SEX FAQ’s: Making Sense of Sexual Intimacy

Have you ever wanted to pick the brain of a sex therapist?? We certainly have and so we did.  This week we asked a colleague a few questions about sexual intimacy. Dorothy Barnes, LPC, CST has been a private practice counselor and certified sex therapist for 25 years.  Here is what she had to say….enjoy!

1. What are some strategies if only one partner will initiate sex?

When only one partner will initiate sex, and it is a problem for the relationship, (for many it is not a problem) then I think it’s important to look at the history:

• Was it that way from the beginning of the relationship?
• If no, when did it start to shift?
• Always first rule out physical/hormonal issues.

Without dealing with the issues and history, some basic strategies could include:

1. Identify physical ways that each partner enjoys being touched, excluding sex.  Create a list for each other of simple and daily ways to connect physically.  Each person can then pick one item from the list to initiate physical contact with the other.  By doing this each person is now initiating some physical connection.  It could be brushing hair, a backrub, hugs, holding hands, shampooing hair, a foot rub…the list is endless. We often give to our partner what we want and not what they want.
2. Agree to only have the person who is not initiating be the only one initiating for a period of time.  I usually recommend at least six months and while working with a therapist on underlying issues.  Of course, the initiator will most likely say “then we’ll never have sex.”  That may be true, however, the non-initiator probably needs to have some non-pressured space to identify any sexual desire that might pop up.  I really emphasize to the non-initiator to act on any sense of desire to be sexual, even if they end up not wanting to have sex.  It could be a phone call or text in the middle of the day.  It could be feeling sexual during a movie and letting their partner know they are aroused.  It could be sending a sexy card while away for work.  The point being that typically the non-initiator has shut down their feelings of desire or does not disclose them so they won’t feel pressured to follow through.  The more freedom one feels to share any desire without pressure leads to more feelings and more sharing.
3. Couples can take turns initiating being sexual.  Try to not set a deadline, as that is sure to backfire.  Also, talk through what is meant by initiating.  When couples focus on only intercourse, they miss out on noticing a whole range of sexual behaviors that might be easy to initiate.

2. Can a couple get the sexual desire back if it has declined?

The short answer is ABSOLUTELY.  I always ask the question, “Was there mutual desire from the beginning?”  When the answer is no, then I’m up front about it being much more difficult to get to a place that didn’t exist in the first place than to get back what was once there.  When sexual intercourse and emotional intercourse match, then desire can be better than it ever was.  Couples who learn that being sexual is often a physical way to express the emotions going on in the relationship have the most sustaining sexual relationships.  For instance, we often think that we are not going to be sexual when we are furious with our partner.  Yet, angry sex (never something that the other does not want) can let the other know that “I love you no matter how much you piss me off”.  It’s also ok to ask for a quicky when we want to connect but have a million things going on in our minds.  The more one can loosen up their awareness of how sexuality should be, the more likely they are to expand their awareness of desire.

4. What are some helpful tips for couples with erectile dysfunction or premature ejaculation?

First, it’s important to understand that this is a very typical and pervasive occurrence for men at some point in their life.  Another misconception is that it only occurs in older men.  About 40% of the time younger men experience PE and ED.  It’s always important to, again, first rule in or out a physical reason.  Many diseases result in decreased blood flow or inability to get or maintain an erection.

Some common psychological issues include early sexual experiences, anxiety, over excitement, depression, stress and relationship issues.  If you can get an erection alone while masturbating and you have normal morning erections, then your issue is most likely psychological.

Here are a few tips to try that a therapist might also suggest:

1. Use guided imagery and meditation to help slow everything down.  That can then be part of your sexual experience and provide a sense of calm control.
2. Talk about it with your partner and then talk about it some more.
3. Try to take the focus off performance and expectations.  If you allow yourself to have ED or PE without judgment you will have an easier time working through to more sustained and lasting sexual experiences.  For the men reading this they might be thinking “Easy for her to say.  She’s a woman.”  Agreed.  However, the more we lean into a problem the easier it is to get off the self-perpetuating hamster wheel of defeat.  When you do this, it allows you to still engage sexually with your partner in a way that satisfies her/him without penetration.  Eventually, this helps to actually reduce issues of ED and PE dramatically.

Some final thoughts, no matter what sexual issues you may be experiencing.  We all tend to communicate through verbal or sign language, body language and sexual language.  The first is the easiest to mask, body language a little more difficult, and the sexual language most difficult.  When I’m working with a couple, their sexual language provides information they may not even be aware of.

During a session I always ask, “What do each of you do when angry?”  While I get many responses including, “We aren’t here to talk about anger,” the expression or lack of expression tells me something that may be behind most sexual issues in a relationship.  The counterpart to anger is passion.  They are both very strong and useful emotions.  When anger is shut down in a relationship, it’s likely that passion is as well.  If I can help both individuals notice and express built up anger appropriately, then it’s like a release for the passionate flow to return.

As a private practice counselor for 25 years the thing I most want new patients to know is I provide a non cookie cutter approach to each new individual, couple, family I see.  One other strategy I find useful is to provide a parallel track of help resolving issues.  One track is to get them as much relief, as soon as possible, while not just putting a band aid on the problem.  The other track is to take a look at how they ended up where they are in the first place.

Dorothy Barnes, LPC, CST (AASECT Certified Sex Therapist for over 25 years; EMDR Level II Certified Trauma Specialist).  Dorothy can be reached at Safe Harbor Counseling (480-318-3671) or you can learn more about her practice at:  www.shccounseling.com.