I began by first seeing Julie, alone, for one hour twice a week. I wanted to create an atmosphere of comfort and safety so that she would not hesitate to tell me all of her issues, and we made quite a bit of progress in the first two weeks. She told me that Andrew was her first love, and that she had never been with any man but him. She revealed that she was bored with her life and had a curiosity about the world, traveling, living in other places, and, finally, being with other men. She said that she sometimes had glimpses of what that life could be like, especially when she was doing some routine household chore with Andrew sitting in the next room. These hints at another life made her doubt her marriage and built up resentment in her. At times she was mean to him (she realized that), but somewhere deep inside she actually enjoyed being mean. This bothered her because she loved him very much and wanted a happy life with him as well. In another session, she talked about how she did not feel that Andrew was a good listener and that the friendship part of their relationship was stagnating. She thought that they had trouble talking about anything that mattered and would argue about sundry things. She said that she was afraid to come to him with her innermost fears and insecurities because she thought he would mock her and hurt her even more. These were serious issues.

I asked her next about their sex life, and her response disturbed me. Julie said that she enjoyed having sex with Andrew but that she could “take it or leave it.” She was rarely if ever excited, and had never had an orgasm with him in any way (which included oral sex). She described having sex with him as follows: Andrew would announce that he was going to have sex with her. She would strip off her clothes and lie on her back with her legs spread open, her knees raised. He would rub his favorite water-based lubricant on his penis and masturbate to erection. He would then mount her and thrust into her for about five minutes until he came inside of her. They would then get up, clean up, and go on with their day.

When I asked her how often this happened, she told me about once a week, usually on Sundays when they had time during the day. I asked her then if she masturbated, and she said that she used to occasionally when she was younger, but had stopped over the years.