Case Study

Is All Fair in Love and Sex?

How Couples Can Embrace their Sexual Differences

Magazine Issue
July/August 2017
A couple holds hands in front of a bed

Most couples therapists, if they were to put aside their mask of neutrality, would agree that women are in a privileged position in therapy because they can usually access their feelings better and have a fuller command of the language for doing so, especially when it comes to sex and intimacy. As a result, couples therapists often spend much of their time trying to get the man to act more like the woman, reclaiming the more feminine parts of himself to deepen his connection with his partner.

In my own work as a couples therapist, I, too, used to side automatically with the woman’s values, especially the idea that relational sex—involving deep emotional connection—is what couples should be having all the time. Like many therapists, I saw nonnormative practices that involved acting out fantasies or deviating from mainstream sexual conventions as problematic, and I’d usually join with the partner who didn’t like them. For instance, I once had a client who was turned on by listening outside the bathroom door to his wife pee before they had sex. It was like a form of exciting foreplay for him, but it angered and disgusted his wife. I wound up agreeing with her and viewing his interest in engaging in that behavior as a form of pathology. Looking back, it seems a better approach would’ve been to help the couple understand the differences in the way men and women often express their attachment to each other in sex.

I certainly don’t want to imply that all men are incapable of expressing tenderness and romance in relationships, or that all women are incapable of expressing lust or unusual desires. Nor do I want to imply that it’s not critical to listen closely and take seriously a female partner’s feeling that her partner’s objectification of her body goes against her values. However, I think we need to reverse the tendency in couples therapy of automatically siding with a female partner in an otherwise healthy marriage when she voices discomfort with her male partner’s nonmainstream sexual preferences.

While it’s important for some men to develop their ability to express attachment using words of love, we shouldn’t ignore the need to help some women understand the provocative kind of sexual attachment language their partner may be using. Women often come into couples therapy asking, “Why can’t we hug more without it always turning to sex?” But if a man’s attachment language is sex or “dirty talk,” why can’t we as therapists help women go there, too? Even if we believe that the gold standard of erotic communication is tender expressions of emotional intimacy, can’t attachment also be expressed in other ways? That was the core issue that Gary and Susan brought to therapy.

Real Talk about Dirty Talk

Gary, a software engineer, and Susan, a college professor, had contacted me because they weren’t happy with their sex life. In their mid-40’s, they’d been married for 17 years and had a teenage son. In our first session, they sat on my couch holding hands, Gary dressed casually in slacks and a sport shirt and Susan more formally in a pant suit. Although they both looked rather apprehensive, from their proximity and willingness to exchange direct glances with each other, I felt that they were a loving couple.

>When I asked them to say more about what brought them in, Gary spoke first. “Well, in the beginning of our relationship, we used to make love for hours,” he said. “I’m actually a pretty romantic guy, and I liked doing all that tender stuff, but a few years ago, I began wanting to do more of the things I’ve always fantasized about.”

Susan turned to me and said with a look of disgust, “He wants me to dress in high heels and black fishnet stockings, and talk dirty in bed. I’ve done it for him many times, but the whole thing feels disrespectful to me. And then I found out that he’s looking at women dressed like this in online porn. That’s where I think he got the whole idea.”

“That’s not where it came from,” Gary said. “I was just too embarrassed to tell you about it before. Actually, I did try to tell you before we were married, but you looked so insulted by the idea of it that I just let it go.”

“Gary, how long have you been fantasizing about women in fishnet stockings?” I asked.

“My whole life. I used to take my mother’s fishnet stockings and masturbate while holding them. Honestly, it’s always turned me on.”

“Well, it doesn’t seem right that you need props to have sex with me,” Susan interjected.

Gary turned to look directly at her. “Susan, I love you, and I love those clothes, and the bonus is when I see you wearing them. If you don’t want to wear these things, I can live with that, but then I’m still going to get my needs met by looking at women online wearing the stockings. I’d rather be looking at you, though.”

“I don’t like that you’d look at that stuff online,” she replied angrily, pulling her hand away from his. “My body should be enough for you the way it is.”

“It is,” Gary insisted, “but I’d like to have these extra things, too.”

Here their power struggle became clear. She doesn’t want to have sex this way, and when she concedes, she feels her husband is more into the stockings and heels than her. Because Gary can tell she’s turned off, he’s turned off as well, putting a further damper on their sex life.

