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A Story With A Happy Ending


Name: Nathan
Gender: Male
Age: 37
Location: Dallas
I’m a married guy with a great wife and 3 beautiful kids. A couple of weeks ago, I went to a masseuse I found on Craigslist. I don’t have a lot of experience with massage and thought I would be safe going to a guy instead of a woman. The guy was really nice and did a good massage, but somehow I popped wood near the end of the massage. I was really embarrassed, but he was like totally ok with that. Then he asked if I wanted a happy ending. I didn’t even know what that was till he started to massage my ass and blow me. I have to admit it was totally amazing. I never felt anything like it before in my life. My wife sometimes will give me oral sex, but nothing like this. I blew a load like nothing I ever did before. I though my insides were coming out of my cock. I was amazed and scared and confused and I could hardly sit up. Then the guy said I had a real healthy prostate. I said, WHAT? And he said he was massaging my prostate while he was sucking me off. I can’t stop thinking about this. I want more but I feel really guilty and I’m afraid this is going to make me gay.

What a great story, Nathan. But we need to clear up a few things. A masseuse is a female practitioner of massage. A masseur is a male practitioner. This is a common enough mistake, but I thought you should know the proper usage for further reference. Because you can see how a little unintended slip like this will make all the difference in the world. If you say a masseuse gave you a blowjob that’s totally different from getting a blowjob from a masseur, don’t ‘cha know.massage_butt.jpg

I’m gonna also guess you never had a prostate massage before this encounter with the masseur. A prostate massage coupled with your first blowjob from a guy…hell, you are lucky your insides didn’t shoot out your dick along with your spooge. I’m joking of course, but it does stand to reason that you had such an intense and explosive orgasm and ejaculation. That’s precisely what a prostate massage does, honey.

Now, let’s see if we can figure out why you can’t stop thinking about this. It doesn’t take a rocket scientist to analyze that either. This was a peak sexual experience for you. I mean, beside the mind-blowing release, the means by which you had this orgasm — the guy’s finger in your ass and the guy’s mouth on your dick were both unexpected and apparently unprecedented. So I figure you had very little time to cognitively respond to the stimuli before things came to their explosive climax, so to speak, as it were. And you did say you were already relaxed and aroused by the massage, right?

I’d be willing to bet that if you had some emotional distance from the experience you would realize your body was simply responding to the stimulus it was receiving. Your dick and your prostate weren’t able to distinguish the gender of the person diddlin’ your ass and suckin’ your dick. And since your brain was occupied with all these new sensations you had little time, if any to process and possibly protest. And maybe you wouldn’t have protested even if you could. Maybe you wanted to take this little walk on the wild side. Trust me, lots of guys do.

come as you areNow that the event has passed, you have plenty of time to process. And process you are…to within an inch of its life…if ya ask me. This experience looms so large for you because it is forbidden fruit, so to speak. It upsets the apple cart of your cozy and predictable heterosexuality. I mean it’s one thing to pop wood on a massage table. It’s something totally different to blow a wad while a guy is givin’ you head.

And now that you have all this time on your hands to keep pouring over and over this in you head, the event has taken on a proportion it probably wouldn’t have otherwise.

Let me put your mind to rest, one blowjob from a guy…even an earth-shatterin, prostate-massagin’ blowjob, like the kind you got from this fabulous masseur…won’t make you gay. Nor does wanting to repeat the experience make you gay. All this experience really tells us is that you like a good blowjob and you now know where to get a really fantastic one when next you want one.

Think about it this way. Say you went to a Chinese restaurant and, to your great surprise, had the best dim sum ever. You were so impressed with the food that you’ve been eager to return to this particular eatery for another go at those tasty vittles. Does this desire for yummy dim sum make you Chinese? I don’t think so…that is unless you were Chinese before you went to the restaurant.

Finally, the guilt you’re experiencing, where might that be coming from? There are so many sources one would be hard-pressed to come up with an exhaustive list. But let’s look at the top contenders.hands & butt

  • You’re married with a family. You had a sexual experience…unplanned as it might have been…with someone other than your wife. BINGO!
  • Our culture’s buttoned-down sex and gender stereotypes — who can do what to whom. BINGO!
  • The dictates of our sex-negative society about what is proper and what is not in terms of sexual exploration and experimentation. BINGO!
  • The shame of possibly being labeled a fag. BINGO!
  • The fear of your own desires and where they might lead you. BINGO!
  • The allure of the forbidden and the explosive charge the illicit. BINGO.

