Sex File: Why won't he hold my hand even though we still have regular sex

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My husband and I have regular, satisfying sex. The trouble is he never wants to touch me outside sex - or even hold hands. He avoids me if I approach him so I don't bother any more. This kind of intimacy has gradually disappeared from our marriage. He brushes me off whenever I raise it.

Intimacy is an interesting word because it is simultaneously defined as "a close, familiar, affectionate and loving relationship" and also as "sexual intercourse". Intimacy therefore describes the emotional and the physical connections that are fundamental to a happy and healthy marriage. At the start of a relationship, the emotional and the sexual are inextricably linked, but everything changes over time and marriage is no exception. Even so, in a good marriage, the fundamentals of intimacy remain and even after decades together touch and small gestures of non-sexual affection are the language through which connection is expressed.

You are, at least, still having sex, so it is possible that your husband is getting all his emotional needs met that way. However, if that was the case, I don't think that you would feel quite so neglected. Because sex provides a unique opportunity for physical contact, you could try integrating the affection you crave into foreplay. When your husband is sexually aroused he is likely to be much more open and therefore is much more likely to respond in the way you want him to. The next time you have sex, try delaying intercourse so that you can spend more time kissing, cuddling, teasing and engaging in pillow talk. If your husband doesn't oblige or is unwilling to co-operate, then there is definitely something else going on.

When a man rejects every bid for affection, even though he knows it upsets his partner, he is sending her a very clear message. I can only hazard a guess at what your husband is trying to communicate, but don't automatically assume it is about you. A lot of men find it incredibly difficult to talk about things that are worrying them, partly because it means admitting that they are not in control of an aspect of themselves or their life, and partly because they prefer to present solutions, not problems. When men feel stressed or anxious, sex provides a very helpful release, but they tend to retreat from emotional interactions that might potentially make them feel vulnerable.

Although the absence of affection might not seem like a huge deal in a sexually active marriage, it is a sign that something is not as it should be. And because relationships tend to change incrementally, by the time it becomes evident that something is wrong it can often be difficult to pinpoint the precise point at which things began to deteriorate. Having couples counselling would help you to work out what has gone wrong before it undermines the marriage any further, but you both need to be willing to commit to it. If your husband doesn't want to go, see someone on your own. Talking to a neutral third party will give you an opportunity to unpack your feelings and to work out what you want. It will also show your husband that you want, and need, something to change - and you are not prepared to settle for one half of the definition of intimacy.

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