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Psychiatry Newsletter - A Clinic Sampler

Hopkins BrainWise Winter 2010

A Clinic Sampler

By: Marjorie Centofanti
Date: February 1, 2010


Sexual problems that couples face vary in surprising ways. The summaries below give an idea of what Hopkins clinicians encounter. Names and other details have been adjusted to protect patient privacy.

Badr and his wife, Farah, in their mid-30s, came to the Sexual Behaviors Consultation Unit from the Middle East with problems that center on cultural norms—problems not uncommon in arranged marriages in traditional societies. Both husband and wife had no sexual experience before they wed; two years afterward, the marriage remained unconsummated. The pressure from their families to have children was intense and constant. SBCU clinicians saw that a combination of performance anxiety (Badr) and psychogenic vaginal pain (Farah) were at work.

Lynne, turning 50, and her husband JP have always had an active social life as a couple. Lynne stayed home to raise their family. Her youngest just left for the Army. Staying fit and looking good have been her personal priority but lately, a touch of arthritis sidelined her from workouts at the gym. That and the empty nest, she says, caused her lack of interest in sexual intimacy. Husband JP, however, has traditional expectations and feels threatened by Lynne’s unwillingness. He stays up late, checking Internet porn sites, a fact that shocks Lynne and cements her reluctance. After their SBCU visit, Lynne was diagnosed with mild depression; JP has an addiction. Both have body image difficulties and poor communication skills.

Brad and Kaitlin, both 26, became engaged just after starting graduate school. They’d dated, then shared an apartment for four months. Kaitlin called the SBCU for what she called “a premarital checkup,” concerned about Brad’s apparent low desire. Their problem turned out to have no physical basis and was rooted in Kaitlin’s unrealistic expectations.

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