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Sexual and Relationship Therapy

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The Good-Enough Sex model for couple sexual satisfaction

Michael E. Metz a; Barry W. McCarthy b
a
Meta Associates, St. Paul, MN, USA b American University, Washington, DC, USA
Online Publication Date: 01 August 2007

To cite this Article Metz, Michael E. and McCarthy, Barry W.(2007)'The Good-Enough Sex model for couple sexual

satisfaction',Sexual and Relationship Therapy,22:3,351 362

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Sexual and Relationship Therapy

Vol 22, No. 3, August 2007

ORIGINAL RESEARCH

The Good-Enough Sex model

for couple sexual satisfaction
MICHAEL E. METZ1 & BARRY W. MCCARTHY2

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Meta Associates, St. Paul, MN, USA, 2American University, Washington, DC, USA

ABSTRACT The Good-Enough Sex model presents a commonsense yet comprehensive perspective
that challenges simplistic notions of sex and encourages couples to pursue positive, realistic meaning in
their intimate lives. With the Good-Enough Sex model, intimacy is the ultimate focus, with pleasure as
important as function, and mutual emotional acceptance as the environment. Sex is integrated into the
couples daily life and daily life is integrated into their sex life to create the couples unique sexual style.
Living daily life well with its responsibilities, stresses, and conflicts provides the opportunity to
experience sexual interactions in a subtly yet distinctively personalized and enriched way. Sex at times
is experienced as pleasure, stress relief, mature playfulness, and on another occasion as a spiritual
union. Intimate couples can value multiple purposes for sex and use several styles of arousal. GoodEnough Sex is congruent with the couples genuine lifestyle. Good-Enough Sex recognizes that among
satisfied couples the quality of sex varies from day to day and from very good to mediocre or even
dysfunctional. Such reasonable expectations are an important feature of sexual satisfaction as well as
inoculating the couple from disappointment and sexual problems in the future. The Good-Enough Sex
perspective serves as the foundation for relationship and sexual satisfaction.
KEYWORDS: Good-Enough Sex model; sexual satisfaction; sexual dysfunction; biopsychosocial model;
couple sexuality; sexual health

Introduction
Approximately 45 percent of couples at a given time suffer a male, female or couple
sex problem (Laumann et al., 1999). While awareness of sexual dysfunction (SD) has
increased in recent years with the advances in sexual medicine, clinical experience
demonstrates that SD is rarely a simple performance problem with a simple cure. A
sexual issue is commonly a profound human, relationship problem, which involves
emotional suffering, distress, even agony. Because of this potentially profound
psychological distress, SD is internationally classified as a psychiatric disorder
according to the American Psychiatric Association, Diagnostic and Statistical Manual
Correspondence to: Michael E. Metz, Baker Court Office Bldg, Suite 440, 821 Raymond Avenue,
St. Paul, MN 55114, USA. Tel. 1 651 642 9317x107. Fax: 1 651 642 1908.
E-mail: mmetzmpls@aol.com
Received 7 March 2006; Accepted 15 September 2006.
ISSN 1468-1994 print/ISSN 1468-1749 online
British Association for Sexual and Relationship Therapy
DOI: 10.1080/14681990601013492

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M. E. Metz & B. W. McCarthy

IV (DSM-IV-TR, 2000) and the International Classification of Disorders-10 (ICD10; World Health Organization, 1992).
SD offers an exceptional opportunity for the helping professional to offer support
and to enhance the quality of life of the individual and couple. Few medical or
psychological problems so clearly offer the clinician not only the opportunity to
relieve distress but also to promote personal and relationship health and satisfaction.
To do this, the following concepts are essential:
1.

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2.

3.

4.
5.
6.

Real-life problems rarely have a simple cause and a simple cure in spite of
peoples longing for quick fixes. SD is complicated. It is multi-causal,
multidimensional and has multiple effects on the person, the partner and their
relationship.
Satisfaction with ones sexual life is fundamentally grounded on realistic
physical, psychological and relationship expectations. Unrealistic expectations
precipitate frustration, a sense of failure, and distress.
The emphasis on perfect sexual performance is self-defeating and needs to be
replaced by the Good-Enough Sex model, which realistically recognizes the
inherent variability of couple sex.
Any approach to SD must recognize that regardless of the cause(s), sex is a
relationship problem affecting the emotional life of the couple.
Treatment for SD needs to be individualized to this couple, not one size fits
all.
Effective treatment must integrate medical, pharmacological, psychological, and
relationship aspects with an individualized relapse prevention plan.

