What does psychosexual therapy involve

Deborah C. Escalante

Media stories, documentaries, and movies often give the impression that sex therapy is a hands-on profession and includes the actual act of sex or a display of some kind of intimacy. But nothing could be further from the truth.

Experiencing psychosexual therapy

I spoke with a psychosexual and relationship therapist, Albertina Fisher, who told me how psychosexual therapy focuses on talking about our preoccupations, thoughts, and emotions when being intimate with ourselves or our partner.

Tao Heftiba on Unsplash

Source: Tao Heftiba on Unsplash

Albertina reassured me that there is no sexual act or performance of intimacy of any sort during therapy sessions. These sessions are all about talking. In fact, the only expectation of intimacy is in the form of tasks set and agreed upon during sessions and done in the privacy of the client’s own home. What a relief.

But how can homework or scheduled intimacy help us overcome our sexual difficulties? In the past, we have probably relied on spontaneity to ignite our passion.

Albertina tells me that these tasks or homework are not set for the purpose of completion, returning the result to be marked, as if we are back at school.

The tasks are meant to help us create the space in our relationship with our partner or ourselves for intimacy to happen. By the time we are ready to look for help, this is often the very thing that is missing and so difficult to re-establish by ourselves.

How challenges are worked with

Psychosexual therapy has its challenges and clients often find themselves surprised at the obstacles they face. Whatever these may be, they are talked about as they happen, which makes psychosexual therapy more than just a set of tasks to be completed.

This type of therapy is a gentle though intriguing journey that explores an area of our lives we rarely have an opportunity to consciously develop. As adults, we are expected to know about intimacy and how it’s done.

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The issues brought to psychosexual therapy

Some of the issues that are typically seen in psychosexual therapy range from low libido or erectile disorder to more complicated issues linked to past experiences or medical conditions. In fact, any reason why we are not experiencing intimacy the way we would like to is a good enough reason to seek psychosexual therapy.

We might believe that psychosexual issues predominantly affect the older age groups. Surprisingly it is becoming more common for younger people to experience sexual challenges and to seek the help they need. Often symptoms are caused by stress and expectations of life, catapulting us into a state of anxiety, which of course can be an antidote to passion.

Why seek psychosexual therapy?

Sex is part of an intimate relationship, and even if we choose not to engage with sex, it is a part of who we are. When there are sexual issues, the knock-on effect for individuals and relationships, if these are left silenced and untreated, can be devastating.

Of course, the prospect of talking about one’s own sex life, especially when it isn’t working the way we would like it to, can be excruciating. We might prefer to let the issues stay hidden or we try to ignore them, hoping the symptoms will disappear by themselves. But hidden issues have a tendency to show themselves in ways that can be damaging to our self-esteem and will no doubt affect our daily experiences of life.

Encouraging messages

The two most important messages that came out of our conversation were:

  1. Psychosexual therapy can help with any kind of intimacy difficultly we experience regardless of whether it is caused by medication, by a physical condition, or if it is completely natural, seemingly with no explanation.
  2. Psychosexual therapy is a specialised therapy. The therapist will be trained not only in a therapeutic discipline but will have a knowledge of how our bodies function and the medical conditions that can affect our sexual performance and will be educated in the research focused on sex, sexuality, and intimacy. For this reason, it is important to make sure that the therapist we see is qualified to work therapeutically with sex and intimacy.
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Finding the courage to make an appointment with a psychosexual and relationship therapist might seem unthinkable. However, I am convinced that once we start the conversation in this therapeutic space, we will benefit more than we can imagine.

What is psychosexual therapy?

The aim of psychosexual sex therapy is to help you improve the physical intimacy between you and your partner and overcome or manage any sexual difficulties you’re having. Psychosexual therapy is designed to help support you to feel more comfortable when having sex. 


Psychosexual Therapy involves the examining the mind to understand the physical and emotional factors that can sometimes cause sexual difficulty. It is brief interpretive therapy using history and examination to explore unconscious thoughts and feelings.

Why do people have psychosexual therapy?

Lots of people have a problem when trying to have sex at some point in their life. Some people can help themselves and resolves their sexual difficulties. For some, sexual problems can cause a lot of unhappiness and distress.

What can Psychosexual therapy he used to treat?

There can be various causes for sexual difficulties and psychosexual therapy can be used to identify them. The various causes for sexual difficulties and origins may be:

  • psychological (depression, anxiety or other mental health conditions)
  • physical (illness, disability/chronic illness, surgery, accident or medications)
  • emotional (unresolved grief, unhappiness in the relationship)
  • situational (certain situations or environments)

Psychosexual therapy can be done to treat a range of common sexual problems. Psychosexual therapy can help with various sexual problems. These include:

  • Loss of libido
  • Painful sex
  • Vaginismus
  • Vulval pain
  • Orgasm problems
  • Erection problems
  • Premature ejaculation or delayed ejaculation
  • Relationship issues as a result of sexual difficulties
  • Tokophobia (fear of child birth)
  • Vulvodynia
  • Persistent unexplained vaginal discharge

What happens in a psychosexual therapy session?

A specialist will listen to you describe your problems and assess whether the cause is likely to be physical, psychological or both.

Each therapy session is confidential and you can decide to see a sex therapist by yourself or with your partner, it may be better for you both of you to attend.

Talking about your experiences will help you get a better understanding of your situation. The therapist may also give you tasks and exercises to do with your partner in your own time.

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Sessions usually last for 30 – 50 minutes. You may be advised to have weekly sessions or to see your therapist less frequently, such as once a month.

What can be done to prepare for psychosexual therapy?

You may like to write a list of problems related to your sex life and try and identify what may be causing them, prior to beginning your psychosexual therapy sessions.

A sex therapist helps people with sexual problems.

Sex therapists are qualified counsellors, doctors or healthcare professionals who have done extra training in helping people with problems relating to sex.

Why do people have sex therapy?

Lots of people have a problem with sex at some point in their life. Some people can help themselves. For others, sexual problems can cause a lot of distress and unhappiness.

A sex therapist can help people with various sexual problems, including:

  • lack of desire
  • difficulty having an orgasm
  • pain during sex or inability to have penetrative sex
  • difficulty getting or keeping an erection (erectile dysfunction)
  • premature ejaculation or other ejaculation problems

What happens in a sex therapy session?

A sex therapist will listen to you describe your problems and assess whether the cause is likely to be psychological, physical or a combination of the two.

Each therapy session is confidential. You can see a sex therapist by yourself, but if your problem affects your partner as well, it may be better for you both to attend.

Talking about and exploring your experiences will help you get a better understanding of what is happening and the reasons. The therapist may also give you exercises and tasks to do with your partner in your own time.

Sessions usually last for 30 to 50 minutes. The therapist may advise you to have weekly sessions or to see them less frequently, such as once a month.

How can I find a sex therapist?

If you have a sexual problem, it’s a good idea to see a GP first as they can check for any physical causes. The GP can refer you to a sex therapist if they think it will help you. However, sex therapy is not available on the NHS in all areas, and an NHS clinic may only offer a limited number of therapy sessions.

You can also find a sex therapist privately, which you’ll need to pay for. It’s important to see a qualified registered therapist. Look for one who is a member of the College of Sexual and Relationship Therapists (COSRT) or the Institute of Psychosexual Medicine.

Organisations such as Relate also offer sex therapy for a fee.

Read the answers to more questions about sexual health.

Page last reviewed: 9 December 2019
Next review due: 9 December 2022

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