Top

Current Sexual Health Reports

Published in:

01-06-2018 | Clinical Therapeutics (B McCarthy and RT Segraves, Section Editors)

Addressing Issues of Sexuality in Couples Therapy: Emotionally Focused Therapy Meets Sex Therapy

Authors: Susan M. Johnson, Zoya Simakhodskaya, Michael Moran

Published in: Current Sexual Health Reports | Issue 2/2018

Abstract

Purpose of Review

The purpose of this article is to describe the use of Emotionally Focused Therapy (EFT) with couples presenting with sexual concerns and how to integrate sex therapy interventions with EFT.

Recent Findings

Sexual issues always present in the relational context and typically have a significant impact on intimate relationships. Literature on attachment theory and sexuality indicates that in long-term committed relationships, attachment and sexual behavioral motivational systems overlap with attachment systems playing a significant role in creating security and safety for optimal sexuality. Research on effectiveness of medical sex interventions reflects the importance of integrating psychological approaches, as well as working systemically with clients and their intimate partners. EFT can be used successfully to improve sexual satisfaction of distressed couples, as well as to improve effectiveness of sex therapy interventions.

Summary

EFT with its emphasis on distilling emotional experience and guiding couples to create a more secure bond offers a model for addressing many sexual concerns and a more successful implementation of sex therapy interventions. This article explores the Emotionally Focused approach to dealing with sexual problems and the implications of this attachment-oriented perspective for our understanding of sexuality and the treatment of sexual issues. Recent research on psychological interventions for sexual dysfunctions is reviewed. Principles of addressing sexual concerns in EFT, as well as ways to integrate behavioral sex therapy interventions, are described and examples given.

Leiblum SR, Rosen R. Principles and practice of sex therapy. 3rd ed. New York, NY: Guilford Press; 2000.

Johnson SM. The practice of emotionally focused couple therapy: creating connection. New York, NY: Routledge; 2004.

Lebow JL, Chambers AL, Christensen A, Johnson SM. Research on the treatment of couple distress. J Marital Fam Ther. 2012;38:145–68. https://doi.org/10.1111/j.1752-0606.2011.00249.x.CrossRefPubMed

Weibe S, Johnson SM. A review of the research in emotionally focused therapy for couples. Fam Process. 2016;55(3):390–407. https://doi.org/10.1111/famp.12229.CrossRef

•• Johnson S. An emotionally focused approach to sex therapy. In: Peterson Z, editor. The Wiley handbook of sex therapy. West Sussex: Wiley; 2017. Important original chapter on using EFT with sexual issues which includes extended case study.

Bowlby J. A secure base. New York, NY: Basic Boks; 1988.

• Birnbaum GE, Reis HT. Evolved to be connected: the dynamics of attachment and sex over the course of romantic relationships. Curr Opin Psychol. 2018;25:11–5. https://doi.org/10.1177/0146167217695556. Most recent research overview of attachment and sex interplay CrossRefPubMed

Birnbaum GE, Mizrahi M, Kaplan A, Kadosh D, Kariv D, Tabib D, et al. Sex unleashes your tongue: sexual priming motivates self-disclosure to a new acquaintance and interest in future interactions. Personal Soc Psychol Bull. 2017;43(5):706–15. https://doi.org/10.1177/0146167217695556.CrossRef

Birnbaum GE, Reis HT, Mikulincer M, Gillath O, Orpaz A. When sex is more than just sex: attachment orientation, sexual experiences and relationship quality. J Soc Pers Relat. 2006;24:21–35. https://doi.org/10.1177/0265407507072576.CrossRef

10.

Stefanou C, McCabe MP. Adult attachment and sexual functioning: a review of past research. J Sex Med. 2012;9:2499–507. https://doi.org/10.1111/j.1743-6109.2012.02843.x.CrossRefPubMed

11.

Birnbaum GE. Bound to interact: the divergent goals and complex interplay of attachment and sex within romantic relationships. J Soc Pers Relat. 2010;27(2):245–52. https://doi.org/10.1177/0265407509360902.CrossRef

12.

Heiman J. Orgasmic disorders in women. In: Leiblum S, editor. Principles and practice of sex therapy. 4th ed. New York, NY: Guilford Press; 2007. p. 84–123.

13.

Mikulincer M, Shaver P. Attachment orientations and emotion regulation. Curr Opin Psychol. 2018;25:6–10. https://doi.org/10.1177/2158244015604695.CrossRefPubMed

14.

Hawton K, Catalan J, Fagg I. Sex therapy for erectile dysfunction: characteristics of couples, treatment outcome, and prognostic indicators. Arch Sex Behav. 1992;21:161–76. https://doi.org/10.1007/BF01542591.CrossRefPubMed

15.

McCabe MP. Relationship factors in the development and maintenance of ED: implications for treatment effectiveness. J Sex Med. 2008;5:1795–804. https://doi.org/10.1111/j.1743-6109.2008.00878.x.CrossRefPubMed

16.