The experience you had with that masseur, Nathan, is so highly charged, both culturally and sexually, that it will take some while for you to find your balance once again. In the interim, my I suggest that you postpone any judgments about yourself or what the incident might imply about you until you’ve have some emotional distance and the time to calmly process all of this. In the final analysis, I think you’ll come to the conclusion that this is a relatively harmless sexual outlet. The masseur is providing you a service…I mean beyond the obvious. He is providing you a safe, secure non-judgmental environment to exercise and expand your sexual repertoire. Think of it like a place you go to learn about the wonders of sexual dim sum.

Good luck

Family History and Addiction Risk: What You Need to Know to Beat the Odds


You grew up in a family of substance users. You know that your risk for developing an addiction to drugs or alcohol is greater because of this hereditary factor. But what exactly are your risks? And is there anything you can do to reduce your risk?

According to the National Council on Alcoholism and Drug Dependence (NCADD), the single most reliable indicator for risk of future alcohol or drug dependence is family history. In an article written for NCADD, Robert Morse, MD, former Director of Addictive Disorders Services at the Mayo Clinic and member of NCADD’s Medical/Scientific Committee, says, “Research has shown conclusively that family history of alcoholism or drug addiction is in part genetic and not just the result of the family environment…millions of Americans are living proof. Plain and simple, alcoholism and drug dependence run in families.”

How Family History Affects your Chances for Addiction

Family history affects your chances of addiction in many ways. Genes are one important factor. But alcoholism and drug addiction are “genetically complex.”

Recent research has identified numerous genes, and variations within these genes, that are 005associated with the addictive process. One way genes affect a person’s risk for addiction involves how genes metabolize alcohol. Another is how nerve cells signal one another and regulate their activity. Such changes in genes can be passed down from one generation to another.

Perhaps the strongest evidence for heredity’s role in addiction comes from twin studies and adoption studies. Studies of twins found a 60% rate of similarity regarding addiction in identical twins vs. a 39% rate of similarity in fraternal twins. Studies of children adopted in infancy and studied for addiction risk in adulthood found that biological sons of alcoholics were four times more likely to become alcoholics, even when the adoptive parent had no issues with addiction, so the l factor of family environment was minimal.

But genetic predispositions are not the only factor in predicting the role of family history in addiction risk. Environmental aspects also play a role, even though they may be less significant in some cases.

Researchers have identified several family-related risks for increased vulnerability:

  • Family dysfunction (conflicts or aggression)
  • A parent who is depressed or has other psychological issues
  • One or more parents who abuses or is addicted to drugs or alcohol

Additional social and personal issues that contribute to risk include:

  • Limited social skills
  • Fragile self-esteem
  • Minimal or no support system
  • Personal history of impulsivity, aggression or difficulty managing emotions
  • A history of trauma or abuse (high risk for post traumatic stress)
  • Other psychiatric disorders such as depression, anxiety or bi-polar disorder
  • Friends or acquaintances who are regular users and who provide easy access to drugs or alcohol

Addressing and Reducing Risks

An alternative viewpoint regarding a family history link for addiction comes from a National Institute of Health (NIH) meta-study of 65 published papers documenting 766 study participants who were college or university students. Controlling for alcohol consumption and use disorders, family history was reviewed as the variable. The meta-study found that students who had family histories of alcohol or drug problems did not drink more but they were likely to be more at risk for problems that are associated with drug or alcohol use (ex: causing shame or embarrassment to someone; passing out or fainting; or having problems with school).

The bottom line is that there are still a lot of uncertainties when it comes to assessing drug and alcohol risks as they relate to family history. The good news is that even if you come from a family with a troubled history, or a history of addictions, that does not mean you will automatically become an addict. The risk is higher, but there are ways to prevent that from happening. You can choose to be proactive and greatly reduce your addiction risk.

