Understanding Sexual Problems in Marriage: Intro

O.K., now that we have talked about why it is important to have healthy conflict resolution in a marriage in order to have a mutually satisfying sexual relationship, we will address the sexual problems that occur in the marital relationship.

Sexual problems in marriage can have many different roots. It may be that there is conflict or unresolved issues in the marriage affecting the marriage bed. It may be that sexual sins, either from an individual's past or that are happening currently or recently in the relationship, have had a damaging effect. There may be challenges if someone has experienced any sexual abuse or molestation in their background. Also, other sin can affect the sexual relationship, including sexual sin, selfishness, or sexual demands.

One of the areas that often goes unexplored for Christian couples is the possibility of medical problems or physiological/biological issues that create sexual difficulties. Some of these will need a medical diagnosis. Others may need medical care. I always recommend that if someone is experiencing ejaculation, orgasm, or pain symptoms, they should seek out a sexual medicine specialist. I emphasize the importance of a sexual medicine specialist, as many in the medical field have limited knowledge, training, or experience specifically with sexual disorder diagnoses or treatment, even those in the fields of gynecology and urology. It can be quicker and easier to prescribe a pill or cream to a problem, but many times things are not so simple. So I recommend speaking with someone who has a greater understanding of the specific issues involved in sexual dysfunctions or going to see your primary and getting a recommendation to a specialist.

In this entry, I will introduce some things that affect healthy sexual functioning. In further entries, I will discuss problems specifically related to erection, premature or early ejaculation, vaginal pain and pain during penetration, low desire and arousal, and difficulties with or lack of orgasm.

Conflict in the Relationship

I have explored this in previous posts. Conflict can be a major factor in how things go in the sexual relationship. It can be hard and unappealing to be with someone intimately when you have just had an argument or you continually experience criticism and attack between you. Unresolved conflict is known to be an important factor in sexual dysfunction. It is associated with a lack of improvement of sexual functioning during sexual treatment. Other couples who have sought sexual treatment have improved in their biological sexual responses (better erections, less pain, etc.), but have not been satisfied with treatment when their relationship conflict still remained high.

I now routinely assess for the level and type of conflict in a couple's relationship in order to discern if this can be addressed either concurrently during sex therapy or whether the couple needs to receive marital therapy first before addressing sexual issues.

Sexual Abuse and Molestation

Individuals who have experienced these types of trauma (or other types of trauma as well) may need individual therapy first for these issues before being treated as a couple for sex therapy. Sexual trauma can come in many forms, including inappropriate touch (i.e., an older individual touching the buttocks of a younger child), exposure to sexually explicit materials or experiences (pornography, having watched individuals engage in sex or masturbation), exploitative sexual comments (sexual jokes, comments about the body, or harsh and negative responses to sexual exploration), or sexual molestation and rape.

When an individual has gained needed healing, it may then work to address how these issues have influenced the current marital sexual relationship. For some who have experienced sexual trauma, touch, even non-sexual touch, can be very difficult and sex therapy can include addressing a gradual approach to intimate touch that is safe, comforting, and eventually, sensually and sexually enjoyable. For others, they may need to both individually and as a couple assess and reevaluate their views of sexuality that may be tainted by the sexual exploitation. The process, timing, and length of therapy may need to be adjusted to include addressing these elements.

Finally, there may be times when what is happening in the marital relationship or in the sexual relationship is re-triggering the sexual trauma. Spouses may need help expressing how this is happening. Or they may need help hearing how they could be doing something that triggers certain painful feelings or negative responses. Bringing about a change in the dynamic of these interactions, learning to communicate about these things, and building a new safety in the sexual relationship, can be very healing for a couple.

Sexual Sin

Often couples become Christians, become disciples of Jesus, after they have experienced sex in ways God never intended. Some individuals carry a number of scars from previous sexual relationships, or have feelings of guilt about sexual choices. Some have engaged in patterns of sexual behaviors that were or later become problematic. God has a great plan for sex. He intends the sexual relationship to be mutually enjoyable and satisfying. We have the opportunity to have a deeper understanding of God’s loving heart through being deeply known and erotically bonded with our spouse. However, our past sexual choices and experiences can influence how that goes.

Other sexual sins that affect the marital sexual relationship are affairs (previous or just revealed) or pornography and cybersexual involvement. When I work with couples, I never assume, if there had been any unfaithfulness in their past, that it is completely resolved. At times, sexual sins get revealed when a couple studies the bible and becomes Christians. Or the affair may happen after they have become Christians and the couple decided to remain together and work through the damage caused by the unfaithfulness. They are commended for how they then forgive their spouse. What sometimes then occurs is a glossing over of the problems that are still there and the hurts that still remain. Often, before beginning sex therapy, I work with a couple resolving injuries to their relationship (both sexual and overall relationship injuries).

Many times, couples come to see me because the sexual sin is happening currently in their marriage. One or both of them have had or have just revealed that they have been in an extra-marital affair. Also, some couples come to me when there has been ongoing or a recent discovery of the use of pornography. I will specifically address pornography in another entry. However, sexual unfaithfulness and pornography have a significant influence on marital and sexual relationships. It is common for couples to share that they had considered seeking out a therapist for help with their sexual relationship in the past, but that they had not pursued it. They then specifically chose to come see me because something has happened, perhaps an affair or the discovery of the use of pornography, and this has now made it crucial for them to deal with what were preexisting sexual problems. Once again, dealing with the level of pain and devastation and the rebuilding of trust is essential before any kind of sexual treatment can begin.

Selfishness, Selfish Demands, and Humility

A book I use at times with clients is His Needs Her Needs by Harley. I also use Harley's Love Busters. One of the chapters in Love Busters is on Selfish Demands. The ability to recognize selfishness and then do something about it can go a long way toward change in the marital and sexual relationship. I have definitely worked with women who are selfish in their sexuality and men who are very demanding in their sexuality. I have seen it the opposite way as well.

However, as many therapists know, couple's improvement is strongly dependent on their willingness to take ownership of their own faults. It takes humility to recognize your faults and to take it when someone else points them out. Humility, or the lack of, has a strong influence on how much change happens for an individual and a couple. John Gottman calls this the ability to be influenced by your spouse. He found that divorce rates were higher for couples when the men did not allow themselves to be influenced by their wives. Les Greenberg has written about couples who have experienced infidelity, and he found that the ability to feel and express remorse had a very strong association with whether the couple reached a point of forgiveness. Humility and selfishness are concepts and words that are not often used in psychology, perhaps because of the religious overtones. However, genuine, lifelong change in a marriage happens when an individual truly understands the cross, and the incredible love and mercy God gives to those who let Him rescue them. As the apostle Paul wrote, truly understanding that love from God can then compel someone to no longer live for themselves.