Abstract
The sexual dysfunctions of secondary erectile dysfunction which may be accompanied by male secondary inhibited desire and female primary or secondary inhibited sexual desire is particularly challenging for the sex therapist. Cognitive–behavioral strategies and techniques are prescribed in detail accompanied by a case illustration. Sex therapy is not a simple, mechanistic procedure, but a multifocused therapeutic intervention that attends to individual, couple, and sexual dimensions. If the couple learns attitudes and skills of intimacy, nondemand pleasuring, and multiple stimulation, these will hopefully inoculate them against sexual difficulties with age. Cognitions about being an intimate team, accepting variability in individual and couple sexual expression, and setting realistic expectations are crucial to prevent relapse.