> "Since men are perfectly capable of masturbating, I would encourage them to choose this over any sex that is offered without love and/or enthusiasm."

I agree with the Dr.'s analysis, but not with this suggestion.

If applied, IMO most “sex-tepid” wives will only feel relieved to not be pushed into sex; this will not make them more collaborative or empathic. They will think that their husband's masturbation is "the solution". Since those wives didn't care about their husbands' happiness before, they would not afterwards either.

I agree with the advice about therapy, though; maybe adding the information that avoiding therapy might mean, eventually, then end of the marriage. In other words, the message from the man should sound like "My happiness is as important as yours. We need to work together on both yours AND mine, otherwise sooner or later we will have serious trouble".