Here are a few suggestions to reduce your addiction risk:

  • Avoid under-age drinking or substance use; early-onset of use increases risk
  • Choose abstinence or carefully monitor your consumption
  • Avoid associating with heavy drinkers or substance users
  • Manage your psychological health; seek assistance from a mental health provider if you are highly stressed, anxious or depressed
  • Participate in workplace or school prevention programs

Intervention Strategies

Should you already find yourself dealing with an alcohol or drug issue, here are some intervention strategies provided by the National Institute of Health, in their publication, Alcohol Alert:

  • Motivational Interview: This strategy focuses on enhancing your motivation and commitment to changing your behavior, if you are currently abusing drugs or alcohol. Typically you would work with an addictions counselor or mental health professional and discuss your beliefs, choices and behaviors associated with substance use. The purpose of the interview is to help you develop a realistic view of your use, problems associated with it and your treatment goals and expectations.
  • Cognitive–Behavioral Interventions: These strategies are taught by a counselor or therapist, or they can sometimes can be accessed via an online self-help program. They help you change your behavior by helping you recognize when and why you drink excessively or use illegal substances. Cognitive-behavioral approaches challenge irrational expectations about substance use and raise your awareness of how drugs or alcohol affect your health and well-being. They provide tools for mentally and emotionally addressing denial, resistance, self-criticism and shame.
  • Drug-Free Workplace programs: Many workplaces now help their employees who are abusing alcohol or drugs. Lifestyle campaigns encourage workers to ease stress, improve nutrition and exercise, and reduce risky behaviors such as drinking, smoking, or drug use. Other programs promote social support and volunteerism. Many Employee Assistance Programs offer employees referrals to substance abuse or other treatment programs, and may help pay for treatment.

Remember, the risk for alcohol and drug addiction does run in families. But you can manage the risk and avoid an addiction problem in your own life. Be proactive in monitoring your substance use, manage your mental and emotional health and seek support if you need it. The final outcome will depend on you and the choices you make today, not on your history.
Complete Article HERE!

A Farewell to a great man

Dear sex fans,

I realize this is a bit off topic for this blog, but I want to acknowledge the death of famed British neurologist and author, Oliver Sacks.

1993: Portrait of British-born neurologist and author Dr Oliver Sacks standing in the admittance driveway of Beth Abraham Hospital with his arms crossed over his chest, New York City. (Photo by Nancy R. Schiff/Hulton Archive/Getty Images)

1993: Portrait of British-born neurologist and author Dr Oliver Sacks standing in the admittance driveway of Beth Abraham Hospital with his arms crossed over his chest, New York City.

In February, he wrote an op-ed in The New York Times revealing that he was in the late stages of terminal cancer, after earlier melanoma in his eye spread to his liver.

“It is up to me now to choose how to live out the months that remain to me,” he wrote. “I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.”

Earlier this summer I read Dr Sacks’s memoir, On the Move.  I love it.  It’s an interesting memoir by a fascinating personality.  And while reading I discovered that we had a dear friend in common, Thom Gunn.  What a small world!  So I decided to send him a note.

Dear Dr Sacks,

I just finished reading your memoir, On The Move.  What an amazing life you’ve lived.on-the-move-by-oliver-sacks

Of all the marvelous things you’ve done and all the fascinating people you mentioned in your book nothing surprised me more than your close friendship with Thom Gunn.  I was a friend of Thom too and I lived directly across Cole Street from him.  I moved to the flat at 1207 Cole Street in 1979.  At the time I was working on my doctorate in clinical sexology at the Institute For The Advanced Study of Human Sexuality in San Francisco.

I didn’t know Thom well at first.  However, I would regularly see him walking both in our neighborhood and elsewhere in town.  He was always in his leathers, rain or shine, and used to think to myself, “What a mensch!”

It finally dawned on me that he lived across the street from me.

Once he saw me in my roman collar.  (I was ordained a catholic priest in 1975 at the age of 25 in Oakland, CA.  I had come out to my local superiors; I was a member of the Oblates of Mary Immaculate, before I was ordained.  Like I said, I was working on my doctorate to become a sex therapist and prepare for an upfront gay ministry.)  Thom smiled at me when he saw me; I blushed and told him what I just told you.  He was fascinated, but I also believe he thought I was a twit.  He probably was right.

I knew nothing about Thom other than he was my neighbor.  Then one day I was in a bookstore on Haight Street and there was a photo of Thom in the window advertising a reading.  That’s when I started asking around about him.  Despite his cult status within the gay community, he was the most unassuming person.  I was honored to have a personal connection with him.small_front

I finished my doctorate in 1981.  My dissertation, Gay Catholic Priests; A Study of Cognitive and Affective Dissonance was directed by Wardell Pomeroy.  A firestorm of media attention followed.  The media branded me as THE gay priest, as if.  I think Thom read about me in the New York Times because next time he saw me he clapped me on the back and said, “Well done.”

No sooner did I complete my doctorate, and because of the media attention my public coming out caused, the leadership of my religious community in Rome began a process of dismissal against me.  I was devastated and lost.  I was even getting death threats.  Thom was always so supportive and encouraging.

