Author: Doreen, The Relationships Service – PST Counsellor
Psychosexual Therapy is a specialised counselling approach that helps individuals or couples address sexual difficulties related to intimacy, desire, arousal, and function. It offers a safe, supportive space to explore emotional, psychological, and physiological factors, aiming to resolve dysfunctions and strengthen relationships. The therapy promotes personal growth and deeper connection.
Psychosexual therapy is usually identified to be appropriate where there is a diagnosable dysfunction. Problems that we work with frequently are vaginismus, erectile disorder, premature ejaculation, desire differences, anorgasmia, male orgasmic disorder and dyspareunia (pain on intercourse). Sometimes couples come having already visited their GP who diagnosed the issue and recommended psychosexual therapy.
Often an individual may have more than one diagnosis, and it is common for both partners in a relationship to have differing diagnoses. For example, if a woman experiences pain on penetration, it is not uncommon for her partner (if male) to develop erectile disorder as he empathises with her pain and unconsciously or consciously does not wish to penetrate. Sometimes couples have struggled for years, and psychosexual therapy is very effective in creating different and new ways to be together intimately.
What is the Psychosexual Therapy Programme?
It is typically a behavioural programme aimed to increase physical and emotional intimacy. The first step of this programme is to reset and start creating new experiences, with this in mind it is usually helpful for all sexual activities to stop and instead to start with gentle sensual exercises in the privacy of their own home. The purpose of taking sex off the agenda is that this reduces performance pressure and allows the couple to just be together without thinking about ‘what next’.
The therapist would normally ask for the exercises to be carried out twice or three times a week and each exercise is approximately an hour in length. Couples will then see the therapist again to provide feedback on how they found the exercise. The type of touching increases to something more sexual and there is a focus on understanding arousal – which helps individuals to identify what they find sexually exciting. Couples often find that by working together to find the time for the exercises their sense of intimacy increases because they are both prioritising the relationship in a way that they may not have done for a long time. The behavioural programme that the couple will work through is called the Sensate Focus and their therapist tailors it to their needs.
Clients may also be asked to do some simple individual exercises whilst being very mindful and to focus on their thoughts, emotions and feelings.
It is important for both partners to know that they will never be asked to do anything which they would rather not do. The PST programme is deliberately slow, and clients will move through the programme at a pace which suits them – and their lifestyle.
Inevitably this behavioural programme will stir up emotions; some couples find the exercises surprisingly moving and are shocked by the intensity of feeling that they stir up while others might struggle to even do the exercises, whatever emotions occur as a result of the programme can be thought about within the therapy.
In the Relationship Service, our Psycho-sexual therapists are also couple counsellors and so move in and out of working with the physical and emotional aspects of the couple relationship to provide a holistic approach to relationship functioning.
Space is provided to think about sex in a safe and non-judgemental environment; the difference between psychosexual therapy & couple counselling is that the couple is set physical exercises as part of the programme. When there are sexual problems within a relationship the partners often avoid any physical intimacy for fear it might lead to sex & avoid talking about sex for fear it might lead to an argument.
Couples or individuals?
The programme as described above is primarily for couples. Individuals who present with various dysfunctions rarely get the same help from the programme because the problem itself cannot be seen in isolation.
For example, a man who presents with erectile dysfunction may often be able to maintain an erection when masturbating – it is maintaining an erection with a partner (especially a partner for whom they care deeply) that is the problem. The help which therapists are able to offer to individuals is therefore quite limited. However sometimes simply allowing clients to talk about their feelings surrounding sex is useful – and there are certain exercises which some individuals may find helpful.
If you are thinking of getting help with your sex life
Our psycho-sexual therapists are aware that making an appointment can seem scary and are experienced at gently puttingclients at ease. We work with everyone regardless of their sexuality or identity. Please come along for a chat to find out more by booking an Initial Assessment.
