Part 2 Working with the Sexual Cycle in Couples Therapy: Who, What, When, Where, Why, and How


Emotional and Sexual Cycles & Attachment Styles
In our first article, What Are Sexual Cycles and Why Work With Them, we presented an overview as an introduction to help couple clinicians work with the sexual cycle as intently as with the emotional cycle, and to forge the strongest bond in couples’ bodies, minds, and hearts. In this next article, we will explore exactly what the emotional and sexual cycles are, the different types of attachment styles, and how emotional attachment styles mitigate sexual attachment.

What are the emotional and sexual cycles?

Let’s first look at the fundamentals of how the emotional attachment cycle and sexual attachment cycle work in romance. In emotional security, partners help defend each other from threat (safe harbor). They respect differences and separateness, encouraging the other to express their individual purpose, work, or calling in life (secure base; Johnson, 2017). When working with a couple’s emotional cycle in distress, we see predictable behaviors from each partner. Typically, one partner, the emotional pursuer, reacts to even a slight disconnect by pushing for engagement, reassurance, attention, or closeness. The other partner, the emotional withdrawer, often pulls away to avoid escalation, trying to protect the relationship by keeping things calm. The emotional pursuer can easily escalate with anger and criticism—getting emotionally louder in a further attempt to reach their withdrawing partner, which can scare their partner, make them feel suffocated, controlled, and/or feel accused of not being enough—thereby causing further shutdown. The pursuer believes pushing is necessary to feel safe. The withdrawer believes not engaging is necessary to feel safe. Each partner’s protective defense reinforces the other partner’s protective defense. Johnson’s model, Emotionally Focused Therapy (the modality used by both authors), aims at helping both partners to identify and unite against their negative cycles of defensiveness and, more importantly, replacing them with positive patterns of responsiveness.

Every interaction—a) where the pursuer feels rejected by the withdrawer’s move away, then, b) the withdrawer feels like a failure when the pursuer pushes with messages that the withdrawer’s disengagement is wrong c) the withdrawer retreats, further sending the message that their pursuer’s needs are too much—strengthens the persistent and repetitive dynamic of this negative cycle. As the negative cycle gains momentum, the costs to the relationship of—increased distance, mistrust, and reactivity and decreased closeness, trust, and safety—are grave.

Sexually, secure pair bonds invite each other into depth and vulnerability by revealing themselves, their desires, their inner erotic world, even reaching heights of spiritual ecstasy during connection and merger (Kleinplatz et al., 2009). Couples who are securely attached have a basis to feel safe, and therefore open to exploration, and enjoy a varied sexual repertoire (Johnson et al., 2018). They like intimate contact of cuddling and kissing combined with explicit genital (oral, penile, anal, and vaginal) contact (Mikulincer & Shaver, 2012). Partners take psychological and emotional risks in bed by sharing their fantasies and wishes with each other. They can “let go” and be uninhibited, trusting that their partner isn’t just “using” them, won’t betray them in infidelity, and wants to meet their sexual needs. This surrender to the moment and ability to “fully express themselves sexually” in secure attachment (Valdez et al., 2021) is what leads to the greatest satisfaction and pleasure sexually (Mikulincer & Shaver, 2012). Furthermore, in secure sexual attachment, they manage to keep seeing their partner as erotic, while partnering through the mundane tasks of living together and perhaps raising a family, thereby stabilizing future generations (Cooper et al., 2006; Hazan et al., 1994).

More than frequency or perfect agreement, it is sexual responsiveness that makes the sexual cycle secure. A responsive partner’s eyes light up when their lover makes innuendo, offering reassurance of their interest. They affirm their sexual desire even if their moods don’t match in the moment, and partners accept temporary unavailability with good humor. Each gives and takes in bed; wanting their partner to be present with them in the moment (safe harbor) and enjoying it when their partner is lost in their own body’s delicious sensations (secure base). They speak plainly about wants and needs, making sexual interactions sensible and understandable without subterfuge or defensiveness.

We’d like to propose that there is a similar pursue-withdraw dynamic in the sexual attachment cycle that may be evidenced by the sexual pursuer protesting: “You never suggest we make love anymore.” This pushes their partner to become aware of their own and the relationship’s need for physical intimacy. Or the pull-away perhaps becomes obvious when after the pursuer’s complaint, the sexual withdrawer seems even less inclined to intimacy and becomes defensive by claiming to be tired, busy, or not getting enough help around the house. Criticism fuels disengagement; disengagement fuels criticism.

