Q:  My husband is much more interested in sex than I am.  If I go along with him, I feel angry, but if I say no, I feel guilty.  What is the way out of this no-win situation?

A:  One of the first things I encourage couples to do when they have gotten stuck in a pattern of sexual activity that isn’t mutually pleasurable is, first, to stop.  Next, the goal is to rebuild and reintroduce only physical contact that is mutually pleasurable – then stop.  Physical intimacy includes hand holding, hugs, and a whole range of other expressions of affection. 

What you have described is a conditional response based on repeated negative sexual experiences.  The goal is to replace the old negative anticipation with positive experiences.

Generally, when couples are experiencing problems with physical intimacy, they are also having difficulties in establishing emotional intimacy and open communication.  If this is the case for you, you and your husband may benefit from couples counseling to address your problem in a more complete manner rather than simply focusing on the sexual issue.