's normal desire so that Partner B feels like they're "broken" and needs to be "fixed". 

Often this pathologizing is unintentional. More often, it's a misunderstanding about how sexual desire works and that there can be either spontaneous or responsive sexual desire which are both normal.

Clinical Vignette

The following clinical vignette is a composite of many different cases:

Janet and Mark

When Janet contacted a sex therapist, she said her husband, Mark, told her she should make an appointment for herself because she didn't want to have sex as often as he did.

The sex therapist told Janet that desire discrepancy (also known as mismatched libido), is a common problem in relationships and it's a relationship problem--not an individual problem---because it's a dynamic between two people.

Janet thought her husband would probably join her after the first appointment, so she saw the therapist on her own the first time.

During the first appointment, the sex therapist told Janet that it's normal and common for two people to have different levels of desire--just like they would have different levels of desire for certain foods and other activities. She told Janet there is no such thing as a "normal level of desire."

After the first appointment, Janet went home and told Mark about what the sex therapist said. He scoffed and told her to see another therapist. So, Janet began therapy with a therapist who had no knowledge or training in sex therapy, but she agreed to see Janet individually.

Janet wanted to please her husband so she was happy to be able to tell him that she would go for therapy and he could stay home. Over time, Janet went to therapy and talked about the problem, but nothing changed. The therapist listened quietly and provided no feedback.

After a few weeks, Janet realized that this therapist was working outside her area of expertise and stopped seeing her.

When she approached her husband again about seeing the sex therapist, he refused. He told her to go see someone else, but whenever Janet called a certified sex therapist, she was told that this is a relationship problem and both people need to be in the therapy.

This went on for a while and Mark was complaining more than ever because Janet didn't want to have sex as often as he did. So, Janet decided to do her own research and she discovered that the first therapist was correct--both she and her husband needed to be in sex therapy together.

After several years passed with Mark being increasingly dissatisfied, he decided to join Janet in seeing the original sex therapist and they began to make progress.

Why Do Some People Refuse to Participate in Couples Therapy For Relationship Problems?

It's always been interesting to me that most people wouldn't tell a medical doctor how to treat their medical issues, but many people insist they know how a therapist should treat relational and sexual problems.

Since a lot of people think that therapy is "just talking", they think they know how it should work. They don't understand that therapy, especially couples sexual therapy, is a specialized treatment that is performed by licensed mental health professionals who have gone for advanced postgraduate training. Also, there are specific interventions that are not about "just talking."

Couples sex therapy is not the only therapy where people tend to designate an "identified patient" as the one who is to "blame" for having a problem. 

Families often scapegoat a certain family member as the one who has all the problems when, in reality, the one who is designated as the scapegoat might be the healthiest one--and the problems in the family are systemic family problems--not the problem of one individual.

Let's look at some of the problems involved in the vignette with Janet and Mark:

The "Identified Patient" Dynamic in More Detail

• Pathologizing Lower Desire: If the issue is desire discrepancy, the partner with lower desire is often incorrectly labeled as the one with the medical or psychological problem. In the vignette above, Mark incorrectly labeled Janet as the problem.

Desire Discrepancy is a Relationship Problem

• Ignoring the Loop: Mark saw Janet's lower desire as being an isolated malfunction. So, he completely overlooked how his behavior, communication style and refusal to split chores acted as a sexual brake for Janet.

• Outsourcing the Problem: Mark hoped a professional would "fix" Janet's behavior so their sexual relationship would change to his preferred baseline of sexual activity so he didn't have to make any personal changes. 

Fear and Vulnerability Avoidance
Couples therapy, including couples sex therapy, acts as a mirror and many individuals are very uncomfortable looking at what the mirror reveals about them:

• Fear of Judgment: Mark worried that a sex therapist would criticize his sexual performance, technique or emotional maturity. This kept him out of therapy.

• Shame Around Rejection: For Mark, admitting that his wife doesn't want him sexually as much as he wants her was deeply painful. By pushing Janet into individual therapy, he pretended the issue was an abstract medical problem.

• Emotional Exposure: Mark was conditioned to hide emotional vulnerability. Attending therapy involves discussing deep fears, inadequacies and failures, which can feel incredibly threatening.

Misunderstanding Sex Therapy

There is an incorrect common assumption that sex therapy is only about the physical mechanics of sex rather than about emotional connection:

• The "Instruction Manual" Myth: Mark believed that the sex therapist would provide Janet with tools, exercises or psychological "tricks" to boost her physical arousal, but this isn't how sex therapy works.