Attachment styles and sex modify each other

Before we move on to how to deal with the pursue-withdraw pattern in the sexual cycle, we need to understand a bit about how attachment styles and sex moderate each other. We look at attachment styles because we emerge from childhood influences the way we experience not only emotional connection but sexual connection, what we value, what we are afraid of, and what is the most successful for us in bed. Briefly, there are three primary attachment styles evolving from a person’s childhood—one secure and two insecure styles:

  • Secure attachment: Feels worthy of being loved and having their needs met, thinks people are safe to trust emotionally, and feels comfortable exploring their own interests and direction, seeks connection with friends and partners.
  • Anxious attachment: Worries that they are not loveable, over-inflates their need and might not respect the boundaries of their partner, has difficulty with independence and acts clingy.
  • Avoidant attachment: Seems to value independence over connection, believes that others are untrustworthy, has difficulty asking for help, invests little emotional energy in relationships.

While we may imagine that our reasons for having sex are unique to the moment, one way to organize our thinking about attachment styles impacting sex is to understand that our motives to have sex fit into four central categories:

  1. Intimacy: the desire to feel connected and express love
  2. Pleasure: to enjoy our bodies in relationship with our partner’s body
  3. Approval: prove attractiveness, find reassurance, avoid conflict, please partner
  4. Coping: minimize negative emotions, self-soothe, gain a sense of status or power

(Cooper et al., 2006)

How emotional attachment styles mitigate sexual attachment:

Motives 1 & 2: Securely attached couples are marked primarily by two sexual motives: intimacy and pleasure, along with high commitment to each other. Initiation is more mutual. In love, their secure emotional connection increases their ability to be present, authentic, and vulnerable, creating more emotional satisfaction in the moment. This brings more intimacy into their sexual attachment. Easy touch, enjoyment of sexual variety, and desire for genital pleasure brings tremendous excitement sexually, which further enlivens their emotional experience (Mikulincer, 2006).

Motives 3 & 1: Anxiously attached partners frequently have sex for approval motives—primarily to eliminate the feeling of relational inadequacy, as well as to induce love, even seeming obsessed with their romantic partner. Yet, they may prefer the expressions of affection in the encounter but are less motivated by pleasure or even uncomfortable with explicitly sexual, genital stimulation (Hazan et al., 1994). And unfortunately, because of their concerns for reassurance and safety (which sex does help with!) they are less attuned to their partner’s sexual needs and preferences. Their experience is more fraught with anxiety about their partner’s love and their own performance (Mikulincer & Shaver, 2012). For example, particularly in the beginning, anxiously attached female lovers may offer lots of sex, believing it’s important to their partner (Butzer & Campbell, 2008). But unfortunately, their motive is more rooted in compliance, seeking to feel desirable to their partner. In their insecurity, they may miss the chance to shape the sexual experience in ways that are sexually exciting to themselves, perhaps later resulting in low desire detached from the pleasure motive. Anxiously attached females might be vulnerable to seeking an affair partner for reassurance if it wanes. Anxiously attached male partners may also worry excessively about their attractiveness and performance, leaving their partner unable to feel their love over their neediness.

Motives 4 & 2: Avoidantly attached partners frequently have sex for coping with intrapsychic negative feelings of stress, sadness, or emptiness as well as for pleasure, but often with a low commitment. They are more likely to have casual sex or be unfaithful, or to use sexual conquests to prove their power. They compartmentalize pleasure from intimacy and find emotionally intimate aspects of the sexual encounter difficult. Sometimes, in committed partnership, to stay self-reliant, this person might prefer to masturbate rather than negotiate with their partner for sex. We can imagine the potential disappointment of their partners. For instance, when someone habitually uses sex as a “sleeping pill”—a coping with stress mechanism, it is unlikely that their partner feels loved or excited by their sexual request. Or, perhaps, a partner who agrees to have sex, but asks, “Can we get it over quickly?” (Cooper et al., 2006; Johnson et al., 2018; Brassard et al., 2012).

Sex mitigates insecure attachment: The best news is that sexual passion can help heal insecure emotional attachment. (Mikulincer & Shaver, 2012; Valdez et al., 2021). For instance, sexual desire from their partner is deeply reassuring and emotionally stabilizing for anxiously attached women, thereby signaling them to fall in love (Mizrahi et al., 2016). And for anxiously attached males, sex creates a positive effect on the relationship soon after the sexual encounter (Mikulincer & Shaver, 2012); or male subjective sexual desire that is responded to cues particularly more avoidant men that this relationship might be safe sexually and emotionally to open up more vulnerably (Mizrahi et al., 2016).

