Can it ever be too late?  Unfortunately, yes.  Some couples wait so long that one partner is already about to walk out the door.  The other will say, wait, let’s go to counseling.  They enter my office, one motivated, one dejected.  If the dejected partner can’t be motivated, if they feel as if they’ve already tried everything imaginable, or if they are so angry and disgusted that they just don’t care any more, yes, it can be too late.  And I have to say, those are the saddest cases that I see in my office.

I can’t say that every marriage like this could have been saved if they had come in sooner; that would be unrealistic.  But what I can say is that the likelihood that the marriage might have endured is increased when there have been fewer years of damage to undo.

How do you know when it’s time to make a call to a sex or couples therapist?  Here are some reasons to call:

• You continually have the same fight about the same topic without any resolution.
• The problem is one that has long roots back into early adulthood or childhood, and you’ve never gotten help for it.
• You don’t talk about the problem, but there is a lot of tension in the relationship.
• You feel unhappy or dissatisfied with your relationship most days.
• You worry that your partner has a mental illness such as depression or bipolar disorder.
• You bicker constantly.
• You dread spending time alone with your partner.
• You fantasize about being single again.
• You’ve contemplated having an affair, or you’ve had or are involved in an affair.
• You have an unusual problem and don’t know where to turn.

There are times when taking a wait-and-see approach makes sense.  If you’ve had a major argument or your partner’s behavior has disappointed you, then time may heal the problem.  Or if you agree to make and implement a change, you may want to have a reasonable time line, such as 6 months, to see if you can remedy things on your own.

Seeing a therapist may be problematic, I know.  Admitting that you have a problem that you haven’t been able to solve, letting someone–a stranger–see you at your worst, and trusting someone is going to give you good value for your money all make going to therapy a tough call.

But consider the alternatives:  Years of arguing, emotional pain, and despair.  Separation or divorce.  The loss of dreams and potential as a couple.

Of course, there is no promise that even if you do contact a therapist sooner rather than later your marriage or relationship will endure.  Sometimes partners hide their motive for coming to therapy, such as making sure that there is someone (the therapist) to take care of their partner if they choose to leave.  Or, they come in so that they can say, “We tried therapy and it just didn’t work out.”  But for most couples, seeing a therapist is the key to staying together–especially if they call before it’s too late.

It is a myth that it is always the male partner that has higher sexual desire.  In my sex therapy practice, it is about 50/50 men to women that have higher desire than their partner.  Another myth is that most partners stop having sex once children have arrived.  If couples had a decent sex life before pregnancy, they will figure out a way to regain their sex life.

What causes differences of sexual desire?  The reasons are as varied as what causes differences in participating in different sports or liking different kinds of food.  Some people have a hormonal profile that makes them naturally more interest in sex.  Other people find that sex is a good way to relax, or feel connected, though their partner may not find sex as effective.  Some partners find that their desire to be with their partner never fades, while others discover that their desire diminishes over time.  People differ in how they were raised to view sex.  They also differ in how important it is to them personally.

Differences in sexual desire can cause a lot of friction in a relationship.  What never works is to nag, harass, beg, argue, or avoid the issue.  If you accept that it is okay, even normal, to have those differences and not read too much into them, then you can calmly and kindly discuss how you can both be happy.  Most couples find that simply compromising on how often they will have sex works well enough, while others prefer scheduling so that both know what to expect.  Some couples find that if the high desire partner has his or her needs met regularly, they are happy, whether or not the encounter is romantic or matter-of-fact.

If you can’t seem to resolve your differences, then you might benefit from the services of a sex therapist.  A sex therapist is a psychotherapist with specialized training in sexuality and human relationships.  The sex therapist can help you understand why you are stuck, give you each an opportunity to voice your concerns, and help you work toward a satisfactory solution.  This involves good communication, compassion for your partner, and a willingness to accept differences.

Asperger’s seems to be current vogue disorder.  HBO recently had a documentary on Temple Grandin, the fascinating woman agriculturalist who has written books about her own experience of Asperger’s.  Last year, three movies were released that featured characters with Asperger’s.  Asperger’s, it seems, is everywhere.