Desire Discrepancy is a Relationship Problem

• Missing the Emotional Link: Mark failed to recognize that for many women (and many men too), sexual desire is linked to emotional intimacy, safety and mutual respect outside the bedroom.

Control and Power Dynamics
For many people, including Mark, refusing to attend couples sex therapy is a way to maintain control over the narrative of the relationship:

• Protecting an Ego: By remaining outside the therapy sessions, Mark ensured that his habits and contributions to the sexual problems weren't analyzed. He never had to look at that his ways of initiating sex and that what he did sexually with Janet wasn't satisfying to her. No one wants sex that isn't satisfying to them.

• Dictating Terms: By sending Janet to therapy, Mark positioned himself as the "healthy" partner and Janet as the "deficient" partner--the one who had sole responsibility for their sexual happiness.

Moving Forward

Once Mark came to couples sex therapy with Janet, they both benefited from learning how to talk about sex, finding out what they each liked and disliked and understanding how each of their personal histories contributed to their problems.

Conclusion

Sex therapy is for adult individuals and couples.

There are times when individual sex therapy can be beneficial in helping an individual to overcome problems like sexual shame or other personal issues. But when the problem involves a dynamic in the relationship, both people need to attend.

Get Help in Couples Sex Therapy

Although it might feel challenging to join your partner in couples sex therapy, the consequences of remaining outside the sessions and sending your partner for relational issues, like desire discrepancy, is a much more challenging issue to face when the problem continues for months and maybe even years.

Desire Discrepancy is a Relationship Problem

Like most problems, the sooner you address them, the less complicated they tend to be to resolve. 

Rather than waiting until the problem becomes worse, get help from a licensed mental health professional who is a certified sex therapist.

Working on your problem together can bring you closer emotionally and sexually so you can have a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, IFS, EFT Couples Therapist, Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

I provide a 10-15 minute phone call prior to setting up an appointment.

You can reach me at (917) 742-2624 or by email for an in person or online appointment.

Also See My Articles:

What is Sex Therapy?

What Are Common Issues Discussed in Sex Therapy? 

What Are Common Misconceptions About Sex Therapy?

Spontaneous Desire and Responsive Desire Are Both Normal 

Overcoming Anxiety-Related Sexual Problems 

Understanding Your Sexual Accelerators and Brakes

Relationships: Navigating Changes in Your Relationship as New Parents

Becoming new parents can be joyous and wonderful, but it can also be challenging to your relationship which can make you feel guilty.

Navigating Changes in Your Relationship as New Parents

The Challenges of Being New Parents

Some of the challenges of being a new parents are fairly well known:

• Being sleep deprived especially during the first few months

• Feeling irritable due to sleep deprivation

• Experiencing poor concentration due to lack of sleep

• Experiencing increased stress and anxiety (see my article: Recognizing the Signs That You're Under Too Much Stress)

• Losing patience with your partner and yourself

• Feeling anxious about being a new parent (see my article: Self Help Tips For Dealing With Anxiety)

• Feeling like you are not a "good enough" parent

• Experiencing postpartum depression

Postpartum Depression

• Feeling jealous that your partner pays more attention to the baby than to you

• Feeling like you are neglecting yourself (see my article: Is Self Care Selfish?)

• Feeling like you and your partner are neglecting your needs as a couple

• Feeling the need to take a break from parenting

• Realizing you and your partner have different parenting styles

• Feeling like you have lost control of your life, your relationship and your household

• Not feeling like a sexual being (see my article: What is Sexual Desire Discrepancy?)

• Feeling less physically attractive

• Feeling less sexually attracted to your partner (see my article: What is Attraction?)

• Having less sex in your relationship (see my article: Have You and Your Partner Stopped Having Sex?).

• Listening to seemingly endless advice and childrearing stories from relatives and friends

• Coping with visits from relatives and friends when you're exhausted (see my article: Coping With Difficult In-Laws).

• Re-experiencing traumatic memories from your own childhood

Awareness and Acceptance That Your Relationship Has Changed

Before you had the baby, the two of you probably had more time to do whatever you wanted to do or to just relax at home.

The two of you could focus on yourself as individuals and your relationship as a couple. 

