Body-to-Body Intimacy

Transformation Through Love, Sex, and Neurobiology

Stella Resnick

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781317301356
• Edition: 1
• Topic: Psychologie
• Subtopic: Menschliche Sexualität in der Psychologie

This book presents an integrative, growth-oriented approach to therapy with couples that demonstrates the dynamic interplay between partners' emotional issues and their sexual difficulties. It offers a model for relational and sexual enhancement that focuses as much on partners' present, nonverbal body-to-body communications as on their words. Dr. Stella Resnick draws on research from interpersonal neurobiology, sexology, positive psychology, and Gestalt therapy, and shares a rich assortment of therapy vignettes to demonstrate the transformative power of pleasure and how a focus on body-to-body intimacy can heal emotional wounds from the past and encourage greater presence, empathy, authenticity, playfulness, and sexual pleasure between intimate partners.

The therapeutic process is explored in four related spectrums: the Problem-Transformation Spectrum, the Attachment-Sexuality Spectrum, the Pain-Pleasure Spectrum, and the Cognitive-Somatic-Experiential-Behavioral-Spectrum. Part I lays the theoretical foundation for the work. Part II examines the early attachment bond between parent and child and its effects on adult capacity for emotional closeness and sexual pleasure. Part III offers methods for resolving painful emotional issues underlying many sexual difficulties. Finally, Part IV describes the procedure for moving from a cognitive reframing of the problem to a somatic focus on the body and tracking present-moment emotional interactions to the repair of relational injuries that nurture transformational change. Also included is a series of process-oriented exercises and a handout that therapists can use in their own practice.

Body-to-Body Intimacy will enable couples and sex therapists to expand their practices and enrich their clients' sexual and relational dynamics. This book also contains valuable information that will be appreciated by anyone interested in a greater understanding of a growth-oriented therapeutic process for couples and what can be achieved together by gaining a deeply loving and sexually fulfilling intimate love relationship.

Part I

The Problem-Transformation Spectrum

1
The Problem: Distress as a Developmental Opportunity

Maybe it’s because I do both couples therapy and sex therapy that I have come to see the clear connection between a couple’s emotional life and their sex life. My observation is this: when a couple has relationship problems, their sex life suffers; when they have sexual distress, their relationship suffers. The two sets of issues are inextricably connected.

If clients come for therapy because of a sexual issue, at some point it certainly makes sense to ask, “How is this affecting your emotional connection?” Or if their primary concerns are about arguing or feeling out of touch with each other, it also makes sense eventually to ask, “How is this affecting your sex life?”

Their answers are diagnostic. The therapist gets a broader sense of the scope of their intimacy issues, their personal and relational challenges, and a beginning peek at their personal and relational resources.

Every course of therapy for a couple typically begins with the couple sitting shoulder-to-shoulder facing the therapist. After some friendly small talk he or she asks, “What brings you to therapy?” There is always an issue that propels the visit. The presenting problem is usually described in behavioral terms, a lack of loving contact, too much fighting, not enough affection, or disappointing sex. They may want more emotional connection and affection; they want to fight less, or they want to enjoy more satisfying lovemaking.

The Present Moment in the Presenting Problem

A therapist attuned to body-based communications between partners begins to assess their nonverbal interactions right from the start. Here’s an example of a woman and man in their mid-thirties whose presenting problem is sexual.

In their first couple session, each voices dissatisfaction with their sex life together. The woman is very attractive with her long brown hair pulled back into a slick ponytail. I particularly make note of her straight posture with her head held high, like a good student. The man is thin and handsome, and he seems more casual, sitting slumped on the couch with his legs crossed, ankle resting on the opposite knee. She speaks first, and says she’s hoping that they can learn some techniques for making sex better.

My mind flashes on a number of touching exercises I might offer them to experiment with at home. I resist the urge to step in prematurely, and sweeping a glance at each of them I ask, “What’s not working for you?”

“That we don’t have it!” the man jumps in with a smile but he doesn’t look happy. Now he’s sitting up, and his voice is tight and tinged with annoyance. She smiles a wry smile back and stiffens her back even more. “He doesn’t seem to be able to remember how I like to be touched,” she says defiantly, still smiling. “I’ve asked you to be gentle with me,” she says turning toward him.

He leans in toward her. “It doesn’t matter how I touch you. You used to be turned on to how I touched you. But now nothing I do seems to work anymore.” Her shoulders and chest collapse with a sigh. She folds her arms across her chest, crosses one leg over the other, and shakes her head from side to side in a gesture of hopelessness. “He just doesn’t get it,” she says to me.

So, is this a sexual issue, a relational issue, or both? Clearly it’s both. All their gestures, facial expressions, tones of voice and bodily movements are subtle, but they are an important part of the body-to-body nonverbal conversation that is triggering painful emotions and sabotaging their ability to hear each other. Their dilemma displays a stuck place not only in their sexual interaction but also in their ability to engage the other intimately and to lovingly work it through.