The need for a new model

Recent developments in sexual medicine to improve male SD (better erections,
ejaculatory control) include PDE5 medications, penile vacuum devices, penile
injection therapy, penile prosthesis (rigid and inflatable) and anti-depressant
medications to delay ejaculation, have become dominant. Attention to womens
SD is also increasing with interest among medical clinics and pharmacologic
companies promoting medical treatments such as the EROS vacuum device
and testosterone supplements. In the last decade, there has developed an imbalance
in the approach to treating SD with the emphasis on one-dimensional medicalization,
especially of male sexuality. At the same time, the failure of these techniques and
technologies to benefit many couples (Brock et al., 2002) highlights the oversimplification of human sexuality by focusing on function to the exclusion or
disregard of the meaning of intimacy and sexuality for the couple.
This current medicalization of sexuality has served to balance the past overemphasis (even to the exclusion of biomedical factors) in the 1960s to 1990s on
the psychological and relational factors of SD. During this period, the classical
understanding of the causes of SD included anxiety, specifically performance
anxiety, spectatoring (a cognitive distraction), a negative valuation of sex (e.g.
shame), perfectionism, unrealistic expectations and negative relationship dynamics.

Good-Enough Sex model 353

While these features are essential, there is a need for more comprehensive
approaches. The optimal model is a psychobiosocial approach to assessment,
treatment, and relapse prevention of both male, female, and couple SD.

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The primary aim of sexual therapies should be couple satisfaction

The unifying, essential, and ultimate purpose of the multiple treatments now
available to address SD must be the well-being of the couple. An integrative approach
recognizes that SD is usually a complicated individual and relationship problem that
undermines personal and relationship happiness. The philosophy of this approach is
to be comprehensive: that is, to use all available resources medical, pharmacological, psychological, relational, and psychosexual skills to increase pleasure,
relationship intimacy, and satisfaction. While this usually requires couple therapy to
enable adequate (not perfect) function, this does not in itself guarantee satisfaction.
In most cases, function is a necessary but not sufficient feature. The Good-Enough
Sex model draws attention to the multiple dimensions of realistic couple sexual
satisfaction. Consistent with the progress in research and publications on positive
psychology (see, e.g. Lent, 2004; Seligman et al., 2005), the Good-Enough Sex
model emphasizes how positive dimensions (such as realistic expectations) can
improve ones coping with sexual problems and promote positive aspects of happiness
(e.g. Lyubomirsky et al., 2005). The Good-Enough Sex model was developed for all
couples who experience SD, as a positive set of principles and anchors to guide sex
therapists in their creative design of individualized cognitive-behavioral sex therapy,
as well as to facilitate couple reflection on the meaning and value for them of their
sexual relationship.
The Good-Enough Sex model
The Good-Enough Sex model (Metz & McCarthy, 2003, 2004) is intended to
organize an integrative approach for sexual health and therapy as a straightforward,
constructive map for couples. Its context is a realistic appreciation of the value of sex
in the relationship. The model challenges couples to set realistic expectations based
on intimacy as the ultimate focus, pleasure as important as function, mutual
emotional acceptance as the environment, and sex at times experienced as mature
playfulness, spiritual connection, and special bonding, as well as pleasure.
In the Good-Enough model, sex is not an isolated fragment of ones life; rather,
it is integrated into the couples daily life and their daily life is integrated into their
sex life to create the couples unique sexual style. Living daily life provides the
opportunity to experience sexual interactions in a subtly yet distinctively personalized
and enriched way.
Features that promote the Good-Enough Sex model (see Table I) include
cognitive, behavioral, emotional, and relationship factors that promote cohesion,
cooperation and intimacy. Cognitive dimensions include a positive attitude toward
sex and a deep commitment to mutual sexual health, taking personal responsibility
for pursuing developmental (lifelong) sexual growth and preparing oneself with

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M. E. Metz & B. W. McCarthy

TABLE I. Dimensions of the Good-Enough Sex model.

