In time-limited sex therapy, termination of treatment occurs after a predetermined period of time. Thus, in the Masters and Johnson model programs, the couple is seen daily for two weeks, after which time treatment ends, regardless of outcome. Presumably, this method is based on the rationale that, if the couple's problem is amenable to sex therapy, they will have responded after 14 sessions; if they have not, extending the treatment will not help.

The immediate cause of this couple's problem was Norma's avoidance of sexual contact. This was aggravated by Norman's pressuring. It appeared that Norma was not afraid of sexual feelings or of penetration because she had functioned well briefly with Norman before their marriage. She also masturbated to orgasm with no difficulty.

The husband was a 42 year old postal worker; his wife was a dietician, age 35. They had been married for five years and had no children because the wife felt she did not want to bring children into this world which she saw as full of pain and danger.

Some work, but only as much as was necessary to foster the patient's insight into and resolution of her success anxiety, was done on her relation ship with her mother. The therapist played a "good mother" role and supported her in her efforts to enjoy her life. Peggy was quite receptive to the concept of success anxiety and gained insight into her tendency to self sabotage her pleasure. She also came to recognize the part she played in the repetitive ebb and flow of closeness in the marital relationship.

Initially, pleasuring and non-demanding genital stimulation tasks were assigned. These met with success but this lasted for only a brief period of time. With every improvement one or the other became resistant and created obstacles. He was "too busy" with cases to spend the necessary two or three leisurely evenings a week devoted to closeness and sexual pleasure. When they managed to arrange a weekend away, she became preoccupied to the point of obsession with her job.

Conflicts about intimacy are handled in psychosexual therapy like other success fears. When resistances and obstacles are evoked in the course of sex therapy by underlying intimacy fears, interpretations on this level are often effective. This may be done in the context of brief therapy with9ut necessarily delving into the earlier derivatives of this problem.

Both the degree and the duration of closeness that can be tolerated vary, although the pattern is highly consistent for a specific couple. It is possible to predict at what level of intimacy and after what duration of closeness and warmth the couple will again engage in distancing behavior.

The fear of intimacy is highly prevalent in our society and may produce problems that extend beyond sexual dysfunctions. We tend to spectator rather to participate together, watch TV, play cards and video games rather than engage in intimate conversation. It sometimes seems that people are more afraid of intimacy than they are of sex.

Good rapport was attained with both spouses rapidly and easily. She was confronted with her resistance to sexual pleasure. She admitted this half heartedly, but stated that if he would learn to become a better lover she would respond. However, she also maintained that she did not have the patience to work with him and that he should visit a surrogate. She was confronted with the irrational nature of her construction, but she gained only limited insight.

During the first part of their marriage they had intercourse two or three times a week. George functioned well and enjoyed sex. Georgia at times felt some arousal but never reached orgasm. The couple did not discuss their sexual interaction. Georgia did not tell George that she found sex unsatisfactory, and he never suspected this.