Melnik TM, Glina S, Rodrigues OM Jr. Psychological intervention for premature ejaculation. Nat Rev Urol. 2009;6(9):501–8. https://doi.org/10.1038/nrurol.2009.147.CrossRefPubMed

17.

Conaglen HM, O’Connor EJ, McCabe MP, Conaglen JV. An investigation of sexual dysfunction in female partners of men with erectile dysfunction: how interviews expand on questionnaire responses. Int J Impot Res. 2010;22:355–62. https://doi.org/10.1080/0092623X.2013.864368.CrossRefPubMed

18.

McCarthy and Wald. Strategies and techniques to directly address sexual desire problems. J Fam Psychother. 2015;26:286–98. https://doi.org/10.1080/08975353.2015.1097282.CrossRef

19.

Grayer J. Emotionally focused therapy for couples: a safe haven from which to explore sex during and after cancer. Sex Relatsh Ther. 2016;1(4):488–92. https://doi.org/10.1080/14681994.2015.1126668.CrossRef

20.

Soleimani AA, Naja M, Kh A, Javidi N, Hoseini Kamkar E, Mahboubi M. The effectiveness of emotionally focused couples therapy on sexual satisfaction and marital adjustment of infertile couples with marital conflicts. Int J Fertil Steril. 2015;9(3):393–402. https://doi.org/10.22074/ijfs.2015.4556. PubMedPubMedCentral

21.

Johnson SM, Whiffen VE, editors. Attachment processes in couple and family therapy. New York, NY: Guilford Press; 2003.

22.

Minuchin S, Fishman C. Family therapy techniques. Cambridge, MA: Harvard University Press; 1981.

23.

Rogers C. Client-centered therapy. Boston, MA: Houghton Mifflin; 1951.

24.

Mikulincer M, Shaver P. Attachment in adulthood: structure, dynamics and change. New York, NY: Guilford Press; 2007.

25.

Johnson SM, Hunsley J, Greenberg L, Schindler D. Emotionally focused couple therapy: status and challenges. Clin Psychol Sci Pract. 1999;6:67–79. https://doi.org/10.1093/clipsy.6.1.67.CrossRef

26.

Dalton J, Greenman P, Classen C, Johnson S. Nurturing connections in the aftermath of childhood trauma: a randomized control trial of emotionally focused couple therapy (EFT) for female survivors of childhood abuse. Couple Fam Psychol. 2013;2:209–21. https://doi.org/10.1037/a0032772.CrossRef

27.

Denton W, Burelson BR, Clark TE, Rodriguez CP, Hobbs BV. A randomized trial of emotionally focused therapy for couples in a training clinic. J Marital Fam Ther. 2000;26:65–78. https://doi.org/10.1111/j.1752-0606.2000.tb00277.x.CrossRefPubMed

28.

Wiebe SA, Elliott C, Johnson SM, Burgess Moser M, Dalgleish TL, Lafontaine MF, Tasca GA (2015) Attachment & sexual satisfaction in emotionally focused couple therapy. Manuscript in preparation

29.

Johnson S, Zuccarini D. Integrating sex and attachment in emotionally focused couple therapy. J Marital Fam Ther. 2010;36(4):431–45. https://doi.org/10.1111/j.1752-0606.2009.00155.x.CrossRefPubMed

30.

Johnson SM. Emotionally focused couple therapy with trauma survivors: strengthening attachment bonds. New York, NY: Guilford; 2002.

31.

Johnson SM. Hold me tight: seven conversations for a lifetime of love. New York, NY: Little, Brown; 2008.

32.

Basson R. The female sexual response: a different model. J Sex Marital Ther. 2000;26(1):51–65. https://doi.org/10.1080/009262300278641.CrossRefPubMed

33.

Janssen E, Bancroft J. The dual control model: the role of sexual inhibition and excitation in sexual arousal and behavior. In: Janssen E, editor. The psychophysiology of sex. Bloomington, IN: Indiana University press; 2007.

34.

Metz ME, Epstein NB, McCarthy B. Cognitive-behavioral therapy for sexual dysfunction. New York, NY: Routledge; 2018.

Title: Addressing Issues of Sexuality in Couples Therapy: Emotionally Focused Therapy Meets Sex Therapy
Authors: Susan M. Johnson
Zoya Simakhodskaya
Michael Moran
Publication date: 01-06-2018
Publisher: Springer US
Published in: Current Sexual Health Reports / Issue 2/2018
Print ISSN: 1548-3584
Electronic ISSN: 1548-3592
DOI: https://doi.org/10.1007/s11930-018-0146-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Addressing Issues of Sexuality in Couples Therapy: Emotionally Focused Therapy Meets Sex Therapy

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 2/2018

Addressing Female Genital Mutilation/Cutting (FGM/C) in the Era of Clitoral Reconstruction: Plastic Surgery

Why the Sexual Tipping Point ® Is a “Variable Switch Model”

Addressing FGM with Multidisciplinary Care. The Experience of the Belgian Reference Center CeMAViE

Treating Compulsive Sexual Behavior

Limits of Pelvic Floor Physical Therapy in the Treatment of GPPD