Episode 86. Sex Therapy 101: Real Problems, Real Solutions | Dr. Clifford & Joyce Penner (Part 2)
Why Most Couples Struggle in the Bedroom (and How to Fix It)
Every couple dreams of “happily ever after,” but the truth is—even the strongest marriages run into roadblocks in the bedroom. Sometimes those struggles are whispered about behind closed doors. Sometimes they’re ignored altogether, leaving both partners lonely and frustrated.
That’s why our conversation with Dr. Clifford and Joyce Penner was so refreshing. With nearly 50 years of experience as faith-based sex therapists, they’ve seen it all. And their message is full of hope: most sexual problems in marriage can be healed if both partners are willing to do the work.
The Struggles Couples Don’t Talk About
One of the most surprising things the Penners shared is just how common sexual challenges are in marriage. Here are a few they see most often:
Physical pain: Particularly for women, issues like vaginismus (painful muscle tightening) or childbirth injuries can make intimacy difficult. The Penners often refer women to pelvic floor physical therapists as a first step toward healing.
Differences in desire: One partner wants intimacy more often than the other. Left unspoken, this can spiral into resentment, rejection, or shame. But often, the “gap” isn’t as wide as it feels—sometimes just one or two conversations can reset expectations.
Arousal struggles: Men may experience erectile dysfunction, while women may find it hard to feel or recognize arousal. Both can be discouraging, but in most cases, medical support and intentional retraining exercises help couples reconnect physically.
Orgasm difficulties: Many women have been told that orgasm “should” happen during intercourse, but research shows that most women climax through clitoral stimulation, not penetration alone. When couples stop treating this as failure and instead explore what works, pressure turns into playfulness.
Pornography and addiction: In today’s world, temptation is a swipe away. The Penners stress that pornography undermines intimacy because addiction is the opposite of connection. The solution? Healing begins with honesty, accountability, and rebuilding trust through intentional, everyday connection.
A Simple but Powerful Tool: The 15-Minute Intimacy Formula
One of the most practical insights from the Penners is their 15-minute intimacy formula. It’s not about adding pressure. In fact, it’s designed to take pressure off by creating daily space for connection without the expectation of sex.
Here’s how it works:
Emotional (5 minutes): Look into each other’s eyes. Share something positive about your day, an appreciation, or a small joy.
Spiritual (5 minutes): Pray together, read a short devotional, or share a thought of gratitude.
Physical (5 minutes): A 20-second full-body hug, followed by a 30-second passionate kiss—not as a warm-up to sex, but as intimacy in its own right.
It may sound simple, but the Penners have seen it transform marriages. Couples who practice this daily often find themselves reconnecting emotionally and spiritually, which naturally strengthens their physical bond.
Why This Matters for Long-Term Love
The Penners remind us that marriage is a journey, not a destination. The rush of “excited love” that fuels the early years naturally shifts into “quiet love,” a deeper bond built on trust and companionship. But if couples don’t know this transition is normal, they may assume the spark is gone.
Here’s the hope: when you understand that quiet love can be just as passionate—only in a different way—you can stop chasing adrenaline and start building intimacy that lasts a lifetime.
A Word of Faith and Hope
For those of us who come from a faith perspective, the Penners’ wisdom echoes God’s design for marriage: mutual love, fidelity, and delight in one another. But even if you don’t share that background, the message still rings true—intimacy thrives when both partners show up with honesty, care, and intentionality.
As the Penners put it: “When people are willing to work on it, they don’t have to stay stuck. Sexual struggles don’t have to define your marriage.”
Final Thought
Whether you’re facing physical challenges, mismatched desire, or just feeling stuck in routine, there’s hope. Healing begins with conversation, continues with intentional practices like the 15-minute intimacy formula, and grows with patience and grace.
So if your marriage feels distant, remember this: you don’t have to do it all at once. Start small. Say yes to connection. And believe, like Clifford and Joyce Penner do, that your intimacy can be renewed—one step, one day, one kiss at a time.
✨ Want more? Listen to Part 2 of our Marriage IQ conversation with Dr. Clifford and Joyce Penner for practical tools, candid stories, and encouragement you won’t want to miss.
