Sexual intimacy and aging - An integrative framework to promote intimacy resilience in couple therapy

Sep 22, 2026

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Work at the Intimacies Project identifies a gap in the couple and family therapy field regarding sexuality and aging. The article offers an integrative clinical framework to help therapists address sexual-intimacy challenges in older couples. It explains how normative sexual difficulties become entangled with stigma, misconceptions, limiting gender narratives, vulnerabilities, and defensive postures, leading to emotional and sexual shutdowns. It then outlines how to deconstruct impasses using vulnerability dynamics, relational sexual histories, Sensate Focus, and skills to sustain intimacy resilience over time.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages20

Reading Time50 min

AccessFree to download

Abstract

Introduction

Aging and the social context of sexuality

Myths and challenges for older adults

Part One

Ageism and the erotic marginalization of the old

Part Two

Integrative framework for transforming sexual narratives

Individual sessions and relational skills

DOI: 10. 1111/famp.12767 OR I G I NA L A RT I C L E Sexual intimacy and aging: An integrative framework to promote intimacy resilience in couple therapy Michele Scheinkman | Suzanne Iasenza | Keren Ludwig | Thomas Cronin | Susan Lemor | Peggy Papp Ackerman Institute for the Family, New York, New York, USA Correspondence Michele Scheinkman, The Ackerman Institute for The Family, New York, NY, USA. [Email:](Email: michelescheinkman@gmail.com)[ michelescheinkman@gmail.com](Email: michelescheinkman@gmail.com) Abstract In our work at the Intimacies Project at The Ackerman Institute for the Family we became aware of a gap in attention about sexuality and aging in the couple and family therapy field. In this article, we provide an integrative framework to guide therapists on how to address problems of sexuality and aging in the therapy room. Starting from considerations about the social context of aging and the self of the therapist, we contend that when normative sexual challenges become entangled with stigma, misconceptions about sexuality, limiting gender narratives, vulnerabilities, and defensive postures, they often result in emotional and sexual shutdowns. Through a combination of the vulnerability cycle with an expansive definition of sexuality, we demonstrate how we deconstruct impasses, disentangle normative quandaries from reactive dynamics, and help couples transform their sexual narratives. We outline how we conduct individual sessions to obtain relational sexual histories, utilize Sensate Focus as a mindful touch exercise, and help partners expand their sexual menus beyond penetration and orgasms. We also describe relational skills that may need to be strengthened to help aging couples deal with the ebb and flow of intimacy, sustaining resilience over time. K E Y WO R D S aging, couples therapy, integrative clinical framework, sexual intimacy We are grateful to Lois Braverman and The Ackerman Institute for the Family for having supported the Couples and Intimacies Project for over 13 years. We dedicate this article to Peggy Papp who co-founded the project and was our continuous source of inspiration. [Correction added on 20 April 2022, after first online publication: Acknowledgements has been moved as footnote on page 1 and footnote has been corrected in this version] Family Process. 2022;00:1–[20. wileyonlinelibrary.com/journal/famp](20. wileyonlinelibrary.com/journal/famp) © 2022 Family Process Institute | 1 INTRODUCTION Life is a process of becoming, a combination of states we have to go through. Where people fail is that they wish to elect a state and remain in it. This is a kind of death. Anais Nin (1964) In the last few decades, the zeitgeist about sexuality and aging has changed significantly. Thanks to burgeoning advances in public health and medical fields, many of us are being granted “extra life”(Johnson, 2021). Through prevention, mitigation of serious illnesses, and repair of old age disabilities (joint replacement, heart valves, cancer treatments, surgeries, medications, and more), we are living longer than any previous generation. Seniors today run marathons and remain involved in political, academic, and creative endeavors through their 70s, 80s, and even into their 90s. Moreover, within this extended life span an increasing number of older adults are dating, marrying, and remarrying, striving to maintain sexuality and intimacy until the end of life. An evolving narrative about life after 60 has emerged in the popular culture. Movies like Something's Gotta Give (2003) and The Best Exotic Marigold Hotel (2011) as well as television series such as Grace and Frankie (2015–present) and The Kominsky Method (2018–present) show the trials and tribulations of older adults and their love lives. The proliferation of dating sites like Sixty and Me, Our Time, and Silver Singles also testifies to the quest for intimacy in later years. A groundbreaking photographic study by Arianne

FAQs

What gap does the article address in couple and family therapy?

It addresses the lack of attention to sexuality and aging within the couple and family therapy field.

How does the article explain why sexual and emotional shutdowns can occur?

It argues that normative sexual challenges can become entangled with stigma, misconceptions about sexuality, limiting gender narratives, vulnerabilities, and defensive postures, resulting in emotional and sexual shutdowns.

What therapeutic approaches does the framework include?

It outlines taking relational sexual histories, using Sensate Focus as a mindful touch exercise, helping partners expand their sexual menus beyond penetration and orgasms, and strengthening relational skills that support intimacy resilience over time.

Sep 22, 2026

Upload by Bulrr