NJ-ACT - Daniel N. Watter

Dan Watter on Low-Sex and No-Sex Relationships

By Lynn Mollick

On Sunday July 26, psychologist and NJ-ACT member Daniel Watter, Ed.D. led our workshop on treating “Low-Sex and No-Sex Relationships.” Forty-one members attended the event which included a Chinese brunch at Cathay 22 in Springfield.

Dan began by pointing out that complaints about the frequency of sexual intercourse are the most common presenting sexual problem in general psychotherapy practice. But what frequency is “too low?” Should we rely on national norms? The average frequency of intercourse among heterosexual couples under 30 is twice a week, but the figure drops to about once a week for older couples. Is it truly a problem to differ from these norms? Should we accept a complaint of too little sex at face value? What if the patient’s partner is completely satisfied? And is having “enough” sex the same as having good sex?

Once we raise these issues of low desire or too little sex, there are few objective markers. Clinicians often side with the higher-desire partner, assuming that more sex is healthier both mentally and physically – but it isn’t.

Dan made a strong argument for normalizing variations in sexual desire. He suggested meeting with both partners individually for at least one or two sessions initially to keep both partners’ perspectives in mind, and to avoid siding with the higher desire partner.

Many factors diminish sexual desire: anxiety, depression, SSRIs, fatigue, pain, body image issues or relationship problems. Removing any of these should increase sexual desire. But Dan reported that in many cases, it does not. Even attempts to intervene chemically – with hormones or Viagra – have been similarly limited in their success.

Dan suggested that we abandon some of our old ideas about sexual desire and consider several new views:

A) Rosemary Basson’s updated description of sexual desire. Many people, especially men, experience “sexual hunger.” They’re interested in sex regardless of what’s going on around them. Others, more often women, spend most of their conscious lives in a state of “sexual neutrality.” They aren’t thinking about sex, but if sex is suggested, they might move into a state of “sexual receptivity” -- they become interested and then enjoy the sexual experience. The concept of “sexual neutrality” does not pathologize the partner with lower interest.

For many women, arousal leads to desire, as opposed to our older view that desire always begins the sexual response cycle. Basson believes that sexual enjoyment or sexual receptivity is a much better indicator of many women’s sexual health than “desire,” the frequency of sex, or the number of times they initiate sex.

B) Esther Perel’s family systems explanation for diminished desire. Perel believes that sexual desire is destroyed by the modern western marriage which encourages companionship, closeness, commitment, security, and a balance of power. In Perel’s view, sexual desire is maintained by separateness and distance, insecurity about the relationship, playfulness, unpredictability, fantasy, naughtiness, and anticipation.

C) Watter’s concept that sexual complaints are a symptom of intimacy problems. Sometimes an individual’s sexual life is completely satisfying until a relationship-deepening event occurs -- engagement, living together, marriage. The relationship-deepening event can provoke two types of fears:

1. Rejection/abandonment. “If my partner really gets to know me well, he or she will discover how worthless I really am and reject or abandon me.”

2. Fear of losing autonomy, i.e. being controlled by one’s partner.

These fears inhibit sexual desire.

In conclusion, Dan asserted that sexual problems usually don’t remit with simple formulations and quick fixes. They are multi-determined and difficult to treat. While it helps to be knowledgeable about sex therapy techniques, treatment often involves good general CBT skills.