"I Forgot What It's Like to Want Sex"

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The Counselor's Turn

"There's a Lot More Than a Physical Cause"

"Low sexual desire can occur at any age, and for a variety of reasons," said the counselor. "It could be lifelong or situational, triggered by physical conditions such as illness, medication, menopause, or just the stress of life. Cassie told me that since her hysterectomy three years ago she'd experienced changes in her body -- vaginal dryness, occasional night sweats, and hot flashes. While it's normal for a diminished sex drive to accompany these symptoms, I suspected there was more than a physical cause at work here.

"I told Cassie that in order to restore her sex drive, she needed to improve her relationship with her husband outside of the bedroom. Their families, children, and careers all became fuel for fights and the animosity severed their communication. Cassie's accusations that Jim didn't understand her need for privacy and suffocated her with demands for closeness made him feel sad and angry. After repeated rejections, he became defensive and stopped investing energy in the marriage.

"We hammered out strategies to short-circuit arguments and improve their communication. They agreed that as soon as either sensed that a discussion was becoming heated, they'd call a time-out. Since both blamed the other for escalating anger, I gave them each an assignment: If Jim called a time-out, Cassie must respect it, instead of pushing for the last word. This allowed Jim to control his temper so he could return later, calmer, to the conversation. I also told Jim to keep a log of when Cassie spoke critically. When he started keeping track, he realized her remarks occurred less often than he had thought. This awareness enabled Jim to drop his guard and focus on the good moments they shared.

"Jim also had to learn to find happiness in his life that didn't revolve around Cassie. It was clear that he was stuck in a midlife career rut. We discussed what he could do for himself to find pleasure. 'My book should be done by the end of the summer,' he told me after several sessions. 'And I've decided to resume teaching in the fall.' Upon my suggestion, he reconnected with colleagues and took up new projects, such as enrolling in a furniture-making class and working for a candidate in their district's Congressional race. 'He's so busy now I have to ask him when he can squeeze me in,' said Cassie, pleased to finally have some time to herself.

"To this end, I suggested the couple make nonbreakable dates with each other once a week. Some dates were to be reserved for taking care of 'business' (such as paying bills and discussing the kids); some were for cuddling only; and some were for practicing the structured exercise called 'sensate focus' that helps couples gradually phase in sexual activity -- undressing each other, touching and kissing -- without the pressure to have intercourse. They set the mood with music, soft lighting, and scented candles. I told them to just enjoy the moment and each other. After a few weeks of these dates, both rediscovered how much they anticipated and enjoyed their time together.

Continued on page 5:  The Counselor's Turn, continued


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