As therapists, we work hard at helping couples learn to accept each other’s differences, but we rarely intervene in the same way for couples when it comes to sex. As I took their history, I could see that they were well differentiated as a couple in terms of everyday living, raising their son, and managing their finances. However, they weren’t well differentiated sexually. The first thing I needed to do to change this was to help them avoid getting stuck in a one-up and one-down position. In putting down Gary’s sexual preferences, Susan was taking the morally dominant position, dismissing his way of experiencing attachment, even wanting to control his private watching of porn. To help them find a way out of their stalemate, I needed to help Susan understand something about fetishes like this.

“Susan, I can tell that this feels like a personal assault to you, but you should know that men typically have more fetishes like this than women.” I said. “Many of my male clients have sexual fantasies that don’t involve their wives, only women to whom they feel no attachment, but what I’m hearing is that Gary wants to do this with you, not other women. That suggests to me that this is a way he wants to bond with you by exploring some of his fantasies with you.” Gary nodded while I was speaking. “Can you hear that Gary is saying that it’s not just about the clothes, that it’s about you, too?” I asked her.

“Maybe,” she conceded, but then the look of disgust returned to her face. “But he also wants me to go on and on about how big his penis is, and how he wants me to swallow his ejaculate. That’s vulgar to me. It’s gutter talk. And the words he uses when we have sex to talk about my own body parts are utterly disrespectful. I wasn’t brought up this way, and it completely turns me off.”

“That makes sense to me that you feel this way,” I told her. Turning to Gary, I said, “Every day, women are fending off male advances—in the office, in the grocery store, while they’re walking down the street. Much of the time, they feel objectified by predatory men, so naturally Susan is sensitive to this kind of disrespect, and she needs to hear romantic talk as well. Does it make sense to you that at times she needs you to stretch more toward her needs?”

“I know that’s true,” he responded rather sheepishly. “I’ve seen how other men look at her. I understand, and I don’t want to make her feel that way. I really do try to let her know how I much I love and respect her, but I guess I can do a better job of that.”

“Susan,” I said, “you may be conflating that lewd guy in the grocery store, or wherever it is, with your husband. It’s important to keep in mind that it’s you Gary wants, not some anonymous woman on the street. For him, it’s not about dominance or disrespect, but about how he expresses his attachment, as odd as that may seem to you right now. However, it’s important for Gary to respect your boundaries. If you say something doesn’t feel good, he needs to respect that and stop.”

Because it was the end of the session, I told them that we could talk about permission and limits in the next session if they felt that was an issue. As they walked out the door that day, I wondered if I’d laid enough of a foundation to help them become more empathetic toward one another and move past judgment. Although I hoped Susan would feel comfortable taking the risk of trying to expand their sexual repertoire, I worried she thought I was siding with Gary because I was a male.

They Try Again

I was pleased to see Susan and Gary the following week, but I noticed immediately that there seemed to be some tension between them. “I thought about what you said,” Susan started immediately. “So when Gary came home from work on Thursday I greeted him at the door in those black stockings. He seemed really happy.” Gary kept his eyes on the ground as Susan spoke, looking a little ashamed. “But as soon as we went upstairs to the bedroom, he started in with his dirty talk. It ruined the mood completely. Instead of saying how much he loved that I did that for him, he told me all the things he wanted to do to me. I took those damn stockings off, put on my jeans, and I decided to walk the dog.”

I looked at Gary, who just shook his head. “I did appreciate it. All I said was that I wanted to fuck her hard and that I wanted her to suck me until I came. I thought after the last session it would be okay, but she freaked out. So when she went to walk the dog, I watched some porn because I was all worked up and didn’t know what else to do.”

Although they hadn’t moved, the space between them on the couch seemed to grow wider as they told me this.

I took a deep breath and turned to Susan. “That’s how many men talk sexually,” I said, “how they express their attachment to their partners during sex. In the same way, women like to say things like ‘take all of me’ or ‘ravish me’ or ‘tell me I’m the most beautiful woman you’ve ever seen.’ One conveys words of love, and one is dirty talk—they’re just different languages. He’s speaking in objectified ways that allow him to be more turned on. You know, Susan, research indicates this is a way men can separate their partner from, say, the mother of their children, and even from their own mother. When people are intimate, many times another persona comes out to play, one that’s hidden from the rest of the world. With Gary, this other persona seems to say that he wants to trust you with this vulnerable, private part of himself, and hopes that you can get turned on, too. It’s kind of a paradox: by objectifying you, and talking dirty to you in bed as if you were a different person than you are in day-to-day life, he ends up feeling closer to you. He’s revealing a glimpse of what I call his core sexual script, and sharing it with you. Maybe it shouldn’t be the only way he talks in bed, but can you perhaps consider it’s one of the ways?”

