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To cite this Article Metz, Michael E. and McCarthy, Barry W.(2007)'The Good-Enough Sex model for couple sexual
ORIGINAL RESEARCH
Meta Associates, St. Paul, MN, USA, 2American University, Washington, DC, USA
ABSTRACT The Good-Enough Sex model presents a commonsense yet comprehensive perspective
that challenges simplistic notions of sex and encourages couples to pursue positive, realistic meaning in
their intimate lives. With the Good-Enough Sex model, intimacy is the ultimate focus, with pleasure as
important as function, and mutual emotional acceptance as the environment. Sex is integrated into the
couples daily life and daily life is integrated into their sex life to create the couples unique sexual style.
Living daily life well with its responsibilities, stresses, and conflicts provides the opportunity to
experience sexual interactions in a subtly yet distinctively personalized and enriched way. Sex at times
is experienced as pleasure, stress relief, mature playfulness, and on another occasion as a spiritual
union. Intimate couples can value multiple purposes for sex and use several styles of arousal. GoodEnough Sex is congruent with the couples genuine lifestyle. Good-Enough Sex recognizes that among
satisfied couples the quality of sex varies from day to day and from very good to mediocre or even
dysfunctional. Such reasonable expectations are an important feature of sexual satisfaction as well as
inoculating the couple from disappointment and sexual problems in the future. The Good-Enough Sex
perspective serves as the foundation for relationship and sexual satisfaction.
KEYWORDS: Good-Enough Sex model; sexual satisfaction; sexual dysfunction; biopsychosocial model;
couple sexuality; sexual health
Introduction
Approximately 45 percent of couples at a given time suffer a male, female or couple
sex problem (Laumann et al., 1999). While awareness of sexual dysfunction (SD) has
increased in recent years with the advances in sexual medicine, clinical experience
demonstrates that SD is rarely a simple performance problem with a simple cure. A
sexual issue is commonly a profound human, relationship problem, which involves
emotional suffering, distress, even agony. Because of this potentially profound
psychological distress, SD is internationally classified as a psychiatric disorder
according to the American Psychiatric Association, Diagnostic and Statistical Manual
Correspondence to: Michael E. Metz, Baker Court Office Bldg, Suite 440, 821 Raymond Avenue,
St. Paul, MN 55114, USA. Tel. 1 651 642 9317x107. Fax: 1 651 642 1908.
E-mail: mmetzmpls@aol.com
Received 7 March 2006; Accepted 15 September 2006.
ISSN 1468-1994 print/ISSN 1468-1749 online
British Association for Sexual and Relationship Therapy
DOI: 10.1080/14681990601013492
352
IV (DSM-IV-TR, 2000) and the International Classification of Disorders-10 (ICD10; World Health Organization, 1992).
SD offers an exceptional opportunity for the helping professional to offer support
and to enhance the quality of life of the individual and couple. Few medical or
psychological problems so clearly offer the clinician not only the opportunity to
relieve distress but also to promote personal and relationship health and satisfaction.
To do this, the following concepts are essential:
1.
2.
3.
4.
5.
6.
Real-life problems rarely have a simple cause and a simple cure in spite of
peoples longing for quick fixes. SD is complicated. It is multi-causal,
multidimensional and has multiple effects on the person, the partner and their
relationship.
Satisfaction with ones sexual life is fundamentally grounded on realistic
physical, psychological and relationship expectations. Unrealistic expectations
precipitate frustration, a sense of failure, and distress.
The emphasis on perfect sexual performance is self-defeating and needs to be
replaced by the Good-Enough Sex model, which realistically recognizes the
inherent variability of couple sex.
Any approach to SD must recognize that regardless of the cause(s), sex is a
relationship problem affecting the emotional life of the couple.
Treatment for SD needs to be individualized to this couple, not one size fits
all.
Effective treatment must integrate medical, pharmacological, psychological, and
relationship aspects with an individualized relapse prevention plan.
354
1
2
3
4
5
6
7
8
9
10
11
12
Sex is a good element in life, an invaluable part of an individuals and couples long-term comfort,
intimacy, pleasure, and confidence
Relationship and sexual satisfaction are the ultimate developmental focus and are essentially
intertwined. The couple is an intimate team
Realistic, age-appropriate sexual expectations are essential for sexual satisfaction
Good physical health and healthy behavioral habits are vital for sexual health. Individuals value
their and their partners sexual body
Relaxation is the foundation for pleasure and function
Pleasure is as important as function
Valuing variable, flexible sexual experiences (the 85 percent approach) and abandoning the
need for perfect performance inoculates the couple against sexual dysfunction by overcoming
performance pressure, fears of failure, and rejection
The five purposes for sex are integrated into the couples sexual relationship
Integrate and flexibly use the three sexual arousal styles
Gender differences are respectfully valued and similarities mutually accepted
Sex is integrated into real life and real life is integrated into sex. Sexuality is developing, growing
