My partner of 20 years says she isn’t anxious about sex. While I consider myself an experienced and sensitive lover, our sexual relationship never developed properly to a stage of openness and comfort. Instead, my partner only responds to my leading and usually in very formulaic ways. She is uninterested in exploring her pleasure range and “forgets” the things that I have repeatedly taught her about what I’m interested in. I gradually lost interest in this unsatisfactory status quo and now we rarely have sex – maybe three times a year. When we try to talk about this, she is open to considering what may be interfering in our sex life, and she has vaguely hinted at historic abuse. But she denies being anxious and doesn’t want to seek counselling (she tried for about two sessions). She is affectionate when we are clothed and “upright” but rarely seeks a cuddle from me in bed. I am considerate of what may be at play in her past life and don’t want to push her in any way – either to get help or to improve our own sex life. But I am frustrated by the dichotomy between what is spoken and what happens physically. I am also concerned that a sexless marriage may be unsustainable. When an impasse such as this develops between two partners and is jointly tolerated for years, there are always important reasons why each continues maintaining the status quo, and the reasons are usually to do with the benefits of the entire relationship. Each partner weighs up the positive and negative aspects of the unspoken contract between them and, if the balance is favourable, they avoid upsetting the apple cart. It is only when the balance tips to the negative for one or both partners that earnest attempts to change are made. So why now? Why, after all these years of very little sex, are you using the word unsustainable? You were once given an important clue about “historical abuse” but this remains a mystery to you. Talk. Be kind. Intimacy is not just about sexual matters. Focus on your non-sexual intimacy and find out who she truly is, and why she is anxious and afraid. And why she withdraws. Share your own true feelings. She probably needs to heal. Although counselling may have been too challenging for her at this point, you can help her … and yourself. Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders. If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.