Healthy Intimacy – Part II
Our previous blog post explored the concepts of interpersonal and sexual intimacy as they
promote healthy intimacy in couples.
Today’s post will look at several forms of therapeutic interventions for couples experiencing
difficulties with interpersonal intimacy, communications and sexual relations.
Sexual problems and Therapeutic Approaches
Sexual problems signify a large portion of people seeking mental health help. Different levels of sexual desire between partners comprise the bulk of what people want to address. Without healthy sexual satisfaction, marital satisfaction and relational intimacy decrease.
Effective conflict resolution, healthy communications about sex, and the ability to open up and show vulnerability to a partner increase the intimacy desired by couples seeking therapy.
When couples seek counseling for sexual issues, they usually choose between couples therapists and sex therapists. Couples therapists focus on communication and styles of relating within the context of the couple system, while sex therapists attend to the mechanics of sexual interactions.
Sex therapy includes prescribing activities, use of the medical model, and looking at sexual problems through a biological lens. Sex therapists have considered body-parts functioning as the most crucial aspects when dealing with clients. The erect penis and the orgasmic female have continued to stand out as therapeutic goals.
Sex therapy has focused largely on individual satisfaction, though in recent times has begun to move towards desire as a central motivator.
Behavioral and Emotion-Focused Couples Therapy
Both behavioral and emotion-focused couples therapy work towards improving marital satisfaction. Behavioral therapy seeks to change behaviors through the elicitation of positive interactions which then become goals towards which couples work by using enhanced positive communications.
Cognitive behavioral interventions challenge dysfunctional thinking patterns but may overlook the role of the unconscious in regards to the development of anxieties.
Emotion-focused (EFT) therapy helps couples distinguish between primary and secondary emotions, thereby tapping into deepest layers of feelings which then can be brought out and aired.
Once couples understand how primary emotions fuel patterns of conflict, they can rebuild emotional bonds and deepen commitment and atonement as they find the freedom to express the secret, hidden or unconscious part of themselves.
EFT helps couples attune to each other’s needs within newly-acquired positive interactions. EFT can help depression as it alleviates discordant couple interactions. EFT for couples can be seen as having better outcomes than most other interventions, including CBT, psycho-dynamic, narrative and even Gottman and Bowen marriage counseling.
Since EFT aids interpersonal dynamics by focusing on attachment and emotion regulation, it changes the intrapsychic landscape, helping to alleviate depression.
The changes noted in EFT appear in three stages:
- The first includes development of a therapeutic alliance where the therapist helps partners flesh out underlying distress through understanding interaction cycles – DE-escalation occurs.
- In the second stage, the therapist helps the more submissive partner state needs. The more dominant partner begins to understand needs and open up his/her vulnerable side.
- Stage three consolidates gains and integrates change.
Emotion-focused therapy can also help those with avoidance attachment behaviors even more than it helps to instill trust. Avoidance tears down relationships while open communications repair them– as a result of rebuilt trust during EFT.
The more withdrawn and avoidant partner learns to manage anxiety, access emotions, and communicate them effectively.
Crucible Therapy
The couple who wants to restore chemistry in their union can be educated on what defines sexual normality and sexual myths. Sexual myths defines sexual normality and lead to constricting action and response.
In addition, the couple learns that as they continue to internalize historical scripts and act out/manifest narratives, they may no longer be able to sustain previous normal sexual interactions. Crucible therapy, as a type of pressure cooker, practically explodes reciprocal insecurities — which a couple may wield to get close or maintain distance – and transforms the material so that it emerges like a butterfly from its hidden cocoon.
This crucible facilitates separation and togetherness, and allows a couple to discover that when each has control over self, real connectedness can happen. This connectedness reflects a couple’s sexual potential.
Crucible therapy guides couples to examine their sexual style so that they become more well acquainted with behaviors and techniques, common occurrences, surroundings and ambiance. From there, couples can begin to explore intrapsychic struggles which they discover through the therapy’s elicitation technique.
No longer do couples have to search for root causes. Instead, each partner in a couple gets to experience his or her own emotional landscape from which springs sexual activity. Each partner begins to see self as the wellspring where self-validation and self-disclosure become possible.