and evolving throughout life
Sexuality is personalized: Sex can be playful, spiritual, special
356
4. Good physical health and healthy behavioral habits are vital for sexual health.
Individuals value their and their partners sexual body
Sexual function is important (although not essential) for sexual satisfaction. Care for
their own physical health and healthy behaviors (e.g. adequate sleep, exercise, eating,
and moderate drinking) are an important dimension of continuing sexual functioning, especially with aging. Because illness is a significant enemy of sexual function and
increases in prevalence with aging, wellness is an important goal. With recent medical
advances, in many cases sexual function may be facilitated with medications and
devices, but these need to be integrated into the couples sexual style, not be stand
alone interventions (McCarthy & Fucito, 2005).
358
10. Gender differences are respectfully valued and similarities mutually accepted
Men and women are often different in their arousal patterns. Typically women will focus
on feeling desired or attractive to their man, while typically men will focus on
feeling invited or welcomed to engage in sex (Fisher et al., 2002). Sexual
confidence, then, is more about function for men while womens confidence may
involve trust, security, and caring. However, as Kaschak and Tiefer (2002) note, both
female and male sex roles are socially constructed, with much overlap, and change as
individuals, the couple, and the culture change. Traditional sex function models
primarily represented male physiologic arousal while newer models such as Bassons
(2001) responsive desire model are more characteristic of womens desire and arousal.
While we believe both patterns are applicable to understanding both men and women
(especially with aging), they suggest that men are commonly prompted for sex by the
bio-physiological drive while women are prompted for sex by more of a bio-emotional
drive (Fisher et al., 2002). Not only accepting but celebrating the gender preferences and
similarities allows the couple to enjoy the Good-Enough Sex approach to satisfaction.
11. Sex is integrated into real life and real life is integrated into sex. Sexuality
is developing, growing and evolving throughout life
The sexual experiences of persons of different ages and life circumstances (e.g. levels of
responsibility such as being a college student, establishing ones career amidst parenting
children, adjusting to chronic illness in mid-life, or retirement) require situationappropriate expectations. The integration of varying life events into lovemaking recognizes the multiple purposes for sex. This can involve sex one time for anxiety release
through orgasm, another time for calm affection amidst fatigue, another time for escape
and fun, another for emotional healing, and still another time sex as a spiritual experience such as having gentle and tender sex while sharing sadness about a parents death a
month earlier. Good-Enough Sex is integrated into the couples daily life and their daily
life is integrated into their sex life to create the couples unique sexual experience.
Life itself provides opportunities to experience sex in a subtly yet distinctively
personalized and enriched way: sex on vacation, during pregnancy, after conflict,
during times of loneliness, after a good friends wedding, during times of career
stress, after a class reunion, during periods of success and achievement, amidst
childrearing, unemployment, during disappointments, times of illness, healing from
disagreements, after business travel or a long absence such as military service, as part
of a romantic evening, during adjustment to the empty nest, adapting to changes
360
with aging, enjoying increased time flexibility after retirement. Good-Enough Sex is
congruent with the couples relationship style and makes it special.
Summary
The Good-Enough Sex model presents a comprehensive, integrative, couple approach
to SD and sexual health. A prime focus is to replace the traditional male perfect
intercourse performance criterion with a variable, flexible pleasure-oriented approach to
couple sexuality, which involves an 85 percent approach to intercourse and orgasm
while validating alternative sensual and erotic scenarios. Satisfaction is comprised of
realistic sexual expectations from a comprehensive psychobiosocial perspective as well
as healthy, cooperative couple skills. Touch and pleasure are as important as sexual
function, and the couple abandons the need for perfect performance. Features of
Good-Enough Sex include relaxation based lovemaking, focus on pleasure, integrating
the five purposes for sex, flexibly incorporating the three arousal styles, and using
sensual and/or erotic non-intercourse scenarios as alternatives if the sex does not flow to
intercourse. Just as important are positive, realistic expectations about the role and
meaning of intimacy and sexuality throughout lifes developmental phases for the
mans, womans, and couples lives. The Good-Enough Sex perspective provides a
positive, genuine foundation for relationship and sexual satisfaction.
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Contributors
MICHAEL E. METZ, PhD, Psychologist and Marital & Sex Therapist in Private Practice,
Meta Associates, St. Paul, MN USA.
BARRY W. MCCARTHY, PhD, Professor of Psychology, American University,
Washington, DC, and certified sex and marital therapist.