1
2
3
4

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5
6
7

8
9
10
11
12

Sex is a good element in life, an invaluable part of an individuals and couples long-term comfort,
intimacy, pleasure, and confidence
Relationship and sexual satisfaction are the ultimate developmental focus and are essentially
intertwined. The couple is an intimate team
Realistic, age-appropriate sexual expectations are essential for sexual satisfaction
Good physical health and healthy behavioral habits are vital for sexual health. Individuals value
their and their partners sexual body
Relaxation is the foundation for pleasure and function
Pleasure is as important as function
Valuing variable, flexible sexual experiences (the 85 percent approach) and abandoning the
need for perfect performance inoculates the couple against sexual dysfunction by overcoming
performance pressure, fears of failure, and rejection
The five purposes for sex are integrated into the couples sexual relationship
Integrate and flexibly use the three sexual arousal styles
Gender differences are respectfully valued and similarities mutually accepted
Sex is integrated into real life and real life is integrated into sex. Sexuality is developing, growing
and evolving throughout life
Sexuality is personalized: Sex can be playful, spiritual, special

physiologic relaxation. Emotional dimensions include accepting and expressing ones

honest feelings about sex and body and distinguishing feelings from behaviors.
Behaviorally, couples cultivate self-discipline, cooperate to ground their sexual
pleasure on physical relaxation, and learn sensual self-entrancement and partner
interaction arousal. Especially important is that the couple cooperate as an intimate
team, prioritize mutual emotional empathy (Jacobson & Christensen, 1996), forgive
each other for prior disappointments (Spring, 2004), and view their sexuality as an
essential relationship forum and opportunity.
The dimensions of Good-Enough Sex
The 12 essential principles for the Good-Enough Sex model are as follows.
1. Sex is a good element in life, an invaluable part of an individuals and couples
long-term comfort, intimacy, pleasure and confidence
Satisfying sex begins with the positive embracing of ones sexuality, appreciating
the built-in personal biological imperative (Fisher et al., 2002), and the positive
contribution of sexual satisfaction for the individual and relationship. It is well
documented that negative fears of sex, disgust or shame-based notions about sex
are serious barriers and risk-factors to sexual health and satisfaction. For example,
sexual shame is implicated in cases of chemical dependency (OFarrell et al., 1997)
and SD (LaPera et al., 2003). Sexually satisfied couples intentionally counter negative
evaluations of sex and value sex as inherently good.

Good-Enough Sex model 355

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2. Relationship and sexual satisfaction are the ultimate developmental focus

and are essentially intertwined. The couple is an intimate team
Sex does not exist in a vacuum but rather in the context of an intimate relationship. It requires that partners cooperate with the activities of daily life, pursue
mutual conflict resolution both in and out of the bedroom, and share emotional
empathy.
Ultimately, men and women want the same benefit from sex intimacy
although they often seek this through different avenues (Blum, 1998).
Whether biologically influenced (Fisher, 2002) or socially constructed (Kaschak
& Tiefer, 2002), men traditionally pursue emotional intimacy through sexual
intimacy while women commonly pursue sexual intimacy through emotional
intimacy. These are complementary, not oppositional, approaches. The essence
of sexuality for both men and women is desire, pleasure, and satisfaction (Foley
et al., 2002).
3. Realistic, age-appropriate sexual expectations are essential for sexual satisfaction
The concept of Good-Enough Sex challenges couples to set positive, realistic
expectations about their sexual bodies as well as psychological and interpersonal
dimensions. Our society is saturated with images and myths about beauty and
manliness, sexual performance and an over-emphasis on romantic and perfectionistic
sexuality (Zilbergeld, 1999). Healthy couples realize that the body has ageappropriate capacities, view sexuality as a life-long developmental process that
involves changes and differences from young adulthood to older age, and adapt their
expectations to each phase of life (Metz & Miner, 1998).
While prevalence studies consistently report frequent SD among couples (40
50% of couples at any given time) (Laumann et al., 1994), an even greater percent
(78 95%) complain of common sexual difficulties (Frank et al., 1978; Laumann
et al., 1994; Metz & Seifert, 1991). For example, sex partners complain of
disagreements over sexual frequency, styles, and preferred behaviors (self
pleasuring, oral sex, sexual variety), amount or quality of partner interaction,
experiences of sexual boredom, hypersensitivity to the sexual partner, anxiety
about intermittent sex function problems, conflict over fertility issues, whether or
not to share fantasies or watch erotic videos together, or discomfort with specific
aspects of sex.
Healthy couples appreciate that much of media advertisement exaggerates
sexual reality for marketing purposes. They can balance this by intentionally seeking
scientifically accurate knowledge from trusted websites and/or books. For example,
sexual science reports that periodic sexual problems are common, sexual enjoyment varies, orgasm is not essential to sexual satisfaction, and men and women
have different physiologic and psychological experiences (McCarthy & McCarthy,
2003). Hype and exaggerated claims that seem too good to be true
inevitably are.

