Uncover more passionate, meaningful sex

Below is an excerpt of David Schnarch's book, "Passionate Marriage: Sex, Love, and Intimacy in Emotionally Committed Relationships."

Chapter One
We came here because we had a sexual problem, but you've helped us recognize it's something much larger. Karen and her husband are leaving my office after our final session. Her smile and gratitude make clear her intent. She speaks like a person who has stumbled upon new possibilities, not like someone who has learned she is more damaged than she thought.

Karen and her husband have flown in to see me for three-hour therapy sessions on three consecutive days. We've come a long way from where Ken, age fifty-seven, opened our initial meeting with his characteristic wit. "Our relationship is good and we want to make it better. Karen asked for time to work on our sexual difficulties, and I gave her twenty-four years! That's my contribution to our lack of sexual progress."

Karen, age fifty-three, showed the courage that would surface in our subsequent encounters. "Initiation became my responsibility. Five years into our relationship I was unhappy sexually so unhappy that I researched the leaders in sex therapy at the time, and Ken and I went to one of them. We did sensate focus exercises . . . and it totally glossed over my problem. My therapist thought we were a model couple in treatment we always look better than we feel." Ken nods from the sidelines, giving Karen center stage.

Sex is routine when we have it, Ken adds. "I know I should be more aggressive, but I'm not and for that I feel guilty towards Karen. My motivation for sex used to be more physiological. I've lost some of my sex drive in recent years."

My lack of sexual desire has always been a problem, too. Karen sounds like she wants everything out in the open once and for all. "I never want sex until we're actually doing it. I like the physical pleasure of touching and orgasm, but it's always a struggle for me. I went on estrogen last year, which helped my lubrication, but it did nothing for my desire. I even tried testosterone for six months but nothing happened so I stopped."

Karen is a tall, comfortable-looking woman who dresses well. Her easy laughter and eagerness to please are likely to put men at ease and signal other women that she'll be no threat. When she's nervous, she echoes the last words of your sentence to show she's following you. Her sincerity and caring, however, don't come from insecurity. Underneath there is a solidity about her.

Ken is taller and thinner, and his tousled white hair and graying beard make him look like the stereotype of an eccentric professor. His appearance is clean but his clothes are rumpled. Few people can match his intelligence, and his esoteric work in theoretical mathematics makes shop talk in social gatherings impossible. Although warm and friendly, he is awkward sharing his feelings with others. He's quiet, apparently used to keeping his thoughts to himself.

As if suddenly self-conscious about their disclosures, they lapse into silence. After several quiet moments, I ask, "What else should I know?"

Well, says Karen slowly, "I have another problem that's hard to talk about. I've always been upset by my sexual fantasies. Ken knows some of this because I get lost in my fantasies while we're having sex. He can tell sometimes I'm off somewhere. When we have sex and I'm not aroused, I turn myself on with these fantasies even though I feel bad about them."

How often are you off in your fantasies during sex with Ken?

I've been less fantasy-dependent since we attended your Couples Retreat. I still go in and out of fantasy to get fully aroused and reach orgasm. But now I want to be with Ken.

Yes, that's our big progress, Ken quips, "now I have her some of the time. She use to be gone about half the time. Now it's maybe 25 percent."

It's gone from 95 percent to about 50, Karen says gently. She monitors his response, trying to avoid hurting him. "I envy how easily Ken gets aroused. He's a great lover. He's patient and he stays with me. If I get more erotic, he gets more aroused. I want to be aroused sooner, even before Ken actually touches me."

I can see Karen is trying to share the spotlight with Ken, who prefers not to speak unless he thinks he's got something worthy to add. She's walking the marital tightrope of trying to reassure him everything is good while also pushing for change. As they sit near each other on the couch, neither pulls away when they touch by chance. She reaches for him often, reassuring both of them. "What else is happening?" I ask.

Two months ago I told Ken that I don't find the way he dresses to be very sexy he rarely buys clothes. I said, 'I get attracted to sexy men, and I want to have those feelings towards you.' Anxiety in the room shoots up a notch.

I don't feel like a sexy man, Ken says defensively when he thinks it's his turn. "And I don't like pretending to be one."

I'm on the other side pretending not to be sexy. I usually don't dare let on what's inside me, Karen adds emphatically.

Oh, this is great! Ken is doing his best to appreciate the irony. "You have no desire and you're hiding your sexiness. My desire is diminishing, and I wish I had something to hide." Karen reaches out to reassure him. She looks hurt and withdraws her hand when he continues to look dejected. I try to keep the session moving forward.

It sounds like you folks are playing hide-and-seek with your eroticism. How often do you actually have sex?

For the last five or ten years it's been once a week, Ken speaks with the assurance of someone comfortable collecting data, but his tone hints that he's feeling inadequate. "When I was hornier, I thought about initiating every night."

Karen senses that he is feeling inadequate and communicates on two levels simultaneously, partly stating her preference, partly reassuring Ken. "Frequency is less important to me than feeling freed up during sex. I want more quality to it. Now it mostly occurs on Saturday mornings."

Because that's a time you're both relaxed and refreshed, or because you're both already there and no one has to do much to initiate?

Karen's response is instantaneous. "Because it doesn't take much initiative or creativity." I notice Karen doesn't always have to support Ken or defend herself. She can say it straight. Ken nods wistfully in agreement. "When sex is good, we usually don't try again soon. I worry that it won't be as good the next time," he confesses.

For me it's just the opposite, Karen says. "When it's good I'm more hopeful, but then I don't act on it."

