The sexual revolution produced cultural convulsions that were unparalleled in the 20th century. The female sex was historically sexualized and required to have orgasms for the first time. Sexual "deviants," particularly homosexuals, achieved partial emancipation.

There are young men who want thrills but no longer value sex, so they do completely different things, including aggressive things.

Perhaps the couple got married at 25 and now they're 45 and this is an option. And if a couple is still together, or perhaps finds its way back together, I like to say that it's forever. They belong together, it's a good fit, it's the right pairing. It almost gives me goose bumps.

Exaggerated portrayals apparently destroy desire more effectively than any repression.

I'm reminded of a female patient who was particularly aroused by the shape of her husband's shoulder. And this hint of perversion should ideally remain a secret for both partners.

Most pornographic images are simply too repulsive.

There are many options in a marriage. If the couple has been together for a certain amount of time and has a certain amount of liberalism or life experience, it could be the kind of relationship in which one partner ventures into the occasional affair, which is then forgiven. This only happens every 13 years on average, but it obviously does occur.