From The Therapist's Couch

Sex won't heal the pain for ever

It often takes time to work out why someone has decided to come for analysis, as complicated, barely articulated uncertainties emerge.

It was much like this for the woman in my consulting room. The initial reasoning as to why she had come was delivered as a troubling question: "I've had lots of men and had a lot of fun in sexual relationships. But it doesn't work any more. I'm moving towards middle age with an awful sense of emptiness about everything I've done."

I ask what she means by: "It doesn't work any more." For years, she has "got through" men, and has the facility to seduce down to a fine art. She realises that there was a pattern; excitement, flirtation, conquest, a honeymoon state of being in love. Then, as quickly as the fire began, it was out. She felt nothing. Well, she felt bored. And restless. So she would dump her man, and soon be in pursuit of the next.

But, she said: "It doesn't feel exciting any more. It feels lonely. And I'm wondering why I get bored so quickly with whoever I meet. Even the sex leaves me numb after a while."

The pattern is surprisingly common. I think of it as the problem of the "switcher". Almost overnight, the switch from lust to emptiness, desire to boredom, warmth to coldness occurs. So what is the cause of her behaviour?

She describes her early years, and I am struck by the appalling lack of emotional containment she suffered. When she was a toddler, her mother became ill and needed a lot of hospital treatment. Her father was out of the picture, so she was passed from pillar to post. This lack of any secure attachment inevitably manifested itself in the pattern she was to bring to the consulting room.

So what now? The old ways don't work now, while the new haven't yet been found. She's in a painful neither-here-nor-there place. The biggest change she must work at is the shift from evading pain to understanding and tolerating it. Her compulsion to seduce men was a way to avoid what she was suffering.

As she moves from avoiding to understanding her unmet needs, she will find a way of relating that accepts rather than blots out her heart's huge hunger.

Elizabeth Meakins is a psychoanalytic psychotherapist in private practice. None of the above clinical material refers to specific cases