ABSTRACT
This chapter presents an approach for treating sexual difficulties that combines psychoanalytic work with behavioural sex therapy techniques. The psychoanalytic techniques are particularly useful in addressing unresolved conflicts. The chapter attempts to fill the gap by presenting theory of couple dynamics, sexual symptom formation, and therapeutic action in couple therapy. The clinical material demonstrates the issues that emerged as the couple performed the exercises, the use of psychoanalytic techniques to address these issues, and how the body and genitalia served as a vehicle for the expression of internal object relations. The successes and failures in carrying out the exercises exert psychic pressure on the couple which, in turn, triggers the emergence of unconscious material. A treatment approach that combines psychoanalytic and behavioural techniques tends to take longer than one that relies solely on behavioral techniques because it focuses on the totality of the couple's relationship.
