Anne:
I think that in Anne’s situation, one of the first things she needs to do is to make an educated decision about having sex. The responsibility is up to her, not her boyfriend and not her mother. One main thing that the therapist would discuss with Anne would be the emotional and physical consequences of having sexual intercourse. They should also evaluate together the relationship between Anne and her boyfriend to decide if her boyfriend is really taking advantage of Anne or not. From the sounds of it, he is putting un-needed pressures on Anne to have sex, and that is one thing she needs to think about; he is not only more mature than her, but he is also more experienced in sexual encounters. Like I mentioned before, the decision to have intercourse with her boyfriend is totally up to Anne. The therapist needs to discuss with Anne, that being an adolescent, she may not realize that there are different types of love, and she needs to be sure that it is actual love that she is in, and not lust, or infatuation while making her decision.
The therapist should touch onto Anne and her mother’s relationship. With Anne being an adolescent, in order for her to show her mother her maturity, she should be open with her mother as she decides to make decisions about sex. This is important in order to build a truthful and honest relationship with her mother. This can lead to Anne showing her mother that she can make smart decisions for herself, and that she is a mature young lady. While she is being open and honest with her mother, her mother should be open to hearing things like this happening in Anne’s life. Her mother needs to not be critical the way she has been. She can discuss her concerns, but “telling” Anne the decision she should make is not right. Just because her mother has anxiety about her daughter having sex, does not mean that Anne should be as anxious as her mother. With their newfound relationship, Anne and her mother should have a stronger bond between them, and it will give Anne a more comfortable situation when she needs advice on birth control, and information on STI’S. Maybe it would be a good idea, if Anne, her mother, and her boyfriend all sat down and talked about his intentions with Anne. It would give the mother some comfort to better understand why he chose to date an adolescent 3 years younger than him.
Tom and Susan:
The mental and physical problems in the situation of Tom and Susan go hand in hand. “Tom should be more at ease to know that a study of 65 healthy men ages 45 to 74 shows an age related decline in sexual desire, arousal, and activity.” Rathus, S. A., Nevid, J.S., and Fichner-Rathus, L.(2005). Tom needs to understand that his body is different than it was when he was younger, and his physical capabilities are not the same, but that does not mean he cannot please his wife just the same. The understanding of this is critical for Tom because he has to understand this before he will be able to release the anxiety he is feeling.
Toms’ biggest problem is probably that he will not be able to please his wife the way he used to and she will not love him anymore. If he would discuss his feelings and anxiety’s with his wife, he would find that this is not the case. The therapist should discuss the sexual exclusions as a couple and as individual’s. I think that Tom could profit from information regarding sexual activities and behaviors. With Tom and Susan being an elderly couple, they may not be physically able to do the things they used to do, but they are still capable of the intimacy, the foreplay, and coitus they used to be capable of. There are sexual exercises that Tom can do to help improve his sexual stamina. Bodily ailments could improve with a liberator lamp (sexual instruments) that may show more contentment for the couple. This could range from a vibrator for Susan or a cock ring for Tom. If Tom and Susan can learn how to be more open with each other about their sexuality, they would find that they would benefit from their newfound openness, and this could aid them in their sexual activities. With Tom and Susan being a couple that has been together so long, they have grown comfortable in their relationship, and they probably have not talked about feelings like this before. This bond that they will build will deplete Tom’s anxiety and I think Tom will begin to exhibit a new found interest in sexual activity like Susan does!
Bill:
The first thing that needs to be discussed with Bill by his therapist is his uneasiness regarding sexual behavior. I think the therapist needs to inform Bill of his many different sexual choices that he has, and fully explain that his disability does not make him any different when it comes to having a healthy sexual relationship. He may not be able to achieve sexual arousal the same way other people do, but he is still has many sexual abilities. The therapist will see that Bill struggles with his sexuality most because of his disability, and like Tom and Susan’s therapist, Bill’s therapist could recommend the use of sexual tools that can help in making a more pleasurable sex life. According to Rathus, Nevid, and Fichner-Rathus “Couples facing the challenge of spinal cord injury may expand their sexual repertoire to focus less on genital stimulation (except to retain the reflexes of erection and lubrication) and more on the parts of the body that retain sensation.” Rathus, S. A., Nevid, J.S., and Fichner-Rathus, L.(2005). I think in this situation that the therapist needs to express the importance of being open and honest with his partner, and tell them how he is feeling about this situation. If he continues to keep these feelings all bottled up in side, it is only going to hurt him in the long run. It may continue to bother him so much that his anxiety will continue to grow and get worse. When he learns to be more open with his partner, and explain to them his anxieties, and why he is feeling this way, they can begin to learn how to accomplish sexual gratification in their relationship. The two things that are most important in all relationships would be honesty, and openness, and without them a relationship cannot survive. Telling your partner how you feel and the things that give you anxiety can help that partner to better understand how they need to commence with their everyday actions. It may be the slightest of change that the other person makes, but it can make all the difference in the world to how you view them from there. If Bill sees that his partner is trying more to accommodate his anxiety, and he begins to feel his partner being sexual in ways he can appreciate, he may just get over his anxieties quicker than he knows!
