The amount of people seeking sex therapy is expected to grow by 22% over the next six years. We spoke to Psychosexual & Relationship Therapist Kate Moyle about why it’s something more of us should be considering.

What is sex therapy?

It’s talking therapy for those who specifically need help with a sexual difficulty and the impact it is having on them. It helps to identify whether the problem is psychological, physical or a combination of both. It also looks to understand the history of the person, any contributing factors, and what is maintaining the issue in their current situation. It can involve a combination of talking therapy, to challenge negative thoughts or behaviours and some exercises for individuals or couples to do at home.

What can we expect from a session?

Psychosexual therapy will start with an assessment process or appointment to determine the best course of action for the individual or couple. The key point is that, like all therapy, this is a confidential process. Talking about sex can bring up feelings of shame or embarrassment, but psychosexual therapists have specific training in order to work with these types of problems and will help you to feel more comfortable. An assessment will help to put a clearer picture in place and, if the therapist suspects there may be a physical cause for symptoms, will refer you. This could be to a GP, gynaecologist, urologist, men or women’s health physiotherapist or sexual health clinic. It’s also important to note that some medications can impact sexual functioning, so telling your therapist any medications you are on is important.

Post-assessment, the therapist will discuss a treatment plan, the approach to the therapy process and what your goals are. The main question that most psychosexual therapists get asked is ‘How long will it take?’, but it’s all about the individual. Like all therapy processes, the more that someone puts into it, the more they will get out of it; hopefully successfully achieving the change they are looking for. Appointments are typically 50 minutes weekly and there may be exercises to be done at home in-between sessions.

Should we go it alone or with a partner?

Either. Many individuals feel like they can’t talk openly in front of their partner about the feelings or symptoms they are experiencing. Although it may sound ironic, it’s often the case that the trickiest person to talk about sex with is the person we’re having it with. Most sexual dysfunctions come with a lot of feelings of confusion and shame that can prevent people from accessing help or trying to work through the problem.

If a sexual problem is occurring in a relationship, it is helpful for couples to attend together as the dynamics may be playing a role in why it’s happening. It also offers the couple a neutral space with someone else there to express how they are both feeling, and listen to and understand each other better. Many people also attend after the break-up of a relationship or because they have met someone they would like to be in a relationship with.

When is the right time to see a sex therapist?

Ideally we’d see someone before the problem becomes too ingrained, but this is rarely the case. For most people. there has been a trigger event, so they attend as a response. If a sexual difficulty is causing you distress, it is better to get it sorted in order to alleviate it and get yourself back to a place of sexual health and happiness — meaning a state of wellbeing and attitude, rather than just being infection free.

The Diagnostic And Statistical Manual Of Mental Disorders characterises that, to be diagnosed with a sexual dysfunction, the symptoms must be present for at least six months but, if a difficulty or dysfunction is repeatedly occurring then dealing with it sooner is preferable. It can become a vicious cycle; the more it occurs, the greater the anxiety around it develops. The more stressed a person becomes about a problem, the more in their head and less in their body they are able to be, which can interrupt the processes of sexual arousal and desire, often leading to a higher likelihood of dysfunction. This, in turn, can confirm stresses and anxieties, making them stronger.

What are the most common issues?

When working with couples, it is about understanding how their relationship and sex life is, or is not, working together. Often it comes down to tackling sexual anxiety in different forms, which seems to be at the root of most psychological sexual dysfunctions.

Common problems are erectile dysfunction, rapid ejaculation, vaginismus, dyspareunia (painful intercourse), sexual anxieties, lack of sexual desire, delayed ejaculation, questions around sexuality or sexual desires or lack of sexual experience. Other issues relate to sexual trauma or assault, inability to orgasm, difficulties with pornography use or genito-pelvic pain.

And then there are the troubles during different life stages, for example trying to get pregnant, having just had a baby or menopause, or as a result of an illness, injury or medication.

Is there a wrong time to see a sex therapist?

There is never a wrong time to see a therapist and it is likely that even voicing your feelings can be helpful in some way, even if it’s making you more aware of your own process and what is going on. However it’s not a magic wand, so sadly can not fix everything. It’s more of a catalyst for helping the person to help themselves. An important part of therapy is setting goals for change, so they may be need to be adjusted, but that isn’t always a negative thing.

How do I find the right therapist for me?

Like all therapy, the thing that is central to a good experience is the relationship between the client and the therapist. It’s important to do your research and understand the approach of the person you want to work with. There are some more specialist organisations, such as Pink Therapy, who work with gender and sexual diversity clients and The College of Sexual & Relationship Therapists (COSRT) offers a listing of all therapists who are accredited members which ensures a level of qualification for the work.

Kate Moyle is a COSRT Accredited Psychosexual & Relationship Therapist and one of the founders of The Thought House Partnership in London.