“What made you think she didn’t like your penis?”
“Why do you wear a t-shirt during sex with your husband?
Every week I ask patients lots of questions, which they generally answer. Sometimes their answer avoids the question, so I ask again, perhaps in a different way.
When patients ask me questions, however, it’s different. I either answer them directly, or I question the question.
That’s when some real therapy can take place, as I challenge patients to look at the assumptions built into a question. Or as I point out that patients are ignoring their knowledge of their own bodies. Or as I encourage patients to communicate with their partner—as a great solution to their “communication problem.”
I also don’t usually answer sex questions that aren’t really questions–those that seem more like a plea for reassurance, or a test of my open-mindedness.
Here are some sex questions I generally don’t answer directly—and a few ways that I do often respond.
Am I normal?
(For example: fantasies, preferences, shape or size of labia)
My various responses: What do you mean by normal? Why do you want to be normal? What makes you think you aren’t? How would it change your sexual experiences and decisions if you knew you were normal? How would your sex life change if you didn’t care whether you were normal or not?
Do I masturbate too much?
My various responses: Too much for what? What are you actually concerned about? How would you change your behavior if I said you masturbate too much? How would you change your behavior if I said you don’t masturbate too much?
If you’re in a sexual relationship, do you have concerns about your sexuality that you should discuss with your partner? If you haven’t, why not?
How do I make my penis bigger?
My various responses: Why do you want to make your penis bigger? What makes you think it’s the wrong size? What makes you think penis size matters? How would it change your sexual experiences and decisions if you were satisfied with your penis? How would your sex life change if you didn’t care whether your penis were a reasonable size or not?
If you’re in a sexual relationship, have you discussed penis size with your partner? If not, why haven’t you?
How much does the average couple have sex?
My various responses: What do you mean by “have sex”? Who do you think of as the “average couple”? In what ways do you think you’re like an average couple? How would it change your self-image and sexual behavior if I said you have more sex than the average couple? Or less sex than they do?
What makes you interested in how much the average couple has sex? Can you tell your sex partner(s) that you want things to change without having to compare yourselves to some “average couple?”
Why won’t my wife initiate sex more?
My various responses: Why would you like your wife to initiate more? Why do you think she doesn’t initiate more? Do you think she wants to, but is holding back? If so, why? Have you invited her to initiate more? If so, what has she said? Do you believe her? If you haven’t invited her, why not?
Are you wanting her to initiate more as an indirect way of saying you’d like to have sex more often? If so, why not talk about that rather than about her initiating more?
Is watching porn a form of infidelity?
My various responses: Infidelity is a category, and it all depends on how you define it. Does it have to include physically touching an actual person? Does it include activity with a sex worker? Does it have to include genitalia? Orgasm? Satisfaction?
You two don’t have to agree on whether porn-watching is infidelity, but surely you agree that one of you is in distress about the other’s behavior. That’s what you two should discuss, not the abstract question of whether it fits into some category.
Similarly, although one of you considers it infidelity, the porn-using other one doesn’t. In what ways does that person define their behavior as fidelity? And what exactly do the two of you want from a relationship regardless of porn use? Have you been talking about? If not, why?
How do I keep my wife from having an affair?
My various responses: Do you think she wants to have an affair? What makes you think she does? If she does, why do you suppose she wants to? If your wife wants to have an affair, why would you want to stop her? If you think she’s interested in having an affair, have you asked if this is true? Why not? Did you believe what she said? Why not?
And by the way: what makes you think anyone can stop anyone else from having an affair?
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