The key is often to feel free to explore and pursue the big O without any feeling of pressure and to do this within the context of deep, genuine intimacy in marriage and loving, warm touch throughout.

One of the areas about sexuality that can be very confusing for Christians is where does God fit in the picture. I probably have about 50 books and 200 articles on sexuality on my bookshelves, some from a Christian perspective, some not. This is only a very small amount of the information out there on this incredibly important area of the marital relationship. As I have worked in the area of sexuality as a therapist and as a Christian, my journey has included a continual search, both personally and professionally, for grounding in the scriptures and for finding what really works in helping couples improve their sexual relationship.
Before I began specializing in sexuality, I took some extensive time to look up every scripture that referenced sex and marriage. If you are a therapist working from a Christian perspective, wanting to grow in your competence in working with sexuality, this is my first recommendation. If you are a married couple, and this is an area of difficulty, this is my first recommendation. There are many books out there in the Christian publishing industry that have many different perspectives and theological stances about the marital and sexual relationship. Although there is some very helpful stuff out there, it is important to take a very critical stance when reading them. Some books, even though the motivation of the author(s) may be to help, do contain some important biblical, psychological, and physiological errors. Others take stances that may be contrary to the heart of the scriptures and the heart God has about sexuality between men and women. I hope you take the same critical view of what will be shared here.
I will go into greater detail in future posts, but I strongly believe that God is very sex positive. In my work with couples and in doing workshops, both as a therapist and in the ministry, I have found there is usually a lot of learning and relearning that has to happen to get God's perspective on sex, to work through false beliefs about sex, and to work through the incredible pain that often surrounds this area of an individual's life. This ties in to the first recommendation I mentioned above. To get help in this area, pray, read, ask, pray some more. Get the help you need and get yourself grounded in the scriptures, not just in the area of sexuality, but period. One thing to watch, which I have seen many times: do not use the scriptures as a tool of coercion, ever. Jesus did not do it. We should not. Allow God to use His word to work on your heart and your convictions.
My prayer is that by doing this blog, I will grow in my own effectiveness and biblical convictions working in this area. I also pray you may benefit as well. May God's Spirit oversee this whole project.

When I work with individuals and couples in the area of sexuality, there is no question that the experiences they had as a child and as an adolescent (as well as experiences in their adult years) influence the way they feel about sex as an adult.
"Yeah, we had a sex talk. My dad basically said, 'so you know how it all works, right, the whole sex thing? Great.' And that was about it. Both my parents were too embarrassed to talk about sex."
"My mom used to say, 'where did you get those thighs?' and continually tell me not to eat this or that or I'd get fat."
"I could hear my parents arguing about sex. My dad would beg my mom, and my mom would just ignore him, and he'd get angry or she would hit his hand away if he touched her."
"My mom would tug my brother's hands out when they were down his pants and swat his hands, and say 'that's dirty down there; only bad boys do that.'"
"My dad had playboy and penthouse hidden in his closet. We went to church every week, and heard a lot about how Satan tempts us to have sex and we need to never think about it 'til we were married. So I got this double message."
"My mom used to say, 'All men are pigs,' and she married 4 different men, and had many boyfriends. In different ways, many of them violated me; they made comments or touched me in really inappropriate ways."
"My mom would tell me to stay away from boys, and that sex was nasty."
"I heard at church.....they taught at school.....my friends always said......I once saw....."
This is very like many of the stories I have heard in my office. This is not a parent bashing entry. The messages may have come from parents, or from society, or from peers, or from a religious upbringing. However, it is a reality that most of us have experiences, during childhood and adolescence, that gave us a skewed view of sexuality. There is a quite bit of research out there on the sexual self-schema, that internal map one has of oneself as a sexual person. This idea can include the way someone thinks about sex, how they view themselves when they have sex, how they feel and respond to their own sexual arousal or to their spouse's arousal and desire, what they think when they see their own body and their own genitals, and the internal dialogue they have about sex or while having sex (sexual scripts).
In my work with married couples, one of the things I have focused on is the development of that sexual self-schema (or sexual self-concept). I look at whether sexuality was a taboo subject in the family, or whether it was spoken about in ways that felt demeaning or crude. I ask if they may have experienced molestation or rape. I also look at comments or lack of comments someone received about their body, especially during puberty. I ask how families discussed puberty, if at all, and how family members responded when, as a child, the individual began to explore sexual sensations and feelings (i.e., genital touching of self or others).
Learning where our beliefs about sexuality come from is not the fix-all to problems in our marital sexual relationship, but it can definitely shed some light on patterns and responses. It can bring understanding and compassion into such a potentially explosive, sensitive area. Exploring like this also helps broaden the picture of what someone needs in order to experience sexuality as God intended.