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M. E. Metz & B. W. McCarthy

4. Good physical health and healthy behavioral habits are vital for sexual health.
Individuals value their and their partners sexual body
Sexual function is important (although not essential) for sexual satisfaction. Care for
their own physical health and healthy behaviors (e.g. adequate sleep, exercise, eating,
and moderate drinking) are an important dimension of continuing sexual functioning, especially with aging. Because illness is a significant enemy of sexual function and
increases in prevalence with aging, wellness is an important goal. With recent medical
advances, in many cases sexual function may be facilitated with medications and
devices, but these need to be integrated into the couples sexual style, not be stand
alone interventions (McCarthy & Fucito, 2005).

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5. Relaxation is the foundation for pleasure and function

Physiological, psychological, and interpersonal relaxation is the basis for sexual
function as well as personal and relationship satisfaction and becomes increasingly
important after age 30. The vitality of youth can overcome high levels of anxiety,
tension, and performance anxiety that otherwise inhibits physical functioning. The
foundational work of Masters and Johnson (1970) and the behavioral exercises they
developed (sensate focus) were grounded on bio-physiologic relaxation as the
cornerstone of adequate sexual function. Although sometimes misinterpreted as a
rigid performance criterion, Masters and Johnson advocated that by removing the
barriers to healthy sexual function (for example, performance anxiety, shame,
cognitive distraction, negative relationship conflict that is, by promoting physical,
emotional, and interpersonal relaxation), the body and mind would naturally
respond and adequately function sexually (e.g. arousal, orgasm) (e.g. Basson, 2001).
More recently, it is also instructive to appreciate that the physiological mechanism of
the PDE5 pro-erection medications is to relax the musculature surrounding the
arteries in the penis to enable blood flow and erection. While counterintuitive,
physiologic relaxation is the vital mechanism of erection. The abundant evidence of
the role of anxiety in sexual dysfunction (see Barlow, 1988) is counterpoint to the need
for physiologic and psychologic relaxation to ameliorate performance pressure and
anxiety, enhance pleasure and share enjoyable couple sex. Men may worry that a
lessening of erotic stimulation if he focuses on physiologic relaxation during sexual
touch may itself cause an erection problem. In fact, physical relaxation and the focus
on the pleasure of touch instead facilitates easy and more reliable erections (Metz &
McCarthy, 2004) as the mechanism of the PDE5 pharmacologic agents demonstrate.
It is counter-productive, for example, for a man to pressure himself to achieve perfect
sexual performance. In fact, it is important to not work too hard sexually, because to
facilitate function one does well to relax both mind and body amidst the sexual
pleasuring. Striving for perfection undermines physiologic and psychological
relaxation, producing performance pressure and anxiety.
Awareness of the value of relaxation also accentuates the importance of
psychosexual skills. Couple sex therapy has refined the cognitive, emotional, and
behavioral skills such as taking personal responsibility for pursuing sexual growth;

Good-Enough Sex model 357

accepting ones honest feelings about sex and ones body; learning sexual response
through sensual self-entrancement arousal; cooperating by giving to get stimulation; sharing pleasuring exercises; and developing erotic scenarios and techniques.

