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Dr. Love

Dr. Chelsea Wakefield at the UAMS Couples Center helps couples bring back that lovin' feelin', or never lose it in the first place.

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LET'S TALK ABOUT SEX: Dr. Chelsea Wakefield, of UAMS, helps couples talk about their love lives.
  • LET'S TALK ABOUT SEX: Dr. Chelsea Wakefield, of UAMS, helps couples talk about their love lives.

There comes a time in every relationship, no matter how seemingly stable and happy it might look from the outside, when things just hit the wall. Most human beings are jars full or fear, hang-ups, worries, sexual quirks and confusions. Seal two of them in the pressure cooker of a busy modern relationship, and you've got a recipe for a spectacular explosion.

Dr. Chelsea Wakefield is helping couples steer clear of the troubles than can sink a loving relationship. An assistant professor in the UAMS Psychiatric Research Institute, Wakefield holds a Ph.D. in clinical sexology and is the director of the UAMS Couples Center. Opened in November 2016, the Couples Center seeks to help couples navigate the unique challenges of relationships in the 21st century by providing counseling, group therapy and community education about love, desire, relationships and sex. The center also teaches student counselors about the unique demands of providing therapy and counseling to couples.

Wakefield, who is the author of two books, "Negotiating the Inner Peace Treaty" and "In Search of Aphrodite: Women, Archetypes and Sex Therapy," has been a psychotherapist for 18 years. She began to study the field of sexology about eight years ago. One thing that's surprising to most people, she says, is that, until very recently, training and education for couples' therapists didn't include much education about sexuality and sexual response.

"There was an assumption in couples therapy for many, many years that if a couple was getting along, the sexuality would take care of itself," Wakefield said. "This is a myth. Many couples who are very companionate and get along very well have either a nonexistent [sex life], kind of a brother/sister relationship, or difficulties with sexuality. We have very poor sex education in this country in terms of how sex actually works, the difference between men's and women's bodies, the process of sexuality in terms of desire and arousal, and how people actually reach orgasm — the technicalities of it."

Even in long-established couples, Wakefield said, she often sees a lack of basic knowledge about sexuality. That can often lead to anxiety or feelings of inadequacy. As an example, Wakefield said that multiple studies have shown that only about one-third of women can reach orgasm from intercourse alone. Because of a general lack of sex education and plentiful misinformation, however (some of it rooted in what Wakefield called the "Freudian myth" of a "superior" vaginal orgasm), Wakefield says there are millions of perfectly normal woman who feel inadequate because they can't reach orgasm solely through intercourse. For men, she said, equally as distressing can be the rarely discussed condition called "ejaculatory incompetence," which makes it harder for men to reach orgasm and ejaculate as they age.

"This is something we talk about a lot, how inadequate and broken people feel when they have this assumption that everybody is having better sex than they are," Wakefield said. "This is such a charged topic for most people, and it is woven in with so much history of being something you really don't want to talk about publicly. Certainly there is a lot of shame about it that people feel — not just shame about sexuality, but shame about body image."

In her work at the Couples Center, Wakefield sometimes helps people deal with difficulties caused by compulsive sexual behaviors, sometimes referred to by what she calls "the somewhat controversial label of sexual addiction." In other cases, she said, a partner might have "a particular template of sexual arousal" that's disturbing, distressing or unusual to their partner.

"We can talk about the formation of that," she said. "How they can manage it in the relationship, how they can communicate about it. Every single individual has a very personalized sexual template. Much of that is formed in their early years." Because a person's individual sexual template is formed so early, Wakefield said, therapists are now seeing an entire generation of young men experiencing sexual problems because they were educated about sex and women's sexual responses solely by online pornography.

"This is leading to a whole new group of sexual difficulties," she said, "and the need to re-educate them when they begin to encounter real living females and what real living females are like in person, and what they want and how their bodies actually work. Pornography itself, if we get completely away from the moral issue, provides terrible sex education."

Wakefield said the field of sexology has advanced quite a bit since the days of noted sexologists William Masters and Virginia Johnson, including the "depathologizing" of many sexual fetishes and kinks, the new appreciation for the importance of educating about sex during couples' therapy and a greater understanding of female sexual response in particular. She says she's also seen a trend of young couples seeking relationship counseling long before they run into problems.

"In the last few years I've had couples come to me, usually young couples, saying, 'We want to get off to a good start. How do we do that?' " she said. "I love to work with couples who say, 'We want to get off to a good start. We're in the early phases of our relationship. What can we do to avoid the kind of quagmires that we've seen other people flounder in, or our parents? "

Asked if there is a secret to a long, happy and fulfilling relationship, Wakefield says she sees relationships as having three levels: First, the "you meet my basic needs" level, then a "roles and responsibilities" level that relates to things like paying the bills, chores and raising a family.

"The highest level of relationship," she said, "is a relationship that I call 'individuation and connection.' That means you have two people who are really continuing to grow and deepen as people and they're sharing that growth in the container of the committed relationship. ... We have to look at things like: How comfortable are you with actually having a go-to person for celebration and suffering over the course of many, many years? What is the depth of your personhood? How developed are you? How adult are you in being able to meet the challenges of life and not blow out, but also to be self-aware and self-revealing? That's the piece that really stays vital: really knowing who you are and how you're growing and changing, and then revealing that to a partner."

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