Working with couples who have concerns about intimacy or sex in their relationship

This year marks 25 years that I have been in private practice. Part of what has maintained my passion and love for what I do is that I am never bored. Over the years, I have worked with children, teens, individual adults, couples and families and each client has contributed in some way to my parenting and relationship books. Of course, I don’t share specific details about any client (unless I get their permission) but the stories that I write to illustrate points are composites of all the clients I have met over the years. The same is true for my most recent book – “Why Married Couples Don’t Have sex….at Least not with each other!”

Colleagues have shared that they can relate when I say that of all the issues that couples present with in my office, problems in the bedroom ranks right up there as one the most common concerns. So, after years of listening to issues about intimacy and infidelity, I wrote two books about it. In 2012, I released “How Can I be your lover when I’m Too busy being your mother?” which hit a chord for women, in particular, who were feeling more like a mother than a lover, to their spouses. The book explores how to get beyond this syndrome so that couples can work towards being on an equal playing field. I co wrote the book with a man so that it presents both sides fairly – for example, women have a tendency to be gate keepers. That is, they want their spouses to be more involved with housekeeping or taking care of the kids, for example, but have a very specific way that these tasks be executed, which often leaves their spouses feeling not good enough.

My most recent book explores all the other reasons couples have lost desire or are not connecting on a physical level. Over the years I have attended workshops and read books to help me delve into this area of concern on a deeper level, but much of my expertise is as a result of experience gathered over the years. If your practice is anything like mine, you will have been asked questions such as “how much is a normal amount of sex to be having each week?”, “How come she’s changed so much over the years. When we were dating, she couldn’t keep her hands off me. Now she pushes me away,” and “Why doesn’t he understand that I’m just too tired at the end of the day?”

As I write in my book, I am often reluctant to answer the question as to what’s normal or not. Although there are stats that indicate ranges of normalcy – such as dating couples having sex almost every time they get together and the tendency for couples who are married for many years to be living in sexless marriages (having sex ten times a year or less) –I say that it’s less important to count the number of times they have sex but rather to make the number of times they have sex count.

Some couples are quite content to be intimate in other ways than having sex such as cuddling and kissing. Others enjoy such passion, pleasure and fun when they’re having sex that they don’t need to be having sex all the time in order to feel connected. These are typically not the couples I see in my practice.

My job, as a Psychologist and author, I believe, is to help people understand what’s gotten them to the place they’re unhappy in and what’s keeping them there. In helping couples get beyond the clichéd excuses and looking at the real reasons they’re not into one another, they can begin to explore how to change their current state of union. Some of the real reasons I help couples explore – in my office and in my most recent book – includes how changes to one’s body (especially for women) affects how comfortable she is about being naked with her partner. Also, if one or both partners are feeling angry, disappointed or hurt, then this too will drastically affect their desire to be intimate. Feeling bored of the same old, or of monogamy in general will have an effect too. Sometimes, couples continue trudging from one day into the next without exploring these real reasons (and others) and then find themselves in a terribly bad place.

The bottom line is that even women who pull back from having sex or being intimate with their partners are still desirous of sex or sexual pleasure, but just not with their partners. Most women say that they’d rather have no sex than bad sex. The trick is for couples to communicate their needs and feelings with one another. Often they need our help with this because they don’t know how or are afraid of winding up in a battle.

As we all know, infidelity is rampant., the world’s most controversial and well known internet dating site for married people, has 26 million members worldwide. For those of us working with couples, we’ve heard stories of everything from a married man or woman exploring a one night sexual encounter with someone outside of his or her marriage to affairs that have continued for years (sometimes with a best friend or neighbour) before being discovered.

I explore monogamy in my book and answer the question as to whether we are hard-wired for monogamy or not. Many well known researchers and anthropologists say not. And so, I explore how coupes can fight the tidal wave of infidelity. Even healthier marriages are not immune to infidelity and so couples who are at odds or unhappy with one another are even more vulnerable. So, in my book (and my office) I ask each partner to ask him and herself some very important questions before they risk losing their marriages by looking or going elsewhere.

Writing a book allows me to research and become more of an expert on any given topic. Not only has this helped me become more knowledgeable when working with couples, I am sure it will do the same for you. I look forward to hearing your comments once you’ve read the books and applied them in your practice. As you’re doing so, if you have any questions, feel free to contact me.


The views expressed in these blogs are the author’s own and not necessarily reflective of those of Psychotherapy Matters.  Copyright © 2015

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Sara Dimerman

Sara Dimerman is a Psychologist in private practice in Thornhill, Ontario and the author of four books (two parenting and two relationship).

One response to Working with couples who have concerns about intimacy or sex in their relationship

  1. Allan Steingart says:

    Thank you so much for the inaugural blog post!
    It’s really interesting how book writing has allowed you to become more expert in your practice. I hope that contributions to “Practice Matters” will inspire us all to grow in knowledge and expertise.

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