1. Authors: Michael E. Metz, Ph. D & Barry W. McCarthy, Ph. D.

2. What is “good enough” sex and can I have some? Media depicts performance oriented aspects of sex “Hype” of prefect sex Physical attractiveness emphasized Relevant to: 20-80 years of age Serious couples

3. What is the GES model? Aim is to relieve distress and the return of sexual function Promote individual and couple satisfaction Five foundations Twelve lifelong growth goals

4. GES Model Promotes sex that serves many values and purposes Biopsychosocial approach Complexity of assessment View of sexual dysfunction: Multi-causal: biopsychosocial Multidimensional: psychological and interactional

5. Twelve Lifelong Growth Goals

6. 1. “Sex is a good element in life, an invaluable part of an individual’s and couple’s long-term comfort, confidence, intimacy, pleasure, and eroticism. Eroticism is an intentional feature and the responsibility of each partner.”

7. 2. “Relationship and sexual satisfaction are the ultimate developmental focus and are essentially intertwined. The couple is an “intimate team” and together promote a vibrant balance of emotional intimacy and eroticism.”

8. 3. “Accurate, realistic, age-appropriate physiological, relationship, and sexual expectations are essential for sexual satisfaction.”

9. 4. “Good physical health and healthy behavioral habits are vital for sexual health. Each individual values, respects, and affirms his/her and the partner’s sexual body.”

10. 5. “Relaxation is the foundation for pleasure and function” 6. “Pleasure is as important as function.”

11. 7. “Valuing variable, flexible sexual experiences and abandoning the “need” for perfect performance inoculates the couple against sexual dysfunction by reducing performance pressure, fears of failure, and rejection.”

12. 8. “Five basic purposes for sex (pleasure, intimacy, stress reduction, self-esteem, reproduction) are integrate into the couple’s sexual relationship. Sex for only one purpose for extended periods of time undermines flexibility and creates a risk of sex dysfunction and distress.”

13. 9. “Integrate and flexibility use the three basic arousal styles (sensual self-entrancement, partner interaction, and role enactment).”

14. 10.“Partner gender differences and preferences are respectfully valued and similarities mutually accepted. Partners cooperate as an intimate team for relationship and sexual pleasure and satisfaction.”

15. 11.“Sex is integrated into real life, and real life is integrated into sex. Partners ensure a “regular” frequency of sex. Sexuality is developing, growing, and evolving throughout one’s life to create a unique sexual style. Regularity ensures an emotional “intimacy blender”.”

16. 12.“Sexuality is personalized: Sex can be playful, spiritual, special.”

17. Treatment Assessment Therapist feedback Core features of GES Treatment details Measuring outcome Sex therapy homework Relapse prevention plan

18. Case Study: Ray and Alicia Ray- 62 years old sex was too infrequent avoided to not feel rejected Erectile Dysfunction Alicia- 61 years old felt sex was on Ray’s rules had fantasies and masturbated Treatment Establish trust position Choose how to play out scenario Strategy involves having a plan A, B, and C

19. Personal View In practice- explore what good sex means to each individual Good message Simplicity of the model Growth goals were the most interesting Recommend use of this model in working with couples Criticisms: assumption that good sex is possible for everyone, what about those who just won’t experience good sex.