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0:02
Welcome to Marriage IQ, the podcast for the intelligent spouse.I'm Doctor Heidi Hastings.And I'm Doctor Scott Hastings.We are two doctors, 2 researchers, 2 spouses, 2 lovers, and two incredibly different human beings coming together for one purpose, to transform the stinky parts of your marriage into scintillating ones using intelligence mixed with a little plan.
0:34
Welcome back, everyone, to Part 2 of our interview with Joyce and Clifford Penner, 2, pioneering sex therapist.They've been around for a long time.Yeah. 50 years.A real privilege to be able to speak with them.This is Part 2.We're talking specifically about details on sexual dysfunction in women that may create problems in the sexual relationship.
0:57
And men.And also in men and specific ways to adjust arousal and orgasm and deep intimacy and connection.In the first episode, we talked more about how we need to develop our own sexual identity.And they've had 60 years together, 64, excuse me, of learning and growing in that.
1:17
So invite you to really go back and listen to that.It's very well done.We're just so glad to have them.And let's jump on into Part 2.I wondered with your experienced over years, what are some of the most common sexual challenges that long term couples or couples who and maybe at the beginning of their relationship but definitely want it to be long term, what are some of the biggest sexual challenges that they face and how can they begin to address those?
1:45
Well, let's let's start with one that may be a surprise, and that is these days and before also a lot of couples struggle with physical pain.It's in the way.Actually, for women, yeah.And this is particularly true for women, and that's one thing that we get all the time.
2:05
OK.And how do you help couples with that?Are you talking sexual pain?We're talking physical.Pain.Great.And that I've really become a specialist in that.And one thing that has helped over the years is pelvic floor physical therapists.
2:22
And I'm not sure if you're aware of those, but it's very important.I usually do a bit of a triage over the phone and then I refer the couple or the woman to a pelvic floor physical therapist and get an evaluation.
2:38
And then with that information, then we move forward in terms of treatment.And sometimes all the treatment that's needed is actually working with the physical therapist.And they don't even need the sexual therapy, though I'm not building it.So they are dependent on us or our associates or people in our field.
2:57
The physical therapist may be the answer that there is muscular tension there.There's some injury that has happened through childbirth or through a fall or something that has caused this pain, and when it's severe, it's a condition called vaginismus, where that's the most common reason for unconsummated marriages.
3:19
Now let's just explain what we mean by an unconsummated marriage is that a couple are married and they've never been able to have intercourse because of this condition called vaginismus.Every now and then it can be something that the man is dealing with, but I would say 95% of the time it's what the woman is struggling with.
3:40
So we regularly deal with unconsummated marriages from all over the world.And that's one of those that we can say we've had 100% success when the couple or the person is willing to do the work.
3:56
If they drop out, then no.But if they and that's when you can measure they either are having sex or they're not.And one of the things we really met recommend for pastors and counselors, if they're dealing with a couple that says, well, sex just hasn't worked for us to be able to ask, have you ever been able to have entry?
4:17
And they'll, if they say, well, we're not sure or sort of, you know, it isn't sort of it either is or is it?And you know, when it has happened.So then you want to get that kind of evaluation and find out for sure what's going on.Often people will come when they want to have children and they might have been married 6 or 10 years and not been able to consummate.
4:41
They may have a very rich sex life without that, but now they want to be able to get pregnant.So I I mean, for me, I'm not a woman.I can only imagine what it's like.But for, I mean, it may be very confusing for a woman because, you know, we're teaching here that it's sex is very pleasurable and nice and etcetera.
5:02
And for a lot of women, young women coming into this whole arena, it's marked with a lot of pain and maybe some confusion about pain and pleasure.And it can be, I think, just really confusing.
5:17
Absolutely.That kind of messaging that that goes through their brain.Absolutely.And what happens then is that many times the couple just pull away from each other and then they'll try again and then pull away.And so it really effects them relationally and emotionally as well.
5:35
So it's something we like to make sure everyone hears about and knows that this is something you can work in it and you can find success.It may take a little more effort.And sometimes it's very discouraging to women saying, you know, teenagers can do this in the back of the car and I can't do it.
5:54
And I'm intelligent and I'm educated and it doesn't work for me.And you know, I feel so embarrassed.Well, I I think for a lot of those teenagers in the back of the car, the girl is in probably in a lot of pain.And she's probably.And she's only doing.It often in a freeze state.
