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Original Articles

What Do You Do When They Won't Do It? The Therapist's Dilemma with Low Desire

Pages 5-12 | Published online: 21 Jan 2015
 

Abstract

This article describes the therapist's reactions when treating couples with complaints of low sexual desire. Despite a variety of approaches, the success as measured by sustained, increased sexual activity is not impressive. Understanding marital dynamics from an object relations perspective is useful, particularly the process of projective identification. The therapist's reactions as the therapy unfolds come to mirror the more difficult aspects of the marital relationship. There is initial excitement at starting something new, which is followed by a progressive series of disappointments and frustrations. Like partners in the marriage, the therapist often questions his/her ability, insight, and effectiveness. Using clinical illustrations, this article discusses how the therapist, in facing the limitations with the couple, can be effective in helping the couple bear the disappointments of an inconsistent sexual connection.

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