Before you had the baby, you probably knew your lives would change and you both would need to adjust, but knowing it and actually experiencing the changes are two different things.

Now, in addition to being a couple, you're both parents and parenting will take up most of your time and energy. You don't have as much time to nurture your relationship as you did before the baby because the baby's needs are the priority. 

In the past, when two or three generations lived close by, new parents had more help, but things have changed in recent years and many new parents don't have close relatives who can help. So, all the responsibilities of taking care of a baby fall on the new parents, which adds to their stress and anxiety.

All of these factors and more can have a negative impact on your relationship as you both realize how much your life has changed.

How to Navigate the Change to Your Relationship as New Parents

• Cultivate awareness and acceptance that your life and your relationship have changed (see my article: Change, Awareness and Acceptance).

• Find ways to practice self care even if these practices are small (see my article: Finding Time for Self Care).

• Approach these new life changes as a team (see my article: Improving Your Relationship By Practicing Teamwork).

• Develop open communication about how you feel about your new role as a parent and feelings it might bring up about your relationship.

• Make time for each other, even in small ways. This can help you to maintain an emotional connection with each other.

• Share responsibilities for the baby and other household responsibilities fairly (see my article: Sharing the Mental Load).

• Reassess the need to shift responsibilities from time to time so neither of you feel resentful.

• Be patient with yourself and each other as you both navigate these changes.

• Get help from a licensed mental health professional if the changes have put a strain on your relationship.

Getting Help in Couples Therapy

Adding another commitment to your schedule might feel like the last thing you want to do with all your new responsibilities, but if your relationship is suffering due to all the new changes that parenthood brings, you could benefit from seeing a couples therapist to salvage your relationship.

A skilled couples therapist can help you to adjust to the changes to your relationship so you can approach the changes as a team.

Rather than waiting until your relationship problems get worse, seek help early so you can have a more fulfilling relationship.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I have over 20 years of experiencing helping individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

 

Relationships: What Do Couples Talk About in Couples Therapy?

Are you and your partner considering couples therapy?

What Do Couples Talk About in Couples Therapy?

If you've never been in couples therapy, you might be wondering whether or not you need to talk to a couples therapist.  

You might also wonder what couples talk about in their sessions.

I've written this article as a way to normalize couples therapy in general and some of the most common topics that couples discuss.

What Do Couples Talk About in Couples Therapy?

Here are some of the most common topics couples discuss in couples therapy:

Life Transitions and Stressors: Major life changes can add enormous stress to a couple's life. These transitions often include:

• Moving in together
• Marriage
• Starting a family
• Infertility stressors
• Parenting
• Purchasing a home
• Career changes
  
• Job loss
• Relocation to a different part of the city or country
• Financial infidelity
  
• Aging
• Medical issues
• Retirement
• Empty nest syndrome
  
• Taking care of elderly parents
• Separation and divorce and Co-parenting After Separation and Divorce
• And more

Communication

Identifying and working on unhealthy communication patterns and recognizing the particular negative cycle a couple goes through can save a relationship including:

• Identifying and working on triggers that lead to arguments and other misunderstandings

• Identifying ineffective strategies the couple has attempted to use

• Learning effective strategies to improve communication and create positive cycles

Trust

Trust is a major topic for many couples.

Establishing trust in the relationship is essential to a healthy relationship. 

What Couples Talk About in Couples Therapy: Trust

This includes:

• Creating an emotionally safe environment to explore emotional vulnerability

• Understanding the root cause of infidelity or other breaches of trust

• Rebuilding trust after infidelity

• Coping with doubt and suspicion

• Coping with jealousy

• Problems related to differences in level of commitment to the relationship

• Distinguishing current problems vs. problems related to past relationships or family of origin issues

• Setting clear boundaries both partners can agree on

Sexual Compatibility

No two people in a relationship think and feel exactly the same way, so it's not surprising that desire discrepancy (also known as mismatched libido) is the #1 topic that brings couples into sex therapy which is a particular type of individual or couples therapy.

    See my article: What is Sexual Desire Discrepancy?).

What Couples Talk About in Couples Therapy: Sex

Aside from desire discrepancy, the other most common issues discussed in sex therapy include:

• Differences in sexual responsiveness between spontaneous and responsive desire

• Sexless relationships where couples have sex only a few times a year or not at all

• Loss of sexual desire in one or both partners and loss of trust after infidelity

• Erectile unpredictability which includes loss of erection, premature ejaculation and delayed ejaculation

• Sexual anxiety including performance anxiety, body image anxiety for both women and men, a history sexual abuse and other related issues

• Lack of sexual experience

    See my article: What Are the Most Common Issues Discussed in Sex Therapy?