6:11
If you're looking at the fight, flight or freeze, she's probably just.She just what she wants to be accepted or loved.But for a guy, for a guy, it's never been painful.I can vouch for that.Like I've never from moment one, it's never been painful for me.It's kind of not rigged, but it's hard for it's not really fair.
6:32
And so that's why I think that it just takes a lot of more time for generally speaking, for women to really get to know themselves.Yeah.I'm just wondering how often in your experience is abuse part of this story?Yeah, we often find that if there's been some kind of violation either.
6:50
Attempt at entry or whatever it is that then the muscles have tightened up and so that's another reason for the tightening, yes.So how do you help you?Got to deal with that trauma too.So that's why I bring up the pain thing, because we always start there first.
7:09
Then probably the biggest area that we get people coming to us about is interest or desire or the lack of interest on the part of one person.Or a difference where one it just has a lot higher desire than the other and how to deal with that.
7:26
And again, how to deal with those differences and make those work for you rather than against you and not impose how one of us is on the other, but finding a way to work that out when we start.
7:43
Often if there is one that came into the relationship more excited about it or something happened that one pulled away a little bit, then it can feed the other.And a little bit of difference can seem way bigger than a lot of difference.
8:00
For example, when a couple comes to us for therapy, we'll have a little form they fill out.And how often would you like to have sex?How do you often do you think your spouse would like to have sex?And the one who wants it more always says, while we rarely have it.
8:16
And the one who wants it less says, oh, that's all he ever wants.And we have it a couple times a day.Then we get we asked them, OK, so how often would you separately?How often would you like it?Traditionally, not always.It's not always this gender.
8:32
But the woman will say, oh, maybe once or so a week.And he'll say, well, two or three times a week.So they're always surprised that they're not as far apart as they thought they were when they again, knowing yourself, the identity, talking about it.
8:51
Because often what's going on is the man doesn't want to miss a window of opportunity, so he's checking every 12.Minutes or the one, the one who wants it more.And sometimes it's a woman.In fact, there's a book out that said but what about me that a woman wrote?
9:06
She said everybody talks about the man wanting it.What if I'm the woman who wants it more?And my husband, that's there too.About 30% is what I think the numbers are of women are the higher, more spontaneous.Right, right.But you're.Talking about how sexual communication really is vital to having a really good sex life and whether it's been consummated or not.
9:31
I love that you said those who had consummated marriages may still have a great sex life.I want to talk about that in just a second.But how do couples who haven't really talked openly about sex before take some of those first steps towards having that honest and safe conversation?
9:47
That's where we just encourage them to take a book and read it out.Loud it.Really breaks that barrier, and it's so hard to break without that.I mean, there's other ways you can do it, but it's so much easier just to have something there that you're reading and discussing as you read it.
10:03
Well, and and when couples come and we talk about it openly.It's easy how?Quickly.They adapt once they feel we're comfortable with it and many times they've said well.I tried to talk to my therapist about it but I got the feeling it made him or her uncomfortable so I didn't go back to it again.
10:24
Right.Last I checked the research, it said something like only 10 or 20% of therapists have been trained to know how to talk about sexuality with their clients.And so, yeah, you're right about that.Yeah, and that's something we do is trained talk to their various therapy groups.
10:44
So, OK, So what I hear you saying is if their people are the couple is struggling, just have that third person that book like they talk in third person, right?Or this podcast or something.Or yeah, yeah.The podcast great.Yeah, or, or have a yeah, third person.
11:00
I like that idea.So pain problems, desire problems, and then the next category we talk about is arousal.Problems and that is mainly Ed for men and that everyone knows about.It's on the TV every day.So I'm not sure, it's probably one of the most frequent.
11:19
I don't think we've talked about it too much on here, so talk away however much when.We talk about Ed, we're talking about erectile dysfunction, where a man has difficulty either getting aroused or keeping can get aroused.But then can't stay aroused long enough for a full sexual experience.
11:36
And with it that we always start, just like with the pain, we start with a physical therapist, we always start with a male sexual dysfunction MD evaluation.So we don't assume it's psychological or even though by the time they come to us, it probably is because even if there's a physical basis for it, by the time they come to us, they probably do need some sexual therapy also.