I tell clients that, often, it is easier to have sex than it is to talk about sex. I don't know that there is anything more vulnerable than opening up about what we think about, feel about, believe about, and have experienced about sex. I once had a client ask me if it had always been easy for me to talk so specifically and openly about sexual topics. This came after a thorough explanation of the physiology of sexual arousal and orgasm, where I used lots of terms (clitoris, penis, orgasm, anus, lips, vagina, head, etc.), drew pictures, shared slides, and detailed the barriers and feelings that get in the way of experiencing fulfilling sexual intimacy. I laughed when my client asked this and I shared that it is way easier for me to explain this kind of stuff to clients or to get in front people and talk about the vivid details of sexuality than it is for me to talk openly with my husband about our sexual life. Mind you, I do that. My husband and I talk openly and specifically, but, truly, most of the time I want to just die when we have those conversations. It is like dragging and forcing the words out of my mouth, it is so deeply uncomfortable. Talking about our sexual relationship takes us to a very deep place of vulnerability

So, the focus of the research study I am doing is communication about sex, probing those vulnerable places within and sharing them with our spouse. The study uses the EIS model of sex therapy. EIS is a mnemonic for Empathy, Intimacy, and mutual sexual Satisfaction, and the Greek word eis means for, into, towards. One of the goals of this model of sex therapy is to guide couples toward greater relational, physical, emotional and sexual intimacy by focusing on three areas of a couples life, the individual, interpersonal, and sociocultural/spiritual aspects of their lives. As a sex therapist using the EIS model, I do this by promoting empathy, guiding genuine communication, and building intimacy skills verbally, physically, sensually, and sexually. I use Graduated Intimacy, a manualized 10 level intervention that incorporates in session tasks and homework exercises that gradually increases intimacy in the marital relationship. A primary focus of the intervention is learning how to take the risk to talk openly, honestly, specifically, and vulnerably about our sexual likes, dislikes, fears, hopes, turn-ons, turn-offs, feelings, needs, etc.

The goal of this work is to increase sexual pleasure, improve sexual functioning, and build relational intimacy. There is a reason that the greatest concentration of nerve endings are in the sensitive erogenous zones of the genitalia. God intends for us to enjoy our sexuality. My hope for each couple I see is to bring them to or return them to that enjoyment.

There is a considerable amount of research on touch. We need it. We are healthier and happier, and live longer, more satisfying lives when we receive it and give it. This is an incredibly important area that I work at with couples. And I am not just talking about sexual touch, the touching of the sensitive sexual parts of the body. I am talking right now about the importance of whole body touch.

As much as we need touch, it can be very difficult for couples to talk about their affection needs. For some women, they would like more touch, but they sometimes begin to feel that touch has become connected only to sexuality. "You only touch me when you want sex" is something I commonly hear. On the other hand, husbands whose wives have withdrawn touch because they do not want to have sex often share that they feel incredibly lonely and apart. Although I am expressing this in a stereotypical pattern, these things can be felt by either spouse.

Couples often dislike certain types of touch and often either tell their spouse in an irritated tone that shows distaste or do not tell their spouse at all. Many couples have been kissing and holding hands for years and one has never told the other "I really don't enjoy kissing like that" or "can we hold hands like this instead." Another important aspect of touch is that our needs change according to our emotional state and to the meanings that touch has for us. For some, touch may have been very connected to physical or sexual abuse, and relearning touch in a safe relationship may be very important. For others, when they are in emotional distress, they may prefer certain kinds of touch. Some want to be held when they are upset or sad. Others do not want to be touched at all in that vulnerable state, but may be open to a light hand on the shoulder or knee at the right time that says "I am here" and "I care." Also, when there have been violations in a relationship or when there have been a pattern of hurts, touch can become highly problematic.

