When I was a teenager, I began a sexual relationship with my sister. She performed fellatio on me one night while I was sleeping. I woke up and we progressed to intercourse. Now, neither of us can maintain a regular relationship or reach orgasm with other partners. We're both just out of college, have good jobs and appear normal to others. Yet we can only have enjoyable sex with each other. We both know it's wrong, but when I try to sit down and talk with her about it, we end up having sex. Is there some way I can broach the subject of us getting professional help? I can't seem to do it on my own.

G.S.

Your question brings up a host of other questions, most of which will have to go unanswered until you talk with a psychologist or other therapist face-to-face. For instance, I'm curious how old you and your sister were when your sexual relationship began, and if there was any power differential (for instance, if your sister was older than you when she initiated the sexual activity). I also wonder if your sister or you had been sexually abused (or physically or emotionally abused) while you were growing up, or if your home was in some way emotionally impoverished. To put it bluntly, the average home environment does not foster an incestuous relationship between siblings. I suspect that something must have been awry even before your sister woke you up on that first night -- and it may be helpful (although possibly painful) to understand and address the contributing factors.

That said, I know how difficult it must be for you to broach this subject with ANYONE, including your sister, and I commend you for reaching out for advice. What I recommend is for you to see a psychologist or other type of therapist initially by yourself -- particularly one who is knowledgeable about incest. Your therapist can help you stop the sexual aspect of your relationship with your sister, which can be done even if your sister never gets help on her own. Therapy can also help you achieve more satisfying relationships (sexual and otherwise) with your peers.

Your therapist can also help you come up with ways to discuss the problem with your sister, whether that involves joint counseling with her or talking with her about it only on the phone, rather than in person, so as to limit the chance your conversation will be derailed by sex. Good luck.