Developing Flexible Scenarios

Illustration: Ivan and Dawn

In his career, Ivan thought of himself as an excellent problem-solver. He had seen too many work projects become stalemated by the blame – counter blame dynamic. He didn’t want that to happen between him and Dawn but feared “talking sex to death.” Ivan’s first attempt to get information and help was not beneficial a for profit male sex clinic where he was prescribed a pro-erection medication, an antidepressant, testosterone, and penile injections. Ivan decided to do careful research on the Internet and was surprised and confused by the very contradictory information and advice. Ivan chose to undergo a complete physical. His internist was aware that erectile dysfunction can be a first symptom of a serious vascular or cardial condition so he was very thorough in his assessment. Happily, there were no major medical problems. He counseled Ivan that erectile problems are best understood and treated as a biopsychosocial problem. He prescribed Viagra but also suggested that Ivan and Dawn consult a certified couple sex therapist for guidance and counseling. Dawn was enthusiastic, but Ivan was reluctant.

He wanted to see if the Viagra alone would be enough. After 3 weeks, Ivan realized the medication was helpful but was not a stand-alone intervention. In making the couple appointment, Ivan was clear that he didn’t want long-term therapy but a focused intervention about regaining erectile confidence and couple sexuality. The therapist was both competent and flexible. He helped Ivan and Dawn to view the erectile problem as a challenge to build a new couple sexual style that would not only help them regain comfort and confidence with erections but inoculate them against sexual problems with aging. Ivan found this approach both intellectually and emotionally appealing.

The hardest concept to accept was the Good-Enough Sex model of variable, flexible sex with 85% of encounters flowing to intercourse. Dawn’s enthusiasm for an intimate, interactive couple sexual style and realization that her sexual experience was congruent with the 85% guideline finally won Ivan over. He was not a perfectionist in the rest of his life, so why would being a sexual perfectionist help him? The single most important thing the therapist said was “Wise men learn to enjoy grow-up erections rather than show-up erections. When intercourse doesn’t flow, they enjoy erotic, non-intercourse sex.”

Exercise: Create Your Sexual Scenarios

Take a moment to think about three sexual scenarios you would enjoy. Ask your partner to do the same. Prod yourselves to be creative and flexible by allowing only one of the three to include intercourse. Then take turns sharing these scenarios, alternating one at a time. Be careful not to judge, but enjoy a variable, flexible, couple sexuality.