When I work with couples, this is an area I focus on both in session and in homework exercises: from simply holding hands, to simple caresses, to relearning how to hug and hold, and learning to talk openly and vulnerably through that. We need touch. Sometimes we also need help in figuring why we feel like we do, what we need, how to ask for and communicate that to our spouse, and how to give them what they need. And the reality is, for many couples and individuals, in order to truly enjoy touch and be filled by it, we need to work through some difficult areas in our relationship.

There can be a lot of conflict in marriage. There is a lot of conflict in most relationships. But why focus on this in a blog on sex. One of the primary reasons is that the patterns of conflict in the relationship are often reflected in the patterns of conflict in the sexual relationship. Working on one effects the other in very important ways. Research has shown that conflict can either lead to greater connection and intimacy or it can lead to withdrawal, disconnection, and/or problems with sexual intimacy. Dealing with fear and anger and having good conflict resolution has been shown to improve sexual problems.

So what level of conflict is problematic? I do have couples who come to see me and say, "we really don't fight much. We don't have a lot of conflict." That can be quite true when comparing themselves to other couples. I have found, however, that even those who do not think they have a lot of conflict often feel some of the same feelings as those in high conflict. An assessment I use with couples has statements such as: "My partner is able to put him/herself into my shoes"; or "My partner has a hard time seeing things from my perspective." This piece of feeling like my partner understands is huge in dealing with conflict and disconnection vs. connection and intimacy in marriage.

In this entry, I am going to focus principally on a couple of the underlying factors for the listener that are crucial to healthy conflict resolution: Seeking Understanding and Getting rid of the Pointing Finger. Other entries will deal with other factors for the listener and factors that are important for the one initiating talking about the problem.

Seeking Understanding

Before discussing understanding, a caveat. Being understanding gets very confused with the idea of being a doormat, which is not what God has in mind at all in this scripture. Having clear boundaries is important in any relationship. It is healthy to know when to say yes and when to say no (Matt 5:37) and when and how to speak the truth (Eph 4:15) and how to deal with someone who is being hurtful with their words. Proverbs advises, "Do not answer a fool according to his folly, or you will like him yourself" (Prov 26:4). Paul also advised, "Those who oppose him (The Lord's servant) he must gently instruct, in the hope that God will grant them repentance leading them to a knowledge of the truth, and that they will come to their senses and escape from the trap of the devil, who has taken them captive to do his will." There are times in many relationships when someone says and does things that are not from God. They are in need of coming to their senses and we are called to deal with these kinds of opposition with the firmness and gentleness of Jesus. No doormats here.

So how about when someone comes to you with hurt or anger about something you have done. The bible does call us to be humble and take correction (Prov 12:1). God also calls us to seek understanding. Prov 4:7 says, "Though it cost all you have, get understanding." It is expensive, though, to understand someone; to truly grasp how they felt and what they experienced. To do that, you often have to truly set self aside and consider them better than yourself.

"In humility, consider others better than yourselves. Each of you should look not only to your own interests, but also to the interests of others." (Phil 2:3-4)

When you strive to understand someone else, to truly hear them when they come to you with something they feel about something you have done or not done, or something that has bothered them or hurt them, you truly do have to put yourself aside in order to hear them. Often, when someone speaks to us, so many things come into our head:

Wanting to Defend. "Excuse me!! You're the one who....." "Yeah, but you....."

Wanting to explain. "That's not what happened." "I didn't mean...."

Wanting to fix it. "O.K., So how do you want me to say it..." "Well, then, let's do this...."

Wanting to apologize. "I'm sorry. I didn't mean....."

