Sexuality is often an exciting and central theme when couples first start dating; yet, I encounter many instances where seemingly very well matched couples who continue to find each other attractive just don’t get what they need from their sexual relationships.

Our modern lives which may have young children, heavy work demands and day to day stresses often leave little space for reflecting on our sexual needs, in fact the very idea of sex may be ‘just one more extra demand’.  Imbalances in libido between partners can mean that avoidance for one partner may lead to feelings of rejection for the other, and once sexual patterns are disrupted and spontaneity is lost, couples can find it next to impossible to break this vicious cycle and get things back on the rails, without some assistance.

In working with clients in regard to sexual issues, I feel that to be ethical the work has to arise from the client’s experience of how they feel about their sexuality and what they feel safe sharing, and if working with a couple then sometimes what they don’t want is just as important as what they do.

Becoming stuck in a sexual ‘rut’ can have a significant effect on relationships, and unfulfilled needs can lead to anger and infidelity, which can shatter relationships and families.  Ideally clients come to me before their relationships suffer any significant damage or rupture.

Life stages can have their own challenges for both men and women.   For many women having children is a huge part of their identity but can leave them less able and even less inclined to invest in the sexual aspects of their relationship.  As well as the demands that children naturally make on the parents, their very presence in the house can introduce worry and fear of detection often arising from taboos surrounding sexuality.  Such worries, interruptions and anxieties can kill spontaneity and make initiating sex very difficult even resulting in partners giving up on initiating sex through fear rejection.

It is very common for sexual challenges to arise due to experiences which pre-date the current relationship, which can range from how our parents viewed intimacy and whether there is any aspect of shame surrounding sex, it can include concerns about body image, and the impact of sexual abuse and rape in earlier life which may go unshared and unspoken.  Being a survivor of sexual abuse is a very difficult thing to carry, with shame and self-blame being natural; moreover, when hidden and unaddressed such awful experiences can be toxic to sexual relationships especially when other challenges such as children are introduced.  Often the partner of a survivor may not understand why advances may be rebuffed and can start to read between the lines, knowing something does not fit but unable to work it out.  Typically partners and families of survivors can become unknowing ‘secondary survivors’, with inexplicable responses leaving them confused and doubting themselves.

The menopause is a significant life change for all women, and can have a huge impact on body image, and mood often over a number of years, but conversely may have an increase in sexual libido!  In men life changes may bring up sexual issues surrounding Erectile Dysfunction (ED) and difficulty orgasming.  Although amazing drugs are available for ED, their introduction to a relationship can actually cause big problems if the relationship is not well grounded; as the man who may have struggled with sexual performance for years may suddenly find super human stamina, which although liberating can cause problems if his partner’s needs and appetites are not understood and respected.