‘sex therapy’

Desire for What?

Every January I look back over the previous year’s cases. And while some issues come and go, one thing is consistent year after year: I always see a lot of couples in conflict about each other’s sexual desire.

People are more than “high desire” or “low desire,” but they–and professionals–tend to use these categories, even though they can complicate things.

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No Orgasm? Lots of Good Reasons

Just about every week I see a new patient who complains that he has trouble having orgasms.

Of course, I ask lots of questions. Does this happen only with a partner, or with masturbation too? What medication is he taking? How much alcohol is generally involved before and during sex? How does his partner usually respond? How does he usually respond?

And if he’s been bothered about this for a while, why is he coming in now?

I want to eliminate medical issues first, so I always ask if he’s seen a physician. Since many of these guys are referred to me by a doc, let’s skip over the possible health issues (such as diabetes, auto-immune diseases, and possession by the devil) and…

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How Much Sex Do People Need?

Old therapy joke:
Q: What’s the difference between defense mechanisms and sex? A: You can go a whole day without sex.

Actually, we can go without sex for a lot longer than that. But you wouldn’t know it from listening to some of my patients. Or their partners.

It generally sounds like this: “So I just need a lot of sex. I can’t help it, that’s just how I am—I need a lot of sex, preferably every day.”

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When Partners Disagree On How Much Sex To Have

As a sex therapist, I work with couples every week in which one partner wants more sex than the other.

When it’s a small disparity people generally work it out. But when one person wants sex twice a week and other wants it twice a year, many couples simply can’t cope. Ideally, couples would struggle over this together: what are WE going to do about OUR problem?

What’s more common, unfortunately, is that each partner sees themselves as having the primary pain. And each person looks at the other and says what are YOU going to do about MY suffering that YOU’VE created?

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