The inability of a man or woman to give satisfactory sexual expression of the uniqueness of their human existence – to suffer from a sexual dysfunction – is one of the most devastating experiences any person can encounter.

How can we, as a psychosexual therapists, offer help? Psychosexual therapy addresses aspects of sexual dysfunction in both men and women relating to sexual interest, arousal, orgasm, performance and psychological attitudes to sex. People often experience difficulties in their sexual relationships at one time or another. Couples frequently have difficulties in discussing these issues. It may feel very embarrassing to ask for help about such an intimate part of a relationship. Our therapists understand this and will help you to feel relaxed in sharing your concerns.

During sessions, our therapists will help you to explore and understand the reasons behind the problems, and look at ways of resolving them. Psychosexual therapy may also help you explore other sensitive aspects of your relationship. Many couples or individuals with sexual problems have found psychosexual therapy very successful.

Everything that happens during sessions will be treated in strict confidence and no information will be given to anyone. The inhibitions that the individual and social groups place on expressing human sexuality, both verbally and in affect create special difficulties for those working with these issues. The intimacy of the working relationship in counselling, nursing, and other care situations place particular demands on the professional in this respect.

Once a thorough assessment has been made, a treatment plan can be specifically designed for the unique sexual problem presented. Tasks are set by the therapist to be carried out at home. This helps to diminish performance anxiety and encourage more positive communication between the couple. Sessions are attended on a regular basis over a number of weeks.

Psychosexual counselling is offered for a range of disorders such as: general sexual problems, sexual health concerns, sexual phobias and sexual orientation difficulties. Others include rape victims, survivors of childhood sexual abuse; pre and post abortion counselling.

People often wonder what happened in the past to patients suffering from sexual difficulty.
A commonly held belief is that “people just got on with it” and somehow managed quite well without any help for their sexual difficulty. This assumption is far from true. Sexual problems left untreated, like any other disorder, have far reaching consequences. The social costs in marital breakdown, infertility and offending behaviour is well known. These factors in turn escalate health costs and human suffering from the resultant mental health problems such as low self-esteem, depression, anxiety, insomnia etc. If the patient’s source problem is one of sexual difficulty then these complications will continue to persist. It is therefore the source problem that requires treatment. People’s shyness in revealing sexual difficulties could lead to the belief that sexual disorder is transitory and uncommon. However, the recent fear expressed in many newspaper headlines that Viagra could potentially bankrupt the NHS would seem to acknowledge the extent of suspected sexual disorder in the general population.

The therapist devotes sufficient time to put the patient at ease and discuss at length with them the nature of his/her sexual difficulty and the context in which it occurs. Sexual difficulties seldom occur in isolation, but normally occur within the context of a relationship. It is because of this factor that the patient’s sexual partner is also encouraged to attend. Having both partners present helps to clarify the difficulty because it is often found that one partner is complicit in the maintenance of a sexual dysfunction. An example is that of a man presenting with premature ejaculation because his partner dislikes sexual activity and this encourages a rapid conclusion to sexual behaviour. In such a case, if a person cannot see any benefit to them-self in a change to their sexual practice as such, he/she will actively sabotage any therapeutic help that can be offered to their partner. It is also our experience that individuals with sexual dysfunctions unconsciously seek each other out as partners. It is not uncommon to find a woman presenting with primary vaginismus who has a partner who is also suffering from erectile difficulty. Although the male may report adequate erectile capability, this is not sustained once the female is free of her response and is able to be penetrated. Consequently it is the couple who must be considered as a unit for treatment and not only the initially referred individual. Assessment of a couple for a sex therapy programme takes approximately seven one hour sessions. This time is required to gain the trust of the couple and to enable the therapist to identify all of the factors involved in the dysfunctions. It is only after this period of assessment that any treatment regime can be offered, whether this is Sex Therapy, Psychosexual Counselling or both. During the assessment for sexual dysfunction, therapists often uncover a history of sexual abuse. As this is often the root cause of the presenting sexual dysfunction then a treatment plan would probably begin by first offering psychosexual counselling to the patient who has suffered the abuse. Only after this treatment has been concluded would ‘couple work’ to address the presenting difficulty begin.

In conclusion, the answer to the question, “sex therapy and counselling service – who needs it?”, is “many more patients than currently have the opportunity to access such a service”.

You will be listened to, understood and accepted as you are, both as an individual and/or as a couple. Provided you meet some basic criteria, an individual programme, using systematically structured sexual experiences with con-joint therapeutic sessions, will be designed specifically for you as a person or couple, and be implemented at your pace.

Sex therapy, which is also good marital/relationship therapy, is ideally suited to a couple who are both motivated to seek an improvement in their sexual relationship. A problem may arise if the level of intimacy between the couple is suddenly changed by the ability to engage in more frequent or different sexual behaviour. Levels of expectation of both intimacy and sexual performance need time to be realised. It is these personal aspects of sexual behaviour which must addressed in any treatment programme to honour and respect the uniqueness of the individual persons and the uniqueness of their relationship. This is just one aspect of sexual therapy that requires the time, skill and expertise of the sex therapist.

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