Autism in the Bedroom

This delicate topic is not usually brought up at the beginning of a couple counseling process, but eventually, it is always raised at some point. Sex is obviously an integral part of a fulfilling relationship and it involves the most intimate and intricate type of communication. As such, it is not surprising that the typical miscommunication that is characteristic of mixed-neurological relationships is also transferred to the couple’s bedroom.

People on the autism spectrum have theory of mind deficits that make it difficult for them to deal with all aspects of intimacy. They can miss or misinterpret the sexual cues transmitted by their sexual partner and they find it hard to anticipate or understand their intimate partner’s reaction to touch. People with Autism often have diverse sensory sensibilities which can add to the complexity of the situation. They also tend to be very rigid and repetitive and lack spontaneity.  These features are likely to trigger major obstacles that prevent the couple from having a satisfying sexual relationship.

On one extreme, men with autism can become obsessive about sex. Their obsession can be manifested in a demand for a very high frequency of sexual activity and can also be transformed into an addiction to virtual sex or pornography. Sexual intercourse with these men can be completely technical, without any expression of affection or romance, which can be a very traumatic experience for women, who end up feeling like sex objects.

Men with autistic features can focus on their own sexual needs and desires, without giving the proper attention to their intimate partner’s wishes and pleasure. I often encounter in my clinic typically developing women who give their consent to have sex with their spouses only because they find it hard to resist the pressure that is inflicted upon them. These women admit that they seldom enjoy sex and that they view it as another one of their tasks.

On the other extreme, men on the autism spectrum might lose their interest in sex and completely avoid the intimate aspects of the relationship. In many of these cases, women find themselves in the role of the ‘persecutors’ who try to initiate sex and intimacy, sometimes for long periods of time, till they get tired of this role and give up, or till they realize that they are the only ones doing it and that their spouse is seldom the initiator.

There is a general agreement that men want and need sex much than women do, so when a typically developing woman tries to analyze and figure out what is going on in her relationship, the first thing that comes to her mind is not that her spouse lost interest in sex, but that he lost interest in her. This thought can lead even the most beautiful women to the conclusion that they are not attractive any more. As it is very difficult to deal with feelings of rejection, women whose husbands do not show interest and desire to have sex with them, often lose their self- confidence and self -image and suffer from severe depression.

Many mixed neurological couples report a complete lack of sexual activity in their relationships. Men on the autism spectrum may have a law sexual drive and become asexual. Sometimes men lose their sexual desire towards their spouses when they feel that they are constantly criticized, that they are disappointing them and or that they never know what to do or say. Consequently, they become even more distant and avoidant and indulge in their hobbies or areas of interest. This obviously worsens the situation and results in women feeling very lonely.

Men’s abusive behavior is another factor that contributes to the deterioration of the relationship and to women’s avoidance of sexual contact. Violent behavior naturally alienates typically developing women, who resent the abuser and refuse to have sex with him. Still, I often encounter in my clinic men with features of autism who cannot understand that there is a direct link between their abusive behavior towards their wives during the day, or their lack of attention and affection, and their spouses’ reluctance to go to bed with them at night.

If it wasn’t so sad, it could really be funny…

Dr. Pnina Arad

Consulting and Coaching

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