Is There Sex After Marriage?: Professional Advice on How to Bring Desire Back and Make Sex Better

Introduction

CHAPTER 1

The Problem So Many Couples Face

ALLAN and his wife Francine, both in their twenties, were sexually active until the birth of their first child, Laurel. Then Allan stopped wanting to make love with Francine. He now forces himself to every three weeks or so, but even though he reaches a climax, he finds the pleasure minimal and the act more mechanical than anything else. Francine complains that they don’t have sex often enough. Allan blames it on his being tired because of his career efforts, but the truth is — although he doesn’t know why — he no longer finds sex with his wife appealing.

Debbie and John have been married fifteen years. They have three children — two boys and a girl, whose ages range from seven to twelve. Although Debbie and John enjoyed sex together at the beginning of their relationship, their desire has gradually withered until now they have intercourse maybe once a month at most.

Larry and Tina have been living together for a year. Although they are happy and compatible in every other way, their sex life is driving Tina crazy. Everything was fine until Larry gave up his apartment and moved in with her. Then all of a sudden he lost interest in sex.

Ginny and Peter married three years ago. Sexual interest between them has gradually dribbled away since then. Though happy with one another in every other respect, they are living together asexually — like a brother and sister who get along very well, as they describe it.

Charlotte doesn’t understand why there’s so much fuss about sex. She never enjoys it, and because of this, she avoids intercourse with Ron, her husband of sixteen years, whenever she can. He feels frustrated and angry, and for years has buried his sexual desires under a pile of work. Today, however, as he approaches his forty-first birthday, Ron is beginning to insist that Charlotte do something about their situation: he wants to lead a normal sex life — before, in his words, it’s too late.

These couples are suffering from the number-one sex problem in marriage today: lack of interest in making love by one or both partners. Leading sex clinics around the country have reported an upsurge in recent years of husbands and wives who, in one stage of their marriage or another, have confronted the fact that the sexual charge is going, has gone, or, in some cases, has never quite been there — and who want to know why.

In Manhattan, for example, at New York Hospital-Cornell Medical Center, Dr. Helen Singer Kaplan, who heads the sex therapy clinic, says that waning desire is the leading complaint of couples she sees. Dr. Raul Schiavi, director of the Human Sexuality Program at Mount Sinai Medical Center in New York, reports that both single and married people complain of other sexual dysfunctions, such as impotence, premature ejaculation, and inability to achieve orgasm, but every male patient in his program suffering from lack of desire has been married. At the Marriage Council of Philadelphia, a survey of patients with sexual problems revealed lack of sexual desire to be the leading complaint. Some therapists estimate that 50 percent of their patients are turned off to sex.

Dearth of desire as a problem in committed, established, long-term relationships has become so noticeable that loss of libido has recently been given an official name — inhibited sexual desire — and classified, for the first time, as a sexual dysfunction in the Diagnostic and Statistical Manual issued by the American Psychiatric Association.

Recent studies back up the fact that infrequent sex is a relatively common phenomenon in marriage. One survey of 100 couples, published in the New England Journal of Medicine, discovered that 33 percent of the husbands and wives were having intercourse with their spouse two or three times a month or less. Another study, published in the American Journal of Psychiatry, revealed that among 365 husbands and wives, one-third had ceased having sexual relations altogether for long periods of time. Although the median period of abstinence was eight weeks, some of the husbands and wives had gone without intercourse for three months or longer.

Until recently, it was widely assumed that sparse sex and lack of desire would most likely be encountered in the marriages of older couples, but the surprising news is that libido can be lost in marriage at any time. Case histories from leading sex clinics confirm this and the American Journal of Psychiatry study makes the fact strikingly clear: more than three-quarters of the husbands and wives making do with little or no sex were under the age of thirty-eight — a prime time in life, when intercourse between spouses, on an average, takes place two or three times a week.

Most people being treated to restore a lagging or defunct sex drive are in their thirties and forties, but men and women arrive at sex clinics at all ages, these days, wanting to revitalize a dying sex life. Dr. Joshua Golden, director of the Human Sexuality Program at the University of California, Los Angeles, has successfully treated couples in their seventies. Dr. Helen Singer Kaplan and Dr. Harold Lief, the well-known psychiatrist and sex therapist who is now in private practice and who headed the Marriage Council of Philadelphia for many years, have seen an increase in the number of husbands and wives under thirty who are concerned about their loss of interest in sex. Dr. Kaplan thinks that younger people, because they are more open about sex in general, often don’t let lack of desire linger as a problem in their relationships the way older people do — which is fortunate, because the sooner you catch the problem, the better the chance to overcome it.