These responses are normal but they get in the way of really being able to hear someone. So what do you do with all those words swirling through your head? Do not ignore them. Do not push them under the carpet. In fact, give them some room; honor them in a sense. Instead of blurting them out or shoving them down, I recommend putting them on a virtual shelf. A shelf you can see almost right in front of you. You put them there for safe keeping and after you get done focusing on your spouse, and truly trying to understand them (truly being the key word), and after you get to the point of feeling empathy for what they experienced, then and only then do you look back up on that shelf and see what is still there. I'll write about what to do with that shelf later. However, putting things up there and choosing to consider, thinking about, putting your focus on what your spouse has experienced, allows you to have room in your heart and brain for genuine understanding.

Dealing with Defensive Listening

Is 58:9-11 says:

"“If you   do away with   the yoke of oppression,
with the pointing finge r and malicious talk,
10
and if you   spend yourselves in behalf of the hungry
and satisfy the needs of the oppressed,
then your light will rise in the darkness,
and your night will become like the noonday.
11
The Lord will guide you always;
he will satisfy your needs in a sun-scorched land
and will strengthen your frame.
You will be like a well-watered garden, like a spring whose waters never fail."

This will be expanded further in a future post. At this time, it is important to understand that a huge barrier in resolving conflict is the use of the pointing finger. It is still amazing to me that there is actually a scripture that addresses this. The pointing finger is the "yeah but you...." in a conflict. God says, get rid of it. Why? Look what you get when you do get rid of it. Your light will shine, God will guide you. He'll satisfy your needs. It is one of those "give up everything for God and he will give you back a hundredfold". Deny yourself and he will lift you up. Get rid of the pointing finger, of defending yourself and blaming others, and God takes care of   you. He will satisfy you. And then, when you decide to stop finger pointing, look what happens. You will be able to spend yourself on behalf of the hungry. All that energy you put toward defending yourself, all that energy you put toward trying to make the other person see their fault and what they need to change; put that toward spending yourself on behalf of your hungry spouse. You are hungry for understanding. You want them to understand where you are coming from. They are also hungry for understanding. Focus on satisfying their need for understanding, fill that need, and God will fill you up. Once again, this does not mean that you never share your own view or perspective. In fact, the opposite is true. "Speak the truth in love." (Eph 4:15). "Rebuke your neighbor frankly." (Lev 19:17). However, it is vital that if we are to have the marriage God intends, we have to work really hard at putting ourselves in our spouses shoes. In order to even get close to that, we have to work really hard at getting rid of finger pointing.

And what is the outcome, when you get rid of the pointing finger? "You will be like a well-watered garden with a spring whose waters never fail." This is what God wants to create in our marriages. The lush, beautiful garden rather than the empty wasteland. This is what is possible when we get rid of blaming, accusing, assuming, and attacking in our relationships.

Having Empathy

Look at God. "In all their distress he too was distressed." (Is 63:9) And then look at His direction to us. "Mourn with those who mourn." God is a God of compassion (2 Cor 1:3-4). He calls us to have compassion and empathy for those he has put in our lives. It's really hard to do that, however, when the person who wants our empathy is complaining or mad at us! And yet, this is God's heart and this is God's call.

In the literature and research on empathy, one of the terms used for this ability to look at things through someone else's eyes is called perspective taking. This ability to genuinely see things from another perspective undergirds the ability to have empathy and resolve conflict. This will be the focus for the next couple of entries.

Susan shared about feeling burning, searing, ripping pain during sex for the last few decades. She was in a happy marriage with a caring husband. She had gone to her gynecologist many times over the years looking for answers. She had tried prescribed estrogen creams, kegel exercises, lubricants, and over-the-counter vaginal moisturizers. She and her husband had gone to a sex therapist who explored issues from her past and dynamics in her marriage that might be effecting the pain. Ultimately, nothing made a difference with the pain.

Like Susan, women may experience discomfort and pain during sex. Some I have worked with have described the same searing and ripping pain when the penis enters the vagina. Others talk about a dull or sharp pain during thrusting and others say they have stabbing pains during orgasm. Sometimes women describe their pain as minor and transitory.

