Psychosexual therapy (or psychosexual counselling) is a specialised therapeutic technique carried out by professionals with backgrounds of counselling, nursing or medicine. It is specifically designed to help people living with difficulties that are of a psychological, sexual nature and that are too difficult or complex to be resolved on their own.
The origins of psychosexual therapy lie in the pioneering sex therapy founded by 20th century Washington University research team, William H. Masters and Virginia E. Johnson. In 1970 they published a report on a "new" therapeutic approach to sexual problems, which revolutionised treatment for such difficulties. Psychosexual therapy incorporates the key behavioural and cognitive principles of Masters and Johnson's original approach, and has proven successful in helping people of all ages, health and sexuality to overcome their sexual problems.
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What sexual problems can psychosexual therapy help with?
Psychosexual therapists are mental health advisors specifically trained to deal with all kinds of sexual problems, whatever the causes. Sexual problems vary in severity and complexity, and while some may be minor and temporary - often linked to more recent experiences that have caused stress - other sexual problems will have been around for some time.
Individuals living with long-term sexual problems are often too ashamed and embarrassed to discuss their concerns with anyone - not even their partner - and this can take a toll on their sex life, relationships and well-being. Psychosexual therapy provides an outlet for people to talk about their issues with a trusted and supportive therapist who specialises in resolving all kinds of sexual problems.
Some of the issues psychosexual therapists will be able to help with include:
- loss of sexual desire
- painful intercourse
- difficulties with orgasm
- arousal disorders
- erectile dysfunction
- premature or delayed ejaculation
- sexual difficulties following abuse
- general breakdown in a couple's relationship
- not being able to achieve penetrative sex
- fear of sex
- pregnancy and postnatal sex
- sexuality and illness
- sex avoidance
- poor body image relating to intimacy.
How does psychosexual therapy work?
The essential aim of psychosexual therapy is to identify the root cause of a sexual problem(s) and then treat it appropriately. Sessions do not involve any examinations, tests, or any sexual acts - psychosexual therapists simply want to listen. Their main priority is to demonstrate to clients that they are relaxed and experienced in talking about sex. Although psychosexual therapists are fully trained to deal with emotional and relationship problems, their approach is focused primarily on helping people to talk openly about sexual feelings and concerns.
Psychosexual therapy sessions begin with lots of talking and sharing, where clients are encouraged to assess their sexual problems and pinpoint thoughts, behaviours and other factors that might be contributing to them. This stage will involve exploring relevant past experiences, such as sexual abuse, which may have unconsciously affected sexual attitudes. Therapists will also ask about a client's relationships in order to identify how sexual problems may be linked to, or causing issues in their personal life.
Once the root cause of a sexual problem is identified, sessions will then move on to treatment. In psychosexual therapy, therapists will explain the physical causes of sexual problems (such as vaginal dryness) while helping clients to rethink unhelpful misconceptions about sex. Often therapists will devise a personal growth programme for their clients, designed to help them become more familiar with their bodies and sexual responses. This may involve a series of exercises (i.e. sensual touching techniques) that can be practiced at home. These can be particularly beneficial to couples wanting to learn more about each other sexually. If relationship issues are the cause of sexual problems, therapists will help clients to tackle conflict and communication difficulties as part of sex therapy.
Who can benefit from psychosexual therapy?
Psychosexual therapy can help individuals of all ages, sexual orientation and health. Some people may be single and not actively having sex, but can still benefit from seeing a sex therapist if something is troubling them. Couples - whether married, cohabiting or living separately - can receive treatment together, but some individuals may prefer to see a therapist on their own.
Generally though, psychosexual therapy is considered more effective if clients in relationships attend sessions together. This is because sexual problems will typically impact both partners equally - even if they are only physically affecting one individual. Psychosexual therapy empowers couples to deal with their sexual problems in a healthy way - helping them to work together to understand their sexual problems, better express their sexual needs and wants, and broaden their choices of sensual and sexual expression.
Some psychosexual therapists are also trained to help people living with chronic illnesses or disabilities whom may be experiencing sexual problems as a result of their condition. Difficulty in sexual function and sensation is common among these clients, but sex therapy can help them to explore other means of sexual intimacy and sexual pleasure - often with the help of artificial aids.
What qualifications should a psychosexual therapist have?
In the UK, practicing psychosexual therapists should be trained with a minimum of two years in a post-graduate diploma in psychosexual therapy, including a minimum of 200 supervised clinical hours. Although it is not a legal obligation, some psychosexual therapists will be registered with the College of Sexual and Relationship Therapists (COSRT) - the UK's leading membership organisation for therapists specialising in sexual and relationship issues. All COSRT members must abide by a strict Code of Ethics and Principles of Good Practice for members, and a Complaints Procedure.
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