James
and Yelena have been married for 22 years and have three grown children, now
out of the house. Sex was never particularly enjoyable for Yelena, primarily
because James was uninterested in much foreplay and Yelena felt it was
unfeminine to make any sexual demands of her husband. However, because of her
love for James, she accommodated his desire for sex two or three times a week,
and consistently “faked orgasms.”
James
also does not think “a real man” should receive any “help” from his wife to get
an erection, even when his erections became less firm and less predictable. As
a result, over the last two years, James rarely initiated sex and Yelena felt
relieved, thinking she would now be “excused from sex.” Furthermore, she is in
perimenopause, and has begun to experience increasingly uncomfortable
penetration. Suddenly, James’ vigor and sexual interest has returned with
greater intensity than ever. Yelena discovered he was secretly taking Viagra,
which he obtained over the Internet.
- Discuss how effective you think
Viagra will be for improving James’ sex life, and why? - Suppose Yelena’s discovery that
James is using Viagra secretly is the “last straw” for her after years of
not addressing her unsatisfying sexual life with him, and she demands that
they seek marriage counseling and focus on their sex life.In this case:
- What part of this dilemma
should a counselor point out is Yelena’s responsibility to acknowledge
and address? Additionally, what special issues regarding her
perimenopause will need to be addressed? - What part of this dilemma
should a counselor point out is James’ responsibility to acknowledge and
address? - Discuss specific treatment
options for this couple that are supported by the research you learned
about in your readings.
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