12:06
But we always want to start with making sure because sometimes it can be a sign of another like cardiac condition and actually have had experiences where the guys gone in for a triple bypass the next day when I said get evaluated by your MD 1st.
12:25
And so we first want to rule out any physical medical reason and then there are many things available to help with it.Now we have oral drugs that help with getting and keeping erections.And I have several women I've talked to whose husbands deal with Ed and they refuse to take medications.
12:49
I think there's so much shame surrounding that and it seems to me like this is an easy fix.I think this would really help.What do you do to help them not feel that shame about going and talking to a doctor about it?If we understand the reality, men reach their peak of testosterone around age 25 and then it begins to reduce at a rate of 1% per year.
13:14
On the average.On average, when you're 50, you only or 75, you only have half as much testosterone as you gave me.You were 25.We always kiddingly saying.Then you get to 125.You run out when you die.What the sense of living without this doctor, right?
13:32
Scott's a physician and I know Scott, you have some of your patients I'm sure that talk to you about it.Are they nervous about that or do you sense they are?What do you do to help them feel more comfortable that this is a not a thing to be ashamed about?
13:48
I say this is really common, very common, especially as you get into your 40s, fifties, 60s, it's pretty much every man is going to have some problems with their erectile function.
14:05
And it's nothing to be ashamed of.It's, you know, everyone.And there are medications now that are no longer really expensive.You can get them for pretty cheap because they're generic.Yep.And you can literally get, you know, 30 tablets that used to cost $1200.
14:26
Now it's 1099 at the pharmacy.And there's just simply no reason to not address that in a relationship.I mean, that is a easy peasy fix.Well, I mean, there's side effects and things that you need to talk about.
14:41
The potential side effects.Not everyone can take it.There's other medications you cannot take it with.But yeah, it's a relative.And it also helps your prostate too.So for guys in their 50s and higher out there with enlarged prostates, that's a 2 for one deal.
15:00
You get help with your prostate and your erectile function.There you go.Great.Now, most of the time the research has shown that women will get aroused when they have sexual stimulation, even if they're not aware of it.
15:15
By that we mean they're the physical signs of arousal will be there, the engorgement, the nipple erection, all of those kind of natural bodily responses that occur.But often women will not be aware of that those physical responses are happening.
15:34
And they may say I just don't get turned on.And yet, if an evaluation were done or you ask them in the specific questions about their body, it's getting turned on.But they're not.They haven't learned how to.Connect with their body.Emotion with what's going on with them.
15:50
Physically.Correct.So how do you help them do that this?Sexual therapy process really helps with that.What we do in sexual therapy is about 2/3 of the experiences we take people through are about physical touch since they focus starting far away from breasts and genitals, just feet and hands, face back, and then including more and more, as we call it retraining to help couples find a new way to discover their sexual responsiveness.
16:23
In our book, Restoring the pleasure that we updated in 2017 is that whole process of sexual therapy or sexual retraining that couples can do on their own, but also trained sexual certified sexual therapists will use that have the couple follow that while they guide couple through that.
16:47
And it really is a process of trying to reduce demand, enhance the mutual pleasure and facilitate the natural physiological responses in the body.So that's what sexual therapy or sexual retraining is about.
17:05
So then once we're dealt with arousal issues, then we get to the what we call the orgasmic issues.Or responsiveness.And for men, that is mainly something called premature ejaculation, where the man ejaculates very quickly before he wants to, sometimes even before entry, but often within seconds after entry.
17:29
And that usually is just how he just trained his body.And we find that our body's physiological responses sexually are very easily conditioned and self perpetuating.And so that's when we are taking them through sexual therapy or sexual retraining.
17:49
We have them stop all sexual activity as they're doing it now and start over and retrain their body because if they keep doing it, like if he keeps having experiences where he's ejaculating too quickly, his body won't learn to hold on to those sensations without moving ahead.
18:08
And so that's why they need that process to get there.For women, it's the opposite side.There are a lot of women who say I have difficulty having an orgasm.The majority of women have their orgasm from external or clitoral stimulation, and that's just. 3 to 7 to 70%.