Roles and Responsibilities

A frequent topic in couples therapy that I hear from clients is how roles and responsibilities are shared (or not shared) by the couple. 

These include imbalances in various areas:

• Household responsibilities
• Financial responsibilities
• Childrearing tasks
• Decision-making tasks
• Planning

A couples therapist can provide a safe environment for the couple to negotiate these issues without hostility (see my article: Sharing the Mental Load).

Family Dynamics

Family and culture often have a significant impact on a relationship, especially when the people in the relationship come from different familial and cultural perspectives. 

Talking about family and cultural dynamics in couples therapy allows the couple to discuss these issues in an environment where each partner feels safe so they can negotiate differences.

    

    See my articles: 

Dealing With Difficult In-Laws

Learn to Stop Interfering in Your Adult Child's Relationship

Quality Time

A common problem for many couples is how much time they spend together including one partner wanting to spend more time than the other (see my article: Learning to Compromise About How Much Time You and Your Partner Spend Together).

A couple can explore their mutual interests and hobbies as well as areas each of them might want to explore on their own without their partner.

Future Plans and Goals

Creating relationship goals is an important aspect of being in a relationship (see my article: 10 Relationship Goals to Create a Stronger Relationship).

What Couples Talk About in Couples Therapy: Future Plans and Goals

Couples therapy is an ideal place for couples to identify and negotiate individual and relationship goals.

These plans and goals can include:

• Identifying individual goals
• Identifying shared relationship goals
• Negotiating individual and shared goals that might be different
• Making a plan together to achieve these goals

Getting Help in Couples Therapy

If you and your partner have been unable to work out your problems on your own, seek help from a licensed mental health professional who is a couples therapist.

A skilled couples therapist can help you to work through your problems so you can have a more fulfilling relationship.

About Me

I am a New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

How Can a Growth Mindset Improve Your Relationship?

I began a discussion about the difference between a growth mindset and a fixed mindset in a prior article (see my article: What is a Growth Mindset vs a Fixed Mindset?).

A Growth Mindset Can Improve Your Relationship

In the current article I'm focusing on how a growth mindset can improve your relationship.

What's the Difference Between a Fixed Mindset and a Growth Mindset in Relationships?

People who have a fixed mindset in their relationship believe that change isn't possible. 

They believe neither they nor their partner can develop new skills or abilities to improve their relationship.

Since they're prone to a fixed and pessimistic attitude, they often avoid risking change even if it's for the sake of improving their relationship. 

They're also prone to giving up more easily when confronted with the need for change. As a result, these relationships often stagnate.

In addition, people with a fixed mindset often do well during the early honeymoon phase of a relationship when things are going well, but when the going gets tough, they're more likely to give up or cheat (see my article: The Allure of the Extramarital Affair).

This is especially true for people who believe in the idea of "soulmates" where they think relationships are either "meant to be" or not (see my article: Why You'll Be Disappointed If You Look For a "Soulmate").

So, when things aren't going well in their relationship, they think the relationship wasn't "meant to be" and, instead of trying to resolve problems within the relationship, they look for emotional and sexual gratification outside the relationship.

People who have a growth mindset see problems as opportunities to develop and grow.  Since they believe in the possibility for growth, they're more likely to take emotional risks by being emotionally vulnerable to make positive changes. They're also more likely to persevere to overcome problems.

How Can a Growth Mindset Improve Your Relationship?

If you have a growth mindset, you're more likely to see your partner's and your own shortcomings as challenges to overcome.  

As a result, you can approach shortcomings in a more empathetic way because you believe you and your partner can improve.

A Growth Mindset Can Improve Your Relationship

If you have a willingness to develop and grow, you can deepen your understanding and trust in your partner due to your belief that things can change for the better in your relationship.

A positive mindset can also help you to be more proactive in overcoming challenges. This allows you to approach problems in a more collaborative way with your partner because you see yourselves as a team.

With a growth mindset you can also experience more compassion for yourself and your partner during challenging times.

In addition, you can experience gratitude and appreciation for your partner, which can help you to get through difficult times together.

