On Monday I meet with Julian and Ken who are describing a typical weeknight in which they come home from work and have 2 hours together, exhausted in front of the TV, and then drop in to bed with only a fleeting thought, “We haven’t had sex in awhile”.
The next day I sit with Karen talking about her ADHD diagnosis and how her symptoms may be related to her difficulty switching into sexual energy or enjoying sex when she is having it.
Tom and Aamani cry together as they share that they stopped feeling sexual desire for each other long ago and have decided they don’t want to work towards reestablishing their sex life. They wonder what this will mean for them now?
Julio shares with me a deep resentment from the near constant bickering with his wife and admits he does crave sex, just not when they feel so disconnected and hostile all the time.
Sarah angrily tells her partner, “I might have sexual desire if you weren’t pestering me for sex all the time! And besides it’s over so fast, why bother?!”
All of these clients may present in your practice for issues of low sexual desire. But their needs for support are incredibly different. Assessing what the issues really are and how they play out for each unique client is a complex process, requiring us to take in to account lifestyle, health, diagnoses, relationship patterns, social expectations, beliefs, myths, and more. There is no one size fits all definition or solution for low sexual desire.
Our sexuality is entwined with all aspects of self and our lives in each new phase. Issues and questions of low desire open deep conversation and exploration into the walls and barriers that clients or others in their lives have put up to keep sexual energy at bay. The consequences for clients with low desire are real, relationships end or can lose vitality, self esteem can be hurt, and an integral part of the self feels lost.
These are tender areas, and clients often tell me that this is the topic they left unspoken for years, until it felt too hard to endure. Sadly, I also often have clients tell me that they did bring this up with a past therapist and felt shut down by discomfort in the therapist, dismissed as though sex is not important enough to focus on, or in one recent case, told to just drink a glass of wine and that would take care of it.
Why is desire so hard to talk about? We have been trained over time to see sexuality as compartmentalized; its own set of private issues. We certainly have been exposed to an unrealistic view of sex based on the desires and abilities of 18 year olds. We have been encouraged to believe that love will automatically be linked to sexual desire and that this energy will take care of itself if we just have enough intimacy. And we have fears and hesitations to talk about sex at all. I use “we” consciously here – we as therapists often share these limiting perspectives with our clients, making it even harder to support them in navigating the intricacies and vulnerabilities of repairing sexual connection. We can do better.
As we think more deeply about what healthy sexuality really looks like in this diverse world, we open new possibilities for healthy expression of sexuality. As we expand our understanding of the holistic aspect of sexuality, we can help clients find their way to a sex life that works for them in their changing and evolving lives and relationships. And as we honor sexuality as a valuable and complex part of who we are, we all benefit.
Explore this topic in-depth with Melissa Fritchle, LMFT, Sex Therapist & Educator during a webinar on 02/19, titled "Sexual Desire Issues in Couple’s Therapy." Click here for details.
Melissa Fritchle is a licensed marriage and family therapist, sex therapist and sex educator in Santa Cruz, CA. She is the author of The Conscious Sexual Self Workbook and writes an ongoing blog on sex and relationships. She is adjunct faculty for two Bay Area graduate programs in Counseling Psychology and travels in the US & internationally to provide workshops and trainings. In 2011, she was awarded the Sexual Intelligence award for her groundbreaking work providing sex positive training for counselors and caregivers in Uganda. In 2014 she worked in Kenya with a group of priests and nuns addressing sex positive approaches to sexual issues within the clergy.