18:31
All the research has shown that and sometimes couples will come in and say we're not successful sexually because I, the woman can't have an orgasm during intercourse.And we always try to sort out whether that's because the man wants her to or because she wants to, because sometimes it makes the man feel like he's less of a, he's not a good lover because he doesn't bring her to orgasm during intercourse, when in fact, that's the majority so.
19:01
Yeah.So just helping them know.We don't.We say we can help you learn to be orgasmic during our intercourse, but we wouldn't see that as a sexual dysfunction or a necessity unless that's something you really want to learn and it doesn't put demand or pressure on him.
19:18
What we so often hear from women is that they can get aroused but they can't take it over the hill.And this is where the body has to shift from.The parasympathetic nervous system, the passive side of our involuntary nervous system to the active.
19:35
And women tend to be more passive and men tend to be more active.And thus we believe that's why men have more difficulty with premature and women have more difficulty letting it happen.So we teach the man to learn to be passive, and the woman learned to go after.
19:51
And so one of the main things that we help women with is help them to get very active rather than just being there and hoping it happens to them.So we teach them to go after it rather.Than actively physically with when you.Say go after it.What does that look like?
20:06
What does that mean?Yeah.Getting active during the sexual experience rather than laying.For example, it could be that it's going to be better if the woman is in the top or superior position and she can be more physically active going after which feels good to her.
20:24
It could be that she would use her hand to stimulate the clitoris even as they are having intercourse.Or it could be that she extends for her toes and or throws her head back or all the things that are natural orgasmic responses.
20:39
There we have a list of orgasmic triggers and practicing.We get her to practice those.And again, just using her body, rubbing against him, just getting it rather than laying passively back and kind of, you know, give me.And she'll say my husband doesn't know how to give me an orgasm, you know, as if it's his job.
20:59
Or he'll say I don't know how to, rather than listening to her body and going after what would feel good to her.One of the differences there is that many women didn't grow up masturbating, whereas most guys start masturbating around age 12 and by the time they are married, they've probably had 500 or 1000 ejaculations and they know the system.
21:21
It's one of the reasons why they ejaculate too quickly because they've practiced that and whereas a lot of women have not been familiar with that part of their bodily responses.Well, that's something new to think about, right?All these things as far as the the sympathetic, parasympathetic nervous system between men and women.
21:42
I'm gonna have to go and.Shifting.Shifting to what is different than your natural state?Yeah, like the woman's kind of driving the the car now or the bus or whatever.She's in control.She knows it, that that baton has been passed to her right where she, she knows now that, oh, I'm in charge.
21:59
So.That requires using some sexual agency there.Well, yeah, it also, it requires some thinking ahead of time, some creativity maybe, because when you have that baton, it's like, I got to run now, right?And you can't just let someone else do it for you.
22:16
Take control over your own agency.Then one, I just want to finish with the main areas we deal with.The other big area is sexual addiction.And that's been particularly true since the Internet is available.All of us have.
22:31
We walk around with 2 billion porn sites in our telephones and it just causes an.Internet, yeah.Not me, I have no Internet on my phone so.Oh, that's great.I see he wants to be a righteous man and protect himself and I don't force him.
22:51
I don't push.Him, I told her.Take it off.Don't let me get it back on there.Yeah, it is hard.We do talk about pornography and related topics quite a bit on here, but any anything you might want to add from a sex therapist?Well, the main thing I think we would add is it that often they they come to deal with this when they got busted when they were caught either by an employer or by a spouse or whatever.
23:17
So the first thing is getting control of the addiction, but then they have to also learn how now to relate.How to be intimate?Relationally.Intimately.And that's where that formula for intimacy really helps.
23:32
Often they have a hard time with eye to eye contact and we'll have them practice doing silly stuff like Google eyes because they get so uncomfortable with doing it seriously.So we have them do fun little bit.The formula for intimacy is very helpful because addiction is really the opposite of intimacy in.
23:54
My studies, definitely a lot of women said what was more hurtful even than the fact they've learned or discovered that he was viewing porn was that he didn't talk to them, didn't touch them, didn't want sex with them.Half the women in my study showed that.
