When people ask you what you do for a job, and you answer ‘a Psychosexual therapist’ there are a typical range of responses:
2)I didn’t even know that job existed
3)So, you talk about sex?
4)I must get a drink / go to the loo / escape as far away from you as fast as possible
5)That’s so interesting, tell me more
This can be anything from vaginismus, erectile dysfunction, rapid ejaculation, lack of sexual desire, compulsive use of pornography and masturbation, pain during sex, the impact of illness such as cervical cancer, questions around sexuality or sexual preferences, the impact of childbirth, or working with those who have suffered sexual trauma.
And this is by no means an exhaustive list, really the work can be considered to cover any issues relating to sex and sexuality. The model I use in my practice looks at concerns in terms of the meaning to the individual. If it is important to them, it’s important to me to help them work through it and understand it in terms of the impact that it has on their life.
We still live in a society where sex and conversations about it are essentially taboo, which is why people find it so hard to reach out for help with sexual problems, but psychosexual therapy offers a safe place to discuss these subjects.
The clue’s in the name – it’s ok to talk about sex here.
It is a non-judgmental space and an open one, where insights and thoughts are offered not based on personal perspective, but on professional knowledge and judgement. For me this started with a degree in Psychology, and after writing a dissertation on how people behave in different situations with recent sexual partners, my direction and interest was confirmed.
Training as a Psychosexual Therapist is a multi-faceted process involving learning, multiple theories, understanding of biology, hormones and human psychology as well as specific training around sexual dysfunctions and their impact.
I trained at The Centre for Psychosexual Health thinks about sexuality with an integrative perspective that considers not only the emotional, psychological and physical, but also the cultural and social.
Every day is different, every client different, every problem different.
This may mean that difficulties are based in our personal backgrounds, or although they present as a sexual issue, that they may have roots in an emotional difficulty, or originate from a part of our lives that we have not connected to our sexuality. For example missing out on a job promotion that may have knocked self-esteem, or an overspill of stress from work into the bedroom, or feeling under pressure to commit to the next step in life, the route to sexual difficulties is not always a direct or immediately obvious one.
Psychosexual Therapy has different components, one being addressing and changing thought patterns, or thinking about the problem differently. Often when we worry about a problem we turn the thoughts over and over in our heads, causing us anxiety which then ironically can increase the likelihood of a sexual dysfunction occurring.
Working through these thoughts and worry and creating strategies for managing stressful feelings, can be an important part of the therapy process.
It is also about communication, whether this is with a partner, or even just those close to us, feeling that we have to keep a problem to ourselves, can compound it or make us feel that we are alone in what we are experiencing.
Behavioural exercises for couples or individuals to do at home are also a part of the therapy.
This may involve self-touch or exploration, in order to get the person more comfortable with their body; or could be masturbation exercises to help with the problem.
For example gaining control over erections, or the use of for example dilators, which can be helpful for conditions such as vaginismus. For couples this may be about experiencing touch without sexual contact, so taking away the pressure to have sex, whilst allowing intimacy.
Pillow Play was also a product that was developed with this in mind, what originally started as an app and is now a 30 day intimacy programme for couples to reconnect without the pressure to have sex. As one of the team who launched Pillow Play it is amazing to see how the simple act of gazing into someones eyes, or just hugging can build connection, but is something that we so often forget to do.
I also work with clients to move away from a definition of sex that is completely focused on penetration.
Sex is so much more than just intercourse, it is touch, it is play, it is communication, it is vulnerability, it is togetherness and it is fun.
A key part of sexuality, is sensuality – building touch, desire and arousal. There are people that can’t have penetrative sex for some reason, but this doesn’t mean that they can’t have sex and sexual experiences together they just have it in a different way – but the importance is, that this model is inclusive rather than exclusive.
It includes different types of sex, sexualities, and choices and none should be thought superior to the other, it’s about what is suitable for the person or persons that are doing it, providing that it is healthy and happy for them. Some people may choose a life without sex, and this is also fine if that’s what they feel is best for them. It’s about informed decision making, exploration and understanding. But sex therapy offers us something that we still don’t have in many places, a taboo-free space where people can fully express themselves and be honest about how they are feeling, and for me, that’s one of the most important things, helping people discover the joy of sex and what that means to them.
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