But is it? Asperger’s has a short history, because it was only first diagnosed in 1994 by Viennese pediatrician Hans Asperger, the number of people in the U.S. who have Asperger’s is actually unknown.  Many adults may have Asperger’s without knowledge of the disorder.   Today, however, many children are diagnosed sometime in their early childhood.  In any case, Asperger’s is

How does someone know that they or someone they know has Asperger’s, anyway?  People with Asperger’s usually have poor social skills, obsessions, odd speech patterns, unusual posture, and other peculiar mannerisms.  In an adult, the person may have difficulty understanding social behavior that others take for granted, for example, laughing loudly or at inappropriate times.  (One male client with Asperger’s, horribly embarrassed when he told me about his Peyronie’s disease, then went out to the reception area after his appointment and confided so loudly to the receptionist that the entire clinic heard him.)  They may have strange collections, such as one physician with whom I’m familiar who collected all things having to do with bees; even his office was decorated in black and yellow.

When people with Asperger’s speak, they may not make sense, not because they speak gibberish but because they don’t know how to segue into normal conversation.  Generally, they learn how to get along socially by observing and copying others.  Since they don’t do well with change in any case, this only contributes to behavior that may appear strange or robotic.  A common myth about Asperger’s is that everyone who has it is a “genius.”  Not true.  There are people with average intelligence that also have Asperger’s.

Because people with Asperger’s don’t fit in socially, they often apply themselves in school or in their careers.  This makes them stable and dependable, which can be attractive to a partner that is looking to settle down.  Many people who partner with someone with Asperger’s will marry in the belief that feelings and intimacy will grow over time.  While this can happen, more often than not the non-Asperger’s partner becomes disappointed and frustrated.

Sometimes this disappointment and frustration becomes focused in the couple’s bedroom.  While adults with Asperger’s vary, many non-Asperger’s partners find the lover with Asperger’s mechanical and emotionally disconnected during sex.  Even if they have sexual experience, they may not understand what is expected of them, e.g., mutual pleasuring, vocalization, or emotional expression.

Besides misunderstanding social cues and lacking in empathy, the partner with Asperger’s may also be overwhelmed by the sensory experiences of sex.  One man, for example, disliked the smell and feel of his partner’s hair.  Another couldn’t stand the little bumps and irregularities of his partner’s skin and asked her to wear a body stocking when they had sex.  A woman with Asperger’s complained that she felt “completely smothered” by her husband during lovemaking and decided it was better to divorce than to put up with having to have sex.

Is there any hope for couples in which one partner has Asperger’s?  Yes, of course.  If both partners are motivated to change, then they can have a more satisfying sex life, one that makes each partner feel wanted and accepted.  But a satisfying sex life generally starts outside the bedroom.  Partners first need to educate themselves about Asperger’s so that they can understand how it is affecting their intimate relationship.  They need to be able to communicate to each other; both need to develop some empathy for the other’s position.

Sensate focus activities may also be helpful in slowing down both partners so that they can concentrate on what feels good, instead of on performance.  Learning to give verbal feedback about sex without creating defensiveness is another valuable skill.  Being realistic about what may or may not change in the bedroom is another facet of acceptance of the diagnosis of Asperger’s.

You’ll have to wait until January 2011 to read a copy of my book, which discusses how various psychological problems, from addiction to learning disabilities, affect a couple’s sex life, but until then here are some links to resources about Asperger’s that may be helpful to you:

Asperger Adults

WEGO Health on Asperger’s

The National Autistic Society

A word about diagnosis and treatment:  Different people react to a diagnosis of Asperger’s in different ways.  Some people are relieved to discover an identity that answers questions for them.  Others are curious.  Still others are upset or go into denial.  No individual should ever be forced into being diagnosed or treated.  However, therapy can be helpful for people with Asperger’s and spouses or other family members who are trying to understand and give them support.

