Understanding sexual desire and fantasies requires an approach that brings together the influences of biology, psychology, sociology and culture. In this challenging scenario, researchers and clinicians have recognized the biopsychosocial model as the gold standard for sexology and sexual medicine studies (Simonelli et al., 2019; Nimbi et al., 2020). However, so far most research on sexual desire and fantasies has focused primarily on the biological factors that influence male and female sexual desire and fantasies. Although biological factors play an important role in the levels of sexual desire and the frequency of sexual fantasies, these seem not to be sufficient for a full understanding of sexual function. In fact, sexual, psychological, socio-relational, emotional and cognitive factors (e.g. depression, anxiety, emotions, communication, discomfort, satisfaction, sexual functioning, conflicts, gender roles) also seem to be involved in the development and maintenance of low levels. of male and female sexual desire (Carvalho & Nobre, 2010; Nimbi et al., 2019). Furthermore, scientific research on sexual desire and fantasies so far has mainly focused on the factors that influence the individual's sexual desire and fantasies, rather than the couple (Ferreira et al., 2015). The scientific literature and clinical practice highlight the need to understand more deeply the psychological, socio-relational and emotional-cognitive dynamics and processes that influence the sexual desire and fantasies of couples (Nimbi et al., 2020) to understand how sexual desire works within intimate relationships and to provide health professionals with useful tools to guide them in an integrated way in their choices regarding clinical treatments. Therefore, the goal of the following research project is to better understand which sexual, psychological, emotional and cognitive factors influence the sexual desire and sexual fantasies of couples and the relationship between them.
Reports on the high prevalence of low sex drive, associated psychological and relationship difficulties (Hayes et al., 2006) have led to consider low sex drive as a public health problem (Traeen et al., 2007).
Sexual desire is an extremely important factor within the couple relationship as it is closely associated with relationship and sexual satisfaction (DeLamater et al., 2008; Pascoal et al., 2013). A decline in sexual desire can therefore affect the quality of life and relationship of both partners of the couple, fueling the likelihood of experiencing greater sexual difficulties and sexual dissatisfaction than couples who do not have a decline in desire (Kaya et al., 2015). Despite this, most researchers included only one member of the couple in their studies, leaving out dyadic influences, the effects of both partners¿ sexual functioning alone, and their partners' sexual satisfaction. Understanding mutual influences between partners is extremely critical to the development of interventions aimed at optimizing aspects of health, including sexual health and well-being (Reed et al., 2013).
In this regard, some theorists conceptualize sexual desire as a relational problem that must be understood within and in the light of the couple-context (Davies et al., 1999). Zilbergeld and Ellison (1980), the first to discuss the problems of sexual desire within the couple, have argued that the assessment of the levels of individual sexual desire within couples is relative in that the perception of one's level of sexual desire on the part of the individual depends on the comparison with the levels of desire of their partners. Considering the desire difficulties at the couple level has advantages over the current diagnostic system, the DSM-5 (American Psychiatric Association, 2013), which only diagnoses the couple member with significantly low levels of sexual desire. Conceptualizing sexual desire as a difficulty involving the couple rather than the individual can help the clinician shift his or her focus from assessing and treating sexual desire problems at the individual level to the couple level. This also allows people with lower sexual desire, typically women, to be understood within a larger, relational context, rather than being labeled dysfunctional or pathological.
The results of this research project would be useful not only for deepening the understanding of the couple's sexual response according to a biopsychosocial conceptual model, but also for their clinical implications. The data from this study could be useful for clinicians during the evaluation phase which potentially would include exploring the variables considered for this study and evaluating them as predisposing, precipitating, maintenance, contextual and protective factors. In sexual therapy, sexual health professionals can include tools that can identify and explore sexual fantasies, use them as a tool for deepening and understanding the couple's sexuality, stimulating critical thinking and open discussion about the intimate sphere of the partners.
This study would expand on the results of previous research that investigated the factors that influence the sexual desire of the individual rather than the couple according to a biopsychosocial approach.
These findings could also have implications for researchers, who could use the couple as a unit of analysis in research on sexual desire and fantasies.