The young married dyad with relational difficulties may or may not visit a marital therapist first, but if a sexual difficulty accompanies the relational problem, that sexual difficulty almost always will become the focus of the complaint. The dysfunctional young married dyad with a sexual dysfunction tends to attribute all their problems to the sexual sphere and assumes that once that is alleviated, their basic problems are solved. Clearly, this is far from being always true, although it should be pointed out again that even when other difficulties precede the sexual difficulty, resolution of the sexual problem usually will help greatly in resolving the more general problems.
When sex therapy begins, both partners tend to be equally enthusiastic. As the therapy proceeds and as the results become apparent, covert sabotaging often begins on the part of the non-dysfunctional partner.
A couple in their late twenties, married for two years, had not consummated their marriage. The husband would become flaccid upon attempting entrance to the vagina and had never been able to penetrate. After the first six months, he was even unable to obtain the firm erections he had had up until the attempted entrance.
In the first phase of therapy, with intercourse prohibited, the husband was able to sustain long, firm erections. When intercourse was permitted, at the couple’s discretion, the couple reported a very strange phenomenon. Even though the wife (not a virgin) was well lubricated, even using the least-threatening (for the male) female superior position, and even with good erections, the husband had not been able to penetrate.
Questioning revealed that the wife was actually dodging the husband’s penis; by her movements she was preventing him from entering the vagina. Further discussion helped the wife realize that she was fearful that once her husband became fully potent and functional, he would be unfaithful and then desert her.
This session was enough to dissolve the unconscious sabotaging problem, and four more sessions concluded the sex therapy. Therapy for other problems, however, continued.
As noted earlier, sabotaging usually results from low self-esteem, although more complicated intrapsychic factors may be present. Ironically, as mentioned earlier, it is rare for the cured partner to leave the other partner, either formally or by seeking extramarital sex, or for example, by the newly orgastic woman turning into a nymphomaniac. In almost every case the whole relationship is bolstered by improved sexual functioning; the typical reaction of both partners is to wish that they had had sex therapy when the problem first arose.
It probably has been noted that I did not define “young” in young dyads. The reason is that there is no real line of demarcation between the young and what I have called the experienced. But it is reasonable, I believe, to consider as young those who are in their twenties, who have been married (or have had a strong commitment) to each other for up to five years, and who do not have children past the age of two. When children come, the couple’s perception of itself alters radically, but it takes some time for the transformation to be complete. When the baby first is born, the couple remains a young couple with a baby; only after about two or three years does the couple consider themselves a family. At that point they are or may be an experienced couple.
How the experienced married dyad views themselves as individuals and as a couple is reflected in their approach to therapy. Most often, when problems, including sexual problems, arise, the couple’s initial visit will be to a marital or family therapist. Even if the patients believe explicitly or tacitly that the sexual difficulty is and has been at the root of their global problem, they still will tend to start out with marital or family therapy.
By the time they do seek therapy, the global problem usually has become severe. Problems neglected before the children came have grown worse. The children, even those without problems, have added new stresses to the relationship, and those with problems have exacerbated the tension and hostility.
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