Dr. Lief and Dr. Kaplan, working independently, first defined interest in having sex as a separate, initial stage of the sex act. Desire has to be present before you can go on to intercourse itself. Dr. Lief and Dr. Kaplan were also instrumental in pinning down the fact that impairment of the sex drive is a sexual dysfunction in its own right; often, patients who couldn’t reach orgasm or were impotent were found to be suffering primarily from lack of desire, which caused other sexual difficulties when they forced themselves to have sex anyway.

Although the problem of impaired sexual desire in marriage has gone public through reports of work being done at sex clinics, the population of patients seeking treatment probably represents only a fraction of a much larger group of married couples who lead lives of sexual estrangement to varying degrees. Journals, books, and papers by marriage therapists, psychiatrists, psychologists, and social workers have reported, from the time of Freud on, a wealth of case histories based on patients who for one reason or another have had trouble feeling sexual passion for their marriage partners. Dr. Edmund Bergler, the late, eminent psychoanalyst, once wrote that the history of sex in modern marriage is, in general, the history of sex sparingly used.

Works of fiction, such as Cat on a Hot Tin Roof, deal with the problem. Broadway musicals have alluded to it; Stephen Sond-heim, in a song from Follies, wrote revealing lyrics about passionless lovemaking once a year. The biographies of public figures contain telling references to it. Freud himself stopped having intercourse with his wife at about the age of forty. Tolstoy hated sex so much that he was moved to remark, Man can endure earthquake, epidemic, dreadful diseases, every form of spiritual torment, but the most dreadful tragedy that can befall him is and will remain the tragedy of the bedroom. He believed in celibacy in his own marriage.

There is no doubt, though, that the largest number of people suffering from loss of libido are those countless ordinary husbands and wives who continue to live together in marriages in which sex is infrequent or absent altogether, and who do so without ever seeking professional help or, sometimes, without even discussing the situation with each other. The aforementioned Dr. Lief, professor of psychiatry at the University of Pennsylvania School of Medicine and chief investigator of sexual-desire disorders for the American Psychiatric Association, estimates that about 20 percent of the general population suffers from inhibited sexual desire. Some of these people consider themselves to be happy anyhow; others feel varying degrees of distress about their sex lives but don’t know what to do about it.

There is some debate among experts about the true state of life in sexless or sexually sparse marriages. Certain authorities believe that when sex is unimportant to both partners but they remain close and affectionate in other ways, they can continue to be reasonably happy. It is, they maintain, when husband and wife are on different wavelengths — with one still interested in sex, while the other is not — that a real problem exists in the marriage.

No one can deny the potentially devastating effect rejection can have upon a partner who is continually refused or ignored sexually. Some slighted spouses seem to take no notice, however. Indeed, if they have a sexual problem of their own, they may welcome the mate’s lack of interest. They are happy they no longer have to be bothered for sex. It is far more common, though, for sexually ignored wives and husbands to feel rejected, inadequate, or unattractive as a result — as if, somehow, it is their fault that the partner has turned off. Many spouses feel very threatened. They worry that the uninterested partner may abandon them. There is often a sense of deprivation or anger. Frustration, bitterness, and resentment may grow over time. In addition, although such fears prove groundless in most cases, spouses these days may secretly wonder if a mate is ignoring them because he or she is a closet homosexual. It is very common for the rejected partner to become depressed, preoccupied, or obsessed about the mate’s sexual rejection.

A forty-year-old woman in a large New England city recently described her reactions in such a situation. She has been married for ten years. Her husband is a lawyer with a very busy practice. Sex with him is great, she says — when they have it. At the beginning of their marriage, they used to have sex two or three times a week. The rate gradually fell off during the year after their wedding until it reached the point it is at now: they have sex once every three weeks or so. She is a woman with a strong sex drive and feels the lack of physical contact intensely. She has confronted her husband in the past about the infrequency of sex, but most of the time he claims he is too tired for lovemaking. He works hard, puts in long hours, and he feels that the way not to relax is to have sex. He regards sex as a chore.