The challenge is, when something is painful, you do not usually want to purposefully seek that out. If you know that placing your hand on that burner causes excruciating pain, you are not going to put your hand there. Our bodies and our brains work very hard to communicate with us about pain and work together to keep us away from it. It can then become very difficult for a woman who is experiencing pain during sex to feel much desire for sex. Many women who experience pain and discomfort during sex continue to engage in intercourse despite the warnings from their body for a variety of reasons. Sometimes they do not feel the pain, and so decide to keep trying. They love their husband and may not want to deprive them sexually. They are concerned about how their husband has reacted or may react to them not wanting to have sex due to the pain. They may feel that this is just what women have to endure. There can be so many different reasons.

However, continuing to engage sexually despite pain will send some very confusing messages to the brain. The pain is saying to the brain, "this is bad, this is bad," and the woman is trying to tell the brain, "this is good; really, this is good." But the brain will often win and for some women, the very idea of sex can become very negative or begin to have little positive value attached to it. Sex should not be painful.

The problem is, when women approach their health care providers about sexual pain, many of the health care providers genuinely do not find any reason for the pain or fail to find a treatment that relieves the sexual pain. A gynecologist may do an exam and not find any physical signs that support the woman's experience of pain. The gynecologist may then prescribe a cream containing estrogen or may recommend therapy for perceived stress that could be causing a tightening of the vaginal tissues leading to pain. There may be a recommendation to a sex therapist. The therapist may then assume that since the woman's gynecologist found no medical reason for the pain, the issue may be relational or may involve the woman's family background or past experiences.

The reality is that many of these issues may very well be involved or may have come to be involved in the sexual pain. However, it is also possible that the actual medical problem has not been identified or resolved. I have worked with numerous mentally and spiritually healthy women who are in healthy, happy marriages with thoughtful partners and they have experienced vaginal pain and not found answers in the medical community. For many of these women, seeing a sexual medicine specialist, who was able to do a much more extensive evaluation and gain a more definitive answer as to what is causing the pain, was of great benefit.

I have attended the same trainings that gynecologists and urologists take from sexual medicine specialists and have noticed that when they have been asked if they had received training on some of the techniques they are learning from these specialists, most of them have said no. It is often assumed that since someone is a medical doctor with a specialization in the gynecological or urological field, they are trained thoroughly in sexual medicine. However, that is not always the case. So, when a woman comes to me and describes her sexual pain, I have learned to ask a lot of questions about exactly how she experiences the pain, when, where, how, and to ascertain what kind of medical care she has sought. And then, if possible, I send her to a sexual medicine specialist or to a gynecologist who has sexual medicine training. This has made the world of difference for many of these women.

In my experience, good care for sexual pain may need to include sexual medicine care in collaboration with sex therapy for the couple. Medical care may include hormonal treatments such as testosterone, estrogen, or progesterone. Other medical treatments may include pelvic floor therapy or surgeries and treatments for issues involving endemetriosis, internal scarring, or nerve damage.

So what happened to Susan? She and her husband came to see me and I included a verbal medical evaluation in my assessment. As she described her pain, I suggested she see a sexual medicine specialist, as I was fairly sure she had what is called vestibulodynia (pain in the vestibule of the vulva, the tissues immediately surrounding the vaginal opening). While she and her husband sought medical care, they continued to work with me on the issues in their sexual relationship that had become problematic. She did receive the diagnoses I had suspected, as they found severe inflammation at the four glands surrounding the vestibule (Bartholin's and Skene's glands). Her process in medical care was then incorporated into the process of couples sex therapy. By the end of therapy, she was experiencing pain free sex, she and her husband had worked through conflicts in their sexual relationship, and they had achieved a renewed relational and sexual passion in their marriage.

Raoul and Rachel came to me for sex therapy. They engaged in sex rarely and Rachel had never experienced an orgasm with Raoul. They had various personal challenges that were also affecting their relational issues. Rachel struggled with obsessive compulsive behaviors and Raoul had a history of risky, relationship damaging sexual behaviors, including engaging in cybersexual relationships and massage parlors. Shortly before therapy began, Rachel had been involved in an extra-marital affair. During that sexual relationship, she experienced orgasm for the first time. Both of them felt betrayed and yet both expressed the genuine desire to repair their relationship.

