Thoughts From The Couch – Let’s talk about sex

Although having sex is a perfectly natural part of life what I see in my practise how difficult most people find it to talk about. I have witnessed how sex is far more prominent now than when I was in my formative years. I recognise how the portrayal of sex in the mainstream mass media provides increasingly explicit and frequent images that keep sexual behaviour on public view and on personal agendas, yet rarely do we see sexually responsible standards represented. Perhaps not as prevalent for today’s younger generation, but in the private lives of my generation, many are still held hostage by old religious and cultural taboos.

What I see is just how much the images of sex so widely and explicitly available impact us all in one way or another. Overtly or subliminally, sex now appears to pervade everywhere: in magazines, and newspapers, erotic and romantic narratives about sex are found in abundance. Casts of films and characters in print and TV advertising appear naturally comfortable with sex that has no consequences. So what fate for those who lack strongly positive sexual self-images and beliefs? Can an individual be simultaneously sexually competent and sexually dysfunctional? Negative body image, lack of desire, the inability to lubricate or be orgasmic, erectile dysfunction – these issues are rarely touched upon and if there are, it is usually to the detriment to the person struggling. The media message is that sex makes you happy and healthy – and if it doesn’t there is something wrong with you.

My original training as a psychotherapist didn’t cover sex, sexuality, gender or relationship structures as topics. As I started out I noticed that it was rare for any of my clients to bring these topics to our sessions and that I never did. My upbringing tells me that sex is a private affair, something we do not talk about, not with family, friends and often not even with our partners. Reflecting back I see how my original training confirmed to me what my cultural and familial messages had been. Sex is a taboo subject.

My wish to broaden my practise meant that I had to take responsibility and do additional training to become a psychosexual & relationship therapist. I wanted to gain a much greater understanding of gender, sexuality relationship structures, along with psychosexual issues, knowing that It is not for my clients to educate and inform me. I took the opportunity to explore my own sexual shame and embarrassment, along with my fears and assumptions. I see how my additional trainings have served me well over many years. I have been able to develop a language that enables me to support my clients in sharing and learning about their sexual selves. Having faced my own shyness I am able to see my clients through unbiased, non-judgemental and tender eyes. 

Even though media portrayals of sex reflect an impractical, stereotypical, often commercial viewpoint, they are repeated so consistently that, for many, it is difficult to hold on to what’s real and not compare themselves with such unrealistic relationships and sexualised images, whether consciously or unconsciously. I work with clients addressing the comparisons made that result in an overwhelming sense of anxiety, shame and feelings of insecurity about self and partners, which inevitably filters through into sexual experiences and relationships in a negative way. 

A lot of my work is in the undoing of what the mass media projects as models of masculinity, femininity, sexuality or what it takes to have the kind of relationship that supports and encourages satisfying sex. We live in a culture that dispenses unrealistic expectations – in particular of both sexual performance and body image, influencing how people relate to their body’s function, its appearance and, ultimately, how we utilise our bodies sexually.

Many of my clients have not been raised in families or cultures where clear, accurate information was available or allowed, and therefore an element of their primary problem may be that they are battling with sexual ignorance, confusion and anxiety and that is when my role as educator comes in. I play a role in my client’s education by supporting them in understanding the physiological aspects of their sexuality, while at the same time witnessing their expectations, beliefs and taboos. It feels important to me that I am able to continually challenge stereotypical assumptions and expectations related to gender differences and sex.

It is little wonder that the topic of sex and sexuality is often laced with guilt, shame and embarrassment. As a result clients find different ways of broaching the subject. They will use the telephone so that I don’t see their face. They send emails, texts and sometimes cover their face or look away when speaking to me. They close their eyes, ask me to look away. They struggle to find words and stutter over sentences. Some are so embarrassed they can’t speak of their embarrassment. I want to be able to guide my clients as they voice sexual concerns, confront physical problems and alter perspectives. Some of what they bring are recent concerns, and for others secrets shrouded in shame that they have carried for decades. As we work together they learn that,‘normal’ sex is varied and that sexual problems are not uncommon and can often be resolved. I hold space for them, trusting my unique personality combining experience, attitude and artistry. After a while, they start to relax, they can look me in the eyes and it is as if we are talking about the most natural of things.

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