How Can a Sexual Growth Mindset Improve Your Sex Between You and Your Partner?

The #1 reason why people seek help in sex therapy is a sexual desire discrepancy in their relationship.

The #1 Sexual Problem in Relationships: Desire Discrepancy

It's not unusual for people in long term relationships to develop stagnant sex scripts where they no longer enjoy sex (see my article: How to Change Your Sex Script).

Familiarity often helps people to feel comfortable with each other on an emotional level, but it can also create stagnation in the bedroom. 

When stagnation sets in and the couple engages in the same sexual activities without any deviation, sex becomes routine and boring.

In addition, if one person wants more sex than the other or wants to engage in different sexual activities than their partner, as in the case with sexual desire discrepancy, the person who wants more sex often stops initiating because they fear getting rejected by their partner (see my article: Coping With Sexual Rejection From Your Partner).

Some partners are especially sensitive to sexual rejection and rejection becomes that much more painful if the couple is having less sex with few opportunities to repair this problem.

When both people have a sexual growth mindset, they're open to being more sexually adventurous by expanding their sexual repertoire. 

They're also less sensitive to sexual rejection because they know there will be other opportunities for sexual pleasure and novelty.

A Sexual Growth Mindset Can Improve Your Sex Life

Even when sexual problems arise, a couple who has a sexual growth mindset believe they can develop the necessary skills and abilities to overcome their problems.  

They're more likely to persevere in overcoming their relational and sexual problems--whether they do this on their own or with the help of a sex therapist.

Getting Help in Therapy

If you and your partner have been unable to resolve problems on your own, you could benefit from seeking help from a licensed mental health professional who is a couples therapist.

If you're having sexual problems, a sex therapist can help you to improve your sex life.

Sex therapy is a form of talk therapy (see my article: What is Sex Therapy?).

Getting Help in Therapy

There is no nudity, physical exams or sexual activity during sex therapy sessions (see my article: What Are Common Misconceptions About Sex Therapy?).

Individual adults and couples seek help in sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Rather than struggling with relational or sexual problems on your own, seek help from a skilled therapist with an expertise in your problem so you and your partner can have a more fulfilling life together.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex-positive therapist who works with individual adults and couples.

To find out more about me, see my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Overcoming Feelings of Sexual Shame and Guilt Due to Interpersonal Issues

In my prior article, Overcoming Feelings of Sexual Shame and Guilt Due to Cultural Factors, I began a discussion based on a book by Lauren Fogel Mersy, PsyD and Jennifer A. Vencill PhD that I have been recommending to clients. It's called Desire: An Inclusive Guide to Navigating Libido Differences in Relationships.

Interpersonal Issues Can Create Sexual Shame and Guilt

One of the topics the authors discuss is sexual shame and guilt and how these personal, interpersonal and cultural factors contribute to shame and guilt.

In the current article, I'm focusing on interpersonal factors and in the next article I'll discuss personal factors.

As a recap from my prior article on cultural factors: The difference between sexual shame and guilt, according to the authors, is:

• Sexual shame is a worry about being rejected for an aspect of who you are as a sexual being. 

• Sexual guilt is a worry about being rejected for your sexual thoughts, feelings or behavior. 

Sexual Shame and Guilt Due to Interpersonal Issues

Sexual shame and guilt can come up in a relationship for many reasons.  

Here are some of the most common reasons:

• Growing Up in a Sex-Negative Family: Early experiences of growing up in a sex-negative environment usually carries over into adulthood if these experiences aren't addressed. For instance, if a child is repeatedly shamed and scolded by a parent for masturbating, that child can grow up believing sexual pleasure is wrong and "dirty" which can create sexual shame and guilt. This can also be complicated by religious or other cultural factors that were sex-negative as opposed to sex-positive (see my article: What Does Sex-Positive Mean?).

• Experiencing Childhood Trauma: If an individual was sexually abused as a child, they might get triggered during sex with their partner. Even if the abuse wasn't sexual, emotional or physical abuse often has lasting effects that can impact adult relationships (see my article: Overcoming the Trauma of Childhood Sexual Abuse).

• Feeling Uncomfortable Talking About Sex With a Partner: This is a common problem--even for couples in long term relationships who are having sex but who feel too ashamed to talk it (see my articles: How to Talk to Your Partner About Sex - Part 1 and Part 2).

