Ross Douthat wrote an essay in the NY Times yesterday that suggests that the reason people in high places step out on their marriages is that putting enormous focus on one’s career makes one into a sexless roommate.  He sites Sandra Tsing Loh’s recent divorce and her essay on how marriage obligations make one into a dull sex partner.

He then further suggests that it is the middle class that is out there having all the fun–ignoring career and other obligations and putting their energy into flings and divorces.

Is that so?  I can’t imagine where he got his data from.  If it’s from reading recent press, he should know better:  the media distorts everything and everyone.  If, as he says, the reason middle America enjoys reading about romps such as Gov. Sandford’s recent sizzler is because it reflects who they are, then who, exactly, populates the highly educated echelons?

His argument made little sense to me.  Living in Orange County, CA, I have seen my share of highly educated couples:  chemists, engineers, attorneys, doctors, and so forth.  But I have also seen other, less educated folks: college students on their way to something more, plumbers, waiters, janitors, and a stripper or two.  I also trained at the Marine base and saw couples of all kinds there.

No one has an exclusive on sexless marriage.  It affects all classes, all ages, all cultures, all religions.  It seems to be an epidemic:  estimates are that in 25% of marriages, couples have intercourse fewer than a dozen times in a year.

The reasons are as diverse as the couples themselves.  Here are some ideas:

1. It takes a lot of mental energy these days just to stay on top of everything.  My father was a civil engineer and his tools were a drafting table, a pencil, and a slide rule.  Now I have more computer power in one laptap than my father ever had at his disposal–but I also have a lot more people and things vying for my attention.  That’s exhausting.
2. Relationships are more complex.  We expect a lot more from our partners.  My parents only expected what was prescribed by society.  We are expected to be confidantes, room mates, friends, financial partners, co-parents, and lovers.  Making big demands of our partners can lead to disappointment that goes both ways.
3. We live in an age of narcissism.  Many people are very self-focused and want things to go their way.  That means that when we look at our partner and see him or her wanting, we think that is a reflection on ourselves.  We become disgusted and turn off to sex.  After all, if you’re perfect, why would you want to make love with someone who is less than?
4. We live by myth.  One myth is that marriages become sexless over time.  Another is that sex is always supposed to be red hot.  A third is that bodies need to be perfect–tan, muscled, and hairless–to be sexy.  These myths interfere with peoples’ enjoyment of sex.
5. We are overstimulated and oversexualized.  The fact that we can have porn in our living room with a click of a button takes away from its sacred meaning and at the same time makes sex seem overly important and larger than life.  When a partner becomes ensnared in the porn trap, it can be difficult to untangle ideas about sex and meaning.
6. We have become secular.  Ideas about marriage and fidelity are considered quaint and out of date.  Never mind that there is richness to be had in a monogamous relationship.  These days the grass looks so green on the other side it’s positively neon green, so green that even people in the very public eye are willing to risk their careers for clandestine sex.

Well, those are my ideas about why marriage becomes sexless.  There are more.  What are yours?  I’d love to read your comments and post them if you allow.

Another comment by TK suggesting that being married to someone with a chronic illness can be such a desperate situation that the well partner is tempted to flee.  TK has a point–that chronic illness, including cancer, can and often do put a tremendous strain on a relationship.  And yes, marriages do break up (though I think that 75% number is too high).

Making a choice about staying in such a relationship can challenge one’s moral center.  A few years ago, I was interviewed by a reporter for a newspaper of a very large retirement community in another state.  At the end of the interview (and, I suspect, the real reason for the interview) the reporter asked, “Do you think it’s okay to have an affair if one partner is ill?”

How could I possibly decide that for anyone? How can anyone possibly decide that for him- or herself?  I could no more answer the question for the reader Read the rest of this entry …

TK, I do so appreciate your comment about how chronic illness can wear down the intimate connection between partners, and that in your case, not even 2 trained sex therapists were able to help you.  I can’t say why that is, except that finding a sex therapist who is also a health psychologist, as I am, is a rarity.

We are sexual beings from the moment we are born until the moment we die.  When I worked with teens with cancer, I observed that the need for sex and intimate contact with another human being was sometimes even heightened.  The thought of leaving this life without ever having experienced the sweetness and mystery of sex was almost too much to bear.  And the teens did have sex, as I learned when I walked into one patient’s room to find a little boy walking in circles.  Surprised, I asked, “Who’s little boy is this?”  “Mine!” came the answer from the male teen in the hospital bed.

