Transforming Sexual Narratives

A Relational Approach to Sex Therapy

Suzanne Iasenza

• Publisher: Routledge
• Year: 2020
• ISBN:
  9780429557446
• Edition: 1
• Topic: Psychology
• Subtopic: Human Sexuality in Psychology
• Index: Psychology

Transforming Sexual Narratives offers readers the opportunity to address complex sexual problems through Narrative Relational Sex Therapy (NRST), an original approach that Suzanne Iasenza has developed during twenty-five years of clinical practice.

This method presents a deeper, richer way of thinking about sexual challenges that has enabled clients to successfully rewrite their mistaken narratives to reclaim pleasure, intimacy, and satisfaction in their erotic lives. Drawing on the strengths of three very different therapeutic traditions — psychoanalytic, couple and family systems, and sex therapy — it delivers a fresh and dynamic way of understanding the complex interrelationship between personal, social, cultural, and familial sexual narratives. Chapters include conversations with diverse couples and individuals from all kinds of backgrounds and cultures, who exist in every kind of body, and in each case show how unconscious and harmful narratives can be transformed into healthy and pleasurable sex lives.

This essential guide will help therapists to identify their client's secret sexual stories and enable them to rewrite their inner narratives and relationship with sexuality for the better. Sex therapists will be able to integrate a relational perspective into behavioral treatment, individual and couple therapists will be able to weave sexuality into general psychotherapy, and psychoanalysts will be able to use the sexual history to identify early dynamics that affect adult intimacy.

PART 1

THE FOUNDATIONS OF NARRATIVE RELATIONAL SEX THERAPY (NRST)

CHAPTER 1

SEX IS POSSIBLE WITHOUT DESIRE

Justin and Kris, a strikingly attractive couple in their early forties, sat across from me in my office for their first therapy appointment. Married for ten years, they had once been passionate partners, but that part of their lives was now history.

“We haven’t made love in over a year,” Kris told me, her voice barely audible.

Justin, occupying the far end of the couch, stared miserably at the rug. “I don’t have a clue about where to go with this,” he finally said, shrugging his shoulders in resignation.

I begin the first session with couples by asking them to describe what attracted them to each other, as a way to explore with partners what they once shared – and may be able to revive. Or, sometimes couples forget that their initial attraction was not sexual or physical, but years later want to experience something they never had. In Kris and Justin’s case, physical attraction was strong from the beginning.

“We met online and started exchanging these playful, sexy messages,” said Kris, blushing a little.

“When we finally got together in person at a local bar, it was lust at first sight,” Justin chimed in.

Kris nodded. “I loved his tall, lean body and his gorgeous green eyes.” She stole a look at her husband.

“And I was wowed by the way Kris approached me,” said Justin. “She radiated this amazing mix of confidence and flirtation.”

“We talked about everything and laughed for hours,” Kris added.

“Then I drove her home,” Justin said. “But before we even made it to her block, we pulled the car over.” On a side street they made love, hard and fast, and never looked back, dating exclusively within weeks and marrying six months later.

“You started off with a lot of desire,” I said. “Then what happened?”

“In the early years, our sexual attraction was pretty intense and constant,” Kris said.

“Everything was easy,” Justin added. “We bought a house and decorated it together. We agreed that we didn’t want kids, and we both loved our work.” Kris was an attorney for a prominent firm, while Justin was a high school guidance counselor.

“And then?” I asked.

“Well, at first I didn’t notice that our sex life had changed,” said Justin. “Then I began to see that I was the one who was always initiating. We still had sex with orgasms, but Kris seemed less into it.”

“I felt I was pushing myself to enjoy the experience,” admitted Kris. “My desire just wasn’t there.”

At this, Justin’s lips tightened. “In my worst moments, I’ve wondered if she’s been having an affair,” he said bitterly. “She works crazy hours during the week and avoids me on the weekends.” He took a deep breath, but his brow remained deeply furrowed. “I’ll be honest – at this point I don’t much care whether we have sex or not.”

“I love him,” Kris broke in, “and I still think he’s the most attractive guy I know. But I can’t believe that Justin doesn’t appreciate how hard I work at the firm or understand my need for some alone time on weekends,” she said. Her arms were folded across her chest. “I feel pretty close to hopeless. I mean, how can we have sex if we don’t want each other?”

