ABSTRACT
How we conceptualize and describe therapy issues shapes how we treat them. The intimacy-based sex therapy I have developed and practice is quite different from sex therapy in the world of formal psychology and medicine. There, success is typically defined in terms of enhanced or restored physical functioning (i .e., achieving and maintaining lubrication or erection, having intercourse or a same-sex equivalent, and achieving orgasm) . In the intimacy-based model, success in a sexual interlude is defined not in terms of physiological functioning but in terms of creating erotic pleasure with outcomes of intimacy, satisfaction, mutual pleasure, and self-esteem. A couple is sexually successful when the partners create erotic pleasure, to whatever level and in whatever form they desire on that particular occasion, and each ends up feeling good about him-or herself and about the other; they both have a good time and enhance their relationship . This definition of success is the cornerstone of intimacy-based sex therapy. To facilitate such experiences is the guiding intention of the therapist.
