Couples Therapy is actually a very recent development in the field of mental health. Marriage and Family Therapy, my field of study, got its start in the 1940’s and 50's when psychotherapists and psychologists began to notice that the ways in which a family interacted affected an individual’s treatment outcome.
It started with many prominent figures in the field working with schizophrenic patients and their families. In every clinic addressing this very serious mental health concern, there was a common theme of patients regressing when visited by family members or after returning home.*
Why would being with your family have such a strong effect on your ability to do better?
I think the answer lies in the understanding that we are social creatures; we form attachments to our caregivers, we find solace in our friends, we generally seek out the people who get us.
We learn how to be functional, or not-so-functional, people from the ones who raised us, who gave us messages about how we could develop and who we could be. It would stand to reason that this also sets us up for finding the people who reinforce our view of the world and our view of ourselves.
This is why I need your partner to come with you if we’re talking about a sexual problem in therapy.
Let me clarify by saying that sexual intercourse is an interaction between people. Notice I said, between. Any dysfunction that happens during sex with your partner(s) is a relationship problem, or maybe a “between-problem.”
Obviously, I will want to be sure that biological causes are ruled out by a medical professional. But even when there is a biological issue, there are still relational factors that could increase your stress level, your anxiety and these will negatively affect your condition. The mind and the body are not as separate as we have been led to believe!
If you can masturbate when you're alone but find that you lose your erection with your partner, it's a between-problem.
If you're experiencing little to no desire for sex and you feel guilty for how it's affecting your partner, it's a between-problem.
Basically, (at least) two people need to be accountable for changing the interactions that got them into this situation in the first place.
In the end only one thing is certain for me if I see one partner for individual treatment: they’re going to regress when they go home, because their partner isn’t going to be on the same page with what I’m asking and progress will either be slow or not at all.
When the above situations, or any number of common sexual dysfunctions are impairing your life and your ability to be intimate you could benefit from seeing a sex therapist who also has training in couple’s therapy. Consider including your partner in counseling, at least in the first session. It could have a huge and lasting impact on your ability to do better!
*Nichols, M. (2013). Family therapy: Concepts and methods (10th ed.). Upper Saddle River, NJ: Pearson Education, Inc.