Here’s another first session with a heterosexual married couple in their forties whose presenting concerns center around having grown emotionally distant. They’ve been together eight years, have no children, and both work and are invested in their career. They seem cordial with one another, maybe even a little formal in their tone of voice and how they look at each other. I can see that they don’t seem to have much emotional connection. I ask, “How does this affect your sex life?” To my surprise, the woman says, “We usually have sex once a week and it’s fine. That’s not our problem.” He wobbles his head in a yes-no gesture suggesting that the sex is okay but not great. Now I want to know more.

I direct my next question to him. “Is the sex not fine with you?” “Oh, it is fine,” he says, “but it’s routine and not very affectionate. I’d like more kissing, more playfulness. I feel like she just wants to get it over with.” She smirks at his response and says nothing. Obviously, their lack of connection plays itself out in their sexual life despite the fact that they are sexually active.

In fact, which problem came first is immaterial. Our emotional, physical, and sexual energies are confluent—they flow together in the body in a shared physiological and dynamic interplay. Two biologically complex human organisms have crisscrossing personal and relational histories from infancy to the present that shape the make-up of our brains and bodily reactivity, especially in how to relate to an intimate.

For most couple clients, emotional and sexual troubles are systemic and interconnected. Disappointments, resentments, and feelings of guilt, shame, or fear are likely to bleed over into many areas of their lives together. If therapy is going to have staying power, it will not only alleviate the distress that brought them to therapy but also have a value added benefit.

Resolving their distress can open up a quality of emotional closeness and sexual pleasure that can heal wounds from childhood. Unresolved painful early experiences underlie a pattern of reflexive defensiveness in a couple. One person’s emotional distance or resentment can elicit the other’s neediness, anxiety, or shame, while that person’s neediness can be a burden to the partner and elicit feelings of obligation and detachment. Therapy has to reach those deeper emotional patterns, the projections that give rise to familiar feelings—the fearful or furious expectations that are triggered when an emotional or sexual intimacy is under stress.

Underlying Sexual Issues in Couples Therapy

Couples who seek therapy with a couples therapist are likely to complain about deficits in how they relate emotionally to one another. They fight too much, or they feel like they are not being heard and respected. Yet that doesn’t mean that their sexual relationship doesn’t play some part. In fact, while it may be easier to talk about “relationship issues,” sexual dissatisfaction may actually have a major role in their relational discontent.

As Johnson and Zuccarini (2010) note, “Couples therapists almost inevitably find that sexual anxieties, conflicts, and deprivation are part of relationship stress.” The authors acknowledge that therapists often expect that if they focus on relationship issues and the couple gets along better the sexual issues will resolve themselves. More likely, however, those therapists may simply know that they are ill equipped to deal with the couple’s sexual interactions. For those couples, picking up on their therapist’s expectation, the sexual aspect of their relationship becomes cordoned off as though sex is a separate issue. This is an unfortunate message to be reinforcing in their clients.

Moreover, the authors recognize that not addressing a couple’s sexual dissatisfaction may contribute to a breakdown of the strides they do make in therapy and a recurrence of the troublesome relational interactions:

[M]any couple therapists find themselves actively helping couples to specifically address sexual difficulties as part of the process of relationship repair and relapse prevention, especially when it is clear that the relationship is contributing to partners’ sexual functioning difficulties… . The line between sex and couple therapy is becoming finer and finer.

(Johnson & Zuccarini, 2010)

However, it cannot be assumed that a couples therapist who has not been trained in sex therapy is automatically capable of comfortably and knowledgeably dealing with sexual issues. A therapist who has not dealt with his or her own sexual history, authenticity, erotic predilections, sexual and/or body shame, current relational sexual satisfaction, and sexual self-acceptance cannot facilitate the deeper work on the emotional challenges with regard to sex that partners bring to one another.

One of the advantages of being trained as a sex therapist is the requirement that trainees look at their biases, beliefs, attitudes, and moral judgments toward individuals whose sexuality is different from their own. The SAR program, for example, is a requirement for all clinicians seeking certification by the American Association of Sexuality Educators, Counselors and Therapists (AASECT). SAR stands for Sexual Attitude Reassessment and is typically a weekend “sensitivity training” program that utilizes sexually explicit videos, diverse speakers, field trips, and experiential processing “to explore the landscape of human sexuality and ultimately themselves” (Britton & Dunlap, 2017).

Besides, though the couple has obvious emotional issues with one another, it may very well be that it is the quality of their sexual connection that is underlying issue. In one study, researchers found that couples in happy marriages attribute only 15% to 20% of their happiness to their satisfying sex life while unhappy partners attribute 50% to 70% of their distress to sexual problems (McCarthy & McCarthy, 2003). This suggests that contented mates view their sex life as one of many qualities they enjoy with one another but when sexual fulfillment is lacking, that deficit can have a big impact on the overall quality of a couple’s connection.