This woman blames herself more than she blames her husband for their predicament. His lack of interest makes her feel humiliated and unattractive. As a result, as soon as the frequency of sex fell off in the relationship, she tried to improve her appearance, thinking that a new look might help to restore her husband’s interest. Although she was not really overweight, she went on a diet. She watches her weight compulsively now. She also started to put on cosmetics the minute she woke up each morning. Her efforts produced no results, however: her husband remains unaroused. Sometimes she feels attracted to other men, but this makes her feel guilty and ashamed, so she fights her sexual impulses. Since she feels so unattractive, she hates to go to parties. She goes with her husband when she can’t avoid it, but she suffers from a sense of inferiority the whole time. The sexual situation in her marriage is never far from her thoughts. She stays married to her husband because he is a kind, protective man who is considerate of her in every other way.

Of course, this woman was insecure to begin with — but most of us are to some degree. Perceived sexual rejections generally feed into whatever insecurities exist or activate dormant feelings of inferiority. Consequently, neglected sexual partners tend to feel worse about themselves than they would otherwise.

Some spouses react to their partner’s sexual indifference by pressuring the mate even more frantically in an effort to elicit a sexual response, which usually makes matters worse: the partner avoids sex even more. A more common reaction among sexually ignored spouses, however, is retreat. The partner who feels spurned eventually withdraws sexually, too, out of fear of further rejection or additional humiliation. As a result, sexual efforts on both sides come to a standstill.

The partner who has turned off may not be bothered by the fact at all except for the spouse’s pressure tactics and expression of frustration. If a spouse does not complain, the indifferent partner may go without sexual activity for years on end without thinking much about it. But, in contrast, many people with impaired desire are very distressed. They may feel damaged, humiliated, or see lack of sexual interest on their part as a sign of aging. Often they think they are washed up sexually. Others interpret their condition as a sign that they no longer love their spouse.

Frequently, both the partner who is turned off and the one who remains interested in sex may try to sit it out on the sidelines, waiting patiently, and somewhat unrealistically, for the problem to go away. Their hope is that the turned-off partner will just wake up one day and be interested in sex once more. Fifteen years can go by in this way, says San Francisco psychiatrist and sex therapist Harvey Caplan, commenting on the number of women and men he sees who wake up late in the game to the fact that diminished sexual desire is a genuine problem in their marriage and that they had better do something about it.

Dr. Otto Kernberg — medical director of the New York Hospital-Cornell Medical Center, Westchester Division, and one of the most well known psychiatrists in the United States — takes issue with those of his colleagues who think that couples with little or no sex in their marriages can be relatively well adjusted anyway if they are not in conflict about lack of sex. A couple can eliminate sexuality altogether and believe that they live very well, he says. "I think, however, that the lack of sex indicates an impoverishment in their relationship. It is an impoverishment that shows in other areas of their life. There is generally a severe restriction in the scope of their emotional life.

If a couple in their seventies has sex once a month, I would like to know how they are doing. How is their sex? It may be satisfactory. But if a couple in their thirties or forties has sex once every three months, I consider this to be a serious sexual inhibition, says Dr. Kernberg. I consider it to be a major problem, even if they don’t. I have found, in my practice, that even people who have severe sexual inhibition haven’t been aware that it is a problem. If they don’t want treatment, I would leave them alone. I’m not saying everybody should have satisfactory sexual relations in marriage. You can’t order people to be normal.

The well-known sex researchers John H. Gagnon and William Simon take a somewhat opposing point of view in their book Sexual Conduct:

It is possible that we have assumed an important role for sexuality and the management of sexuality in the maintenance of the marital bonds because we have assumed that sex itself is an important part of most people’s lives. This may not be true. Particularly after the formation of the marital unit, it is quite possible that sex — both as a psychological reward and a physical outlet — declines in salience. It may become less important than alternative modes of gratification (work, children, security, constant affection — any or all may become more significant), or the weight of these alternative modes of gratifications may minimize the effects of any sexual dissatisfaction.

The results of various surveys and studies that have explored the relationship between sex and marital satisfaction perhaps tell the story best. Time after time, these studies come up with the same findings: the couples who consider themselves most satisfied and happy in their marriages also lead enjoyable sex lives. The most recent of these reports was the Love, Sex, and Aging survey of over 4,000 men and women over fifty done for Consumers Union by Edward Brecher, which found that high enjoyment of sex correlated with happy, long-term marriages and low enjoyment of sex correlated with unhappy marriages.