Except we aren’t cave people.  Tch.  I’ve written about this before.  If we were to imitate our cave ancestors, we’d all smell bad, have no teeth, and have hair in all kinds of places we really don’t find attractive any more.  (I’d also not exist, as I am completely blind without contacts and would surely be eaten.)  We’d have sex like this:  Man clubs woman, drags her into the tall grass, has rear entry sex as quickly as possible to avoid being dragged off by a saber tooth tiger, then they both go back to doing what they needed to do to survive (and it isn’t making microwave kettle corn).

Look, if a couple has an agreement to be polyamorous, or have multiple partners, I’m not interested in judging their behavior.  But when a couple agrees to be monogamous, then each partner should have an expectation of honesty.  Better to have open discussions about the challenges of monogamy than to pretend and lie.

I enjoy monogamy.  I’ve been married to my husband for 24 years and have been monogamous for nearly 30.  Being monogamous gave me much needed stability after growing up in an unhappy home.  It helped me learn how to make a healthy, loving attachment to another human being, which in turn allowed me to give that to our child.  Monogamy lets me explore my sexuality fully because I am always with a safe partner that I trust.  Monogamy pushes me to keep growing and developing into a better person for my partner.

Maybe monogamy isn’t for anyone, but the idea that we should dump monogamy because our ancestors didn’t practice it doesn’t seem like much of a reason to screw around.

There are so many stereotypes when it comes to sex and the mature adult.  I always remember a man in his 30s telling me, “My wife and I need to hurry up and start having a lot of sex, because we’ll be done by the time we’re in our forties!”

You’ve gotta be kidding.

Just because you don’t move as quickly or forget your glasses are on top of your head occasionally doesn’t mean that you aren’t spry enough to have sex.  The body may not be as beautiful, but feelings of love and desire may grow even stronger with a couple that has been bonded for years.  And for couples experiencing romance in their later years, the sparks can still fly pretty high.

Enjoy the article, and let me know what you think!

In my newsletter this month (you are signed up, aren’t you?) I included a Valentine’s Day sex life check-up that included items like the following that you can discuss together:

1. What was the best part of our relationship last year?
2. How did you feel supported by me?
3. Did I do anything particularly loving over the past year that you’d like me to repeat this year?
4. What was the least helpful thing that I did?  What would you like me to do instead?
5. What does our relationship mean to you at this point in time?  (Companionship, co-parenting, a sexual partner, a major support in times of stress, etc.)
6. What are your thoughts about our sex life?  Is it fine as is, or could it be improved?
7. What do you see as challenges for our relationship over the coming year?
8. What would you like us to do differently this year?
9. What would you like to keep the same?
10. What can I do to make you feel loved and cherished?

After all, people check-up on their physical health, their financial health, even the health of their garden.  Why not do a check-up on your sex life?  Part of the joy of being in a long-term relationship or marriage is that you have a safe place and a safe partner with whom to explore your sexuality.  You change, your partner changes; why not take a moment to learn a bit more about yourself and each other?

May you have a sweet Valentine’s Day celebration!

Sometimes marriages naturally go through dry spells.  A partner might be sick, be pulled by care-giving demands, or absent due to military or other job obligations.   But when couples go for a year or longer without connecting in the bedroom, there’s a problem.

What causes a sexless marriage?  Many couples stop having sex during the last part of pregnancy and during the first months they have a newborn.  They struggle with finding time, but also with feeling sexy when there’s an infant in the house with all the demands of parenting.  Other couples struggle with sex from the beginning.  One partner may have been raised in a very strict religious home and can’t let enjoy sex, even though they’re married.

There can be serious issues that get in the way of a couple having regular sex.  If one member of the couple has been sexually abused or assaulted, then they may avoid sex because it triggers bad memories.  Other problems, like depression or substance abuse, can get in the way of sexual pleasure.

What can you do about a sexless marriage?  First, it’s important that you and your partner acknowledge there is a problem.  Try to talk it out together to figure out what the root cause is.  When you do try to restart your sex life, be realistic.  Though it may not seem romantic, you may need to schedule times for making love.