Although I don’t have the particulars of TK’s situation, I would wonder if intimacy was difficult to achieve because of fears of losing one’s partner.  I would guess that there would be on-going grief, watching one’s mate deteriorate over time.  I think, too, that seeing one’s once strong partner becoming more and more fragile would not be terribly sexy.

The most important thing to know, I believe, is that sex can be more broadly defined than intercourse and orgasm.  We are, as one linguistics professor said, “coitocentric,” overly focused on coitus being the pot of gold at the end of the foreplay rainbow.

Sexuality is more than that.  Sexuality can also be expressed sensually, through touch, sound, scent, sight, and taste.  For couples challenged by chronic illness, sex can be experienced by soaking together in a warm hot tub with jasmine nearby and music playing.  Intercourse may not be possible, due to pain or other factors, but you can probably figure out other ways to have an orgasm, through manual or oral play, or the use of sex toys.

Sometimes being sexual when a partner has a chronic illness or cancer takes a team:  a physician, a nurse, a physical therapist, and a sex therapist.  Each provider has a different role in helping a couple resume or keep their sex life.  However, it is important to realize that your sex life may be changed forever.  You may need to grieve that, too.

I remember reading an interview with Dana Reeves, in which she was asked flat out if she and Christopher had sex.  She said yes, they did.  She added that their sex life might not look like everyone else’s, but it was very satisfying for both of them.  But, you don’t have to be Superman to figure out how to have sex.  Human beings are very inventive when it comes to sex.  Keeping an attitude of playfulness and curiosity can help you have a sex life that may be unique just to the two of you as a couple.

If you are separated from your partner, divorced, or widowed, at some point your thoughts may naturally turn to sex.  In fact, it isn’t unusual for me to get a call from someone who is new on the dating scene after being in a long relationship.  My colleague Yvonne Fullbright has written a blog entry, “Navigating Newly Single Sex,” that gives great tips on how to be sexual, both with a new partner and with yourself.

One comment I have to add is that sometimes people are most worried about their sex life when, quite honestly, there are bigger issues to address.  For example, if a newly single person has children, their needs must come first, because they have developed fewer ways of coping with separation and loss.  Or, if a person is separating or divorcing, there may be legal and financial battles yet to be fought.  Conserve your energy for the business of separating; be patient, because a better time to entertain a relationship will come along soon enough

Kind regards,

Dr. Stephanie Buehler, Director

Late last month, I was invited to blog on the topic of menopause and sex by my fellow blogger and former editor Lynn Armitage on her new blog, Old, My Ass.  Do read my informative post as well as Lynn’s humorous and astute observations on being female and aging in America.

Kindly,

Dr. Stephanie Buehler

Just learned about a new online learning program from the National Vulvodynia Association about vulvodynia.

What is vulvodynia, anyway, you may be asking yourself.  Vulvodynia is chronic pain that occurs in the vulvar area of a woman’s genitals that doesn’t have an identifiable cause.  That is, when a woman complains about having pain, say, around the entrance of her vagina, and a doctor who examines her cannot see anything, she is diagnosed with vulvodynia.

Because the doctor and patient both see nothing, it is difficult to diagnose and treat.  The fact that it is pain in the genitals just makes things more complicated.  At one time, vulvodynia was thought to be mostly in a woman’s head.

Now it is understood as a chronic medical condition, but as with all chronic conditions and illnesses, there is a psychological component to it.  Why psychological?  Because women with vulvodynia experience anger, shame, and frustration.  Vulvodynia also affects a woman’s sexuality and her relationships.

A sex therapist can be a very helpful part of a woman’s treatment team.  A sex therapist can help a woman cope with the condition, talk about how to have satisfying sex, and improve communication and empathy between the woman and her partner.  Single women can also benefit from learning how to communicate about vulvodynia to a potential sexual  partner.

Dr. Stephanie Buehler

Director, The Buehler Institute

A NY Times article, “When Sex Leave the Marriage,” presents a pretty gloomy picture for partners who are in a marriage that has lost its sexual zip.  The way the researcher is quoted, you’d think the only thing left for couples in this type of situation is to throw in the towel.  He doesn’t mention the fact that there are marital therapists who do specialize in this (they are called sex therapists!) and that you can find one at www.aasect.org.

Three things a couple can do immediately:

1.  Call it.  One of you needs to break the ice and call a meeting to talk about the state of the (non) union.  Let your partner know that you have noticed that the two of you have not been having sex, and that you’d like to talk about changing that.  Do not threaten, pout, or point blame.
2. Assess.  One of the biggest obstacles to a good sex life is lifestyle.  Take a look at yours.  Are you overbooked?  Stressed?  Eating crummy food?  Forgoing exercise for vegetating on the sofa?  Do you smoke or drink too much?  Let interpersonal problems with family members wreak havoc in your life?
3. Brainstorm.  What can you do to overcome the obstacles?  Do you need to cut back on social activities so you have more time to relax at home?  Start exercising so that you feel better about your body and have more energy for sex?  Accept that your mother is never going to be happy with you and move on so that you can devote energy to your marriage?  Whatever you identify, create an action plan and start to make changes today.

