Resilient Sexual Desire in Heterosexual Couples

Abstract

Inhibited sexual desire (ISD), characterized by low sexual interest and sexual avoidance, is a common problem for heterosexual couples presenting to sex therapy. ISD is multicausal and multidimensional and manifests differently for males and females. Precipitating factors include traumatic sexual experiences, negative self-image, sexual guilt or shame, deviant or variant sexual behavior, relationship difficulties, and a chronic sexual dysfunction. Regardless of whether the male or female experiences ISD, the effect on the couple is that the cycle of positive anticipation, pleasure-oriented intercourse, and a regular rhythm of sexual contact is replaced by anticipatory anxiety, unsuccessful intercourse, self-consciousness, and avoidance. This article outlines a therapeutic plan for establishing resilient sexual desire by emphasizing intimacy, pleasure, satisfaction, and realistic sexual expectations.