Readiness for Sensate Focus Assignments

When using sensate focus, it is helpful to remember it is a tool for the couple. As we all know, couples will only use tools if they are ready. Part of being prepared to engage in the sensate focus exercises involves having motivation and a positive attitude about wanting to do the exercise. In order to determine a couple’s readiness, the therapist describes what is involved in the sensate focus, noting each partner’s reactions. Additionally, the therapist will want to inquire directly to determine if the couple is prepared to proceed to the systemically oriented sensate focus exercises.

• • Do the two of you believe that you are ready for assignments that involve physical touch?
• • Physical touch can be sensual, sexual, or any combination of feelings. What does it mean for the two of you to be sensual with each other?
• • What does it mean for the two of you to be sexual with each other?
• • How are the two concepts, sensual and sexual, alike or different?
• • In what ways do the two of you think you are sensual/sexual beings?
• • What does it mean to experience pleasure from being touched?
• • What does it mean to experience sensual/sexual pleasure?
• • What do the two of you like most/least about being sexual?
• • What does it mean to actually communicate your sensual/sexual feelings and wants?
• • Do you think it will be difficult to communicate about touch, sensual, and sexual wants? Why? Why not?
• • Can the two of you think of any negative consequences of experiencing sensual/sexual pleasure or becoming more intimate as a couple?
• • Can the two of you think of any ways that you might avoid these exercises?

If the attitude is generally positive, the therapist can proceed with the exercise. However, if one or both partners expresses hesitation, ambivalence, or negative attitudes about the exercises, it is necessary to process those feelings first.

Structure and Application of Sensate Focus

For sensate focus to be successful, the exercises must be constructed in several graduated increments and designed according to the specific needs of the couple as they progress through treatment. Every assignment is created assiduously and modified as necessary. All pressure and anxiety must be removed from the touching, sensual, or sexual stimulation to ensure a positive outcome. Desensitization to sexual anxiety and mindful touch are gradual and systematic; thus, treatment requires a series of many steps that are based on the successful completion of the last. The therapist needs to continually assess the type of physical interaction and communication that produce successful completion of each step. Additionally, the couple should be helped to continue mindfulness techniques from the beginning to the end of the exercises through review and reinforcement. It can sometimes be difficult to maintain a mindful attitude during sensual touch exercises when dealing with slow, incremental progress. The couple must be validated for their efforts.

The specific assignments are practiced at home at least three times per week. Repetition provides plentiful opportunities to gradually reduce anxiety, change behavior, and break old habits that contributed to sexual difficulties. Therapy sessions, therefore, should occur on a weekly basis in order to monitor and modify the assignments and the therapist must be available for clarification between sessions if necessary (Gambescia 8c Weeks, 2006). It is important for partners to understand that sensate focus permits occasions and opportunities for them to rebuild their physical, sensual, and sexual relationship. The therapist might suggest that the partner who has been passive in the past take the initiative to begin the exercise and decide which role he or she defines as the active role. Some couples like to do the exercises spontaneously. Others will prefer to put the times or days on a calendar. We often suggest picking five times to schedule the exercise with the goal of doing three. This gives them an out for two of the sessions when they aren’t in the mood. Also, couples often need prompting to relax and enjoy the unhurried pace rather than accelerating the process.

The couple completes only the required behavioral increment each time; thus, the burden of responsibility and resulting performance pressures are eliminated. Writing some notes when giving the exercise to the couple to review often helps them control the pace. The therapist must be mindful that couples will sometimes go beyond the limits of the assignment. In such instances, the rationale for pacing and structured exercises must be clarified.

Another way of thinking of the exercises is that the therapist provides a general guideline or shell for the exercises and asks the couple to fill in the details. For example, the therapist might suggest that the couple is ready for gentle back touch. The couple can decide who initiates it, how much clothing is on, where it takes place, how long it lasts, and so on. Once they have all the elements in place, the therapist summarizes the exercise and asks how they feel about it. One other point that should be mentioned is that the communication that is to take place during the exercise is to always be positive unless something hurts. The couple is asked to avoid saying what they do not like and think about what they do like or want and to express that thought.