Skip to main content

Advertisement

SpringerLink
Log in

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

  • Clinical Therapeutics (B McCarthy and RT Segraves, Section Editors)
  • Published:
Current Sexual Health Reports Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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

    Google Scholar 

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

    Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. 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.

    Article  Google Scholar 

  5. •• 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.

    Google Scholar 

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

    Google Scholar 

  7. • 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

    Article  PubMed  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. 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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    CAS  PubMed  PubMed Central  Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Google Scholar 

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

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. International Centre for Excellence in Emotionally Focused Therapy, University of Ottawa, Ottawa, Canada

    Susan M. Johnson

  2. New York University School of Medicine, New York Center for Emotionally Focused Therapy, 352 7th Avenue, Suite 1005, New York, NY, 10001, USA

    Zoya Simakhodskaya

  3. New York Center for Emotionally Focused Therapy, New York, USA

    Michael Moran

Authors
  1. Susan M. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zoya Simakhodskaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Moran
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zoya Simakhodskaya.

Ethics declarations

Conflict of Interest

Susan M. Johnson, Zoya Simakhodskaya, and Michael Moran declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Clinical Therapeutics

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Johnson, S.M., Simakhodskaya, Z. & Moran, M. Addressing Issues of Sexuality in Couples Therapy: Emotionally Focused Therapy Meets Sex Therapy. Curr Sex Health Rep 10, 65–71 (2018). https://doi.org/10.1007/s11930-018-0146-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11930-018-0146-5

Keywords

Search

Navigation