Within this dynamic, Schnarch’s sexual crucible/pressure cooker enforces containment of emotional reactions until metamorphosis is achieved. Metamorphosis equals the ability to be present during intense experiencing.
Crucible therapy allows each partner the opporunity to mine individual resilience in the face of discomfort and anxiety. Rather than opting for the lessening of anxiety, crucible therapy will ask clients to tolerate uncomfortable messages, and disclose truths which, when hidden, act as barriers to sexual potential.
Schnarch’s (1991) wall-socket sex implies an electrical current, or energy current, that runs through and informs the sexual experience. When two partners within a couple attain their own version of wall-socket sex, they discover that layers of defenses and masks get peeled off so that they can reach a more fundamental connection between eye and eye, or the authentic ‘I’ and ‘I.’ This union is experienced as knowing and communion.
Crucible therapy uses Four Points of Balance to help couples resolve relationship gridlock:
- by maintaining a solid and flexible sense of self;
- approaching and dealing with anxiety and conflict through self-soothing and a quiet heart;
- remaining invested emotionally during reaction phases in ways which neither dominate nor avoid;
- and endure, when necessary, but also know when to give up. The stronger the Four Points of Balance within relationship processes, the more successful will be differentiation outcomes.
Our next blog post will continue to explore therapeutic techniques for enhancing intimacy. Stay tuned!
References :
Brooker, E. (2018). Transforming performance anxiety treatment : Using cognitive hypnotherapy and EMDR. Routledge.
Capps, F. (2006). Combining eye movement desensitization and reprocessing with gestalt techniques in couples counseling. The Family Journal, 14(1), 49-58.
Fraser, J. S.,& Solovey, A. (2018). The process of change in brief sex therapy. In D. Flemons & S.
Green (Eds.), Quickies: The handbook of brief sex therapy (pp.70-98). W.W. Norton & Company.
Hardy, N. R., & Fisher, A. R. (2018). Attachment versus differentiation: The contemporary couple therapy debate. Family Process, 57(2), 557-571. http://dx.doi.org/10.1111/famp.12343
Konzen, J., Lambert, J., Miller, M., & Negash, S. (2018). The EIS model: A pilot investigation of a multidisciplinary sex therapy treatment. Journal of Sex & Marital Therapy, 44(6), 552–565. https://doi.org/10.1080/0092623X.2018.1436626
McCarthy, B., & Ross, L. W. (2018). Maintaining sexual desire and satisfaction in securely bonded couples. Family Journal, 26(2), 217-222. http://dx.doi.org/10.1177/1066480718775732
Moser, M. B., Johnson, S. M., Dalgleish, T. L., Wiebe, S. A., & Tasca, G. A. (2018). The impact of blamer-softening on romantic attachment in emotionally focused couples therapy. Journal of Marital and Family Therapy, 44(4), 640-654. http://dx.doi.org/10.1111/jmft.12284
Rathgeber, M., Bürkner, P., Schiller, E., & Holling, H. (2019). The efficacy of emotionally focused couples therapy and behavioral couples therapy: A meta-analysis. Journal of Marital and Family Therapy, 45(3), 447-463.http://dx.doi.org/10.nn/jmft.12336
Schnarch, D. M. (1991). Constructing the sexual crucible: An integration of sexual and marital therapy. W.W. Norton & Company.
Schnarch, D., & Regas, S. (2012). The crucible differentiation scale: Assessing differentiation in human relationships. Journal of Marital and Family Therapy, 38(4), 639-52.
Wiebe, S. A., Johnson, S. M., Moser, M. B., Dalgleish, T. L., & Tasca, G. A. (2017). Predicting follow up outcomes in emotionally focused couple therapy: The role of change in trust, relationshipspecific attachment, and emotional engagement. Journal of Marital and Family Therapy, 43(2), 213-226.http://dx.doi.org/10.1111/jmft.12199
Wittenborn, A. K., Liu, T., Ridenour, T. A., Lachmar, E. M., Mitchell, E. A., & Seedall, R. B. (2019). Randomized controlled trial of emotionally focused couple therapy compared to treatment as usual for depression: Outcomes and mechanisms of change. Journal of Marital and Family Therapy, 45(3), 395-409. http://dx.doi.org/10.1111/jmft.12350