Why don't you? I ask, adding, "not that you're supposed to."

I don't know. Sometimes I think about it before Ken gets home, but I lose it when he's here .

Wait a minute, I cut in. "It's sounds like you have sexual imagery and get aroused at least sometimes before you have sex. That's different from what I thought you said before."

That's right. That's also changed since the Couples Retreat. Sometimes now I get aroused before we start, but it doesn't last.

Do you find it curious that someone who complains about not having sexual desire gets lost in richly detailed fantasies during sex? I do. If anything, it sounds to me like Karen has a robust sexual fantasy life. When people examine the apparent contradictions in their sexuality, it becomes their window into new ways of living. To Karen, her lack of sexual desire and uncomfortable intrusive fantasies are two separate problems. I begin to wonder how they might be connected.

Later in the session Karen tells me she reaches orgasm one way or another in almost all their sexual encounters. Ken's orgasm is never in question, although in the early years of their marriage she rarely touched his penis. He, on the other hand, usually fondled her breasts and genitals trying to arouse her. Ken always made sure Karen had her orgasm before he ejaculated. "He never has a problem getting an erection," she says, half envious and half complaining.

Karen also tells me she's been getting more active and experimenting sexually in recent years. She often strokes his penis and occasionally mounts him for intercourse. "I've experimented letting Ken come in my mouth twice this year something I'd never do before."

I don't feel adequate doing it yet, Karen says with a trace of defensiveness. "I'm particularly uncomfortable with it if he's been inside me."

Why is that?

I'm uncomfortable tasting my vagina. I've read all the women's lib books, but I guess I still think it's unclean.

Another emotional window suddenly appears. "Tasting your husband's penis doesn't bother you?"

Not anymore.

That's an interesting form of self-rejection. You think your partner's genitals are cleaner than yours.

Karen eyes widen in sudden recognition. Something she already knew about herself has surfaced where she never expected oral sex. "I've always rejected myself," she says unhappily, "I don't like that about myself."

Her quiet decisiveness suggests that Karen has reached a turning point. I decide not to push her to say more about it. If and when she's ready to do something about it, I want it clear that she's acting on her own.

I start to wind up the session, thinking we've already witnessed the main event. Almost as an afterthought, I ask, "You've told me a tremendous amount in a very short period of time. Anything else I should know now?"

Karen and Ken eye each other for a long moment. She finally turns towards me. "I'm troubled by the content of some of my fantasies."

Which fantasies? I have the sense we're about to enter a whole new level.

One or more men forcing me to have sex in painful or degrading ways S and M fantasies that embarrass me because they turn me on. They've gotten better, but they still bother me.

Karen obviously thinks what she's saying is embarrassing only she doesn't seem to be feeling embarrassed. She seems to be gaining strength as she talks. Ken is staring at her. He's gone from feeling protective, to being proud, to being in awe of her. He's heard some of this before, but he's never seen her so unashamed. I sense a demonstration of an important link between fantasy and actual sexual encounters is about to unfold.

In what way have the fantasies gotten better?

They changed after therapy. There's still an authoritarian man or men telling me what to do but it's things that arouse me. Sometimes I'm asking them to teach me about sex. The fantasies seem more consensual. I still feel guilty about them, especially when I'm having sex with Ken.

Did you know that your arousal pattern and imagery are common?

I'm not the only one?! What's causes them?

I'll gladly discuss that later, but I don't want to talk theory. For now, let's stick with your experience. If the theory is useful, we'll arrive at the same place by following what's true for you.

I don't have any more to say about it. Karen looks disappointed and waits a few moments to see if I'll tell her what she wants to hear. I don't, and she changes the topic.

What's true for me is I don't initiate now because I'm afraid of looking pathetic and fraudulent. Body-image being fat has always been a problem. Karen realizes I'm looking at her. "I'm not that heavy now, but it really was a problem when I was younger. Occasionally I fantasize taking off all my clothes and coming to bed wearing just a necklace, but I don't have the nerve."

I don't say anything for a few moments. "Nerve . . . or integrity?" I ask quietly.

Integrity?

Look at yourself through the lens of your sexuality. When you look at the issue of wearing only your necklace and a smile, what do you see?

Karen's insight from the oral sex discussion is still fresh. This time it only takes her a moment. "I'm putting myself down, telling myself I'm not attractive, that only beautiful women should do that." She's proud and upset in the same instant.

So the issue isn't just lacking the courage of your beliefs. It's not just that you feel bad and then don't follow through. When you back down, you denigrate yourself.

Karen is taking it all in. "But what does this have to do with integrity?"

Integrity and integration are one and the same. You're describing a lack of integration between who you think you are and who you aspire to be. In fact, if I've read you right, when you said 'I don't like that about myself' during our discussion of oral sex, you were coming upon it as an integrity issue not as a genital issue. Karen's eyes widen.

Absolutely! All my life I've never felt good enough.

Good enough for whom and what?

I used to think, good enough for Ken or anyone else! Good enough to act the way I think a real woman would!

Is that an integrity issue?

I guess it is.

Is the issue of tasting your own vagina the same thing?

What?

You act as if Ken's penis is clean enough to taste but your vagina is too dirty. Are you putting yourself down while you're making love? Does it ever bother you that Ken gets more pleasure from your body than you do?

You're not just talking about sexuality! This is the story of my life. Everyone gets more pleasure from me than I do. That's starting to piss me off. I belong more to everyone else than to myself! Karen pauses to glance at Ken. "It's staring me in the face! I'm amazed I could avoid this for so long."

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