Psychosexual Therapy – What is it, and Could it Work for You?

by Andrea M. Darcy

Is your intimate life a mess? Or do you have a sexual problem you’ve been keeping to yourself for so long, that it’s directly affecting your ability to feel good about life and yourself? Psychosexual therapy is for you.

What is ‘psychosexual therapy’?

Put aside any worries from sensationalist stories you have seen in the media about a person watching you have sex. This is not at all what a licensed psychosexual therapist, aka ‘sex therapist’, does.

Psychosexual therapy is talk therapy that focuses on discussing and troubleshooting issues with your intimate life, and exploring the connections between mind and body. 

UK charity “Relate” reports that in a study of 5,000 British citizens, over one third had suffered a sexual problem. 

Why do I have sexual issues?

It can be emotional or psychological blocks that affect your ability to be intimate, called ‘psychosexual disorders’.

Or it might be a physical or medical issue that has made your sex life different, confusing, or difficult. 

Of course psychological and physical reasons for sexual issues are often related and intertwined. For example, a long-term illness might have left you feeling  less desirable. But being less desirable makes you feel depressed. And depression also affects libido.

I have a sex life, but I’m unhappy. Do I need help?

Sexual issues don’t have to be just about the mechanics of sex. They can be about desire, or arousal, or even about identity and communication.

Does my partner have to come to sex therapy with me?

Not at all. You can go with a partner or partners, but you can also go by yourself. One-on-one psychosexual therapy is a chance to delve deep into your thoughts and feelings around sex, intimacy, and your body.

What sorts of things are okay to talk about in a sex therapy session?

Anything. They are your sessions. You might want to discuss things like: 

• sexual function and performance
• your ideas and beliefs about sex, gender, and your body
• worries and anxieties
• childhood experiences
• previous sexual experiences
• desires, dreams, hopes, fantasies
• questions you have about sex and relationships
• issues in your relationship(s).

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And you can of course talk about things that are not directly related to sex. If you had a hard week and want to talk about it, then talk about it. Intimacy is intricately connected to how we feel about ourselves in general.

If you attend relationship with a partner(s), then you will also discuss things that have come between you and troubles with communicating.

Note that psychosexual therapy is more than just talk. You can be given ‘homework’, exercises to try out during the week you then discuss in your next session. 

Why me? The origin of sexual problems

“Human sexuality is complex and multidimensional, with biological, psychological, social, and cultural aspects.” [Narang et al.]

Physical factors that can lead to sexual issues include genetics, hormonal changes, injury. Ageing, illness, bodily changes, pregnancy, gender identity. Ongoing STIs, and side-effects of medications.

Psychological factors can be stress, depression, anxiety, addiction, low self-esteem, and guilt. Distorted body image, unpleasant sexual experiences, and physical and emotional abuse.

It might be religious ideas that block you, or difficult childhood experiences like poor parenting or abuse that left you with negative beliefs about yourself and intimacy.

Environmental/social factors can look like living with in laws or other family, or having children. Moving to a new country or house you can’t relax in. Gender roles you aren’t happy in. Or perhaps you are simply bored of your relationship and afraid to move forward. 

Cultural issues can mean you were raised with ideas about sex, gender, and intimacy that now present problems for you. Perhaps you were misinformed, or raised with superstition and lack of sexual education.

But it’s really just a physical issue, how could talking help?

By: Pedro Ribeiro Simões

Yes, in cases like Peyronie’s disease, age-related erectile dysfunction, and hormonal issues, it is a physical issue. And you do need to talk to your GP, who might suggest medication.

But this doesn’t mean you can’t benefit from psychosexual therapy. These kinds of problems can cause psychological distress and relationship issues. Without support you can spiral into low self-esteem, guilt, and even loneliness.

Despite our society being modern in so many ways, honest conversations about sex and intimacy are not as common as they could be. Being able to say anything and feel safe, accepted,  and understood can be a tremendous relief.

My sexual issues are too weird to tell a therapist

Therapists are not judgmental and they have heard it all. They deal with clients with all sorts of issues and preferences. They are there to listen and help, not judge your orientation, gender choice, or what types of relationships and sex interest you.

But my problem is really minor

If something about your sexual life is upsetting you, then it matters.

And often, what seems minor can be more convoluted than it first appears. For example, a sudden lack of interest in sex can end up related to a new job that has lowered your self-esteem, or suspicions your partner is cheating that you haven’t been able to bring yourself to admit to. It’s only when we gather our courage, make that appointment, and start talking that we identify what is really upsetting us.

“Just talk to your partner”… is it enough? 

It’s the advice the magazines give. And it might work… if you and your partner both have high end, similar communication skills. But if you are having sexual issues and they have been dragging on for some time, then that’s unlikely. 

Psychosexual therapy can also be about learning how to communicate what’s upsetting you, and your wants and needs, in a productive way that others can hear and respond to.

What makes a good sex therapist?

A good sex therapist creates a safe, trusting environment for you to be open and honest in.

And they are properly trained and qualified. Here in the UK, a sex therapist needs to have taken a post-graduate diploma in psychosexual therapy, and finished their hours as a trainee under supervision.

They should also be registered, either with one of the registrars for counsellors and psychotherapists like the UKCP and BACP, with the College of Sexual Relationship Therapists (CORST), or the Institute of Psychosexual Medicine. 

Time to find help for your worries about sex and intimacy? We connect you with top psychosexual therapists in London. Or use our booking platform to find UK-wide sex therapists and online psychosexual counselling. 

Still have a question about what is psychosexual therapy? Or want to share how it helped you? Post below.