• Engaging in "Duty Sex": Instead of sex being a way to connect in a mutually enjoyable, playful and intimate way, sex turns into a chore or obligation to avoid conflict and guilt. This problem is related to problems with talking about sex because the partner who is engaging in "duty sex" often doesn't know how to talk about it and the other partner, who might sense their partner is engaging in sex as a chore, also doesn't know how to address it.  Often neither partner feels good about "duty sex" because it's usually not pleasurable for either of them and it often creates more problems than it was meant to to avoid.  It's not unusual for one or both partners to find reasons to avoid having sex altogether so, eventually, they become a no-sex couple (see my article: Have You and Your Partner Stopped Having Sex?).

• Experiencing a Partner Turning Away Sexually and/or Emotionally: Asking for emotional or sexual connection is a vulnerable act.  When a partner responds in an unsupportive way, this can create shame and guilt in the partner who is looking for support as well as the partner who can't or won't give it. This includes situations where a partner is turning towards the other partner for emotional or sexual connection but not getting it (see my article: Emotional Vulnerability as a Pathway to Emotional and Sexual Intimacy).

Experiencing a Partner Turning Away Sexually or Emotionally

• Lacking Sexual Experience: If one or both partners is sexually inexperienced, they might feel ashamed about this and guilty that their partner might not be enjoying sex with them. This can be due to cultural, religious or the partner's values. There's nothing wrong with waiting for sex, if that's part of a person's values.  It becomes a problem if it creates sexual shame or guilt.

• Experiencing Body Image Problems: There are messages everywhere--magazines, social media, TV--about how men and woman should look.  This is especially true for women. Both men and women can experience problems with body image in terms of weight, height, breast size, penis size and so on. Problems with body image can engender shame  about one's own body (see my article: Is a Negative Body Image Ruining Your Sex Life?). 

• Experiencing Libido Differences: Sexual desire discrepancy between partners is a common problem in relationships. Most couples don't have the same exact likes and dislikes in other areas of their life, so why should they experience sexual desire in the same way? It's only a problem when the couple can't reconcile these differences, which often causes sexual shame and guilt. Libido differences are the #1 reason why couples seek help in sex therapy (see my article: Mismatched Libidos in Relationships: What is Sexual Desire Discrepancy?)

• Experiencing Different Preference: Vanilla vs. Kinky Sex: If one partner only likes vanilla sex (meaning conventional sex) and the other partner only wants kinky sex, this can create sexual shame and guilt between the partners if it's not addressed. It can also lead to their becoming a no-sex couple. However, these preferences can be negotiated, and it's possible to reach a compromise if both partners can be flexible and find common ground (see my article: What is Kinky Sex?).

Sex Comes in Many Different Flavors: Vanilla and Kinky

• Having Misconceptions About Spontaneous and Responsive Sexual Desire: According to Sex Educator Dr. Emily Nagoski, who wrote Come As You Are, only about 15% of women experience spontaneous sexual desire, so the vast majority of women experience responsive desire. There are also men who experience responsive desire instead of spontaneous desire. However, many people aren't sexually informed about responsive and spontaneous desire due to a lack of sex education and a skewed portrayal of sexual desire in the media. These portrayals almost always show only spontaneous desire. In addition, in long term committed relationships, after the limerence phase of a relationship (also known as the honeymoon phase), many people, even individuals who experienced mostly spontaneous desire before, often experience responsive desire over time. Neither type of desire is better than the other. When partners have differences in the way they experience sexual desire, a willingness on the part of the responsive desire partner to begin having sex often results in enhancing sexual desire for that partner once they get started. This also requires the spontaneous desire partner to be patient and hold the "sexual charge" for both of them until the responsive desire partner gets aroused (see my article: Spontaneous Sexual Desire and Responsive Sexual Desire Are Both Normal).

• Experiencing an Orgasm Gap Between Partners: Problems with an orgasm gap tend to occur more often in heterosexual couples as opposed to LGBTQ couples. An orgasm gap occurs when one partner has a tendency to experience an orgasm during partnered sex and the other does not. This doesn't refer to occasional instances when one partner has an orgasm and the other doesn't. Instead, an orgasm gap refers to an ongoing problem. Problems with an orgasm gap usually affect heterosexual women. A common reason for this is that there isn't enough clitoral stimulation for the woman because the couple is relying only on sexual intercourse, which is not the best way for most women to have an orgasm. Another contributing factor to an orgasm gap occurs when a couple approaches sex solely in terms of goal-oriented sexual performance rather than sexual pleasure. In addition, couples who are stuck in a rigid sex script or who are stuck on a linear and rigid sexual staircase can also experience problems with an orgasm gap. In addition, sexual boredom can be an issue, especially in long term relationships. There can also be other reasons (see my articles: Closing the Orgasm Gencap Between Heterosexual Men and Women - Part 1 and Part 2).

