Rick Reynolds, LCSW
by Rick Reynolds, LCSW
Founder & President, Affair Recovery

Recovering from infidelity: Difficulties with Intimacy

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In recent years, one of the most popular topics in sexology has been female sexual desire disorders. For the past four decades, women have been pathologized for not being like men.

For instance, according to University of British Columbia psychiatrist Rosemary Basson, "sexual difficulties are particularly prevalent among women seeking routine gynecological care. In population surveys, some 30%–35% of women aged 18–70 have reported a lack of sexual desire during the previous 1–12 months." The percentage of women reporting sexual difficulties after an infidelity are even higher.

But is there something wrong with the woman who lacks desire if she's dealing with a painful situation, or is it a normal response to difficult circumstances (e.g., a problem with the relationship, sexual context, or cultural factors)?

Long Standing Assumptions

The traditional assumption for both men and women has been that desire precedes sexual arousal. Therefore, if a woman is no longer experiencing desire, it is assumed that she now has some sort of sexual hang up or disorder and just doesn't want her mate.

While this may be true for men, research in the past 10 years reveals a different pattern for women.

Men tend to be more like a loaded gun ready to fire. All that's needed is someone to pull on the trigger. A man's libido acts as a drive similar to hunger or thirst. For the past hundred years, sex professionals have assumed that a woman's libido was similar and that if a woman didn't feel desire, something had to be wrong.

Contributing to the problem are the messages delivered through media. Women are sexually portrayed in books, movies, articles, and even in church circles as men in female form. This mistaken and toxic belief concerning female arousal and response patterns has left generations of men and women believing something that's false. Hardly a day goes by that some couple doesn't come in to my office arguing about the wife's lack of sexual desire. This leaves women feeling that they are somehow flawed because they don't share the same sexual interest as their husband.

What If Desire Does Not Precede Arousal?

That is exactly what Basson discovered after interviewing hundreds of women. Contrary to the conventional model, for many women, desire is not the cause of lovemaking but rather the result. Basson's research revealed that women often begin sexual experiences feeling sexually neutral. But as things heat up, so do they, and eventually desire is experienced.

This explains why Viagra doesn't work for women, and why sex-boosting supplements are only minimally successful. Products that change the physiology of sexual arousal do not affect desire. At best, they can only increase blood flow into the genitals. It's easy for men to be aware of increased blood flow because erections are hard to miss. From there it's only a short step in a man's mind from erection to the assumption that they have desire. Women, on the other hand, are often unaware of gentle blood engorgement, and even when they are aware of it they frequently report no feelings of arousal.

If women don't experience a sense of desire, as most men know it, then most men might wonder why a woman would even want to be sexual. According to research, women tend to be sexual for reasons that affirm their relationships, but their reasons are not inherently sexual. These might include wanting to please their lover, a desire to feel close, to prevent strife, to reconnect after a fight, or because they feel a responsibility.

Research supports the old adage that men become intimate to have sex and women have sex to become intimate.

From this perspective, the critical question becomes not 'how do you ignite a woman's desire for sex,' but instead, 'what kind of interaction arouses women sufficiently to enable them to experience desire?'

Rushed Lovemaking Won't Work

The types of interaction that fuel desires in women are playful, leisurely, sensual (lovemaking based on whole body massage that can include genitals but certainly is not focused on them). In surveys, the primary complaints of women are about interactions with their husbands which are non-sensual, too rushed, too focused on breasts and genitals, and too quickly plunged into intercourse. Rushed lovemaking fails to give women the time most need to respond to become aroused enough to experience desire.

Further complicating the issue is the culture created by Viagra. Men mistakenly believe they are sexually aroused when they have an erection. Therefore taking Viagra and having an erection means they're good to go. However, erections have nothing to do with psychological arousal. Any erectile medication can give a physical erection, but does it create an excitement to be with your mate or enhance true connection through the wonder of who they are? Far too often, a man's genitals on Viagra will be at 100 percent, but his psychological arousal remains at 10 or 20 percent. Once the erection is in place, he proceeds on to intercourse, skipping the steps which would create psychological arousal for both himself and his wife. This creates a growing sense of dissatisfaction (and disconnection I might add) for the woman since she is not experiencing the necessary relational interactions and arousal to make the experience as pleasurable as possible for her.

Sexual Neutrality?

Research shows that many women do experience spontaneous desire and interest when they're involved in a new relationship or when coming back together after long-term separation from their partner, but it also indicates that most women in long-term relationships rarely think about sex or experience spontaneous sexual desire. Therefore, women seem to operate more from of a point of sexual neutrality - where she is receptive to being sexual, but does not initiate sexual activity. Many women report that the goal of sexual activity is not necessarily orgasm but rather personal satisfaction, which is then experienced as physical satisfaction (orgasm) and/or emotional satisfaction (the feeling of closeness and connection with a partner).