After confirming that neither of them had been talking directly to each other about sexual issues, I wasn’t surprised to hear that they were arguing constantly, about everything from spending habits to the correct placement of food in the refrigerator. They had been referred by the gynecologist Kris had consulted for her “desire problem.” As they sat with me now, both reported feeling turned off, pissed off, and helpless to make a change.

Humans have been having sex throughout history. Yet, despite the vast accumulation of art, music, poetry, and literature on the subject, the advice passed down from parent to child, the Kama Sutra, the porn industry, magazine articles that “de-mystify” orgasms and erogenous zones, sex chat rooms, and on and on, couples of all sexual orientations still encounter the same old problems in the bedroom. The initial passion wanes, the partners blame themselves or the other partner, and conflict gets expressed both inside and outside of the bedroom. Disappointment, bitterness, disconnection, or open hostility often follow. How could something that was once satisfying become so fraught with awkwardness and tension?

To address this problem, most therapists focus on fostering good communication skills, come up with more constructive options to resolve conflict, and help partners learn to negotiate and compromise. For several decades these techniques have been thought to improve the erotic environment for a couple, and they sometimes do.

But where else can we turn for answers? In my practice as a psychodynamically oriented sex therapist, I have found that couples’ erotic lives improve reliably and dramatically when I help them identify and transform unconscious internalized narratives derived from family and other relationship histories.

In addition to individual unconscious narratives that were formulated in childhood, we are all exposed to social scripts (Gagnon & Simon, 1973; Laws & Schwartz, 1977) that shape us from an early age – homophobia, transphobia, sexism, racism, classism, and all the other “isms.”

Psychoanalytic theory is based on the assumption that all adult romantic relationships have their roots in infancy and childhood. From the moment children are born, they relate to objects (people, caregivers) around them and start internalizing, or introjecting, their influence. For example: you cry, mommy (caregiver) feeds you, and you get the message that the world is a caring place. If you have a caregiver who ignores your screaming, you learn that no one is coming to help you with your needs. We carry our internalized messages with us for the rest of our lives. Imago therapy, which became popular in the 1990s with Harville Hendrix’s book Getting the Love You Want, focuses on how partners’ interactions are based on internalizations from their earliest caregivers’ relationships with them – typically, the parent-child dyad.

Theorists at the Tavistock Institute of Human Relations in London went beyond the parent-child dyad to examine the “internalized parental couple,” a concept associated with the Object Relations branch of psychoanalysis. Toddlers and young children internalize their first experience of a parental couple (which could also be a single parent’s relationship to an absent spouse/partner – two parents don’t have to be physically present). In this vein, I have found it to be remarkably helpful to ask couples to explore their first models of romantic relationship. Awareness of the parental dyad is often a child’s first experience of feeling excluded, leading to his or her first experience of feeling jealous and competitive. I help clients see what they might unconsciously be replicating in their adult relationships, in patterns that can be both constructive and destructive.

G.R. DiCeglie, in his paper “From the Internal Parental Couple to the Marital Relationship” (1995), emphasized that the experience of our parents’ relationship influences how we conduct adult relationships, saying that in the best of all worlds we can have and want, desire and identify with, both members of the parental couple in a fluid way. This enables us to experience the greatest degree of flexibility and richness in adult love relationships. When one or both parents relate dysfunctionally with the child and/or each other, the child’s ability to fluidly move amongst all possible internal parental object relations is hindered. These hindrances emerge later in adult love relations as sexual shutdowns, anxieties, or defenses. One of my goals is to help couples reveal and work through the unconscious conflicts underlying their sexual difficulties.

Even though our romantic and sexual relationships may appear quite different from our parents’, psychoanalysts believe that none of us, no matter what our sexual orientation or gender identity, escapes the messages (good and bad) from childhood. In my experience, inquiring about the internalized parental couple moves my clients’ work to a deeper level beyond the present relationship, freeing them from confusing sexual patterns that often involve the loss of desire (Iasenza, 2006).

