“Sex is… perfectly natural. It’s something that’s pleasurable. It’s enjoyable and it enhances a relationship. So why don’t we learn as much as we can about it and become comfortable with ourselves as sexual human beings because we are all sexual?” ― Sue Johanson
Are relationship and sexual dynamics distinct in important ways?
Much of relationship research has focused on general relationship satisfaction, which is itself an area of clear importance. However, research may not have looked specifically at sexual outcome measures and whether there are ways to specifically cultivate better sex. While sexual satisfaction and healthy communication contributes strongly to greater overall relationship satisfaction, sexual communication is likely to be very different from general relationship communication (Mark & Jozkowski, 2013), and it may be incorrect to assume that working on improving general communication quality alone will improve sexual communication.
With some exceptions, couples therapy tends to focus on general relationship issues, and may leave sexual issues less directly addressed. For example, according to a 2003 study, while that vast majority of health/mental health professionals noted the importance of specially addressing sexual issues in treatment, most of them reported that they were poorly trained and unlikely to discuss sexual issues with patients (Haboubi & Lincoln, 2003). Another study found that even licenced marital and family therapists felt uncomfortable with and unprepared to discuss sexual issues (Harris & Hays, 2008). It may be that professionals addressing relationship issues have assumed that if general communication and relationship satisfaction improves, then sexual communication and sexual satisfaction will follow suit. However, this has not been shown to be the case.
I have found in my professional experience that unless clinicians are specifically trained to address sexual issues, they often will not bring them up with patients, sex therapists being the most obvious exception. Considering how important sex is for many couples, it is concerning that therapists may not be addressing sexual issues directly with couples as much as would be useful. As with other taboo subjects, it may be that therapists and clients alike tend to shy away from difficult areas―sexuality, trauma and abuse, money, and race and cultural issues, to name a few―and stick to what is more familiar and comfortable. While training can help to prepare mental health professionals to feel comfortable bringing up issues more easily avoided, it is also important to recognize that timing and diplomacy are essential in order to effectively assist with sensitive issues.
Researching sex-specific communication patterns in the context of general relationship considerations
In order to better understand the role of sexual communication on relationship and sexual satisfaction, researchers Jones, Robinson and Seedall (2017) developed a study design to examine whether greater sexual communication leads to better sex. Surprisingly, research on relationships has not focused as much as we might expect on how we communicate about sex (process) and what we communicate about (content) when it comes to sex. In order to better understand how sexual communcation may be related to various outcomes, they looked at sexual and general relationship communication as well as sexual outcomes and relationship satisfaction overall.
Because much of the prior research on relationships and sexualty has been in “convenience” samples of college students in shorter relationships, they sought out a more representative sample for the present study. They recruited 142 heterosexual couples in long-term relationships, often but not always married, who completed a 30 minute online survey carefully conducted to tease apart the important factors (see below for the measures used). The average relationship length was 9.6 years (from 3 months to 61 years), the average participant age was about 32.4 years (from 20 years old to 83 years old), and the average number of children was 1.5 (from 0 to 8 children). In 22 percent of the couples, at least one partner expressed dissatisfaction, and all the couples included reported being sexually active. They were predominantly Caucasian, and the majority had at least a couple of years of college education.
The survey, combining items from many prior studies to look at all the areas of interest, included the following measures:
- How much each individual talks about sexual matters: Using a revised Sexual Self-Disclosure Scale, looking at how much people talk about sexual issues with their partners. Items included: Sexual behaviors, sexual sensations (e.g. during foreplay), sexual fantasies, sexual preferences, the meaning of sex, sexual accountability, distressing sex, sexual dishonesy, and sexual delay performance (putting off sex).
- How people tend to communicate: In order to look at how people talk about sex (and not just what they might talk about), participants completed parts of the Communication Patterns Questionnaire to look at how positively participants experience communication, adapted it to look at positivity of sexual communications as well (the Sexual Communication Patterns Questionnaire).
- Sexual satisfaction: Using the New Sexual Satisfaction Scale, they looked at the following: Sexual sensations (quality of orgasm), sexual presence/awareness (surrendering or letting go during sex), sexual exchange (balance of give and take during sex), emotional connection/closeness, and sexual activity.
- Relationship satisfaction: Using a version of the Couple Satisfaction Inventory, they used several items looking at overall relationship satisfaction, using different approaches to measuring overall satisfaction (e.g. hopefulness, overall satisfaction).
- Sexual intercourse frequency: Less than once or twice per year, less than once a month, once a month, two times a month, 1-2 times a week, 3-5 times a week, and almost daily. The average couple here was having sex 3-5 times per week, and they generally agreed on the frequency, reporting very similar rates.
- Orgasm frequency: Asking in what percept of sexual encouters did they reach orgams, rated in 5 categories from 0-20 percent of the time to 80-100 percent of the time.