I fought the church for the next thirteen years in an effort to save my priesthood and ministry.  Alas, the writing was on the wall back in 1981 and it was only a matter of time till they had their way with me.  I wrote about the travail in a book that was published in 2011, Secrecy, Sophistry and Gay Sex In The Catholic Church: The Systematic Destruction of an Oblate Priest.

Thom was always so solicitous about my wellbeing.  He knew how difficult life had become for me.  And both of us found ourselves on the forefront of caring for friends who were dying of AIDS.  One of my landlords died in 1986.

Thom introduced my housemate and I to Augie Kleinzahler and his girlfriend, Caroline Lander, who lived only a few blocks from us in Cole Valley.  We all became great friends and copious amounts of strong drink were consumed.  I wonder, do you know Augie?

When Thom turned sixty I surprised him with a homemade German chocolate cake.  I told him he was the oldest person I knew.  This made him laugh and he called me a whippersnapper.

In 1992 the surviving landlord sold the Cole Street duplex and I and my housemate moved to Oak and Ashbury.  Sadly, I didn’t get to see Thom as much as before.  I move up here to Seattle in 1999 because I could no longer afford to live in SF.  I was deeply saddened to learn of Thom’s death in 2004.  He was such a great guy, what a marvelous soul.

Again, thank you for your memoir; it was grand getting to know you on a personal level.  I read The Man Who Mistook His Wife for a Hat when it came out in the mid-eighties and loved it.  But I never guessed you and Thom knew each other or that you actually visited him when I lived across the street from him.  What a small world.  I wish I had known you back then.

Anyhow, thank you for the bringing me this unexpected flood of memories of Thom.  I wonder what he would have made of yesterday’s Supreme Court decision (Obergefell v. Hodges).  I contend that we got marriage equality only because we walked through AIDS first.  I think Thom would have agreed with me.

All the best,

Richard Wagner, M.Div., Ph.D., ACS

To my astonishment, Oliver wrote back; I mean that literally, a handwritten note.  Apparently, he never used a computer.

Dear Dr. Wagner (can I say Richard?),                                                          6/60/15

I am greatly interested and greatly moved, by your letter — your courage in being honest and forthright, at a time and on a subject bound, sooner or later, to cause your ejection from the priesthood. In another few years perhaps, with Pope Francis at the helm, these last bastions of Catholic bigotry may have fallen.

I like to think of you as living across the street when I visited Thom, and glad to know that he appreciated you and your works. I still miss him deeply — there were not too many people with whim I could be entirely open — and I like to think that his ghost is pleased that my title came from his poem. (I find it a huge relief being open now to all and sundry {Oliver came out earlier this year} — I am so glad I completed my book before I became ill).

And what a liberation, an affirmation for us all that the Supreme Court voted as it did. I suspect that Ruth Bader Ginsberg, quite ill now, stayed on to ensure the 5/4 decision.

Thanks for your letter and my very best wishes,


Oliver Sacks01     Oliver Sacks02

Click on this link to see a copy of Oliver Sacks’s note.

Thank you Dr Sacks and farewell!

A Boy’s Own Story

What follows is an exchange I had recently with a young Catholic Canadian man.

Hi Dr. Wagner

My Name is Jack, I am a catholic teenager who is wondering if the act of masturbation is still considered to be a sin. Also is it really considered to be gravely disordered and always morally wrong? I am 18 years old and I am somewhat late going through changes physically. I do believe that it is a natural way to find out about ones body and how it can be used. I have heard that it is not a sin but a natural and healthy thing to do. I have also heard that it is a sin. I have heard mixed reviews I have heard that a vast majority of both boys and girls do it. I can understand if one does it while thinking about other people then it is a sin but if one is doing it to get rid of old stuff then does it count as a sin. I have done it recently and I am going through puberty. There are no thoughts, images or fantasies involved. I do think that it is better then having a nocturnal emission and having to clean your underpants and to hide it so no one think that I wet the bed. I also believe that it is better to masturbate rather than waking up to find a sticky mess in my underpants, which has happened to me, and it was not fun. I don’t want to have to go to bed worrying about a mess in the morning. I have also heard that it can help reduce the risk of prostate cancer. Is it normal to feel confused about it after doing it? I am planning to talk to my parents and a priest to see what they think of it. If my parents say that it is natural and a normal thing to do does that mean it is all right to do. The only tricky thing is that I am not entirely sure how to approach the subject with them. I have mentioned it to my mother and she doesn’t seem to be bothered by it. She said that it is better to do that than to be out having intercourse with girls. I haven t done it in 3 weeks and I feel conflicted over it I see both views on the issue and I am not sure. I don’t want to feel guilty for doing something that has been labeled natural and normal. I love and believe in god and want to know what the views are on it. I do not have any addiction whatsoever I have very good control over myself nor do I need counseling or therapy. I am just a curious teenager wondering if masturbating is a sin or not.