Underlying Relational Issues in Sex Therapy

On the other hand, if the couple seeks a sex therapist it doesn’t mean their emotional connection is not the issue. Couples may come in with a specific sexual concern like low sexual desire for one or both, or an inability for a man to sustain an erection or for a woman to orgasm. Yet a man’s chronic inability to sustain an erection may reflect his expectations of disapproval from his partner, perhaps a re-surfacing of old feelings of sexual inadequacy and shame, which may be reinforced by subtle signs of frustration on his partner’s face.

A woman’s inability to orgasm or a condition of vaginal spasms preventing penetration may result from obliging her husband’s impatience for intercourse. Vaginismus may occur when a woman consistently sacrifices her need for more sex play and loving connection in order to become aroused and lubricate. Short-circuiting warmth and affection during lovemaking may also be a pattern in their day-to-day life.

In other words, the presenting problem may be indicative of the relational disturbance that is currently most disruptive, but it could also be the concern they can both agree to concentrate on, though one of them may be more eager to tackle that issue than the other. While clients focus on symptoms, the experienced clinician is alert to signs of unacknowledged or hidden disruptive dynamics between partners or within the subjective experience of each individual that may be contributing factors.

For more than a decade, prominent sex therapist and researcher Peggy Kleinplatz has bemoaned the lack of integration of up-to-date psychotherapy research and treatment applications into the practice of sex therapy. As a result, sex therapists have been primarily focused on fixing performance problems rather than maximizing a couple’s erotic potential. She notes:

My objection here is to the implication that problems are to be understood primarily as technical difficulties, subject to treatment and cure devoid of the psychological, relational, and social contexts in which they come to be perceived as problematic… . In fact, to the extent we confound sexual symptoms with the underlying problems they mask, clinicians may be inclined to target the wrong problem.

(Kleinplatz, 2012)

Other voices in sex therapy have also drawn attention to the myopic model of sex therapy focused on fixing performance rather than the dynamics of the relationship limiting the quality of the experience. Instead of focusing on sustaining erections and controlling ejaculation for men or achieving orgasms or preventing vaginismus for women the shift for many clinicians has been to tackle some of the deeper issues that may account for the sexual distress.

Couples therapists and sex therapists alike recognize the need for greater integration in their practice. For example, David Schnarch (1997) drew from Bowen’s family systems theory to examine how the lack of differentiation between mates can dampen their sexual interest in one another. Carol Ellison’s sex therapy is centered on helping the couple achieve a more fulfilling emotional connection (Ellison, 2012). Esther Perel focuses attention on intimate partners’ unrealistic expectations of one another—to be best friends and lovers, where friends are supposed to be predictable and lovers are most exciting when they are spontaneous (Perel, 2006).

Integrating Couples and Sex Therapy

As a body-based Gestalt therapist, my work has always been present-centered, experiential, and interactive. But it wasn’t until I came upon the relational neurobiological work of Allan Schore that I came to more fully understand the developmental neurobiological programming underlying the emotional and relational patterns in the couples I was seeing. I have found the theory and research spurred by the relational neurobiological attachment model to be consistent with and most productive in my somatic approach to working with couples.

Securely attached individuals come to an intimate relationship with an expectation that they will be treated with respect, that their needs matter, and that when there are differences between mates, they will be able to work it out. These people are most likely to enjoy sexual contact for the emotional connection and shared pleasures.

Insecurely attached partners are more likely to have the opposite expectations and depending on their backgrounds and programming anticipate that when there is conflict, they are less likely to get their needs met and they have less faith that they can work things out. Sharing a lifestyle together may involve more familiarity than intimacy.

Satisfying sex for both members of a couple involves a quality of bodily intimacy that is not easily achieved when they are stressed or in conflict. Each person needs to feel safe to relax in the presence of the other. They want to feel loved and accepted for who they are and not for who they can pretend to be. All this can be challenging for a couple with unresolved attachment issues between them.

The ability to desire bodily contact with the partner and feel physically unrestrained and emotionally free to surrender to the pleasures of skin-to-skin intimacy requires the capacity to be present with and open to one another. Achieving this quality of emotional, physical, and sexual connection in an intimate relationship is always a process of personal as well as relational growth. Growth occurs on many levels throughout the life of the relationship. What all levels have in common is the capacity to be focused and present in the moment, in tune with one’s own body, empathically attuned to the other, and welcoming pleasure. This body-to-body intimacy is the healing factor that links relational and sexual fulfillment.

Body-to-Body Intimacy

In the popular culture being intimate with someone typically has two possible meanings: either you can tell each other anything and still be friends, or you have sex. In this social schema, the one you can say anything to, you generally don’t have sex with. Conversely, the one you have sex with, you may hold back your true thoughts and feelings. The first passes for emotional intimacy, the second for physical intimacy. Clearly, therapists can do better than that.

I like to refer to the original meaning of the word intimacy in the Latin root, intimus, inmost, and the verb, intimare, to press into. Following t...