This doesn’t mean that a sexual dysfunction cannot exist in a contented marriage. It may, indeed. William Masters and Virginia Johnson, prominent authorities on human sexual behavior, have estimated that sexual dysfunctions exist in about 50 percent of the marriages in the United States. But in spite of a dysfunction, many happy couples still desire and value sex in their relationship. Having sex — even if it’s not always perfect — seems to make life fuller and better for the overwhelming majority of husbands and wives at any age.

Nevertheless, as the pioneering sex researcher Alfred Kinsey and others discovered, sexual appetites differ greatly from one human being to another. Some people need a great deal of sex, while some seem to have naturally lower libidos. For example, although three-quarters of the men in Kinsey’s landmark study had coitus in the range between once a week to a little over six times a week, there were also 7 percent who averaged seven or more times a week, while a little over 11 percent had sex only once in two weeks. There was considerable variation, in other words, from Kinsey’s mean average for all men: 2.34 sexual experiences per week.

Statistics gathered by Kinsey, as well as those compiled by Morton Hunt for his book Sexual Behavior in the 1970’s, indicate that the average married couple has sex between two and three times a week until their midthirties. Between the ages of thirty-five and forty-five, they have intercourse approximately once or twice a week, then once a week until their midfifties. At age fifty-five and over, the average is between once every week and once every two weeks. But there are couples who have sex once a day, year in and year out, and others who have always been content engaging in intercourse no more than once every two weeks or so. According to Hunt’s findings, married people are having somewhat more sex today than they were in the 1930s and 1940s when Kinsey’s data were gathered. He also found that women enjoy sex more and have a greater appetite for it in marriage than they did in earlier times and that frequency of sexual activity in marriage declines less with advancing age now than it did in the past.

Most experts hesitate to talk about what is average or to publicize statistics about frequency of sex. This is because people tend to compare their own sexual behavior to published statistics and try to live up to what they think is normal, and they feel deficient if they don’t succeed. It should always be remembered that sexual practices among human beings vary widely. The person who wants sex once a day is no more normal than the one who wants it only once a week, assuming that no significant psychological, health, or interpersonal problems are interfering with sexual expression. One generalization can be made, however: feeling no desire toward your mate is simply not a normal state in a reasonably contented marriage to a partner you still like.

Throughout his life the normal person experiences spontaneous sexual desire, and also has the capacity to be aroused by an attractive partner, writes Dr. Helen Singer Kaplan. Even when a man and woman are happily in love, sexual desire normally fluctuates, so that interest in making love shows some variation. However, it never remains absent for long for normal couples.

The effects of aging, often falsely blamed for diminished sexual desire, are gone into elsewhere in this book. It is enough to note here that although passion may dim somewhat with advancing age, interest and sex drive never go away completely unless certain medical problems intervene. Whatever effect aging has on sex occurs only very gradually over the years. The truth is, throughout most of our life — in youth and old age, in marriage and out — most of us are physically capable of much more sexual activity than we actually experience.

How can you tell, then, if something is wrong? How can you differentiate natural fluctuations in sexual interest from inhibited sexual desire? Let’s quickly look at some typical circumstances that might cause a temporary loss of interest. At times of great tension or stress, you may lose your libido for a while. When conditions change and the stress lifts, however, desire usually returns spontaneously. The same is true of anger. If, for some reason, you are mad at your mate, you may not want sex while you are still upset. But once you stop being angry, your desire automatically returns of its own accord.

The sign that something is seriously wrong, though, is when your sex drive — or your partner’s — diminishes significantly and stays that way. In other words, something is amiss if day after day, week after week, either or both partners want sex much less than they formerly did, or, for unknown reasons, don’t seem to want it at all.

Experts find that impaired sexual desire takes two forms: global and situational. It is global if you are no longer interested in sex at all and are not aroused by anyone. (I don’t even look at pretty girls anymore, complained one man.) You no longer even fantasize about sex. (Even Robert Redford wouldn’t turn me on, joked a wife, bitterly.) You don’t masturbate.

On the other hand, the lack of interest could be situational. In that case, you feel no sexual desire for your partner, but other people still ignite your interest. You still may have erotic fantasies or masturbate when you are alone.

