All kinds of things affect our expectations and beliefs about sex. For example, what life stage we might be in, how long we have been in a relationship, our family background and life experience, the way sex is portrayed in the media and easier access to the internet and social media. All of this can lead to unrealistic expectations of sex and misunderstanding about what is possible.
- Your sexual relationship is a very intimate and personal aspect of your life and relationships. So although the way of working with a sexual problem is slightly different to working with a relationship problem I never ignore the relationship whether this is with yourself or others.
- The aim of sex therapy is to help you resolve any issues that you or you and your partner may have about the way that you are sexually. It is not about making you do or be something you do not want to do or be.
- You may be sexually active or not, you may be interested in being sexual or not. There is no correct way of being only how you would like to be. We are all different and difference is something to be valued, honoured and accepted.
- Sex therapy focuses on any sexual concerns or problems that an individual or couple has. I work integratively where I draw on different models of psychotherapy and ways of working with human behaviour whilst respecting your autonomy. This enables me to choose a way of working that utilises models of therapy that suit you and your needs best.
What can sex therapy help with?
- Concerns around sexual desire such as a discrepancy in desire between you and your partner, unusual desires and fantasies.
- Differences in what each wants from and can give to the other
- Difficulties experienced around having intercourse including pain, erectile and ejaculation difficulties.
- Misunderstanding or lack of knowledge about sex, your body and how it works.
“Sexual Addiction” or compulsivity
- Although this term is often used in the media it remains controversial so some clarification might be helpful.
- Someone who enjoys an active, legal and consensual, sex life perhaps with a number of partners is not necessarily addicted to sex or acting compulsively.
- If, however, a person feels that their sexual behaviour is out of control and is interfering with their life, work and relationships then we could describe this as problematic behaviour.
- Many people attempt to soothe emotional distress through using food, gambling, alcohol or sex. This is often experienced as an easy, quick’ relief of distress and so gets repeated and can, for some, eventually become compulsive behaviour. When behaviour becomes compulsive in this way it can be accompanied by distorted thinking and rationalisation and justification of the behaviour.
- If the person is unhappy with their problematic behaviour and they want to make some changes then therapy can be a way of helping them achieve their goals.
What happens at the Assessment Session (first appointment)?
- You may attend sex therapy alone or with a partner.
- At the initial assessment session I will explain my confidentiality and disclosure policy (see confidentiality page) and ask you a few standard questions. Then you will have the opportunity to talk to me about what you feel the problems are and I can discuss with you how I can help you. It is at this session that we can explore what kind of therapy will be most helpful to you.
- For individuals, it will involve one session. For couples, assessment will usually involve three sessions, one with you and your partner and one with each of you alone. Occasionally it may be possible to do a full assessment in one session and then proceed to individual sessions for history taking. I ask clients to allow up to 50 minutes for their first appointment and each subsequent session.
- The first appointment will involve finding out what you or you and your partner perceive the problems to be. Once any physical or medical problems have been identified including the impact of any medications you are taking and if sex therapy is felt to be the right kind of therapy at this time, then we can proceed to history taking.
- You do not have to answer any questions you are uncomfortable with.
- After this I will talk to you about what has precipitated and maintained the problems. I will also suggest a programme of change for you or you and your partner to work on at home. This can be discussed and modified appropriately and will be reviewed regularly.
- Please note that you do not have to do any exercises I suggest. I work in a way that is comfortable for you or you and your partner.
- You will not be expected to have any kind of medical examination and all suggested exercises are done in private at home.
- Appointments are usually weekly to begin with but may be less often once you have started your programme of change, eg every two or three weeks, to give you time to try out any exercises.
- People often worry that a sexual problem might be due to a physical or medical reason. Some medical conditions and medications can affect sexual functioning and it is my normal practice to ask you about what medical problems you have or had and what medications you are taking. Nevertheless most sexual problems have a psychological factor and this is why the process of taking a full history is important. Once history taking has been completed I will be able to share with you our mutual findings. I will then suggest a programme of change that I have tailored to your needs. This programme will always be available to modification and review.
- We will then agree how much time you need to try some of the suggested exercises and this allows us to make suitably spaced follow up appointments.
- At each of the follow up appointments we can explore and talk about what went well, what you have learned and work towards resolving any problems.
A note on childcare arrangements
- It is not normally appropriate for children to be present during a therapy session for ethical reasons and because I have a duty of confidentiality to all my clients.
- If you have children please make sure that you have adequate childcare arrangements in place so that your therapy session can proceed.