This is important simply for the fact that there is not something necessarily wrong if a woman is not experiencing the same desire and arousal patterns as a man. Men and women are not the same.

As couples begin to rebuild their relationship and recover from infidelity, operating from right assumptions about how men and women function sexually is essential. Women need to quit being so hard on themselves if they don't experience the same desire as their husbands. And men need to quit thinking there must be something wrong with their wife, or themselves, if she doesn't experience sexual desire as he does.

If men or women experience a lack of desire in a marital relationship multiple factors need to be explored. The following is a list of factors from Rosemary Basson's article:

Women's sexual dysfunction: revised and expanded definitions

Interpersonal and contextual factors

In a recent national probability sample of American women 20–65 years of age, their emotional relationship with the partner during sexual activity and general emotional well-being were the 2 strongest predictors of absence of distress about sex. Women who defined themselves (using standard psychological instruments) to be in good mental health were much less likely than women with lower self-rated mental health to report distress about their sexual relationship (odds ratio 0.41, 95% confidence interval 0.29– 0.59). The healthier women were therefore 59% less likely to report distress about their sexual relationship. Feeling emotionally close to their partner during sexual activity decreased the odds of "slight distress" by 33% relative to "no distress," and "marked distress" by 43%; in other words, the stronger the emotional intimacy with the partner, the less distress. Other contextual factors reported to reduce arousability included concerns about safety (risks of unwanted pregnancy and STDs, for example, or emotional or physical safety), appropriateness or privacy, or simply that the situation is insufficiently erotic, too hurried, or too late in the day.

Personal psychological factors

Frequently a woman's arousal is precluded by the nonsexual distractions of daily life, but also sometimes by sexual distractions (e.g., worry about not becoming sufficiently aroused, reaching orgasm, a male partner's delayed or premature ejaculation or a female partner's lack of orgasm). Empirical studies have shown a high correlation of desire complaints with measures of low self-image, mood instability and tendency toward worry and anxiety (without meeting the clinical definition of a mood disorder). Differences between a group of 46 consecutive women with a diagnosis of desire disorder without clinical depression and a control group of 100 healthy women were significant for 6 out of 8 scales in the Narcissism Inventory (a standardized self-administered instrument). The scales indicated that the women with desire disorder had self-esteem that was weak or even fragile, emotional instability, anxiety and neuroticism. Sexual arousal and orgasm, especially in a partner's presence, necessitates a certain degree of vulnerability, which is impossible for some women who cannot tolerate feelings of loss of control generally, and loss of control specifically of their body's reactions.

Further inhibiting psychological factors include memories of past negative sexual experiences, including those that have been coercive or abusive, and expectations of negative outcomes to the sexual experience (e.g., from dyspareunia or partner sexual dysfunction).

Biological factors

The biological and pathophysiological underpinnings of normal and abnormal female sexual response are only recently receiving attention. Most of the basic science and animal experiments in this area are beyond the scope of this review. Some promising attempts are noted, however, in part because they relate attempts to ameliorate sexual dysfunction by means of off-label use of available drugs and to avoid the negative sexual side-effects of medications such as antidepressants.

Depression is strongly associated with reduced sexual function. Of 79 women with major depression surveyed before treatment with medication, 50% reported decreased sex drive; 50%, more difficulty obtaining vaginal lubrication; and 50%, far less sexual arousal when engaging in sex. Only 50% had been sexually active during the previous month. In addition, sexual dysfunction can constitute an adverse event of antidepressant use, especially among patients who had low levels of sexual enjoyment before the onset of their depression. When patients are specifically asked about sexual side-effects, they are acknowledged by as many as 70%.

Sexual dysfunction is also a common side-effect of treatment with antidepressants. Among women being treated, it has been found to be more common in those who are older, married, without postsecondary education, without full-time work, or taking concomitant medication (any type); those who have a comorbid illness that might affect sexual functioning, or a history of antidepressant - associated sexual dysfunction; those who deem sexual function unimportant; and those whose previous sexual engagements had afforded little pleasure.

Currently under scrutiny is the role of dopamine and other neurotransmitters in influencing sex hormone receptors and how the neurotransmitters are, in turn, influenced by sex hormones. Estrogenized female animals change their sexual behaviour when administered progesterone; studies have shown that the same changes can result from dopamine or the presence of a male animal. Among 75 non-depressed women with a DSM-IV diagnosis of hypoactive sexual desire disorder who received bupropion (a dopaminergic drug; average dose 389 mg/ d) or placebo, improvements in pleasure, arousal and orgasm were statistically significant for those administered the active drug. Interestingly, these changes were unaccompanied by increased desire.

