Getting help
with sex and relationship problems
Psychotherapy for sexual
and relationship issues
Related Pages:
Many people struggle with relationship and
sexual problems. Relationships tend to bring
up all the personal issues that in normal
life we can hide even from ourselves.
Relationships only work with a deep
attachment between two people. Once an
attachment is forming, it will re-stimulate
a person's thoughts and feelings about their
earlier history and issues with attachments,
which can be very difficult. Therefore,
relationships are often difficult and need a
lot of effort from both you and your partner
to work. They are not easy. Struggling with
issues in your intimate relationship is
normal and maybe even needs to happen for us
to grow as people.
Sexual problems are also
quite common, despite the fact that people
normally don't talk about having them. A
recent study of people attending their
doctor's surgery in London showed 22% of
men and 40% of women have a clearly
identifiable sexual problem (Nazareth et al
2003). The most common problems for men were
erectile failure (problems with getting an
erection) and lack or loss of sexual desire;
for women, the most common issues were lack or loss of sexual desire
and not
reaching orgasm. Sexual problems are
common and should not be seen as a personal
failure. To read more about
sexual problems click here.
Medical check ups
Sexual problems can be
caused by many different factors. Some are
caused by medical problems, such as high
blood pressure or hormonal imbalances. Quite
often sexual problems are caused by a mix of
medical and psychological factors. For
example, a woman may have caught an
infection, which results in a painful
irritation of her vagina, which is a medical
issue. However, even after it is cleared up she
might feel worried about sexual intercourse and
develop vaginismus, a psychological
response, to her fears about pain.
If you do
have a sexual problems, please always
consult your medical doctor.
It is important that you rule out any
medical causes of sexual problems. For example problems with
erections can be caused by the onset of
diabetes or high cholesterol. The medical factors
need to be identified and dealt with before
you look for sex therapy. However, not all doctors are
very educated about sexual issues. Some
general practitioners have not had a lot of
training in this area or may not be very
interested in sexual problems.
If you are not happy with
your doctor's response to your problem,
please consult a specialist.
Your
issue is important and you need to get it
checked properly. If you are not sure your
doctor is doing so, please ask for a
referral or think about paying for a private
consultation.
If you are a man you would
need to see a urologist, that is a doctor
who specializes in the male sexual and
urinary (kidney and bladder) system. You may
also see an endocrinologist if you have
hormonal problems, or a doctor who describes
himself as an "andrologist" - i.e. one who
specializes in male sexual issues.
If you
are a woman you will need to see a
gynecologist, a doctor who specializes in
the female genital system, or an
endocrinologist for hormonal problems. Very rarely a
woman may also need to see a urologist if
she has a urinary problem.
In some
countries some sexual issues may still be
dealt with by a psychiatrist, a medical
doctor who specializes in mental health
issues. This could be a help if you feel
your main issue is, for example, depression,
which has caused your sexual problem.
Sometimes psychiatrists also still deal with
issues around gender dysphoria. (That's when you are
distressed about the sex you are and would
like to change).
Psychological help
Many psychological factors
can contribute to sexual and/or relationship
problems. Stress, grief, ongoing arguments
with your partner about sex, money or indeed anything, really,
will have an impact on your relationship and
your sex life. Also, psychological factors
from your past can greatly influence your
experience of the world today. If you have
left-over feelings of insecurity from your
childhood, or strong inhibitions about sex,
or a tendency to withdraw when under stress,
all of these factors will have been learned
in childhood and can still influence your
life today in a negative way. The good news
is that you can tackle all of these issues
and that you don't have to do it on your
own.
The professionals who deal
with psychological issues are
called psychotherapists. There are many
different types of psychotherapists, such as
those who specialize in couples work, and
psychoanalysts who often specialize in long-term individual work. The psychotherapists
who specialize in sexual issues may call
themselves psychosexual psychotherapists or
sometimes sex therapists for short. However,
other psychotherapists may also work in this area.
The most important aspect
about picking a psychotherapist is that you
find somebody, who is properly qualified. In
some countries such as Britain there is
no law regulating the profession of
psychotherapy, therefore anybody can call
themselves a psychotherapist.
You need to interview the
therapist you're thinking of working with
very carefully
and ask about his or her training background!
Psychotherapists tend to train
for at least four years and must attend
personal psychotherapy for themselves, again
for at least four years. This is
essential to have some confidence that the
professional will be able to keep his or her
personal life separate from the issues you
may be dealing with. Also, a psychotherapist should be
in ongoing supervision with a more
experienced practitioner and work within a
clear code of ethics of a reputable
organization in his or her field.
It is OK for you as a client
to ask about all of these credentials before
agreeing to work with somebody. If they
object, go somewhere else.
How does sex therapy
work?
Firstly, a
psychotherapist will never ask you to
undress. You talk with the therapist
about the issues, but you are not required
to do exercises in front of him or her, or
have a medical examination in front of them.
A very few centers for psychosexual issues work with surrogates. This
would mean that you work with your therapist
as usual only talking about issues, but that
you have an additional session with a
"co-therapist", "assistant" or "surrogate",
with whom you can do the practical
exercises. This type of work may lead to
intercourse with the surrogate. However, very few
centers worldwide
work in this way and there will be a clear
contract with you before embarking on this
type of work. You can look up "sexual
surrogates" on the internet if you wish to
know more.
Generally speaking,
psychosexual therapy involves the therapist
taking a sexual history and asking you about
the problem you have come to get help with.
He or she may also want to know about other
factors in your life that may contribute to
your problem, such as issues in your current
or former relationships,
medical conditions, how you deal with stress
or the existence of childhood trauma.
The
psychotherapist will try and identify
factors, which you can work on such as
anxiety management, old repressive beliefs,
unhelpful behavior patterns etc. He or she
will probably also give you practical things
to do as homework. Two of the classic
behavioral techniques used in sex therapy
are Sensate Focus
to build up confidence with being sexual
with your partner and masturbatory exercises
to learn about your own sexual response.
Again, these are things you would practice
at home by yourself or with your partner and
then talk about with your therapist later on
in your session.
How to find a sex
therapist
The internet allows you to
look for a suitable professional online
fairly easily. The best way would be to look
for an established psychotherapy
organization in your country and then to
find the section of psychotherapists who
work with couples and/or psychosexual
issues. This way you have a better chance of
finding a qualified person quickly.
Alternatively, ask your medical doctor for a
referral or a recommendation for a
psychosexual psychotherapist.
In Britain most
psychotherapists are registered with the
UK
Council for Psychotherapy or UKCP for
short. Psychosexual therapists in
Britain are members of the
British
Association for Sexual and Relationship
Therapy, or BASRT, which has a register
of practitioners on their web site.
In the US, the
Kinsey Institute is a leading research
centre for sex, gender and reproduction. If
you click on "about the institute" you come
to the homepage, which gives you the option
to go to "Related Resources" in the top
right hand section of the page. You can then
find sexuality
information links in the text. Here you
can find contacts for various organizations
and links to "Sex Therapy" associations.
References:
Francoeur, R. (1995) The
Complete Dictionary of Sexology. New
expanded edition, Continuum
Nazareth, I., Boynton,
P., King, M. (2003) Problems with sexual
function in people attending London general
practitioners: cross sectional study.
British Medical Journal 327: 423.
http://www.bmj.com/cgi/content/full/327/7412/423
Written by
Anna 14.03.07
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