Susan thought for a moment and seemed to soften. Then her body stiffened and she said, “Well, I’m not okay with him looking at porn or masturbating when he has access to me. I think that when guys do that they start wanting other women and going out to find them. He shouldn’t have to do that.”

I pointed to David Ley’s well-researched and humorous book called Ethical Porn for Dicks: A Man’s Guide to Responsible Viewing Pleasure, which resides on my bookshelf. “This psychologist’s research clearly shows that men enjoy both porn and sex with their partners, and don’t replace one with the other. Think about books like Twilight and Fifty Shades of Grey,” I told Susan. “People call these ‘cliterature’ because they’re a turn-on for women. They express a desire to imagine a partner who’s more exciting than the person with whom they’re sharing their bed. But having such fantasies doesn’t have to mean that a woman will betray her husband with someone else, or that their relationship is somehow doomed. It’s just fantasy.”

“Well, I guess I hadn’t thought of that,” she said, turning to Gary with the hint of a smile on her face. “Is that true?” she asked him.

“Yes!” Gary said. “Seeing the stuff online is just something that makes me horny. And it’s a role I want to play with you. It excites me! You excite me!”

“But when you say the things you do, it’s hard for me not to feel disrespected,” she replied.

At this point, I interjected, “What if you were to turn this around, Susan? What if you were to take a dominant position, and say something like ‘I want your cock. It’s mine. It belongs to me,’ or ‘Take all of me’ or ‘Fuck me now’? In romance novels, many women reading them find it sexy to be ravished and possessed by an alpha man.”

I asked Gary, “How would that feel to you? Could you handle that?”

“Oh, my God, yes!” he exclaimed. “That would turn me on for sure, and it would make me feel like you see and accept this part of me without all the judgment.”

I said to Susan, “Do you think you might talk with some of your girlfriends and find out if any of them enjoy some of this kind of talk and behavior? I think you might be surprised by their answer.”

“I guess I can do that,” she said, smiling. “Maybe it’s more normal than I thought.”

“Again,” I suggested, “think of your sexual encounters as play, like you’re acting out different scenarios. You might find it exciting, and even grow closer as a result.”

Making Progress

Over the months that followed, Gary reported that by experimenting with these roles, he was surprised that the passion and romantic feelings they had in the beginning of their relationship had reawakened, and they could again make tender love for hours. Susan reported awakening dormant sexual fantasies and thoughts she’d had as an adolescent, like slowly stripping off her clothes (all except the stockings and high heels) and masturbating for Gary. She bought more sexy bedroom outfits and some toys, and gave herself permission to experiment with her sexual connection to Gary in ways she’d never dreamed of. They were grateful for their newfound pleasure, and felt more bonded than ever.

Just as it’s therapeutic for couples to work through and accept differences relationally, this is also true of sexual and gender differences. Such differentiation is essential for both partners. Too often, the sexual health of the couple is steered toward the partner who’s most uncomfortable and disgusted with the other’s sexual interest, leaving that partner to find other ways to channel his or her sexual interests secretly, rather than openly.

Couples struggling with different interests in sexual behavior have an opportunity to engage in sexual differentiation by listening deeply to each other, forgoing reactivity, or making one partner right or wrong, good or bad. Most therapists understand and would agree with this when sex isn’t involved, but when the conflict is about sex and sexuality, many therapists’ unexplored sexual biases intrude. Their countertransference often takes couples to a place that aligns with the therapists’ beliefs about sexuality, or with the partner with whom they most agree—which isn’t helpful. Instead, therapists need to allow the couple to have uncomfortable sexual conversations, and therapists need to sit with their own discomfort and keep their bias out of the therapy room. For many therapists, I suggest some postgraduate training in human sexuality to understand the nuances of sexual expression by both men and women.

We need to help our clients discover and overcome the false assumptions that they, and we, often make about the myriad ranges of sexual expression. Sex and sexuality can be dirty, crude, messy, smelly, and sometimes very politically incorrect—which is often what makes it so hot for people. But it can also be a source of pain and discomfort if partners don’t understand that what seems awful and wrong during the day can become erotic and intriguing at night.

