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Q. I've dealt with guilt that stems from years of premarital sex. Yet whether it's thoughts of former relationships or fears that I'll be hurt again, I find that my past still sometimes gets in the way of a healthy sex life with my spouse. What can I do?

A. We appreciate your candor in describing some of the negative effects of premarital sex. Be assured that there's hope for you and your spouse to move beyond the past to discover fantastic sex together.

One key to redeeming past hurts and fears is talking about the consequences of your premarital experiences. This should not be done with a sense of blame or comparison, but rather to explore its impact on your marital satisfaction. For instance, often premarital sex is a self-focused event in which people strive to affirm their sexual adequacy. That dynamic, which minimizes or disregards the sexual partner's feelings, promotes a sense of being used as a sexual object rather than being loved as a person of worth. The consequences are fear and distrust. A wedding doesn't eradicate those defensive barriers to allow passionate vulnerability. Rather, the unsuspecting mate may interpret those defensive restraints as rejection.

Talk about how premarital sex—either with each other or with other partners—has affected you. Whenever your past rears its ugly head, threatening to strangle your sexual intimacy, realize that you can disconnect old emotional responses from your present life experiences. Clarify the triggers, then refuse to allow them to control your marriage.

If certain sexual behaviors, such as oral stimulation, have been hot buttons to elicit defenses, decide together to avoid those triggers, and you'll avoid the automatic negative responses.

It's important to replace the old images with new ones you can create with your spouse. This takes practice and patience, so you'll have to allow yourselves hours and hours of sexual play.

Q.When my wife and I make love, I feel as if I do all the work. How can I get her to engage more?

A. Recent surveys indicate a slight shift in whether husbands or wives have greater interest in having sex. There's more of a balanced picture for about half these couples. The other half were divided with slightly more men reporting a higher drive. It's understandable that the person with the higher desire would be the "initiator" and the mate with lower desire, the "responder." You must fit into that group.

Here are some helpful insights that can contribute to your wife's responses.

1. Arousal tends to be more complex, more gradual, and more easily interrupted in women. Arousal begins in a person's thought life. Some women and most men have an active sexual fantasy life, thinking often about sex or sexual images. Others rarely think such thoughts. It's important to recognize the various sexual triggers in your wife's arousal. These are weighted toward relational factors rather than physical stimulation. Loving words and acts are much more effective than genital caresses. Find out what your wife considers romantic. When you've pushed her buttons she's more likely to push yours.

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