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As many a couple can attest, sexual relations can be surprisingly and at times infuriatingly complicated. One complicating factor is how important intimacy is to sexual relations.

Mark Banschick M.D., writing for Psychology Today, makes the point by saying, “You can have intimacy with or without sex. And, you can have sex with or without intimacy.” But the ideal is sex combined with intimacy. If a couple is not working toward the ideal, if not approaching it, then it’s uh oh, trouble. Or, as Banschick says, “Lack of intimacy and sex means that the relationship is being held together by something unhealthy — perhaps fear or mutual dependency.”

Many couples become more and more intimate through the years, which is wonderful. But if good sex is not part of the picture, it could be a red flag. “Most sex therapists will tell you,” says Banschick, “that most of the issues they deal with are psychological and not mechanical.” For more insight about the psychological aspects of both intimacy and sex, read the full article here.