The analysis included a dyadic data analysis approach which allowed them to look at effects from the specific pairs of couples (actor-partner interdependence model) as well as general patterns accross all couples. They analzyed the data from two perspectives―the first model, the “satisfaction model”, controlled for communication process and length of relationship, and the second model, the “sexual and orgasm frequency model”, only controlled for relationship length, allowing for communication process to vary. They used “path analysis” in order to map out the relationships among variables of interest, which has advantages when looking at complex data sets, allowing for analysis of multiple ways different factors can connect sequentially rather than looking at correlations alone.
- More extensive sexual communication content correlated with overall relationship satisfaction for men and women, independent of relationship duration. The more people talked about the details, the more they reported feeling satisfied overall in the relationship. Sexual satisfaction itself was more important for men than for women in determining overall relationship satisfaction.
- Sexual communication process was not correlated with overall relationship satisfaction.
- General communication process was correlated with relationship satisfaction. As with sexual communication, women’s positive general communication process led to greater general satisfaction in male partners. Greater male satisfaction in turn was correlated with greater female partner satisfaction.
- Sexual satisfaction was correlated with sexual communication process for men and women. Positive sex communication was correlated with greater sexual satisfaction. For paired partners, women’s positive sexual communication process predicted male sexual satisfaction―when women talked about sex, on average men experience greater sexual satisfaction.
- Men and women reporting higher sexual satisfaction were overall more satisfied in their relationships. Male sexual satisfaction in particular had a positive effect on women partner’s overall relationship satisfaction. However, those who were satisfied overall in their relationships were not necessarily more satisfied sexually.
- Orgasm frequency was in the 80 to 100 percent range for men and 60-80 percent for women (though in some other samples it is reported as being much lower, less than 50%). For women, greater sexual content was correlated with frequency of orgasm, which is generally lower for women to begin with. If men provide greater sexual content within an effective communication process, women may experience more orgasms as well as greater sexual satisfaction. All participants correlated frequency of orgasm with sexual satisfaction.
- Frequency of sex decreased with duration of relationship. The longer people were together, they less sex they had. While frequency of sex did not correlate with male sexual satisfaction in this sample, for women it did.
- Sexual communication process and content were associated with overall sexual satisfaction for men and women. For pairs, men showed increased sexual satisfaction with greater content and positive communication process from female partners, above and beyond the general effect.
- Notably, not only was sexual satisfaction correlated with one’s own orgasm frequency, sexual satisfaction was also correlated with the partner’s frequency of orgasm, highlighting the importance of mutuality.
Here are the summary graphs for each of the models, which show the complex relationships among the main results, for the two different path analysis models (the satisfaction model as well as the sexual and orgasm frequency model). They show a network of key factors connected by lines which show the strength and direction of correlation. Solid lines show statistically significant relationships, dotted lines insignificant correlationship, and arrows the direction of the association:
Source: Jones, et al., 2017
Source: Jones et al, 2017
For further consideration
Taken together―and given our developing understanding of relationships and sexual satisfaction based on prior work―these findings support the importance of recognizing that general relationship communication and sexual communication are distinct from, yet intertwined with, one another when it comes to relationship and sexual satisfaction. While elements of sexual communication may contribute to overall relationship satisfaction as well as sexual satisfaction―and in turn increased pro-sexual behaviors―general relationship satisfaction in-and-of-itself does not necessarily lead to sexual satisfaction in those relationships. While for many people sexual satisfaction is necessary to be satisfied overall, other couples may experience overall relationship satisfaction without high sexual satisfaction.
Men and women in this sample tended to have different needs for sexual and relationship satisfaction, in some ways, while in other ways, overlapped. Couples with women reporting positive contributions to relationship and sexual communication had more sexually and relationally satisfied husbands, and were themselves more satisfied in both. When men were more sexually satisfied, their female partners reported being more relationally satisfied. The study authors suggest that for “dyadic, relational and sexual satisfaction, it is important for men to be attuned to their partners’ communication needs, and for women to be attentive to their partners’ sexual expectations.”
Specific communication about sex is required to address sexual issues and likely to achieve greater sexual satisfaction, qualitatively and quantitatively, for women and for men in different ways. In particular, women have room for more orgasms, which is associated with sexual satisfaction, and communicating about sexual specifics may pave the way to positive outcomes. Men, on the other hand, orgasmed almost every time, but found greater sexual satisfaction when women spoke more positively in their sexual communication.
Sexual communication process did not predict relationship satisfaction, and general communication process did not directly affect sexual satisfaction, highlighting the validity of viewing them as separate aspects of communication, which may potentially act in concert. Focusing on sexuality in detail and as an independent factor―as well as in the context of general relationship communication―is often necessary and irreplaceble for couples and in couples’ therapeutic efforts. Future research will be helpful to sort out which factors and possible what ways of discussing them are most useful, and to what extent these findings apply to demographic groups beyond the predominantly white, monogamous, heterosexual sample surveyed in this study.