It’s the one topic we’re reluctant to discuss: the health of our sex lives. But desire can take a nosedive at any age and for myriad reasons, from stress to work worries. Once you lose intimacy in a relationship, you can feel lonely, guilty, frightened or embarrassed, so it’s important to deal with the underlying causes, which are often a mix of physical, emotional, psychological and situational factors; sex therapy can be a way to do this.
Who can it help?
Anyone, for any reason, but the most common concerns that bring people into sexual therapy are around levels of sexual desire – someone may have too much, too little, none at all or there may be a big mismatch in their relationship. Some people may feel uncomfortable about their desires, because they seem unusual or even scary. Difficulties climaxing are common, whether it’s reaching climax too quickly, or failing to orgasm at all. Some women have vaginismus, where they find it almost impossible to be penetrated, and pain during sex is also common. Sex therapy can help all of these issues, as well as complications with physical or emotional intimacy. It can also help if sexual problems are preventing you from conceiving, by addressing psychological and physical issues.
What is sex therapy?
You can see a sex therapist alone or with a partner. They will first assess you by asking why you are there. They will ask about any medical problems, medications you take (some have side effects that impact libido). They will talk to you about your current relationship as well as past ones. Once your therapist has a grip on why you are struggling, each session you will work on this through a combination of talking therapy and exercises for you to try at home. You will discuss your life more generally, as well as your sex life and relationship, as this can have a knock-on impact – things like work stress, family problems and financial worries can all dent libido and desire. People tend to internalise sexual problems, so the therapist may want to explore anything from their early life that’s still affecting them, and why problems have stuck.
If you go with your partner, you’re likely to be encouraged to talk to one another, to improve communication. There are different styles of therapy. Cognitive behavioural therapy (CBT) helps you spot habits and behaviours that are causing problems and change them. Person-centred therapy is about exploring emotions around sex, and what constitutes a good relationship to pinpoint unhelpful messages. Existential therapy is about challenging viewpoints we’ve built up through life that at one point would have been helpful, but are now blocking us. Sessions usually last 50 minutes and tend to be weekly or fortnightly, or you could can sign up to a more intensive weekend workshop.
Isn’t it embarrassing?
No, you won’t undergo physical assessments, you’ll keep your clothes firmly on and any requirement for ‘touching’ won’t be in front of your therapist, but will involve exercises to try at home. You don’t have to talk about anything that makes you feel uncomfortable. Members of professional bodies such as the College of Sexual and Relationship Therapists (COSRT) must follow a strict code of ethics. The tasks to do alone tend to focus on re-establishing confidence, taking away stress associated with sex and exploring fantasies. They may involve things like making an effort to compliment each other in a non-sexual manner, and non-sexual touching – to re-establish attraction and closeness, and take the pressure off sex. It’s worth the effort; 93 per cent of couples who’ve used Relate for sex therapy say it improved their sex life.