Integrating Sex Therapy into Couple Treatment

by David Mars, Ph.D.

Introduce sex as a topic early in treatment with a question like: “So is your sexual connection part of what you want to improve as part of your work here?”  Or “What would you say your sexual quality and frequency is compared to what you want it to be with each other?”  The theme is to bring it to become explicit that talking about sex is a natural part of couple therapy from early in treatment, often in the first session.  It is not important to be super-specific and detailed, unless either or both couple members invite that.  Almost universally it is true that sexual quality and frequency has declined when couples come into treatment, so when the couple therapist brings it up, then the couple members can go into the sexual realm more fully from early sessions, since we set the tone of treatment.

The transformance strivings (the biological drive to evolve and grow) are the key to increasing the felt experience of eros, the life force, which energizes sexual desire and momentum toward sexual connection.  Complaints about sexual “performance” are quite shaming and demotivating to both anxiously-attached and avoidantly-attached couple members alike, while speaking about what each partner wants is a conversation starter in-session and between sessions.

Since the Seven Channels of Experience include the energetic, sensation, movement and visual channels, there is much we can do to kindle the fire of erotic connection without being overt about it.  Pinkness in the cheeks and reddening of lips are guides to increased arousal in couple relating.  We are all mammals of course and the nerve bundles of the pelvic area are linked to facial pinkening that we can see and the couple members can sense. By bringing attention the inner sensations of warming in the face and drawing the attention of the partners to each other’s brightened eyes, pinkened cheeks and deepened and brightened iris color, we can open up a primal “conversation” with humor and delight amplifying an energetic lightening and stirring that is then shown through couple members movement channel as well.  This movement of leaning in toward each other, curling up on the couch (with shoes off) and hands moving toward hands, feet moving toward feet can then be encouraged, moving beyond the edge of the habitual stopping places into breakthroughs that bring relief and new openings to bring home.
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A new paradigm in couples treatment

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Going Beyond Emotion in Treatment