I live in Ontario where the ministry of education has released a updated sexual education curriculum where it mentions that masturbation is natural and normal. There is a part of me that really wants to do it as I feel it takes the edge off. I have heard that some catholic organizations are backing it. This leaves me confused if it is still considered to be a sin. I also believe that it is a crucial part of understanding how ones body works and learning about oneself. I do find it a little hard to understand that we can somewhat accept the sexual orientation of people but people still consider touching ones genitals to be a sin.

Thank you
God Bless

Dear Jack,

Thanks for your question. Might I add, you are exceptionally articulate for a teenager.a boy's own story

If ya ask me, Jack, and you are actually asking me, you’ve pretty much answered all of your own questions. And that tells me you are on the right track.

You ask about Catholic sexual ethics. Before you wrote, did you know that I was a Catholic priest for 20 years? And, not to boast, I am the only Catholic priest in the world with a doctorate in human sexuality. This later part explains why I no longer practice as a public minister. It’s a real long story and I’d be happy to tell you all about it sometime, but for now know that I didn’t go quietly. I wrote my doctoral thesis, Gay Catholic Priests; A Study of Cognitive and Affective Dissonance, back in 1981. And once word got out about this groundbreaking research, the writing was on the wall, so to speak, for my public ministry. I fought for my priesthood and ministry for 13 year, but it all pretty much came crashing in on itself in 1994. If you’ve got nothing better to do, you can read about it HERE.

Enough about me, let’s get back to you and your questions. Although, I wanted to mention that when I was in seminary, way back when god was young, in the late 1960’s and early 70’s, enlightened spiritual directors were already beginning to advise us seminarians that masturbation wasn’t sinful or disordered. Of course, even now you’ll find orthodox hard-liners who insist that self-pleasuring is a moral sin, but they think all sexual expression is sinful. Here’s a tip: you’re never gonna find consensus on any sexual matter.

Like you, I found it difficult to believe all that mortal sin stuff that the hardliners promote. I mean, if mass murder and genocide are mortal sins, how could a little wank be their equal. It just don’t make no sense, right?

However, I can’t agree with you that masturbation might be sinful if there are fantasies involved. Remember, using your mind is an essential part of learning about your sexuality. That being said, most teenage boys are randy at the drop of a hat, so maybe you don’t need to be all that specific with your sexual mental imagery.

I also caution you to be careful when tossing around words like normal and natural. What’s normal and natural to some may be abnormal and twisted to others. But you’re right; few people, professional as well as lay people, these days would consider self-loving anything but normal and natural.

For you edification I suggest you use the search function or CATEGORY pull-down menu in the sidebar of my site and search for pertinent topics, like masturbation, wet dreams, sexual response cycle, etc. You’ll find a wealth of information about all these topics in both written and podcast form.

the shadowI too reported, back in 2011, on the startling new data that came out of Australia about masturbation. Australian researchers questioned over 1,000 men who had developed prostate cancer and 1,250 men who had not, about their sexual habits. They found those who had ejaculated the most between the ages of 20 and 50 were the least likely to develop prostate cancer. The protective effect of poppin’ one’s nut was greatest while the men were in their 20s. And get this; men who ejaculated more than five times a week were a third less likely to develop prostate cancer later in life.

I also contend that masturbation is the most basic building block to all of our sexual expression. When you know how your body works; when you are familiar with your sexual response cycle and are confident about talking to others about it; you’ll be better situated to be a good sexual partner to another.

In the end, I encourage you to continue to think for yourself when it comes to things sexual. I can see that you are already doing that, so keep it up. Continue to ask questions and consider the input you get from others, myself included; but then make up your own mind. When you own your sexuality and your sexual response, you’ll be a grown-up. Notice I didn’t say you’d be an adult. That’s because there are lots of adults out there who don’t own their sexuality and sexual response and despite being grown up, they’re not grownups.

