Couple therapy is always about sex therapy eventually. It may not be the first thing mentioned but it comes up long before the 3rd thing, whatever that might be.
I think of 4 levels of sexual hunger for wives and husbands.
Won’t or Would (but) — Couples avoid sexual intimacy for lots of reasons (e.g. broken trust, lack of practice, fears, medical difficulties, etc.). When couples “won’t,” or “I would if you weren’t such a ______,” anger builds and the relationship becomes cold and parallel, only joined by non-intimate things.
Waiting or Watching — Some couples are watching for the other to prove their desire, rather than initiate themselves. They are “waiters,” hoping for more and usually blaming the other for the lack of sexual friendship they experience. Sometimes people are waiting for the right context or response, like a Jamaican holiday.
Willing or Welcoming — The willing spouse (usually the woman) will satisfy the sexual desires of the other (usually the husband) but not be satisfied themselves. This is like being a missionary to the sexual needs of the spouse.
Wanting or Wishing – This is sexual hunger, a loving lust and longing that produces a marvelous merging. That is, if both partners are on the same step.
Sometimes one partner is on one step (e.g. a sad waiting) and the other is on another (e.g. a needy wanting). Frustration and fractious conflict is usually the result of this misstep.
At other times the couple are together on step 1 (e.g. exhausted from work and caring for a sick infant) and at other times they luxuriate at level 4.
I tell you this to give you a vocabulary for your sexual hunger. It helps to know where your spouse “is” rather than guess. It helps to know where you are as well.