Sex in Couples therapy in Shillong

Over the years, it has been made clear again and again that dealing with issues within a relationship between two individuals is hard and challenging. Of course, traditional thinking of men’s roles and women’s roles has always been an issue because both these genders seldom want to move beyond their comfort zones. Then, religious teachings add more complications and strengthen gender roles to the point that a typical therapist would give up trying to “make things work” but would themselves submit to the socially acceptable roles of gender and throwing out all ethical codes of conduct and assume an authoritative role of telling them exactly what to do.

They are not to be blamed. In Shillong, majority of the counsellors are untrained anyway. The overlapping of roles of different professions has aggravated this problem. However, there are those who dare to question- question how the dynamics of a relationship should be, how gender roles are but mere conformity to the stereotypical roles setup by a masculine and patriarchal society, how sex needs to be discussed, debated, acted out, and how we need to stop looking at things from the male perspective.

It is interesting that most times, amongst heterosexual couples, just the woman comes for therapy and asks us, “What can I do?”. Men do not see therapy sessions as important or even worthy to explore. For us counsellors, the task to counsel is difficult and almost impossible when only one party is willing to invest in the process.

The therapist of course would try to help using the skills and techniques they have learned like active listening, looking for non verbal cues, reflection, paraphrasing and so on, and yet, nothing works. So begins the teaching of “positive communication” with the ‘I feel’ and ‘I understand’ sentences that would help avoid the possibility of the partner misinterpreting the woman’s anxiety as anger, contempt, or rejection and perhaps, he will listen attentively and respond supportively. We understand that the male creature will respond to a certain tone and language with affection and love but if the counsellor does not get carried away by this premature success, they will realise that the male creature has taken a defensive stance and that their defense mechanism is activated.

More times than usual, because the male creature has now been put on the spotlight, he will retaliate by throwing the blame either on his partner or on any other situation that they can which is believable so as to not be on the spot anymore. Years of being taught that men are not as emotional as women or that woman have to make peace when there is war, makes him happy because he is the head of the household.

What now counsellor ? More exercise, more assignments? What about sex? Too soon? Non sexual communication exercises? That’s it, more of those?

But, where to begin? Let’s start by ensuring that the counsellor is comfortable in dealing with questions of sex and sexual activities. This means, no blushing, no hesitation, no dilli-dallying, not too eager but not too distant; after all it is someone’s personal, private, intimate experience.

I personally have always had trouble talking to someone about their sex-lives, not because it makes me uncomfortable or that I am unprepared, but because I wouldn’t know how to start the discussion with someone who is unaware of their own sexuality. Are they conscious of their preferred sexuality? Do they even masturbate? Do they know how to? Do they Orgasm? Have they ever had an orgasm?

This part of couple’s therapy is often difficult to many counsellors. I believe it becomes more of a problem if the counsellor cannot separate the professional with the personal. Individuals who enter the profession of counselling thinking it is a ‘calling’ (from god), have the most difficult time. Religious teachings can be used in a progressive tone, which can have a tremendous effect in the way a professional conducts their sessions. It can become a hurdle that cannot be passed if that individual comes from an orthodox and conservative religious perspective which dismisses others’ points of view for their own.

Anyways, assuming that you are at a stage where both partners are willing to enter the therapeutic process, there is still a hurdle of their reaction to a third party’s involvement in their sex-life. Rapport building is not enough. It requires a different level of acceptance by their union to allow an external influence in their matter. Hence take it slow. Ensure that the couples are there willingly; both their motives are set on building bridges and working towards a comfortable place in their relationship and that both are ready to explore and discover. It is important not to assign couple sexual homework until the couples feels confident about their own sexuality and wants to begin exercises with a partner.

This is where non-sexual communication exercises can actually come into play. It will fail on its own, it will not succeed without the participation of both partners but it’s a crucial initial step for the couples to be able to proceed with other aspects in their relationship. Exercise like ‘listening’, to each other problems and anxieties especially with regards to sex, can also improve their overall behaviour with each other. While one person talks the other should listen with interest but without offering advice or suggestions. Active listening exercises which can be found in Gordon’s P.E.T.: Parent Effectiveness Training (1970) is also another effective method. Recreating and adapting an exercise described by Bach and Goldberg (1974) can help couples get rid of resentment and increase appreciation. When couple’s communication improves, their acceptance to the methods and techniques in counselling becomes more open and their willingness to cooperate becomes much better.