Experiencing an Orgasm Gap

• Experiencing Sexual Disorders: A sexual disorder can be frustrating for both people in a relationship. It often leads to one or both people wanting to avoid sex as a way to side step dealing with the problem. Many sexual disorders, including painful sex (dyspareunia, vaginismus, pain related to a sexually transmitted infection or other issues) and problems with erectile unpredictability (erectile dysfunction, premature ejaculation, or delayed ejaculation) can have physical and psychological causes. Ruling out a physical problem first is essential. If a physical problem has been ruled out or there appears to be a psychological component in addition to the physical problem, couples can be helped by a sex therapist. When there are physical and psychological problems, they are dealt with at the same time with the physical problem being handled by a urologist, sexual medicine professional or a pelvic floor physical therapist, and the psychological component being treated by a sex therapist.

• Dealing with a History of Cheating: Most people assume that partners cheat because they're unhappy in the relationship, but most of the time this isn't true. Cheating often occurs for complex reasons. Also, contrary to popular belief, most couples usually work out these issues, especially if they have been together for a while and they attend couples therapy. Of course, this is a personal choice and many couples are unable to work out issues related to cheating either because the partner who feels betrayed can't and/or won't do reconcile or because the partner who cheated won't give up a sexual affair (see my article: Why Do People in Happy Relationships Cheat?).

Dealing with a History of Cheating

• Dealing with a History of Compulsive or Out of Control Sexual Behavior: When a partner has a history of compulsive or out of control sexual behavior, this usually presents a problem in the relationship. There are many misconceptions about sexual compulsivity in terms of how to define it, whether it's an addiction, and other similar issues. But if the couple is willing to work on it, it's possible to overcome problems with sexual compulsivity in sex therapy.  In addition, many people are misinformed about this issue. For example, a man who thinks he is sexually compulsive because he masturbates occasionally in the privacy of his home, might actually be contending with sexual shame and guilt if his masturbation doesn't get in the way of the rest of his life. Another example would be a wife who thinks her husband has a "sexual addiction" because he watches porn occasionally. She is most likely misinformed. This doesn't mean that the husband watching porn might not be going against their relationship agreement. But it's probably not an "addiction." Of course, every case is different and context matters. So, a case where someone watches porn occasionally at home in private is different from someone who watches porn occasionally at work where they have been warned that they could be fired for violating the company policy. If that person continues to watch porn at work, knowing they are being monitored and they are jeopardizing their job, they have a problem (see my article: What is Out of Control Sexual Behavior?).

• Disagreeing About Whether or Not to Open Up the Relationship: Many people, who are currently in monogamous relationships, would like to have an open relationship, but their partner doesn't want it.  Couples who have a conflict around this issue could benefit from sex therapy where this issue can be negotiated, if both people are willing. Other couples want to open up the relationship, but they don't know how. There are many forms of consensual nonmonogamy. A couple can work out an agreement that suits both of them or they can acknowledge they're not compatible and end the relationship amicably. Sex therapy can help with all of these issues (see my article: What is Consensual Nonmonogamy?).

Disagreements About Opening Up a Relationship

• Experiencing Other Stressors in the Relationship: Chronic stress is usually a libido killer that can exacerbate already existing shame and guilt about sex. This can include:

• Health issues (in addition to the ones mentioned above)
• Lack of sleep
• Stress involved with child rearing
• Family problems
• Money problems
• Work-related stressors
• Other problems

Next Article: Overcoming Feels of Sexual Shame and Guilt Due to Personal Issues

Getting Help in Sex Therapy

Sex therapy is a form of talk therapy (see my article: What is Sex Therapy?).

There is no sex, nudity or physical touch during sex therapy sessions (see my article: What Are Common Misconceptions About Sex Therapy?).

Individual adults and couples seek help in sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

If you're struggling with a sexual issue, rather than struggling on your own, seek help from a licensed mental health professional who is a sex therapist.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex-positive therapist who works with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.