Before we move on to how to deal with the pursue-withdraw pattern in the sexual cycle, we need to understand a bit about how attachment styles and sex moderate each other.

Clinical implications

Congruent interplay: To understand this from a clinical perspective, we see that attachment style may cause a partner to either move away or toward their partner in a congruent direction in both cycles. For instance, a female emotional pursuer also chases her partner sexually, but her partner withdraws from her emotionally and sexually, preferring the use of masturbation with porn.

Crossover interplay: But the most common pattern we encounter in our heterosexual couples is the crossover interplay. The emotional pursuer switches roles in the sexual cycle to the withdrawer and the emotional withdrawer becomes the sexual pursuer. They reverse their direction from and toward their partner sexually. For instance, the male partner finds security sexually, motivated by both intimacy and pleasure, but his overall emotional protective strategy is withdrawal. And the female partner wants emotional connection but downregulates her sexual need by using the deactivating strategies that follow.

We believe it is up to the therapist to make sense of these failed approaches through reflection and evocative questions to help bring emotional intelligence to the sexual interactions. It is easy to make sense of their dynamics if we simply follow the push toward or pull away from their partner in whichever cycle we are tracking.

But when there is misattunement, the couple can have a negative sexual cycle that loops repetitively, leading the sexual pursuer to choose hyperactivating strategies:

  • Mental preoccupation about sex
  • Vigilance about their partner’s signals of desire or rejection
  • Worry about their personal attractiveness
  • Efforts that become manipulative, even coercive

And the sexual withdrawer to engage in deactivating strategies:

  • Inhibition of sexual desire and dismissal of their own sexual needs
  • Dismissing or disparaging a partner’s sexual bids
  • Repression of sexual thoughts, memories, and fantasies
  • Suppression of arousal and orgasm (Mikulincer, 2006)

Therapists must be trained to see that sexuality, along with emotional attachment are intrinsically and inseparably what create connection in secure partnership. With its primal longing, sex elicits what is best and worst in relationships. Swinging from the highs of passion to the lows of rejection, sex offers us plenty to engage with and talk about and is often an entree into exploring both the sexual and emotional cycles that need healing. Yet most of us find it extremely difficult to talk about sex, especially outside the bedroom. Unsurprisingly, silence and lack of engagement are the key features of bad sex. Instead of finding connection, too many partners discover loneliness in their sexual pursuits. To help couples truly capture the glorious design of sex to enrich their lives, therapists need to get more comfortable explicitly facilitating conversations about sex. Increased confidence working in the sexual realm directly correlates to increased opportunities for the therapist to help facilitate bonding conversations between partners. After all, there is nothing as vulnerable as risking giving your body, heart, mind, and spirit to another in the act of lovemaking. To capture the incredible power of sex, therapists need to be more intentional in using the sexual cycle as a doorway to tap into the deepest recesses of our being. This investment of time and energy into exploring the sexual cycle promises each partner a chance to learn, grow, and strengthen their connection.

Be sure to check out the first part of this series, “Part 1: What Are Sexual Cycles and Why Work With Them?” for more on working with the sexual cycle in couples therapy.

Laurie Watson, PhD, MA, LMFT, LCMHC, is an EFT Certified Therapist, AASECT Certified Sex Therapist, and an AAMFT Professional Member holding the Clinical Fellow designation. Watson has been a licensed couple’s counselor for over two decades and is certified in EFT and sex therapy. In clinical therapy, she has helped thousands of couples recover sexual passion and make love again in joyful, intimate, creative, and exciting ways, sometimes even after years of a sexless marriage. Due to her many years of counseling experience, Laurie remains incredibly hopeful that committed love and monogamous sex can fulfill a couple, heal deep wounds from childhood, restore each spouse to a sense of hope, and offer stability from which to face the world together. She is the author of Wanting Sex Again – How to Rediscover Desire and Heal a Sexless Marriage, a blogger for WebMD and Psychology Today with over 15 M reads, and the owner/director for Awakenings Counseling & Counseling Near Me throughout North Carolina.

George Faller, MS, LMFT, is an EFT Certified Therapist, Supervisor, and Trainer. He is an AAMFT Professional Member holding the Clinical Fellow designation and a licensed marriage and family therapist in New York and Connecticut. Faller is the founder and President of the New York Center for Emotionally Focused Therapy (EFT). As an EFT Trainer, he teaches several classes at the Ackerman Institute for the Family (the oldest family institute in the United States) in NYC, is a board member of the Porter Cason Institute for the Family at Tulane University in New Orleans, and is the director of training at the Center for Hope and Renewal in Greenwich, CT. Specializing in trauma, Family EFT, and self-of-the-therapist issues, Faller is committed to bringing EFT to underprivileged populations and pushing the leading edge of effective therapy. He is the co-author of three books: True Connection: Using the NAME IT Model to Heal Relationships (Living with Hope), Sacred Stress: A Radically Different Approach to Using Life’s Challenges for Positive Change and Emotionally Focused Family Therapy: Restoring Connection and Promoting Resilience. He has an online training series called Success In Vulnerability.

