Our society is saturated with images and myths about beauty and manliness, sexual performance and an over-emphasis on romantic and perfectionistic sexuality. Meanwhile, approximately 45% of couples at a given time suffer a male, female or couple sexual dysfunction. (Laumann et al., 1999). This sexual dysfuntion goes beyond a simple performance problem with a simple cure, and the approach to it needs to be individualized to the couple, not “one size fits all”. The optimal model is a psychobiosocial approach to assessment, treatment and relapse prevention of both male, female and couple’s sexual dysfuntion.
With this in mind, Metz & McCarthy (2007) developed “The Good-Enough Sex model” as a positive set of principles and anchors to guide sex therapists as well as to facilitate couple’s reflection on the meaning and value for them of their sexual relationship. The model challenges couples to set realistic expectations based on intimacy as the ultimate focus in order to achieve couple satisfaction. This intimacy is sought by both, men and women, although often through different avenues. Whether biologically influenced or socially contructed, men traditionally pursue emotional intimacy through sexual intimacy while women commonly pursue sexual intimacy through emotional intimacy. An essencial feature to achieve intimacy and satisfaction is the ability to be playful during couple’s interation because for play occur trust, mutual acceptance, pleasure, freedom to be oneself and deep valuing of the relationship must exist and those idiosyncrasies make relationship special.
Lastly, sex should not be an isolated fragment of one’s life, rather should be integrated into the couple’s daily life and their daily life integrated into couple’s sex life creating couple’s unique sexual style that will grow and evolve throughout life.
The couple should cooperate as an “intimate team”, prioritizing mutual emotional empathy and use their sexuality as an essencial relationship forum and opportunity
by André Barcelos, MD and Alberto Silva, MD
Hospital Professor Doutor Fernando Fonseca, EPE - Lisboa /Portugal