Episode Summary:
In this insightful episode of M.E.S.H., host Pamela Brewer sits down with licensed clinical social worker, psychotherapist, and certified sex therapist Deborah Fox for a candid conversation about the realities of modern relationships. Together, they delve into topics like Imago Relationship Therapy, the myths and facts of sex therapy, maintaining connection after children, handling infidelity, and what to look for in a couples therapist. Deborah offers practical advice and reassurance to couples facing common challenges, highlighting connection, communication, and the value of seeking help as acts of self-care and growth.

Topics Covered:

• What is Imago Relationship Therapy?
• The real work of clinical sex therapy versus myths and media portrayals
• Signs it’s time to consider couples therapy: too soon or too late?
• The nature of conflict (or “conflict-free” claims) and connection in relationships
• Changes in sexual desire and ‘responsive’ vs. ‘intrinsic’ sexual styles in couples
• Navigating sex when partners have mismatched drives or routines
• The impact of children (and step-parenting) on intimacy and partnership
• Recovering from infidelity: Is the relationship over?
• What to expect in couples therapy sessions—including structure and therapist fit

Key Takeaways:

• Effective couples and sex therapy is structured, active, and home-focused, not just talk.
• It’s never too early (or late) for couples to seek support—therapy can be a powerful gift at any stage.
• Disconnection often underlies relationship distress, whether or not couples argue openly.
• Sexual desire styles differ—understanding these differences is crucial for lasting intimacy.
• Prioritizing “coupleness,” even after children or in blended families, keeps relationships strong.
• Infidelity, while deeply painful, does not have to end a relationship—with help, trust can be rebuilt.
• The right therapist creates space for connection and guides, rather than judges or takes sides.

Questions I Ask (Best Questions from Pamela Brewer):

• “What is it that a credible clinical sex therapist actually does?”
• “Is there ever a time it’s too soon [for couples therapy]? Is there ever a time it’s too late?”
• “What’s the value if any, or what’s the red flag if any, when you hear someone say, ‘Oh, we never had any conflict’?”
• “Their anticipation is that the magic is going to go… What do you say to those couples?”
• “When there is an instance of infidelity, does that mean the relationship is over?”
• “Is there a way to know that the therapist you’re working with is not a good fit for you?”

The Six Best Quotes:

1. “The best possible way to get yourself into relationship trouble is to assume someone else can read your mind and that you can read theirs.” — Pamela Brewer
2. “What happens in my office is we have a conversation, we figure out what it is that’s getting in the way…but always what it’s going to come down to is what is that couple going to do at home…” — Deborah Fox
3. “Conflict is a part of any relationship. The sooner you can learn how to approach, how you can talk about things that are your differences or tension points, you’re in a so much better position.” — Deborah Fox
4. “They may not know the word disconnection, but when you say it, they go, yeah, that’s it. That’s what’s missing. We used to feel connected and now we’re not anymore.” — Deborah Fox
5. “For this group of people [responsive desire], particularly, often desire comes after arousal, which is also something we don’t understand in our culture because our movies, which is our major source of sex education, they don’t talk about that part.” — Deborah Fox
6. “We all get stuck, you know, and, and when we get stuck and we can’t really feel the way we want to feel, please get help. It’s available.” — Deborah Fox

Connect with the Guest:

• Website: debfox.com
• Based in Northwest Washington, D.C.
• Additional articles on Medium (search “Deborah Fox”)

Resources List:

• Deborah Fox’s website for therapy resources: debfox.com
• Deborah Fox on Medium for her articles (exact link not given; search her name on Medium)
• Imago Relationship Therapy (general info: imago-relationships.com, not directly mentioned in transcript but for further reading)
• No specific books, organizations, or courses were named in this episode.