Many people are unaware that there is a type of professional called a sex therapist that is available to help couples that have a sexless marriage.  A sex therapist is a psychotherapist that specializes in sexual problems.  It is talk therapy.  If you do decide to see a sex therapist, check with your state’s licensing board online to ensure that they are licensed to help you.

Sometimes couples disappoint each other in the bedroom and have trouble with forgiveness.  A man’s female partner can’t have an orgasm and he berates her for being unresponsive.  A woman’s male partner ejaculates too quickly and she becomes caustic and critical.  The couple may just have different expectations about their sex life, but be unable to discuss it; they may quietly suffer for years.  The angry partner may also become critical, sometimes, in other parts of the couple’s relationship; at other times, the couple may put a lot of energy into putting up a front to the world that their relationship is really much better than it is.

Can you forgive your partner for their sexual shortcomings, be a good friend, and support them toward change?  Can you let go of your resentment and become compassionate, realize that your partner may be hurting, too?  Sexual forgiveness takes maturity, too.  Your partner perhaps didn’t learn how to be a long-term sexual mate.  You can learn together.  If mistakes or missteps have been made, be patient and above all be forgiving.

But foreplay isn’t just about orgasms.  It is also a way to connect with your partner.  You can take turns giving one another pleasure.  You can choose to be passive and let your partner give to you, or to be active and please your partner.  Or, you can have mutual foreplay, both giving and receiving pleasure at the same time.  It’s more about sharing an intimate, fun experience than about preparation for intercourse.

If foreplay is imaginative, there may be no need for intercourse; orgasms may be experienced in other ways.  Foreplay can also allow you to explore one another’s bodies, to understand what is erotic for each of you.  It is a time to free yourself and be creative, to try out scenarios that turn you on.  You may find out that you enjoy some of the same things, or that you need to make adjustments so that your fantasy is fun for both of you.

Foreplay builds a sense of connection and intimacy.  When someone doesn’t want foreplay, for me as a therapist, I am always curious about whether they are able to be truly intimate with a partner, to let a partner get into what they are really about in the bedroom and to get into their partner’s thoughts and feelings.  Foreplay is one of life’s great free experiences, right there in the privacy of your own home.

Women’s sexual desire is more complex than a man’s.  Especially for women in long term relationships, sexual desire is less driven by hormones, though they do play a role.  What seems to be more important is the quality of the relationship between a woman and her partner; her mood, energy, and stress level; her feelings about herself and her body; and her overall enjoyment of sexual activity.

Also, while men feel horny and then want sex, women in long terms relationships often need some loving before they feel horny.  If a man approaches his wife or partner with his motor on “idle” and gives her some time to warm up without pressure, letting her tune in to her own needs to see if a “no” might become a “yes.”

Another way to help a woman enjoy sex more is to take the time to find out what she enjoys.  If she can’t communicate it verbally, ask if she can show you by guiding your hand with her own.  Encourage her to explore her own body so that she can share what she has discovered with you.

If your wife complains that she doesn’t have any energy, help her out.  If you are feeling amorous, take over a few chores so that she can put her feet up or take a warm bath.  Try doing this regularly, whether or not you are looking for an opportunity for sex.  It’s a fact:  Men that help out have sex more frequently.

There are some rather serious reasons that women may lack desire.  One is that they experience sexual trauma.  Another is that intercourse is painful.  A third would be medical problems, both gynecological and non-gynecological; a woman that has no drive should definitely seek a medical examination.  Problems with depression and anxiety can also interfere with drive.  Finally, changes such as the birth of a child or menopause can have an effect on libido.  These experiences are real and need to be addressed; they just don’t go away on their own.

There is nearly always a reason a woman’s drive goes missing.  Invite your wife to do some detective work with you and then work on the problem together.  If you solve it, great.  If not, perhaps you are both too close to the problem or haven’t considered some of the other many reasons this happens; try using the services of a AASECT certified sex therapist to help you.