This is when a trained counsellor would also increase their dose in treatment, moving from mere communication to actual touching. Touching is a very important form of communication. Having a couple resume nonsexual touching that prohibits sexual interaction reduces anxiety and allows sexual feelings to surface. This in turn will help the couple become closer and instigate feelings of love and lust and new found desires for their partners. The work of Masters and Johnson (1970) described massage exercises that follow certain ground rules. These exercise aim at helping couples who have lost that intimacy between them regain confidence and sexual desires for their partners. It often involves touching with massage of the extremities (hands, face, feet) avoiding breasts, genitals etc. We all have heard of role playing, and even here, playing doctor is another method one can use. This technique was designed by Hartman and Fithian (1972) to desensitize couples to touching each other’s genitals, as well as to provide a forum for exchanging explicit information about genital sensitivity.

The therapist must ensure that couples understand that these exercises can be a little awkward and uncomfortable at first but if instructions are followed as they should be, then the possibilities are endless. It is vitally important that the therapist themselves are well acquainted with the step by step process of these exercises.

It will be no surprise that breaking the rules of these exercises will occur, and the therapist must be ready for the consequences that follow. For some couples, they are at a stage comfortable enough to go beyond and that will not present any problems in the treatment process but, there are those that will find that breaking the rules means increased in anxiety and confusion and that it would have undone the months of work they have put in trying to fix their situation. To them it will seem to be a dead end. This is when the therapist steps in, recalibrate and restart the process using the same techniques and steps or alternate them with the many other available to ensure that the couple get the help and the trust intact.

It is important that at any given stage of the therapeutic process, the counsellor maintains control and confidence which should show to the clients at every twist and turn. This is important because they need to know that if the ship is sinking, they will not be left stranded alone in the oceans with sharks and poisonous jelly fish and flesh eating piranhas. They need to know that you can help steer to safety.

When the therapist feels confident that the exercises (above mentioned or any other) produced the desired results or changes, then much more intensive exercises aimed at improving sexual communication can be implemented to further the closeness and strengthen the relationship of the couple. Exploring new things in sexual activity can help in the development of new feelings, new ideas about one’s partner which can be exciting and vulnerable at the same time. The request can be in verbal form to a non verbal action.

The sexual readiness scale, developed by Engel (1977), is helpful for couples with seemingly dissimilar sex drives. Couples in a society like ours have been found to have dissimilar sex drives. This can be to the role they are expected to play even in their private time together as a couple. This scale is placed here as it is important for couples to express their desires and moods to sex so that none of them feel pressured into an activity they are not really into.

Masturbation with a partner or for a partner is another exercise that couples that have lost touch with, which would help them feel excited to be in a safe relationship that allows expression and discovery. The seventh step in Lobitz and LoPiccolo’s (1972) masturbation program is for the woman to masturbate in front of her partner. This puts control in the woman and it diverts from the traditional expectation of the man in control. However this does not involve the belittling of the man. In fact, it teaches the partner the exact areas and types of stroking that gives his partner the most pleasure.

The exercises are but tools used by the therapist to ensure a successful outcome. Usually, once the couple is able to openly to discuss their feelings about sex, their preferences, and of course their attitudes towards new behaviours, their acceptance to changes within the relationship as the relationship gets older also grows. Their willingness to experiment and to re-interact with one another in such naked and vulnerable circumstances can make them more able to come out of the various difficulties they would face as a couple.

However, in our society (the one that seems repulsed by change and progressiveness) accepting that sex is a big chunk of an individual’s life that can enhance a couple’s togetherness is still far off. The lack of professionally-trained counsellors in many schools, hospitals etc. and the unwillingness to bring a change in the education system to include sex-ed as part of the curriculum will continue to break relationships, have unhappy homes and to create many mental health issues associated with an uninformed public. It is thus important that trained psychotherapeutic counsellors speak out and move beyond their world of work to bring about important changes in society.

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Raiot

Roney Lyndem Written by:

Roney Lyndem works as counsellor and is a Union activist with Thma U Rangli Juki (TUR)

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