Compulsive sexual behaviours

Compulsive Sexual Behaviour is a term that broadly means an intense focus on sexual fantasies, urges or behaviours that can’t be controlled. This can cause distress and problems for your health, job, relationships or other parts of your life.

Compulsive sexual behaviour may involve different kinds of commonly enjoyable sexual experiences. Examples include masturbation, having multiple partners or using pornography.  But is these things become a constant focus in your life or are difficult to control, cause problems in your life, or are harmful to you or others…then it is likely that you are facing a compulsive sexual behaviour.

Specialist therapists can help you:

• Understand the impact of compulsive behaviours
• Manage behaviours and understand their origins
• Deal with impacts on relationships and partners

Chemsex refers to using drugs as part of sex life.  It is most common amongst gay and bi men but not exclusively.  Psychosexual and Relationship Therapists can get involved in assessment, planning and treatment protocols including: 

• Understanding the underlying causes of Chemsex
• Making a Chemsex Care Plan with you
• Understanding Chemsex treatment protocols including clinical interventions

Sexual desire is a universally experienced sexual response and concerns with sexual desire, whether high or low, are common. Sexual desire discrepancy, where one member of the couple has higher or lower sexual desire relative to their partner, is one of the most frequently reported sexual concerns for couples and has been shown to be negatively associated with sexual and relationship satisfaction and overall well-being.

Maintaining sexual desire in long term relationships is a struggle for many and sexual desire discrepancy may be an inevitable occurrence over the course of a relationship.

Specialist therapists can help you:

• Understand the different types of desire
• Explore how sexual desire discrepancy functions in a relationship and the impact it has
• Mitigate sexual desire discrepancy and problematic sexual desire

Having a physical or intellectual disability doesn’t change sexuality, the desire to express it, or the emotions that can go with it. In fact, the World Health Organization says that sexuality is a basic need and aspect of being human that cannot be separated from other aspects of life.

If your disability impairs your physical ability to engage in a regular sex life, or makes you lack confidence, you may feel worried about having sex. Lots of people – with or without a disability – have anxiety about sex and sexual performance, and these feelings are completely natural.

A specialist therapist can help you tackle issues such as:

• Worries about finding a partner.
• Worries about whether your partner will find you attractive.
• A lacking of confidence about sexual abilities or performance.
• Concerns about how your body moves or works.
• Anxiety over your partner’s feelings about you.
• Fear over pain during sexual activity.
• Worries about what others will think, and about discrimination.

Disordered eating

Eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding or eating disorders (OSFED). It is estimated that between 1.25 and 3 millions people in the UK are affected by an eating disorder with around 25% being male.

Most develop during adolescence the most common age range being 16-40 years old, though increasingly cases are seen in younger and older age groups. Research suggests that individuals who have family members with eating disorders are more likely to develop disorder themselves.

An eating disorder is a form of communication, wordless and hard to interpret, usually aimed at someone in the household. It is an indication of distress and needs to be put into words that can then be discussed, processed and worked on to facilitate an outcome.

This process is made difficult because even if the target can be identified, the disordered eater rarely knows what it is about in that the disorder is at an unconscious level.

Specialist therapists can help you with a range of issues such as:

• Making the purposes of the disordered eating conscious.
• Attending to the underlying issues related to relationships.
• Managing the disorder within the couple or family by other and less destructive means.

Domestic violence and abuse is devastating and has huge impacts on couple relationships, including same-sex and trans couple relationships. There are dynamic natures to couple relationships that can give rise to violence and abuse. Intervening safely in couple relationships where there is violence and abuse is vital and specialist therapists can help. 

Specialist therapists understand definitions and typologies of violence and abuse.  They understand the nature of violence and abuse within couple relationships, including sexual violence.  They know about the potential differences concerning same-sex and straight couple violent and abusive relationships.

‘Erectile difficulties’ means that men have difficulty in obtaining and maintaining an erection, which makes penetration difficult or impossible.  In some cases an erection is never achieved.  This can be very upsetting for the sufferer and their partner, who often feels to blame and so the stress cycle becomes greater.

If there is no medical reason for the erectile difficulties, then Psychosexual and Relationship Therapy combined with a cognitive behavioural approach can be extremely effective in bringing about rapid improvement. 

If there are medical reasons why erectile difficulties have occurred, Psychosexual and Relationship Therapy can still be very helpful in helping the man explore way of adapting his sexual practice to manage the difficulties.

Often partners can be involved in these sessions.