24:10
So yeah, it really does have some negative impacts on a couple's sexuality.So those are the, those are the big categories that affect the sexual.And then there's all the all the relational stuff, you know, come with unresolved trauma in their past because of abuse or something, or if they come with some bad hurt from some prior relationship.
24:35
Or even in their relationship, you know, things that have gotten in the way.But that could be all kinds of things that I'm sure you deal.One last question for all of you.This has been so great.One thing that we haven't really tackled as much on here when it comes to sexuality is some of these things that would lead people to a sex therapist.
24:54
So this has been especially helpful.If there's any advice that you can give or wisdom that you can give a couple who may be struggling a little bit, what would that be?First thing they'd want to make is a general statement that it is our experience that when people are willing to work on it, they don't have to be stuck with their sexual issue.
25:16
They can get past it, it can be resolved.Any of these things are because God designed us to be intensely sexual responsive people.And what stuff has gotten in the way of that, whether it was how we were taught in our home or experiences that we had or things we heard or read.
25:39
Well, and sometimes when I hear us say that, I think of a number of women who over the years have said that's a lie.You know God did not do I.He missed that in me.You left that computer chip out of me because?
25:56
And yet we would say when we really are allowed to get into there, there's a reason that that got blocked.That's not God blocking it.It's something in the world that blocked that some hurt happened.But if you don't, if you're listening and don't believe that, we're not going to force that on.
26:15
You just need to, when you're ready, find that door.And where is there any kind of an organization that allows people to look for a specialist sex therapist if they feel like the.Organization is right here.You too, it's your organization.
26:31
So do you have a website?What I mean is people call Joyce.We.Give our emails everyday.Yeah.We give our number and our e-mail address on our website for questions and I'm not seeing clients anymore.Cliff is very, very little because we're partly retired, but I still take all the calls and do kind of a triage for and then find someone and we have list of we call our professional resource list for sexual therapists around the country and some around the world.
27:04
And are you OK with us sharing that phone number and e-mail address?Yes, yeah.That's our Home Office now.So we're on the West Coast, so only between 8:00 AM and 6:00 PM.Every now and we'll get a call at 5:00 in the morning.Or maybe we just give them their the website address.
27:20
I think the the website address is the best way.Yeah, that's good.Passionatecommitment.com.Passionate commitment.Com and on there they'll find the books if they want to start with the book first.That's where they can also send us emails to in terms of any question that they might have.
27:37
Wow, what a wonderful resource.And.Literally just listening.If you if you e-mail me or call me and I don't answer right away, be patient.We were gone for a couple weeks and oh man, people were.I guess you just don't want to answer my question.So you've traveled too still, right?
27:56
You're still active in your 80s.We got a big family.So, well, we're active, but we're like, we also do seminars and be a.American Association.Associate of Christian Counselors in Nashville are heading up to the human sexuality track.
28:14
Wow.That's wonderful.Right.In fact, fun, fun story week, there's a group called the Institute for Sexual Wholeness of Well, now it's Dallas.Used to be in Atlanta.We'll have to find.Them Yeah, that's a great organization.Also to find sexual therapists, the Institute for Sexual Wholeness, and I think it's sexual wholeness.com OK.
28:37
That's a great resource, thank you for sharing.The people that go through that course have to take 630 hour courses and we teach the last of those courses.So for those when you asked, are we still doing stuff?We have three days where we are on our feet for 10 hours a day teaching and.
28:56
It's every two years, so we don't know it was the last it.Was a year ago.A year ago, yeah.So and then we can still.Do this we could.So now we're going to try it again next year.Because we're all very impressed that at our age we could stand there for 10 hours and teach.
29:12
But we love it.And I think that's when you're doing, when you're fulfilling what God called you to do.And it's so rewarding and so.I feel like we can.Make a difference.You want to keep doing it.Well.It's wonderful, Clifford and Joyce, this has been such a treat.
29:30
A pleasure for us.To gain your insight, your wisdom, your knowledge, you know, we, we do this a lot and I was just picking up on a lot of things I can do here.And we're just so grateful for the time you've taken today to spend with us and hope that those our listeners can do the same and reach out to you if they're interested.
29:52
And folks, that wraps it up today for this episode of Marriage IQ.We look forward to seeing you next time on another exciting episode of Marriage IQ.