It would be characteristic of situational loss of desire for a woman to feel romantic and turned on by a love scene she sees on television or reads in a book, but turned off the minute her husband makes a sexual advance. Similarly, a man with situational inhibited desire might get an erection while reading Playboy on the train coming home from work, or have sexual fantasies about a woman he sees across the aisle, but then feel completely un-aroused by his attractive wife once he gets home. A person with this type of impaired sex drive could function sexually with a pickup with whom contact has been minimal, yet fail to be excited by a loving spouse who desires a close, sexy relationship.

Although this is out of the range of conscious knowledge, spouses suffering from impaired libido often avoid pleasurable or erotic thoughts when their partner is present. At bedtime, for example, they may start to worry about problems at work, financial difficulties, or troubles with an aged parent or an unruly child. They might think about one of the spouse’s bad habits (She always leaves her shoes in the middle of the room, or I wish he wouldn’t expect me to pick up after him); or they might concentrate on some unpleasant feature of the mate (When she gets excited her voice becomes so shrill, or He has black rings under his fingernails).

Sometimes, however, people with lowered libido can force themselves to engage in sex (often out of guilt toward their partner) and can even reach orgasm if their genitals are stimulated sufficiently, but in most cases the experience is not really satisfying and is not apt to be repeated. Dr. Kaplan likens it to eating when you’re not really hungry.

The unerotic aspects of physical contact — hugging, cuddling, kissing — may be pleasurable to some people whose desire is inhibited, but others hate any kind of contact and avoid it — and sex — like the plague. Some who force themselves to engage in sex feel that they have to leave the partner immediately afterward to wash up or take a shower. Often, any attempt by the partner to interest or seduce the person with impaired sexual desire will either fail to produce any feelings at all in the partner or will produce negative ones, such as irritation, tension, disgust, the desire to escape, even sleepiness.

Partners who feel turned off to sex with their spouse generally try to avoid sexual situations through a variety of strategies. The most obvious one, of course, especially in the case of men, is that they stop initiating sex. Some people, particularly when anger is behind the turn-off, tell a mate that they are not interested more subtly: they engage in sex but do so in such an unenthusiastic way that their lack of ardor is obvious to the partner. (This acts to turn the mate off as well.)

Some spouses with impaired desire withdraw only sexually, while others do so both emotionally and sexually. There is often the fear that if they show affection in nonsexual ways, it will lead to sexual expectations.

The use of avoidance tactics is universal. You come up with a variety of excuses such as I’m tired, or the famous one — I have a headache. You may have an allergy attack, or you may complain that the weather is too hot. You may throw all your energies into work so that you forget even to think about sex. You may bring a pile of work home from the office or watch TV until long after your mate has gone to bed.

You may sabotage. For instance, you may pick a fight, make an impossible demand, criticize or insult at bedtime or whenever you feel sex is a possibility. One wife told her husband when he started to make sexual overtures on a weekend afternoon, The children will be back any minute now, which instantly dampened his ardor. Another wife, in the middle of intercourse, reminded her husband that he had forgotten to mail an important letter. A husband started to criticize his wife’s handling of their young son when he thought she was getting amorous. Another husband continued to smoke his pipe in the bedroom even though he knew his wife hated the smell of tobacco.

A specifically sexual put-down can be used to sabotage. For example, you may let your wife know that you wish her breasts were bigger, which will make her so self-conscious about her body that she will be unable to have an orgasm or even want sex. Or you may remind your husband that he may not be able to get it up, like the last time, which will create such anxiety for him that your reminder will turn out to be a self-fulfilling prophecy.

Lack of sex in marriage may currently be considered a symptom of a new sexual dysfunction, but as a subject it’s old. It has been a topic of humor among men for a long time, with wives frequently being depicted in jokes as not interested in sex (they have headaches) or so sexually passive that, since they just lie there, a husband could easily turn off, too.

One example of the wife-as-turn-off type of joke:

DOCTOR [to heart patient]: You must not get too excited during sex.

PATIENT: Oh, that’s easy. I’ll have sex with my wife.

The new wrinkle in the old game of marital sexual ennui, however, is that in today’s social climate, with sexual expectations rising and women’s roles changing, there is often a switch in the roles partners play. Dr. Harold Lief finds that a great reversal has taken place among the patients he sees. It used to be husbands who complained that their wives weren’t interested in sex; but now, he says, the number of wives complaining about their husbands is striking.

In the