ABSTRACT
This chapter discusses the conflict between aggression and sexual desire. Aggression in the form of assertiveness is required in the act of sex. Where physical merger in sex is in the service of love and provides mutual satisfaction of erotic needs, then partners’ aggressive drives have been successfully integrated in their psyches. However, when couples in treatment have remained in an infantile merged state, they need the therapist’s help to accept the reality of their psychological separateness and acknowledge and respect their differences. Sensate focus has a potential role in the move towards this separateness and individuation and in couples’ learning how to play together in the Winnicottian sense. Partners may then develop the capacity to be alone without feeling abandoned. Some couples have greater capacity for change than others and the therapist can work with and respect their ambivalence about changing, using the tactile intervention to clarify their goals. In couples where aggression, conscious or unconscious, is paramount, or where there are indications of early trauma such as neglect through maternal loss or unresolved sexual abuse, then sensate focus is contraindicated. Cases in which the therapist should definitely not introduce the caressing exercises are discussed and the therapist’s judicious use of her subjective experience, including her countertransference, is explored.