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6. Pleasure is as important as function

Pressure for sexual performance (e.g., sex on demand) is a common and poisonous
feature of distressed sexual experience. For example, couples following infertility
protocols with the demand for intercourse determined by the womans temperature (ovulation) experience erectile dysfunction (ED) and/or inhibited sexual
desire in as much as four of five couples (Burns, 2006). Such a protocol
unintentionally sets up performance anxiety (a common cause of SD) as well as
undermines pleasure. In the Good-Enough Sex approach, touch and pleasure are
emphasized as well as function (McCarthy & McCarthy, 2002).
7. Valuing variable, flexible sexual experiences (the 85 percent approach)
and abandoning the need for perfect performance inoculates the couple against
SD by overcoming performance pressure, fears of failure, and rejection
A vital aspect of the Good-Enough Sex approach is the candid recognition that
among emotionally and sexually well-functioning and satisfied couples, the quality of
sex varies. Research findings (e.g. Frank et al., 1978; Laumann, et al., 1994) as well as
clinical experience indicate that while these satisfied couples are regular in
frequency (e.g. 1 2 times per week), the sexual experience is very good quality
about 20 25% of the time, good quality about 40 60% of the time, fair but
unremarkable 15 20% of the time, and dissatisfying or dysfunctional 5 15% of
the time. Such data support the association of relationship satisfaction with an
appreciation of the variation in the quality of sex by developing reasonable
expectations. This expectation engenders sexual acceptance and serves to inoculate
the couple from sexual problems, especially with aging. Unreasonable expectations
set up a self-fulfilling prophecy of sexual decline.
8. The five purposes for sex are integrated into the couples sexual relationship
While clinical experience has taught us that sexual difficulties can arise from differing
goals (purposes) for sex, sexually satisfied couples integrate the five fundamental
purposes for sex: (1) reproduction; (2) tension and anxiety reduction; (3) sensual
enjoyment and pleasure; (4) self-esteem and confidence; and (5) relationship
closeness and satisfaction (Metz & McCarthy, 2004; Mezzich & Hernandez, 2006).
Reproduction is the natural biological function of sex. Stress and anxiety
reduction is a common psychophysiological purpose of sex. Sensual enjoyment and
pleasure is a basic function of sex in long term, satisfying relationships. Individuals
may also seek enhancement of self-esteem through sex, and pursue feelings of selfworth, confidence and pride in being a sexual person. A fifth purpose is the use of
sex for a variety of relationship dimensions such as love, affection, healing and joy.

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M. E. Metz & B. W. McCarthy

In healthy relationships, these are positively motivated purposes. In dysfunctional

relationships, the purposes are often negative, such as manipulation, control, proving
something to self or partner, hurt or revenge.
Individuals may pursue different goals at different times. For example, a man this
particular time may seek tension release prompted by testosterone and work-day
pressures, while a woman may seek the gains (Basson, 2001) of self-esteem,
satisfaction and closeness with the partner. Most but not all individuals pursue each
of these five purposes for sex at one time or another in their lives. Often multiple
purposes are pursued simultaneously. In fact, when the focus becomes too singular
for example to conceive at all cost as may happen for couples in infertility treatment
sex can become distressing and eventually dysfunctional.
The priority of one purpose over another can fluctuate significantly from time to
time even day to day. For example, one partner may engage in sex with 40% of the
purpose to feel physical pleasure, 40% for loving feelings, 20% for self-esteem, and zero
percent for procreation. Another may seek sex for 50% procreation, 20% self-esteem,
10% love, 10% tension release, and 10% for pleasure. In a couple, the potential for
conflicted sexual interaction exists as the partners feel a difference in agenda.
Realizing and accepting that individuals have sex for multiple and fluctuating purposes,
avoiding unilateral and inflexible goals, clarifying the sexual agenda, and developing
partner congruence enhances cooperation and sexual satisfaction.
9. Integrate and flexibly use the three sexual arousal styles
Flexible sexual scenarios are important to handle the periodic, normal sexual function
difficulties. Appreciating different sexual arousal styles can help couples with this
adaptation. Mosher (1980) proposed three arousal styles distinguished by their focus
of attention the partners body and interpersonal activity, the individuals own
physical and emotional pleasure, and fantasy and role play.
Partner Interaction arousal focuses on the partner. This person is active, eyes
open, looking at the partner, talkative (romantic or erotic talk), and energetic.
This is the sexual style on TV and in the movies passionate and impulsive
sex. Each partners arousal plays off the others.
Self-entrancement arousal focuses on ones own body as the source of
pleasure and sexual arousal. The self-entrancement person typically closes
his or her eyes, goes within, becomes quiet, and looks detached and passive.
Routine and stylized touch help the person to become aroused. The focus is on
physical and emotional relaxation and accepting touch.
Role enactment arousal focuses on role play, fantasy, variety, and
experimentation, Examples include dressing in sexy lingerie, role playing
being tough or hard to get, acting out a scene from a movie or fantasy,
having sex in new places (e.g. vacation), using toys (massage oil, vibrator,
erotic video) to build excitement through erotic playfulness.

