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Quaderni di Psicoterapia Cognitiva - Open Access

La sessualità in psicoterapia cognitivo-comportamentale

No. 57 (2025)

Rediscovering Intimacy: Overcoming Sexual Difficulties in Couples Therapy

DOI
https://doi.org/10.3280/qpc57-2025oa23131
Submitted
giugno 24, 2026
Published
2026-07-16

Abstract

Difficulties in intimacy and sexuality within the couple are a frequent reason for seeking clinical help, prompting exploration and understanding of the functioning of emotional bonds in order to promote increasingly effective treatments. The couple is a dynamic system in which meanings, implicit and explicit rules, and physical, relational, and psychological boundaries are coconstructed. Within this system, sexual behavior is not solely a biological function related to reproduction, but also an identityrelated language and a space of negotiation, cooperation, and affectivity. Internal working models of attachment and the dynamics associated with interpersonal motivational systems influence desire, emotional regulation, and modalities of contact, comunication and connection. Sexual symptoms often emerge as the outcome of circular dysfunctional relational processes.

This article presents an integrated model for the treatment of couple sexual difficulties that combines sensatefocusbased exercises, experiential work on meanings, Integrated Sequential Reconstruction (ISR) and includes guidelines for the integration of EMDR when personal or relational trauma contributes to the onset and maintenance of the symptom.

 

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