The Case of Bob and Carl

Like Justin and Kris, Bob and Carl were experiencing problems with sexual connection. Both in their forties, they came to see me for therapy because both reported loss of sexual desire, taking turns refusing offers of sex during their five-year relationship. Their sexual histories contained ample evidence of enjoyable sexual experiences, both partnered and solo. They presented as a peer marriage (Schwartz, 1994) – intellectually, emotionally, and socially well-matched. They bought and furnished beautiful homes in Manhattan and outside the city. Carl’s parents, who lived near them, welcomed Bob as their son-in-law. The men enjoyed a rich social network of colleagues, friends, and family, and were out to everyone as an openly gay couple.

Bob grew up in a Southern Baptist family. Both of his parents abused alcohol, and his father was physically and verbally abusive. Bob became aware of his sexual and romantic feelings for boys very early, but knew that his physical and mental survival depended on secrecy and silence because of his parents’ strict religious beliefs and his father’s obsession with hyper-masculinity about himself and his two sons. Bob didn’t have much of a social life, and his sexual explorations were confined to masturbation (fantasizing only about boys) throughout his teen years.

As Bob and his brother entered adolescence, his father’s abuse and neglect of his mother intensified, and she regularly turned to her teenage sons for company and comfort. Bob remembers with disgust and anger her controlling rituals, demanding that he and his brother kiss her on the lips before leaving the house or hug her tightly before they retired at night. Bob saved himself by excelling in academics and leaving home for college. He decided to come out to his parents at the end of his senior year of high school, only to have his father disown him and refuse to pay for college. He never wanted to meet any of Bob’s boyfriends. Bob’s mother, afraid to defy her husband, silently went along with him.

Carl and his sister were raised in a comfortable, middle-class New York family with supportive and attentive parents who often praised him. His father and mother were highly successful and well-known in their fields, and they encouraged Carl and his sister to pursue their unique talents. Carl had traveled throughout Europe by the time he was a teenager and took private music and language lessons. His parents were very polite with each other and enjoyed focusing on their children’s achievements. He could hardly remember them fighting. His seemed like the perfect family.

Carl was a straight-A student and president of the debate club, as achievement was highly valued in his family. He believed his parents would probably react well to the news that he was gay because many of their friends were openly gay and lesbian, but he carried a deep concern about not measuring up to their expectations; he suspected that their outward politeness might hide feelings of disappointment.

As a slightly built, non-athletic boy, Carl was taunted and bullied so badly by boys in the locker room that he avoided the showers and dressed as quickly as he could whenever “hey faggot” started getting thrown around. He never reported these shaming experiences to anyone, including his parents. He openly dated girls and secretly dated boys throughout his early teen years, until he fell in love at age fifteen with a boy. By senior year the pressure of the secrecy was too much for Carl’s boyfriend, who abruptly announced one day that he was “going straight.”

Carl was devastated because he thought he would spend the rest of his life with his boyfriend. He suffered in silence, never letting on to his parents how wounded he was. He didn’t come out to them until after college, when his mother asked why he was so distant and didn’t bring friends home to meet the family. Both parents were supportive when he came out, but in the midst of their acceptance Carl mostly felt grief about the many years he had suffered in loneliness and secrecy in his family.

As Bob and Carl shared their histories in therapy, they began to realize how much they were replicating key family dynamics with each other. Saying no to sex was protective for both of them. Bob needed to feel some control after so much violent and inappropriate behavior from both parents, and Carl wanted to protect himself from the abandonment he experienced with his first boyfriend and that he feared from his parents. Neither had experienced parental couples who expressed anger in constructive ways, and each felt pulled into the parental triangle to contain their parents’ conflicts.

Once some of their unconscious motivations about saying no to sex were revealed, we began the work of creating an erotic environment in which they could explore, expand, and enjoy their sexual potential with or without sexual desire. Having good sex often mobilizes guilt and anxiety about boundary maintenance, comfort with intimacy, body image, religious and family attitudes about sex, and feelings of worthiness. The family, relationship, and sexual histories of lesbian women and gay men often can contain additional sources of sexual guilt, anxiety, and shame due to societal and internalized homophobia.

Sex therapy helped Bob and Carl begin to break the silences and secrets that characterized their sexual life with each other. As they shared fantasies and wishes – first in sessions and then at home – they created a safe space to overcome sexual shame and express their particular sexual needs. Bob transformed his narrative that attachment involves harm by working through his fear and anger about the abuse in his family, and Carl transformed his narrative that love leads to abandonment by grieving the loss of his teenage boyfriend...