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Relationship and psychosexual psychotherapy
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Relationship and Psychosexual Psychotherapy

“We can only learn to love by loving" Iris Murdoch

I came to Psychosexual Therapy after working for many years with people who had been sexually abused and I quickly realised the challenges these experiences sometimes had on people’s relationships and sexuality within themselves in either negative or positive relationships.

A significant part of my work is with couples having relationship challenges, also individuals and couples with sexual difficulties.

Having a picture of a more fluid society can be helpful; couples often no longer begin their relationship as a precursor to marriage, nor necessarily staying together ‘till death do us part’. Cohabitation, single parenting, shared parenting/blended families and second/third relationships are all more prevalent. Much of the confusion for couples in permanent relationships’ may be linked to the debate about their respective roles. The male and female partners are often placed in an equally ambiguous situation, no longer being able to rely on their traditional role, often being asked to be both a caring sensitive parent and an authority figure in relation to their children whilst having the responsibility of being the main wage earner.

Additional uncertainties relating to employment opportunities, redundancies or relying on benefits can leave both genders feeling vulnerable, defensive or undermined, no wonder relationships can sometimes become off balance.

Intimacy and sexuality

Being intimate with a partner is (or can be) the most rewarding experience in which we celebrate our relationship and love for each other. However, many people (for various reasons) struggle with some areas of closeness and intimacy and this can throw up many challenges to the couple and can reverberate throughout their time together.

Sexual coupling can either be a very simple or a very complicated, emotional and physical process whilst carefully considering each individual’s needs, desires and expectations. When, as in sexual intercourse, it involves two people taking complimentary roles the challenges and joys are ‘multiplied. Just a few difficulties could come from inhibitions, myths, fears, expectations, and fantasies for self or mutual enjoyment of intimacy, tenderness or passion. Maybe it’s more surprising that the majority of couples enjoy their sex life sufficiently well to take it for granted when for the others it may go wrong and cause difficulties.

Sex can be an individual psychological event; and the attitudes of the individual, his/her earlier experience, anxiety, tiredness, overwork, can all have an influence.

A person who has been sexually abused as a child may anticipate sexual contact or intercourse with various degrees of anxiety and vulnerability. A man or woman who was beaten by a parent as a child may have challenges in being intimate with his/her partner if he/she touches him/her in certain ways that bring up memories.

An intimate relationship that meets each person’s need for intimacy and security is of great value. The relationship bond of respect and trust motivates the couple to keep their sexual intimacy vitalised. When respect and trust are lacking, trying to restore intimacy can be a challenging struggle. If built up resentments are not dealt with they invariably cause the person resenting to either withdraw or be angry which in itself is not a sexual place to be.

A no-sex or low-sex relationship can rob the couple of intimate feelings for each other, especially when affection and sensuality are absent. The relationship may have genuine strengths however; and sometimes the ability to resolve sexual problems can overwhelm the couple.

Secrets are poisonous and can kill families

"Sex is the stage on which many relationship dramas are played out." Betty Berzon

Hidden agendas can be sensitive and explosive. Some people can deal with them, whereas others find they become a challenge to far. Couples deal with many agendas; fear of pregnancy, fear of being abandoned, shame about a fetish arousal pattern. A lack of desire maybe caused by the side effect of medication or a multitude of eventualities, or even fear of raising the subject in case the partner might be angry or leave. Hidden agendas can destroy sexual anticipation – they need to be disclosed and dealt with sensitivity and this can be a challenge to far for some people.

The question of whether a relationship problem causes a sexual problem or sexual problems cause relationship dissatisfaction is more than a chicken and egg argument. It is unlikely there is a simple answer the couple can deal with easily on their own however, when explored with tenderness, honesty and support a whole new realm of possibilities are open.

Sometimes ‘mistakenly’ seen as the weaker sex, fragile and needy, however I believe this myth is now well and truly dispelled. I’m finding most women strong, independent and brave.

Most women expect an egalitarian relationship rather than the traditional roles of men leading the way and the female bringing up the children etc. 
The sense of female bodies as mysterious and unknowable even to women themselves affects the expression of desire.


The reality is that some men have as many personal problems as women, including problems with sex. However, because it’s so fraught with meaning if a man has a difficulty, he can find himself in an incredible bind. Not being able to acknowledge it can mean he can’t try to resolve it on his own or with his partner. His partner invariably knows there’s a problem and can’t get him to acknowledge it, which puts them both in a bind as well. It doesn’t take long before the partners are distant and the relationship deteriorates. This is sad, because in the majority of cases the problem could be easily dealt with, if only it could have been confronted.

Males and females

"The only secret to pleasurable touching and sex is to be fully present, to be alive in the moment, even if the moment lasts only a few seconds. The difference is immediately noticeable. When you’re really present, the touch means something, no matter how brief it may be. When you’re not present... well, you’re not present. You can’t experience something if you’re not there when it happens."
(Bernie Zilbergeld, Ph.D. 1999)

Conditions for sex and intimacy

Cultural differences

Difficulties with communication


Erectile dysfunction

Ejaculatory control

Getting your mind on your side (spectatoring)


Inhibited sexual desire

No time for us

Orgasm challenges

Power struggles

Premature ejaculation

Situational retarded ejaculation

Special needs and concerns


Arousal dysfunction

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