Guide Continued And Concluding Comments

Attraction is crucial within a sexual relationship and while mutual love and respect are important factors as well, loss of attraction in a relationship can be an obstacle to healthy sexual functioning. Thus, if feelings of attraction have been lost, it is important the couple take active steps to restore these feelings. Attraction includes both physical and emotional attractiveness. A therapist may provide useful guidelines and suggestions to couples about how to restore their attraction and desire for each other in healthy ways.

A restricted sexual repertoire is a risk factor for sexual dysfunction that refers to limiting one's thoughts and sexual practices to intercourse alone. We have discussed numerous risk factors for developing sexual dysfunctions, and many are not preventable. For example, the natural aging process is something we cannot escape but does impact sexual functioning. If we restrict our perception of sex to intercourse alone, and our ability to have intercourse becomes impacted, we are more likely to incorrectly believe that physical intimacy is no longer possible. Expanding what we consider to be fulfilling sexual activity is important. For many people, sexual intercourse is la crème de la crème when it comes to sexual activity, and discounting the importance of sexual intercourse is not the goal of this section. To loose one's ability to have sexual intercourse is devastating. However, if you are able to keep an open mind and incorporate different types of sexual activity into your sexual repertoire, sex after aging can still be pretty exciting. The concept of non-demand sex is an alternative perspective that can help remove the pressure to "perform." Non-demand sex is simply living in the moment and enjoying sexual activity without the pressure to engage in sexual intercourse, or to achieve an orgasm. While it may lead to sexual intercourse, its purpose is to learn to enjoy a full range of pleasant sensual feelings with your partner.

If you are experiencing sexual difficulties with your partner, remember that partnered sex involves more than one person, so maintain a couple's perspective. Assist your partner by communicating understanding and support, ask questions, and otherwise demonstrate that you view the sexual problem as a shared problem. To the fullest extent possible, it is best to try and fully participate in the treatment process with your partner. This may mean attending doctor's appointments, learning to use assistive devices, understanding medications and their side-effects, and learning to share natural feelings of loss and disappointment in caring and sensitive ways with your partner.

It is important to recognize that partners of people who experience sexual dysfunction are significantly affected by sexual dysfunction and may need their own support. This often comes in the form of psychotherapy as these are private topics that should rarely be discussed outside the relationship except with a professional helper, or self-help support group intended for this purpose. However, individual therapy is often contraindicated during couples' therapy. If you are currently participating in couples' therapy, and feel you need some additional support of your own, please discuss this with your therapist.

Partners of people with some of the more disturbing sexual disorders, such as pedophilia or sexual addiction, may need additional support. But this support is often hard to find as these are not topics most people would want to disclose to friends or family. There are 12-step support groups that are available for partners such as S-Anon that are patterned after Al-anon, a support group for partners of alcoholics. Many people find that the ability to discuss their anguish with someone who has "been there" to be profoundly healing.

As mentioned throughout, sexual functioning is complicated which in turn means that sexual dysfunction is complex as well. If you are dealing with sexual difficulties in your relationship, remember that sex usually involves more than one person, so maintain a couples' perspective. From a couples' perspective, blame has no place. When viewed as "our problem" the solution becomes a shared experience where both partners receive compassion, empathy, and understanding.

Concluding Comments

We began our venture down the road of sexuality with the saying: Variety is the Spice of Life. Throughout our discussion on gender differences, changes across the lifespan, sexual health from a holistic perspective, sexual dysfunction, paraphilias, and gender identity disorder, it seems quite clear that sexuality is no stranger to variety!

Comments
  • Anon

    Great and comprehensive article. One big question:

    You wrote... (emphasis added)

    "Attraction is crucial within a sexual relationship and while mutual love and respect are important factors as well, loss of attraction in a relationship can be an obstacle to healthy sexual functioning. Thus, if feelings of attraction have been lost, it is important the couple take active steps to restore these feelings. Attraction includes both physical and emotional attractiveness. A therapist may provide useful guidelines and suggestions to couples about how to restore their attraction and desire for each other in healthy ways."

    Question: Like what? How in the world can one restore physical attraction and desire? I get it emotionally, but what about the physical side? Is it like looking at a piece of that you don't like, and then when you're educated about that art, you come to like it? Or developing a taste for beer when you don't have one? Or is more like like learning to love beets again if you once liked them and now they taste terrible to you?

    I'm only being partially facetious here. I can't imagine anything more difficult than getting someone to will themselves to respond erotically to someone who does not inspire an erotic response.

    Can you elucidate what you meant?

    Dr. Dombeck's Note: See if this helps. Attractiveness (or revulsion) is a perceptual thing in part. it implies a judgment or appraisal process has taken place with regard to one's attitude towards a partner. This appraisal process is in turn a sort of filter judgment is based on what you pay attention to. So what you pay attention to is vital to what your judgment of attractiveness will be. With many couples, an initial period of high mutual attractiveness gives way over time (and demands of work and family and sometimes other stressors like illness, or war, or whathaveyou) to co-habitation. You still like each other but the spark is gone it's no longer thrilling to be with the partner. No therapist can do magic, but what a skilled therapist can do - with the cooperation of both partners (and only with that cooperation) - is to help each partner in the relationship to *pay attention differently* so as to balance any injuries and grudges one partner may hold against the other with a focus on what is good and likable about the other partner. Often times, to do this couples must make it a mutual practice to spend time with one another, shielded from outside pressures (like children and work) as the good is often only visible when it has a little breathing room. As one's attention shifts to see the good in better balance with the bad, perception changes and what was once less attractive becomes more so. In different phases of a relationships's life what is seen as attractive and desirable may shift. As well, with increasing maturity, characteristics that may have been missed earlier in time (such as responsibility or honesty) can be attended to and seen as beautiful.

  • Anon

    Dr. Dombeck, I'm thrilled and honored that you responded so quickly to my post.

    My "comment title" above is only half-way facetious. What you set out is a fantastic techniquye for creating harmony between people. I am not belittling it at all when I say it is a variation on a theme that I use with my fifth-grader, when she comes home complaining about Girl #1 being a total blabbermouth, or Girl #2 being stuck-up, or Boy #1 being a jerk because he hits you to show you that he likes you.

    That is, I always tell my fifth grader that she should try to focus on the good qualities of the person and not focus so hard on the ones that annoy her to no end, because everybody has good qualities and she'll have happier relationships with those kids if she emphasizes those.

    In your terms, I'm telling her that "judgment is what you pay attention to."

    Now, this technique works fine on the interpersonal, in the real of emotional attraction. It can get estranged marital partners to find things that they once liked about each other, again. What it doesn't work so well with is in the real of the bodyl, the erotic, and the sexual, where the response that's in question is a physical, gut response. You can't will yourself to focus on your partner's beautiful eyes instead of his or her -- well, you fill in the blank! -- because will doesn't enter into it. I can think of so many women I know who would like to respond sexually to their husbands again, but who just don't find them sexually attractive anymore. And all the will in the world isn't getting the job done in terms of getting the physical response they want in themselves.

    Nor can I imagine telling my -- God forbid, but it's coming! -- sixteen-year-old-to-be to ignore her lack of attraction to Nice Homely Boy #2 who asked her out, and to focus on other things, because maybe then she'll find a way to find him, for lack of a better word, hot.

    If you had any other thoughts in this arena, I'd be honored. Again, thank you so much for your quick post.