Some couples, well, most couples, when they come to see me for sex therapy, have a few things to work through before we go straight to what's happening in their bedroom. I work first on verbal intimacy, then on relational intimacy, and then on the intimacy involved in simple affectionate touch. It's important to talk about how much affection you, as a couple, engaged in during dating and engagement and then during early marriage. Some couples talk about experiencing conflict around touch and affection during dating and engagement, either due to concerns with becoming sexual, or due to early awareness of their differing likes and dislikes around affection. Other couples say that they had free, exciting, fun, easy affection throughout dating and engagement, but found that simple, non-sexual touches had disappeared beginning early in their marriage. As mentioned in an earlier post, some individuals have a history of problematic reactions to touch for various reasons. These might include sexual abuse, demands for hugs and kisses from family members during childhood and adolescence, an overall physical dislike of touch from an early age, or experiences in the marital relationship where affection only occurred in connection with sex. As a couple, talk about these things and see if your spouse feels or has experienced any of this.

It's also important to talk about what kinds of intimate touches occur in your relationship currently. So I ask couples: Do you hold hands in public and/or private? Do you kiss when you greet each other or when you leave? Do you gently caress each other when you pass one another? Do you engage in hugs, cuddling, spooning?

One thing that is important to note is that for some, when we start working on touch, many of the underlying conflicts, hurts, and frustrations come to the surface. This isn't always negative or unexpected. That is why I always recommend working first on building quality verbal, emotional intimacy first alongside working on conflict resolution skills that lead to empathy, understanding, and connection. If you have already been working on these skills, and they are going well, you'll now have the opportunity to put them into practice when conflict arises around affectionate touch.

If you have been deeply disconnected before working on touch, this can be a very tricky stage. Beginning to touch again or return to touching again when there are still serious, unresolved conflicts may require additional healing. Otherwise, trying to improve in affection touch can be quite damaging and improvement in the relationship can stall. For some couples, if they are still not emotionally connected, doing touch exercises can become just a mechanical obedience that ends up either not helping them at all or actually doing harm. If you get stuck while trying to work through issues on touch, I recommend that you stop and get some help, either from a couple you are close to, or from a professional.

So what happened to Raoul and Rachel? Obviously, there were some serious relational injuries that needed to be repaired. This was the focus of early therapy as well as general conflict resolution and building a new friendship through growing in verbal, emotional, and relational intimacy. This was also a couple committed to their walks with God, so therapy included discussions about how they were involved with other Christian couples helping them and how they were repenting and being open with their personal struggles. As we approached working on touch, I checked to see if they were continuing to talk openly and often and if they were going on dates regularly. Touch was very awkward at first as Raoul had become very worried how Rachel would respond and Rachel did not know what to do with some of the negative feelings she had when they began to touch. It was very important for them to be genuine with each other about their feelings and their fears. When affectionate touch became genuinely enjoyable to both, we were then able to begin working on the enjoyment of sensual and sexual touch. However, through the process of therapy, I periodically came back to checking on the areas of verbal and relational intimacy and affectionate touch to see if any of those areas needed strengthening before we continued.

Roger and Marcia have been married 18 years and they have relatively low conflict. They make most decisions together and parent their three children effectively. They both feel, though, that they are two roommates who get along well but have little emotional connection. Eduardo and Rosalie both work full time and have 2 children who have very busy extra-curricular lives. Eduardo works long hours and Rosalie feels the challenge of working while trying to be a good, supportive mom. They spend time together as a family, but Eduardo and Rosalie have little to no time for just the two of them. They continually interact with irritation and frustration that simmers underneath their relationship. Chiyo and Kwan are recently married and have busy ministry lives. When they were dating, they engaged in many fun, adventuresome activities. Currently, they spend all their spare time meeting with individuals and couples that need their help. They connect on intellectual and spiritual levels but the rare times that they spend time together are full of talking about people they are helping. Their intimate physical relationship is minimal.