Case Commentary

by Tammy Nelson

The trend toward the feminization of couples therapy isn’t all that surprising considering the majority of couples therapists today are females. It’s also not surprising that the focus of most couples therapy is on the partner who feels more wounded, experiences the greater betrayal, or has the louder complaint. Since women are enculturated to be connected and relational, this partner is often the female, and the absence of this kind of intimate bonding is usually what leads women to seek therapy in the first place. So as therapists, we’ve been taught to focus on attachment as the primary means of healing the breach in relational intimacy.

Yet expressing emotion may not be what makes men, or those with a more masculinized view of the world, feel connected in a relationship. Indeed, many men come into therapy wanting only a list of what they can do to please their partner and fix the relationship. But as Joe Kort points out, this doesn’t mean that men don’t also want to be connected emotionally. On the contrary, many men feel an intense relational bond through sharing fantasies and opening up about their deepest desires, however “forbidden” they may seem. This often means focusing on the physicality of sex, rather than on the exchange of feelings that’s emphasized in most couples work.

Kort does a good job of helping Susan understand what Gary desires, so she can also focus more about what turns her on. He helps both partners untangle their confusion around the role of fantasy, consent, and the differences in what turns them on. Men are often taught that being emotionally available in bed always means being as tender as possible and being particularly sensitive in understanding when no means no. And yet at the same time, we now live in the age of Fifty Shades of Grey, which opens a window on women’s desires, on the more forbidden, edgy side of female eroticism. So it’s not just men who objectify women and their sexuality. This is understandably confusing for both men and women, as they try to figure out the limits of what’s appropriate and meaningful in the bedroom.

The other issue that Kort brings up is the idea that Susan doesn’t “own” Gary’s sexuality and how understanding this leads to a more mature level of separation and individuation, in which it’s okay for men and women to have different desires. Although it may seem frightening at first, fantasies that differ and even objectify may actually bring a couple closer, keeping the relationship more passionate and alive. After all, relationships that feel more attached may feel safe, but a sexual relationship that welcomes all different types of desires can be more erotic, which can lead to deeper levels of connection.

The only thing I might take issue with in this case is after Kort suggests that Susan might check with her girlfriends about their fantasies. When Susan says, “I guess I can do that” and adds, “Maybe it’s more normal than I thought,” I’d have jumped in to clarify her use of the word normal, letting her know that while normal may be a setting on the washing machine, it means nothing in human relationships. There are as many variations of sexuality as there are people, and thus couples. We all desire passion and aliveness. Our job as therapists is to help people find how to get there.


Illustration © Sally Wern Comport

Joe Kort

Joe Kort, PhD, LMSW, is a board-certified sexologist and the founder of The Center for Relationship and Sexual Health, and runs a private practice in Royal Oak, Michigan. Dr. Kort, a therapist, coach and author, has been practicing psychotherapy for more than 25 years and has spoken internationally on the subject of gay counseling. He specializes in sex therapy, gay affirmative psychotherapy, sexually compulsive behaviors, and IMAGO relationship therapy designed for couples to enhance their relationship through improved communication. Dr. Kort is a blogger for the Huffington Post and Psychology Today on issues of sexuality. He has been a guest on the various television programs on mixed orientation marriages and “sexual addiction”. Dr. Kort is the author of several books, including, LGBTQ Clients in Therapy, Gay Affirmative Therapy for the Straight Clinician, 10 Smart Things Gay Men Can Do To Improve Their Lives, 10 Smart Things Gay Men Can Do To Find Real Love, and Is My Husband Gay, Straight or Bisexual.



Tammy Nelson

Tammy Nelson, PhD, is an internationally acclaimed psychotherapist, Board Certified Sexologist, Certified Sex Therapist and Certified Imago Relationship Therapist.  She has been a therapist for almost 30 years and is the executive director of the Integrative Sex Therapy Institute.  She started the institute to develop courses for psychotherapists as the need grew for certified, integrated postgraduate sex and couple’s therapists in a growing field of mental health consumers who need more complex interventions for their relationship needs. Dr. Tammy is a TEDx speaker, Psychotherapy Networker Symposium speaker and the author of several books, including Getting the Sex You Want: Shed Your Inhibitions and Reach New Heights of Passion Together (Quiver, 2008) and the best-selling The New Monogamy: Redefining Your Relationship After Infidelity (New Harbinger, 2013), as well as When You’re the One Who Cheats: Ten Things You Need to Know (RL Publishing Corp., 2019) and the upcoming Integrative Sex and Couples Therapy (PESI, 2020). She can be followed on her blog,