Managing sexual difficulties: a qualitative investigation of coping strategies

Biomedical interventions offer effective treatment for only a small proportion of individuals experiencing sexual difficulties. Where treatment fails, individuals have to find ways to cope and adjust. Currently, little is known about how individuals do this. This article presents data from 32 semi-structured interviews with individuals representing a range of sexual function experience. Three broad coping approaches are identified. The first, changing circumstances to fit goals, included strategies such as seeking biomedical treatment and ending a relationship. The second approach, changing goals to fit circumstances, included strategies such as changing one's definition of "good-enough" sex. The final approach, living with a gap between goal and circumstances, included strategies such as normalizing and avoiding the problem. Several factors appeared to be key in determining successful adjustment: the severity of the problem, causal attributions made about the problem, and the partnership context. The findings are explained in terms of Brandstadter's distinction between accommodative and assimilative coping strategies, and suggest that a flexible definition of good-enough sex, as well as a flexible stance toward the importance of sex, may enhance the process of adjustment.