There may be parts of these stories that seem familiar to you. The reality is that sexual intimacy goes best when there is a foundation of strong friendship. For many couples, though, the friendship in their relationship is or has become weak. John Gottman, in 7 Principles for Making Marriage Work, talks about the importance of truly knowing your spouse, having a map of the territory of their lives. This might include things such as knowing what their day is like for them, what relationships are hard for them, what their hopes and dreams are, and why a particular time of day or particular holiday is important to them. Really knowing your spouse's world is integral to genuine intimacy. The truth is that many married couples, after dating, engagement, or early marriage are over, put little time or effort into nurturing their friendship. Harley, in His Needs Her Needs, explains how this impacts relationships using the idea of a love bank. When a literal financial bank account is full, car problems that cause a withdrawal from that account usually create minor anxiety. But if that bank account is low, a car breaking down and needing new, crucial parts can create havoc and stress. In a relationship, when the emotional love bank account is full, a disagreement or hurtful comment will cause a withdrawal from the relationship account, but since there is so much capital in the account, so much cushion, the pain of that withdrawal is usually not difficult to overcome. If you are regularly contributing to the bank account of your relationship by spending time together, talking through life and through conflicts in a way that builds closeness, doing small acts of kindness for each other, and engaging in affectionate and intimate touch, the relationship has a foundation, a cushion that provides a buffer from the pains and hurts that even close companions inflict on each other. If, however, you do not often talk openly, share your hopes, dreams, and fears, laugh and play together, prioritize time together, or work through conflict constructively, the emotional bank account in your relationship may be low and withdrawals, like hurtful words or disagreements, may be causing havoc in your relationship.

There is no question that a healthy, vibrant marriage takes work. It can be fun, rewarding work, but it is work. Mature love, in comparison to the infatuation early in a relationship, needs nurturing. There are several things I recommend evaluating in your emotional intimacy. Are you going on dates and how are you at getting time away? How much do you engage in casual talk and more vulnerable discussions? How is your balance of togetherness and separateness? This includes understanding how comfortable or uncomfortable each of you are with independent activities (the separateness) and how you negotiate individual interests, time alone, or time with friends. This also includes how you both feel about your amount of time together (the togetherness), if you get anxious when you are apart, if you ever feel smothered, or how you respond when you feel like you do not have enough time together. A simple way you can evaluate this is to read this paragraph and ask each other these questions.

There are some simple ways to improve your friendship, such as talking more, going out together, and doing small acts of kindness and intimacy. I regularly give couples homework to go on dates. I have them play communication games like the Ungame (which is not really a game). To promote genuine, vulnerable sharing, I have also given couples the monologue exercises from Dave Carders Torn Asunder workbook. Some couples need help in finding mutually enjoyable activities to do together. Harley has a section in His Needs Her Needs on recreational companionship that makes a great addition to my work with couples. His workbook 5 Steps to Romantic Love has a simple, detailed worksheet to help couples explore how they like to recreate and guides them in choosing new activities to engage in together. I also assign a Cup Exercise where both the husband and wife write requests and put them into a cup and do those things for their spouse that following week. These might be simple things like a 5 minute foot rub, sitting on the porch at night looking at the stars together, or making a special lunch for work. As you look at these different ways to strengthen your friendship in your marriage, you may want to choose one of them and put it consistently into practice. That small, consistent change can have a huge ripple effect.

So how did the couples mentioned above overcome their difficulties? Each of them came in for sex therapy. However, their overall relationship intimacy needed attention in order to improve their sexual relationship. Roger and Marcia learned how to work through the fears and risks that come with genuine vulnerability and began to be intentional about their time together both in and out of the home. This made a huge difference in their sexual enjoyment. Eduardo and Rosalie had to do some hard work on how they attacked or withdrew during conflict. Then they put regular, fun dates back into their schedule in order to intentionally prioritize time just for the two of them. When they began working on their sexual relationship, this foundation of vulnerable communication and playful fun made a significant difference to their enjoyment of each other sexually. Finally, Chiyo and Kwan got back to laughing and genuine sharing that went a long way toward working on the difficulties they had been having in their sexual relationship.