Good-Enough Sex model 359

Partner Interaction is the classic male focus as visual eroticism gives evidence,
while self-entrancement is more common with women; each most likely is neurologically influenced (Fisher et al., 2002). However, men and women are capable of
blending the styles for increased enjoyment and as a source of variety in the long-term
relationship. Such blending is an important feature in flexibility and adaptation to
lifes stressors, as well as an inoculation against SD. The major sexual cue for both
men and women is an involved, aroused partner.

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10. Gender differences are respectfully valued and similarities mutually accepted
Men and women are often different in their arousal patterns. Typically women will focus
on feeling desired or attractive to their man, while typically men will focus on
feeling invited or welcomed to engage in sex (Fisher et al., 2002). Sexual
confidence, then, is more about function for men while womens confidence may
involve trust, security, and caring. However, as Kaschak and Tiefer (2002) note, both
female and male sex roles are socially constructed, with much overlap, and change as
individuals, the couple, and the culture change. Traditional sex function models
primarily represented male physiologic arousal while newer models such as Bassons
(2001) responsive desire model are more characteristic of womens desire and arousal.
While we believe both patterns are applicable to understanding both men and women
(especially with aging), they suggest that men are commonly prompted for sex by the
bio-physiological drive while women are prompted for sex by more of a bio-emotional
drive (Fisher et al., 2002). Not only accepting but celebrating the gender preferences and
similarities allows the couple to enjoy the Good-Enough Sex approach to satisfaction.
11. Sex is integrated into real life and real life is integrated into sex. Sexuality
is developing, growing and evolving throughout life
The sexual experiences of persons of different ages and life circumstances (e.g. levels of
responsibility such as being a college student, establishing ones career amidst parenting
children, adjusting to chronic illness in mid-life, or retirement) require situationappropriate expectations. The integration of varying life events into lovemaking recognizes the multiple purposes for sex. This can involve sex one time for anxiety release
through orgasm, another time for calm affection amidst fatigue, another time for escape
and fun, another for emotional healing, and still another time sex as a spiritual experience such as having gentle and tender sex while sharing sadness about a parents death a
month earlier. Good-Enough Sex is integrated into the couples daily life and their daily
life is integrated into their sex life to create the couples unique sexual experience.
Life itself provides opportunities to experience sex in a subtly yet distinctively
personalized and enriched way: sex on vacation, during pregnancy, after conflict,
during times of loneliness, after a good friends wedding, during times of career
stress, after a class reunion, during periods of success and achievement, amidst
childrearing, unemployment, during disappointments, times of illness, healing from
disagreements, after business travel or a long absence such as military service, as part
of a romantic evening, during adjustment to the empty nest, adapting to changes

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M. E. Metz & B. W. McCarthy

with aging, enjoying increased time flexibility after retirement. Good-Enough Sex is
congruent with the couples relationship style and makes it special.

