Archive for Some Advice

Sex and the elephant in the room



I routinely ask my patients about sex. When I do, there is a huge sigh of relief or blushing embarrassment.

People seek therapy for lots of different reasons.  Often, the reason for the appointment is sex related, although that may not be initially revealed.

Consider a scenario in which a 30 something year old man reports a lack of interest in sexual interaction with his wife. He recognizes that there is no intimacy, romance,  or meaningful conversation about each others’ desires. Because he wants more depth in his relationship, he is seeking help. He does not know where or how to begin. He wonders if he is gay. He wonders if he has fallen out of love. He wonders if he fears that his wife wants a child before he is ready. He worries he will never be ready.

Another scenario is of a woman in her 40s who feels unattractive and fears rejection by her husband. As a result, she withholds from him.

She withholds sex. She withholds praise. She stays very busy so that she has no time for him.

There is a substantial emotional cost in both case scenarios.

How can a therapist  help?

(And just for clarification sake: A therapist’s role is to provide verbal and emotional intervention. There are strict legal and ethical standards regarding boundaries between therapist and patient. The therapist is not a masseuse or sex surrogate.)

The first step is to feel safe and comfortable in the therapy office.

Building rapport takes time. Developing skills to talk about sensitive feelings and difficult topics in the therapy office paves the way to similar discussions at home.

Learning how to have these conversations is essential.

Sex can be a powerful vehicle to personal growth and is an essential aspect of  a romantic relationship.

A recent “60 Minutes” interview of an unmarried couple in their 90s (who had been dating a few months) smiled when asked about their sex life.

Leslie Stahl asked, “Is sex still relevant at your age?”

The woman smiled, coyly. The man gave a huge grin and immediately and enthusiastically said, “YES!”

My husband and I decided an active sex life may one day be a prescription for a long life. Or at least one worth living!



Choose where mediocrity is ok, and where it isn’t ok

There is nothing inherently wrong or bad about mediocrity.

Consider, though, the fact that mediocrity is  associated with a tendency to settle for less than you deserve or desire.  Sometimes when we settle for less, we get even less than we settled for.

Is settling for less love and passion an area of your life where it is ok to have a low bar?

Stay connected to what you desire.