Can a sexual symptom be fixed without taking account of the couple?

As a teacher in sexology and a couple therapist for more than 30 years with experience of more than 1000 couples helped for sexual difficulties, our aim was to try to answer the question which is always at the forefront of any treatment for a sexual disorder: can a sexual symptom be “fixed” without taking account of the couple? We reviewed the literature pertaining to couple therapies and selected four clinical cases as examples of the pitfalls of the numerous therapies where the partner is not involved. These two approaches show how important it is to meet both partners in the couple when tackling any sexual disorder. As early as 1970, Masters and Johnson were insisting on this constant functional interaction between the partners, and what they called at the time the “clinical role of the couple”. Our recommendation is that each partner should be interviewed at least once by the therapist in order to fully understand the dynamics of the couple, and provide adequate support in helping the couple move towards resolving the symptom.