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

The Good-Enough Sex model challenges couples to consider not only lovemaking
behaviors and psychosexual skills but emotional experiences and meaning in their
intimate relationship. This model advocates that emotional intimacy and relationship
satisfaction is the ultimate focus. The experience of satisfying sex is at times playful,
spiritual, special. A reliable indicator of Good-Enough Sex is the occasional presence
of playfulness (Margolin, 1983; Metz, 1988). Certain features of traditional sex
therapy were designed to reestablish couple playfulness (Tullman et al., 1981) as
couples experiencing SD have been found to be sexually rigid and deficient in
private playfulness. For example, Metz and Lutz (1990) compared sex dysfunction,
marital dysfunction, and satisfied couples and found the SD couples notably deficient
in playfulness even compared to maritally distressed couples. Playfulness may be such
a good indicator of Good-Enough Sex because for play to occur, other aspects of
intimacy must be functioning well: trust, mutual acceptance, priority on pleasure,
freedom to be oneself, and deep valuing of the relationship. The idiosyncratic nature
of couple playfulness during sexual interaction (such as affirming teasing or
nicknames for sexual body parts) adds uniqueness to the couples sexual
experiences and personalizes the bedroom (makes it special).
Couple reports of sexual playful behaviors include: special apparel (negligee, leopardskin briefs); role play/enactments (e.g. acting out sex fantasy (pirate/maiden; movie
scenarios); sexual toys vibrator, dildo, fur mitt, body oil; sharing fantasies and sexual
dreams; erotic movies (R- or X-rated); special places (beautiful bed and breakfast, beach,
woods, car); special teasing (romantic seduction, playful withholding); special times
scheduling sexual times such as afternoon delight; public and private dancing with/for
the partner; nicknames for sexual body parts (e.g. Grand Tetons, Big Ben).
The idiosyncratic meaning of sexual playfulness is illustrated in two couple
descriptions of their sexual playfulness. The first is a 34-year-old male lawyer who wrote:
We spend time tickling each other which is sometimes sexual and sometimes
not. We will touch each other sexually while doing normal everyday things. We
will accidentally touch each other. We chase each other in the house. I will
sneak up on her while she is changing. I will expose myself at times in the house
when we are alone. My wife will give me a sneak peek when she teases. We take
showers together and will sometimes wash each other with sexual overtones.
A 32-year-old female teacher explained:
I love to dress up for my husband in lacy clothes one time, then my regular
underwear another. I also sometimes beg him in a playful way (I get down on
my knees and BEG dramatically!) to dress for me in his tuxedo or leopard skin
briefs . . . that I have to have him this way . . . Its a spoof and a tease! But it

Good-Enough Sex model 361

really feels like were willing to please each other . . . thats why I think I so love
this . . . I also prize the way we can giggle and smile sometimes when were
making love. I feel so special then.
Such delight in playfulness is more than trivial (Metz & Lutz, 1990) and has the potential
to acknowledge with respect and acceptance the complexity and ambiguity of life, the
multiple levels of reality, the spiritual dimension, and the priority on interpersonal
connection. Such play involves cooperation, comfort, feeling safe, unconditional acceptance, trust, union, and delight. Sexual playfulness enhances and strengthens intimacy.

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Summary
The Good-Enough Sex model presents a comprehensive, integrative, couple approach
to SD and sexual health. A prime focus is to replace the traditional male perfect
intercourse performance criterion with a variable, flexible pleasure-oriented approach to
couple sexuality, which involves an 85 percent approach to intercourse and orgasm
while validating alternative sensual and erotic scenarios. Satisfaction is comprised of
realistic sexual expectations from a comprehensive psychobiosocial perspective as well
as healthy, cooperative couple skills. Touch and pleasure are as important as sexual
function, and the couple abandons the need for perfect performance. Features of
Good-Enough Sex include relaxation based lovemaking, focus on pleasure, integrating
the five purposes for sex, flexibly incorporating the three arousal styles, and using
sensual and/or erotic non-intercourse scenarios as alternatives if the sex does not flow to
intercourse. Just as important are positive, realistic expectations about the role and
meaning of intimacy and sexuality throughout lifes developmental phases for the
mans, womans, and couples lives. The Good-Enough Sex perspective provides a
positive, genuine foundation for relationship and sexual satisfaction.

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Contributors
MICHAEL E. METZ, PhD, Psychologist and Marital & Sex Therapist in Private Practice,
Meta Associates, St. Paul, MN USA.
BARRY W. MCCARTHY, PhD, Professor of Psychology, American University,
Washington, DC, and certified sex and marital therapist.