Dear Amy: After 10 years of therapy and antidepressants for PTSD from childhood sexual abuse, my wife of 20 years decided that she can no longer tolerate sexual activity, including kissing. All she wants is to hug and hold hands. She believes this state is permanent and necessary for her healing. Amy, we are only in our 50s. I am far too young to no longer have any sexual activity. I have compassion for her pain, but this feels unbearable. I have supported her through her therapy, but I want her to support my needs and desires, also.

We have twin teenagers who are wonderful. We have lots of friends and a happy house. I want to also have a wife, not just an affectionate roommate. My therapist thinks my wife should try harder on my behalf. What should I do?

— Desperate Husband

Dear Desperate: Your therapist is most likely going to support your goals; your wife’s therapist will naturally encourage and support her goals.

Because you are both open to receiving therapy, you should consider committing to joint counseling; that way, at least you will both be coached through a conversation about this very important topic.

Of course your needs are as important as your wife’s, but in a partnership the person with the lower libido controls the connection. You seem to have had a sexual connection at some point, and it is natural to want to maintain — or restore — this connection. Some unknown event may have triggered your wife’s reaction to you; menopause or medication for her depression may be a contributing factor to her low libido and sex aversion. Her sexual history is traumatic — this is the X-factor in your dynamic.

I hope she is willing to try to recover your intimate connection. The effort of keeping you at arm’s length, and feeling responsible for your unhappiness, will contribute to the aversion cycle.

You two make mutual decisions about your house, your friendships and your children. Your sex life should be mutual, too. When your wife refuses to kiss you, you feel unwanted and unloved. If you describe your desire for intimacy in heartfelt and emotionally relatable terms, she might understand and empathize.

Esther Perel is a therapist specializing in working with couples. Her TED Talks and podcast offer insight into relationship dynamics. Her book “Mating in Captivity: Unlocking Erotic Intelligence” (Harper Paperbacks, 2017) will offer ideas for how you and your wife could try to relate differently.

Dear Amy: I usually host the holiday dinners, and every year I listen to my husband complain about my brother’s eating habits. No matter what the entree, he uses ketchup and puts it on most things on his plate.

It is not something I would do, but my husband is outraged. His position is that it’s an insult to me — and the time, energy and expense involved to make a meal. I’m not offended. I think it’s odd, but it really doesn’t affect me.

This year, my husband chose to make remarks loud enough for my brother to hear but not directly to him. I was furious, and after everyone left I told him I thought his behavior was rude and disrespectful to my brother and me. Needless to say, he does not agree. How do I navigate this minefield at the next holiday dinner?

— Holiday Stressed

Dear Stressed: You could offer a solution to your husband: If he will prepare and serve the holiday meal, then he will have earned the right to feel offended if your brother smothers it in ketchup.

Your husband does not have the right to be rude and claim it is on your behalf. A gracious host accepts people as they are, annoying quirks and all.

Dear Amy: Responding to “Unsure Grandparents,” about giving gifts to stepgrandchildren, I was the stepgrandchild who spent 10 Christmases watching my cousins open the latest clothing, toys and electronics, gifted by our “grandparents,” while my sister and I were given a sweatshirt and pants obviously from discount stores.

If these grandparents can’t or don’t wish to treat these two children the same, then they should find other ways to dote on their son’s child that won’t rub the sibling’s face in it.

— Been There

Dear Been There: Wise. Thank you.