Testosterone itself is being investigated as to its role in sexual function and dysfunction. About half of daily testosterone production in women is from the ovary. Some women with sudden loss of all ovarian production of androgens lose their sexual arousability. Supplementation to high physiological (as opposed to pharmacologically evident) levels of testosterone recently has led to increased arousability and more intense orgasmic experiences, but not to increased sexual thinking, fantasizing or spontaneous desire. Of 75 surgically menopausal women aged 31–56 participating in a randomized clinical trial of testosterone versus placebo, those given testosterone (300 μg transdermally) in addition to estrogen reported increased frequency of sexual activity, sexual pleasure and intensity of orgasm. So, reminiscent of the animal model, supplementation with a dopaminergic drug or testosterone can increase some women's sexual arousability; but so too, as in the animal model, can environmental change (a new partner).


This may be far more information than you wanted, but I hope it helps you begin to understand the complexity of this issue.

My personal experience with couples trying to recover from infidelity shows additional factors. If a man or woman has fallen in love with someone else, they will discover they have difficulty being connected to two people simultaneously. For their heart and desire to return to their mate, they must first release their affair partner and let go of the resentments they hold toward their mate.

Remember, our feelings are 100% true about what we believe, but they don't necessarily reflect the truth.

Only time, experienced support, and bringing things to the light will allow truth to be revealed. Ultimately, the beliefs you hold about yourself and your mate, along with the perceptual lens through which you see yourself and your mate, need to shift. But this won't happen unless you allow the right voices beyond your own to speak truth. As Einstein said, "no problem can be fixed by the same consciousness that created it." You have to be open to other points of view.

If you're the unfaithful spouse, and your mate is ambivalent toward the marriage, then at the very least begin to focus on becoming the person God or your best self wants you to be. You at least want to be a person you like to be with and possibly someone your mate might like to be with.

Reconnecting is not a fast process, but it's more than doable. I hope you will allow your current crisis to provide the catalyst for a new connection for both you and your mate. I hope you'll give our Virtual EMS Weekend a chance to provide the backdrop you need for safety, expert help and marital transformation. If you don't believe me, please make sure you watch the EMS video testimonial and read the testimonies at the bottom of the page. You will find them very encouraging.

"This is the best thing we could have ever done for our relationship following infidelity. I don't know that we would make it without EMS Online. I now have hope."

EMS Online registration opens monthly. Subscribe to be notified.
This online course walks you through the critical steps required to address the infidelity and reconnect as a couple. It fills up quickly, so don't wait!

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"Before arriving at EMS [VIRTUAL], I was hesitant and didn't believe that 3 days would do anything to help the state of my marriage (which was broken beyond recognition). I didn't believe that a group of strangers would help me open up to the extent that I did. Lastly, I had no faith in the idea that I would ever feel connected to anyone in that group or want to stay in touch with them. However, at the end of EMS weekend, all of the assumptions and reluctance that I had prior was completely gone. Within 3 days, I was able to share feelings to my wife that I hadn't our entire marriage, I understood the damage I did on our marriage more, and most importantly her pain and anger... It gave myself and my wife hope that we could have a great marriage in the future as long as we take what we have learned through EMS and continue to apply."
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  1. Basson R. Female sexual response: the role of drugs in the management of sexual dysfunction. Obstet Gynecol 2001;98:350-353.
  2. Basson, R. Women's sexual dysfunction: revised and expanded definitions. CMAJ, 2005; 172:1267.
  3. Whipple B, Brash-McGreer K. Management of female sexual dysfunction. In: Sipski ML, Alexander CJ, eds. Sexual Function in People with Disability and Chronic Illness. A Health Professional's Guide. Gaithersburg, MD: Aspen Publishers, Inc.; 1997, pp 509-534.

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Comments

perfect timing!

Excellent, excellent article and video! Thanks for tackling and talking about sex! Since God created the union between a husband and a wife, the subject of sex should not be awkward or hard, but as we all know, it is so much of the time. And there is so much mis-information and so many myths to be de-bunked!
Not sure I would have absorbed the content early on, so this is perfect timing in our recovery process to hear and read this info. We are almost four years from d-day and three years this month from EMS weekend, the start of our healing and recovery. Healing/recovery is ongoing, so I very much appreciate still receiving the weekly emails to continue us on down that road!
Thanks AR!