Of course, there can be many other issues such as fears about sex, past sexual trauma, disliking a partner’s technique, chronic illness or cancer, or sexual or other types of pain.  All of these issues have a solution.  No, your sex life may not look like it did when you were 22, but you can still have a satisfying, intimate life together if you want one.

Over the past week, a number of articles on sexual abuse were drawn to my attention by various sexologists.  The first was about a TV special called “Hot for Teacher,” which features Mary Lou Letourneau, a married teacher who slept with her teenage student (whom she met when he was in second grade), for which she was imprisoned.  After she was released, and having been divorced by her first husband, she married the boy and had children with him.  The TV special suggests that since she married him, all must be fine, that there is nothing unique about her relationship with someone so young.

Next, my colleague and fellow sex therapist Stephen Braveman, MFT, was featured in an article in Rolling Stone on a teenage boy who was molested by his teacher.  Outwardly, the relationship may have appeared to be consensual and even condoned.  Deeper investigation, however, shows that the boy became extremely distressed over the relationship.  It affected his grades, his relationships with peers, and his mental health.

Finally, as I was casually researching topics today for both of my blogs, I happened across two more articles, one in the Star News and one on a NYC news website about female teachers molesting students.  Both the Rolling Stone article and this one have a similar theme, that there is a prevalent myth that boys are unaffected by sex with a woman in a position of authority.  In fact, it is because of this myth that many boys may not come forward if they have been bothered by a similar sexual experience.

Another myth is that boys cannot be coerced into sex.  But erection is an automatic response to stimulation; it doesn’t necessarily take consent Read the rest of this entry …

About one-third of the couples who come into our offices at The Buehler Institute have a complaint of low sex drive in the male partner, not the female.  Social myths make it hard to believe that there are so many men who have low libido.  Men are expected to “always think about sex,” ever ready to perform.

When men have a low sex drive, female partners often complain of being extremely confused and hurt.  They feel isolated and unloved.  They talk about a lack of intimacy in the relationship.  Sometimes they are even angry that the person with whom they most want to have sex is physically unavailable.

Why do some men lose their zest for sex?  One reason has to do with physical health, especially testosterone levels.  Most every man who has low drive should have their hormone levels tested, because one of the hallmarks of a low drive in men is low testosterone.

However, you can’t get too caught up on hormones.  There are men whose testosterone tests at low levels who still have a drive, and men with normal levels who don’t care to have sex.  So you need to look at other physical, psychological, and relationship issues as well.

For example, sometimes when a man is out of shape or overweight, he may not only feel more fatigued, but have poor body image.  It’s not just women who get hung up about lumps and bumps on their body.  Second, he may have a poor diet, leading to a lack of energy.  Or, he might not be getting adequate sleep.  Stress, too, can take its toll on a man’s physical and sexual well-being.

Another important physical aspect to be aware of is the effect of some medications on drive.  For example, antidepressants, while helpful, can cause sexual side effects.  This is another reason to check with one’s doctor when drive is low.

Psychologically, a man may have performance anxiety, pressuring himself to please his partner.  After awhile, sex becomes a drag to be avoided at all costs.  He may also have a mood disorder such as depression, which is causing him to shut down, isolate, or feel unable to enjoy things he once liked–including sex.

Relationally, a man may withhold sex when his feelings are hurt.  Men don’t much like to be criticized by day, then expected to perform sexually at night.  A man may also stop having sex when he is the one who is angry.

An additional reason in the “sad but true” department:  A man may stop having sex because he is gratifying himself with pornography, call girls, or having an affair.

Sometimes, there really is nothing wrong with a man’s drive.  The problem is just that the woman’s drive is naturally higher.  But again, because of the myths surrounding male sexuality, the woman with the higher drive may have difficulty believing that the cause of low drive is natural, not personal.

Have you ever thought about the connection between yoga and sex?  Yoga is an ideal complement to having a healthy sex life.  Learning breathwork can help you to stay relaxed during sex, and the postures help with flexibility.  Yoga can be especially helpful for women with pelvic floor issues; postures such as “happy baby” can strengthen the muscle and help relieve constipation.  Check out this blog post based on a new book called Sexy Yoga.

Dr. Stephanie Buehler

Director, The Buehler Institute