The types of sexual issues that can present themselves in a relationship are numerous. Are sexual issues preventing true connection and closeness? Does one partner lack knowledge and experience about sex? Does one partner have a history of abuse that challenges intimacy? Does the male have performance issues, and are they actually caused by anxiety? Is there an issue with significantly different levels of desire between partners? Is sex actually painful for one of the partners? These are just some of the many issues related to sex and intimacy, and ones that can cause distance and frustration in a relationship. Both individual and couples therapy can be extremely effective in addressing these issues. Be mindful that therapy is for individuals who are growing to believe that their sexual issues individually, and as a couple, are emotional in nature.
Psychotherapy
Sometimes it can be as simple as a therapist explaining a person's sexual response cycle and the mechanics of sex, and the couple is able to take it from here on their own. Some partners have a history of sexual abuse, rape and trauma that they need to work through in therapy. This can have significant implications for their ability to be intimate, close, and completely trusting with another person. Other times, people are unhappy with other areas of their life such as work, stress, obligations, and this plays out with lack of intimacy. Many of these issues can be worked out in individual therapy. Find a therapist that you are comfortable with, so that you in turn are comfortable talking about material that may previously been embarrassing, or you have never admitted.
Couples work can help to resolve a number of issues as well. A couple's therapist will identify the issues that exist between the couple, and will work on exercises to restore trust and communication between them. Often resolving these issues will help to resolve sexual tensions and distance between the couple. The couples work can also address different attitudes that each member of the couple has towards sex, intimacy, and sexual material. While one person may have no issue with viewing sexual images, one may view this as cheating or disrespectful. This is important to talk through, and to help the couple better understand their attitude towards sex, and their comfort levels.
Through therapy and growing understanding, the couples can learn non-sexual touching techniques, called sensate focus, to enhance their excitement and pleasure. This can also help to minimize pain during intercourse. Another important piece is that each partner learns to grow to be more comfortable expressing their sexual needs and desires. Many clients may find addressing these issues through telehealth platforms such as Betterhelp.com, American Well, or Teledoc to be more favorable, due to the increased level of anonymity. Patients feel more inclined to openly talk about uncomfortable subject matter when they are not sitting in a room with the person. While some strongly prefer the face to face interaction, it is wonderful that individuals and couples have more options to address these issues before they damage their relationships.
Lack of Desire
It is becoming more and more common that individuals report a lack of desire, or greatly decreased desire for sex with their partner. This can be caused by depression, anxiety, stress, trauma, or strain in the relationship. This lack of desire, and lack of intimacy, can cause major issues in a relationship. It tops the list if reasons that couples enter couples therapy, that a member of the couple is unfaithful, or that the couple ends up divorcing. Therapists can help to address any mood issues, any unresolved issues of trauma, or any long standing attitudes about sex that an individual might be grappling with. With a lifted mood, a new found ability to lower their defenses with their partner in terms of intimacy, or a new comfort level with openly talking about sex, the partner may be able to have improvements when it comes to their level of desire for their partner.
Erectile Dysfunction and Premature Ejaculation
Believe it or not, a prescription is often not the answer. Much of the time, erectile dysfunction and premature ejaculation is a symptom of anxiety. Many times, once this has occurred, men become increasingly anxious over their performance, causing the problem to happen over and over again. So what can be done to help with this? Reduce distractions in the environment, have the partner give more positive messages to the other. Too often the partner takes this as rejection or lack of attraction. This only adds to the pressure and the problem. A therapist can help you explore any underlying emotional issues that are adding to sexual issues. They can help the individual learn to handle sensation for longer and longer periods of time. Once discussions have occurred which address anxiety, fear of failure during performance, stress in the relationship, and how to better communicate each person's desires, we often see significant improvement in function and ability.
It's Possible, It's Possible, It's Possible!
As you can see, most issues of sex and intimacy can be solved with individual or couples therapy work. If medical causes such as low testosterone, diabetes, medication side effects or dyspareunia (painful intercourse) have been ruled out, talk therapy may be the solution! With so many options to get the help you need, including telehealth, mhealth, and face to face therapy, an individual has many options to receive services that can improve upon their relationship and sex life. It seems well worth the time and effort to improve these issues and strengthen the relationship.
Need help? In the U.S., call 1-800-656-HOPE for the National Sexual Assault Hotline.