Porterbrook Clinic
Sheffield Care Trust
Getting the Most out of
Psychosexual Therapy
Understanding Why Sexual
Problems Arise
Information for Users of our service
Dr Kevan Wylie
Clinical Lead
Porterbrook Clinic
75 Osborne Road
Nether Edge
Sheffield S11 9BF
Telephone: 0114 271 6671
Fax: 0114 271 8693
Email: [email protected]
www.porterbrookclinic.org.uk
Sexual images are all around us in
Being overweight or out of
today’s society – in films and television
condition is also very likely to have a
programmes;
knock-on effect on your sex life,
in
magazines
and
newspapers; on posters and on the
both in terms of your physical
internet.
capacity and the way
Sex is widely portrayed as
“natural”, and it is … however, natural
you feel about your body.
doesn’t necessarily mean trouble-free.
Although sex is a natural human
function, all kinds of problems and
2. Lack of information,
misinformation and sexual myths
situations can reduce our enjoyment of
sex, or stop it happening altogether.
Not knowing what to expect
This leaflet describes some of them, in
Not knowing what to do.
no particular order.
Since it is no longer taboo to talk about
sex in many communities the way it
1. Health problems
once was, we might imagine everyone is
well informed nowadays when it comes
Sexual problems can be caused by a
to sex.
This is not always the case,
wide range of medical conditions,
however; the amount and quality of
such as diabetes mellitus, multiple
sexual education young people receive
sclerosis, hypertension, arthritis,
can vary widely.
hormonal problems or heart disease
Mental health problems, such as
3. Problems in the relationship
depression, anxiety or psychotic
conditions, are another major cause
Feeling angry, bitter or resentful
of sexual dysfunction
towards your partner
Medications for a large number of
Fear of being rejected or hurt
physical and psychiatric illnesses can
No longer finding your partner
affect sexual functioning as one of
attractive, which may arise from
their side effects
changes in your partner, or from
Damage caused by accident or
changes in you – for instance, if you
pelvic surgery, such as radical
have begun to question your
prostatectomy or hysterectomy
sexuality.
Getting the most out of Psychosexual Therapy
Sometimes
a
problem
in
your
relationship causes problems with sex;
and enjoy sexual closeness
Lack of comfort, warmth or privacy.
sometimes it’s the other way around.
7. Substances
4. Negative feelings about sex or its
consequences
Use or misuse of alcohol, nicotine
and recreational drugs can all affect
Feeling guilty or bad about sex, or
sexual functioning.
that sexual acts are dirty or
disgusting
What keeps problems going?
Fear of getting pregnant
Fear of sex being painful or causing
If there are many different origins of
injury
sexual problems, there are two core
Fear of losing control, or of your
factors that are almost guaranteed to
partner losing control.
keep them going, even when the original
difficulty may be long past: performance
5. Negative feelings about yourself
anxiety
and
difficulties
with
communication.
Feeling unattractive, fat or unhappy
with your body
Performance anxiety
Internalised homophobia (negative
feelings about being lesbian, gay or
Nothing kills passion quite like worrying
bisexual)
about whether a previous problem will
Feeling depressed, worthless or that
recur, or whether you will be able to
you don’t deserve pleasure.
‘perform’.
For starters, feeling sexy
usually starts with feeling relaxed, and
6. Unsuitable circumstances
anxiety is the enemy of relaxation. Even
worse, if you are worrying about your
Fear of being caught, overheard or
performance, you will start to watch
interrupted
your sexual activity as though you are a
Feeling too tired, hurried or
spectator rather than a full participant –
preoccupied with other things, such
and the more you watch from the
as work or family worries, to relax
outside, the less you will respond.
Understanding Why Sexual Problems Arise
During your time at the Porterbrook, you
affects his ability to get an erection even
may find that your therapist sets definite
further, so he avoids intimacy even more
limits about how far you should and
… and so it goes on.
shouldn’t go in a love-making session.
At first, this might seem rather clinical, as
A problem in one partner can also spark
though you are having to make love “to
a sexual problem in the other, particularly
order”. It is really important that you
if each is making assumptions about
take your therapist’s advice seriously
what the other wants.
though, because it is designed to
example, a woman finds sex painful. Her
minimise performance anxiety, and help
partner might conclude it would be best
you learn again to enjoy the moment,
to ‘get it over with’ as quickly as possible,
without worrying about what is going to
in order to minimise her discomfort,
happen next.
without actually asking her if this is what
she wants.
Difficulty communicating
Let’s say, for
This may mean, however,
that she never reaches orgasm, and finds
sex ever less satisfying, meaning her
It can be terribly difficult to talk about
discomfort increases.
In response, her
sexual problems, but it is vital, otherwise
partner gets even faster, and may even
all kinds of misunderstandings can occur.
develop his own sexual difficulty, such as
Here’s an example:
rapid ejaculation or loss of desire.
A man starts to avoid sexual situations
You can see how easy it is for problems
because he is worried that he might
to snowball if they are not discussed.
struggle to get an erection. He changes
This is why we encourage couples to
the subject whenever sex comes up and
attend therapy together. If one of you
develops a sudden liking for late night
has a sexual problem, then you both do
television.
His partner starts to worry
– don’t be tempted to think ‘it’s his
that he has gone off her, or gone off sex
problem or her problem, it’s nothing to
– perhaps he’s having an affair! – and
do with me’.
becomes tense and irritable. He guesses,
wrongly, that she’s noticed his erection
Improving the communication between
problem and no longer thinks he’s a ‘real
you is likely to be one of the main goals
man’; his self esteem suffers which
of your therapy. Whether the issue is
Getting the most out of Psychosexual Therapy
specifically connected to the sexual
difficulties outlined at the beginning of
difficulty, or more general in nature,
this leaflet.
improving communication can help
experience sexual problems at some
resolve
and
point! This does not mean your
misunderstandings that so often cause
relationship is over, or is not a good one.
sexual problems, and then keep them
The existence of problems is not a sign of
going.
failure; it's a normal part of relationships.
the
resentments
All couples will probably
The crucial thing is to keep a positive
Next time you are tempted to think,
attitude and see problems as something
‘everyone else is having great sex - no
to be worked at, rather than as
one else has problems like we do’,
impossible hurdles that you will never be
consider the many causes of sexual
able to overcome.
Written by ROSE WHITELEY for the Porterbrook Clinic, Sheffield
© Porterbrook Clinic 2006
Understanding Why Sexual Problems Arise
NOTES
Getting the most out of Psychosexual Therapy
NOTES
Understanding Why Sexual Problems Arise
A2
© Porterbrook Clinic 2006