Laurie Watson and George Faller are the co-hosts of the podcast FOREPLAY – Couples and Sex Therapy with over 10 M downloads.

Brassard, A., Péloquin, K., Dupuy, E., Wright, J., & Shaver, P. R. (2012). Romantic attachment insecurity predicts sexual dissatisfaction in couples seeking marital therapy. Journal of Sex & Marital Therapy, 38(3), 245-262.

Butzer, B., & Campbell, L. (2008). Adult attachment, sexual satisfaction, and relationship satisfaction: A study of married couples. Personal Relationships, 15(1), 141-154.

Cooper M., Pioli M., Levitt A., Talley A., Micheas L., Collins N. (2006). Attachment styles, sex motives and sexual behavior: Evidence for gender-specific expressions of attachment dynamics. In Mikulincer M., Goodman G. (Eds.), Dynamics of romantic love: Attachment, caregiving and sex (pp. 243-274). New York, NY: Guilford.

Hazan, C., Zeifman, D., & Middleton, K. (1994). Adult romantic attachment, affection, and sex. Paper presented at the 7th International Conference on Personal Relationships, Groningen, the Netherlands.

Johnson, S. (2017). An emotionally focused approach to sex therapy. In Z. D. Peterson (Ed.), The Wiley handbook of sex therapy.

Johnson, S. M., Simakhodskaya, Z. & Moran, M. (2018). Addressing issues of sexuality in couples therapy: Emotionally focused therapy meets sex therapy. Current Sexual Health Reports 10, 65-71.

Kleinplatz, P. J., Ménard, A. D., Paquet, M.-C., Paradis, N., Campbell, M. et al. (2009). The components of optimal sexuality: A portrait of ‘great sex’. Canadian Journal of Human Sexuality, 18, 1-13.

Mikulincer, M. (2006). Attachment, caregiving, and sex within romantic relationships: A behavioral systems perspective. In M. Mikulincer & G. S. Goodman (Eds.), Dynamics of romantic love: Attachment, caregiving, and sex (pp. 23-44). The Guilford Press.

Mikulincer & Shaver. (2012) Adult attachment and sexuality, attachment insecurities bias the functioning of the sexual behavior system. In P. Noller & G. C. Karantzas (Eds.), The Wiley-Blackwell handbook of couples and family relationships. Blackwell Publishing Ltd.

Mizrahi, M., Hirschberger, G., Mikulincer, M., Szepsenwol, O., & Birnbaum, G. E. (2016). Reassuring sex: Can sexual desire and intimacy reduce relationship‐specific attachment insecurities? European Journal of Social Psychology, 46(4), 467-480.

Valdez, C. M., Leonhardt, N. D., & Busby, D. M. (2021). Sexual passion and attachment: Sexual passion style as a mediator between attachment insecurity and sexual satisfaction in committed relationships. Journal of Marital and Family Therapy, 47(3), 614-628.

Other articles

Gray Divorce: Splitting Up Later in Life
A Message from the President

Necessary Losses

I first read Judith Viorst’s book, Necessary Losses, when it came out in 1998, towards the early phase of my career. The idea that loss was necessary, not just an inevitable part of life, was somehow radical for me as a child of refugees, growing up with multiple losses of family, home, and history.
Silvia Kaminsky, MSEd

Meaning of Aging in a Time of Crisis

Common Misconceptions About Portability

Easy licensure portability—it is something everyone in a licensed profession wants, but it is not always easily understood. And as AAMFT embarks on a strategic effort to expand licensure portability for the MFT profession, it has never been more important to understand this process and to correct misconceptions that often circulate about it.

Gray Divorce: Splitting Up Later in Life
Systemic World

An Unstoppable Teenage Life Force: Face to Face with a Class of Syrian 7th Graders

Several years ago, while I was working on a project in Lebanon, I came face to face with a class of Syrian 7th graders. The 7th graders had been displaced to Lebanon by the war taking place across the border. I had been brought to the school, and the nearby refugee camp where the Syrian children lived with their families, as a consultant family therapy “SME” – a “subject matter expert.”

Laurie L. Charlés, PhD