Good luck, pup

Hi Richard,
Thank you for responding. You have cleared come of the confusion. I guess I got confused because when I would masturbate I would feel like I let my self down.
Thank you again
God Bless

One thing you should know is there is generally a sort of “let down” phase after orgasm. (See information about the refractory phase of the sexual response cycle HERE.) Your body can’t stay in that heightened state of arousal so there’s often a “deflated” feeling.

There’s even a name for if. It’s called post-coital tristesse. And you should know that it’s a physiological phenomenon rather than an emotional one.

Feelings of elation and wellbeing that accompany arousal and orgasm can sometimes morph into a sense of shame during this “deflated” phase. People with lot of scruples about sex are particularly vulnerable to this.

Thank you for clearing that up and for the reassurance that it is natural and normal and not considered to be a sin.
— Jack

Sex Therapy—What Is It and Who Needs It? – Part 1

I’m often asked about my work as a sex therapist. I’m surprised at how few people have any sense of what a sexologist does. While I can’t speak for all my fellow therapists, I can tell you a bit about my own practice.

Most of the work I do is Cognitive Behavioral Therapy (CBT): short-term, goal-directed and personally liberating (I don’t believe this kind of therapy should become a lifestyle). Basically, I suggest that people with sexual issues change the behaviors that contribute to their problems as a surefire way to solve them. I try to give my clients all the tools they need to successfully work things out on their own once the therapeutic intervention is over. This approach doesn’t fit everyone; however, 99.9 percent of the people I work with respond positively.

I encourage my clients to give themselves permission to investigate their sexuality. This in turn assists them in taking charge of making themselves feel better and/or perform better. And as soon as they do, they almost immediately have a greater sense of wellbeing. Like they say, nothing breeds success like success.

Once we identify an area of concern, my client and I create a plan of action for them to implement. I believe the more an individual is part of their own healing process, the more productive that process will be.

Sadly, I find that fewer and fewer people are willing to give their sexual issues the attention they deserve. Rather than investing the time and energy to get to the bottom of their issues, many opt instead for the quick fix—the “Give me a pill for that” mentality. They’re often unwilling to make the necessary lifestyle changes to actually solve their problems. For example, I encounter people who are eating themselves to death, or abusing alcohol or drugs. Of course they have the accompanying sexual response issues—erection problems for men and arousal concerns for women. They may desperately want to resolve these issues, but without committing to any change in behavior—i.e.: “I want my erection back, but I won’t stop drinking”—such interventions almost always ends in disappointment.

Sexual dysfunction of one sort or another is the issue I see most recurrently in my practice, although the reason why a client reaches out varies. Sometimes an individual’s tolerance level peaks, and they finally decide to do something about an issue that may have been smoldering for years. Sometimes it’s a partner who brings in their proverbially “broken” partner, telling me to “fix him/her.”

Couples often seek sex therapy together, as sexual problems tend to be more obvious within relationships. However, by the time the couple comes for therapy, the issues have most likely been plaguing them for some time. The relationship often comes close to ending before the couple agrees to address the problem. For example: Say a guy brings his wife in because she’s “frigid,” whatever that may entail. They’ve been married for X-number of years, and he’s finally had it. She, on the other hand, doesn’t want to be in therapy, because she doesn’t really think there’s anything wrong with her. She just doesn’t want to have sex anymore, and she doesn’t want to discuss it. Period.

This is a difficult way to start therapy. Resentments are high and frustrations rage. If the couple does continue, we usually discover that there’s also something desperately wrong with the husband. Inevitably, we ascertain that he’s an ineffectual lover—and his inability to pleasure his wife is the root of her “problem.” It’s often painfully clear that he knows little (if anything) about his wife’s sexual needs or desires. Meanwhile, the wife has never had permission to know her body, so she’s unable to help or direct him. As you can imagine in a case like this, there’s a load of remedial sex education that must come before anything else is resolved.

Couples also seek therapy when one spouse has cheated on the other. The “cheat-ee” declares, in no uncertain terms, that this therapy is the last-ditch effort before “the end of the road.” Often in such cases, it’s too late for a successful intervention, because each partner is so angry and shamed that the chance of turning the situation around is slim. Sometimes the best we can do is end the relationship with as little acrimony as possible.

In difficult couple counseling situations like this, my first effort is to get the couple to disarm. There will be no sex therapy—and God knows there is a need for sex therapy—until there is some semblance of peace between partners. If we don’t establish at least a small bank of goodwill, our efforts are doomed.

We’ll pick this up next week at this time.

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