Infidelity

Infidelity is at its core, the breaking of a promise to remain faithful to a romantic partner.  That is most often understood as a physical act.  But depending on people’s beliefs and boundaries, it can include things such as emotional infidelity – where someone in a relationship has a level of emotional intimacy similar to romantic relationships with someone else.  Or it may be a partner using pornography or online technology to build a form of relationship with someone.

Infidelity is quite common.  It can present big psychological challenges.  And it can raise a range of questions to try and answer.  Issues that a specialised therapist can assist you with include:

• Understanding what monogamy means to you alone or as part of a couple.
• What kinds of affairs there are and what might trigger them. 
• Whether extra-marital sex is a problem?
• Dealing with the negative effects & consequences of an affair.
• How to deal with anxiety after you have experienced an affair.
• Lies, secrecy and confrontation.
• Rebuilding a relationship after an affair.

Involuntary childlessness can have diverse and significant effects on those impacted.  Effective therapy, with a practitioner aware of how this life changing issue affects lives can be vital. 

Specialist therapists can help you

• Deal with the disenfranchised grief of involuntary childlessness and what it means for you and others affected
• Explore impacts on emotional and sexual intimacy
• Develop strategies to rebuild intimacy

For many people sex and sexuality is an important factor in their quality of life.  Yet for many they face challenges during and after a range of medical treatments and interventions from cancer treatment to operations or certain drug use.

Depending on you and your intervention, you might find treatment or its effects or even the illness itself changes your body image affecting the way you feel about yourself and sex.  Some people lose interest in sex and feel very tired. But some people say that they want to have sex more than usual. If you are in a relationship, a crisis can sometimes bring couples very close together.

Specialist therapists can help you explore, understand and address challenges such as:

• Changes to your self esteem
• Communicating with others
• Coming to terms with changes to your body
• Sexual dysfunction arising from treatments

Orgasm Difficulties

Many individuals – both men and women – experience difficulties in achieving an orgasm, and there are some individuals who rarely or never orgasm. Whilst not all individuals need or want to orgasm to enjoy their sex lives, you may find yourself in a situation where would like to achieve orgasm with your partner or yourself.

Specialist therapists can help you:

• Dispel myths around orgasms
• Develop strategies to understand your body and mind
• Build programmes leading to you being able to orgasm in time

Couples and individuals face a range of developmental challenges through pregnancy, birth and beyond. There are a range of emotions and challenges facing couples as they prepare for parenthood.  And there can be huge impacts of children on the couple relationship.

Given the changing nature of intimate family relationships in the context of wider society, therapists pay attention to the ways in which couples as parents negotiate their way through the transition.

Specialist therapists are able to work with diverse representations of family life (contrasting these with traditional notions of family constellations with an emphasis on the heterosexual conjugal unit, rooted in marriage and co-residence).  Whilst they can also help tackle issues such as the idealisation of motherhood and its impact on the couple in the context of parenthood.

Complex PTSD (CPTSD) can have a range of impacts on people’s relationships and sexual function.  Repeated interpersonal trauma impacts on the brain and body in significant ways and therapists with specialist training can help:

• Understand Complex Trauma and the Brain
• Explore and identify symptoms of CPTSD
• Carry out Trauma-Focused Therapy

Sexual Trauma

Sexual trauma is incredibly common, and it often negatively influences the sexual and romantic lives of survivors. Taking time to heal, finding ways to work through the trauma, and creating strong coping mechanisms during recovery from sexual trauma is important, but what happens after that? How does one gain a positive relationship with sex after the experience of sexual trauma or move into a healthy sexual relationship?

Therapists know it is crucial to consider the sexual lives of survivors of sexual trauma beyond the trauma itself, especially as it relates to the pursuit of sexual pleasure.  There is solid research for professionals to build their work on when exploring sexual pleasure after experiencing sexual trauma.  Critically, this includes approaches to creating a clinical space that provides an opportunity for clients to explore their own sexual pleasure, feel empowered by their sexual autonomy, and be open to healthy sexual relationships with others.

A specialist therapist can help you deal with a range of issues including:

• The impacts of sexual trauma on your ability to access sexual pleasure.
• How you can navigate communicating your experiences of sexual trauma to future or current partners.
• Strategies for pursuing a healthy pleasure-filled sex life post-sexual trauma.
• The role of lifelong sexual health education in navigating a healthy sex life after experiencing sexual trauma

Technology

Technology has become ubiquitous in people’s lives, and the Internet has a huge role in people’s romantic relationships, often social media in particular.

Specialist therapists can help you:

• Approach online dating in a rewarding and healthy way
• Understand the distracting effects of technology
• Explore how and why your might present your romantic relationships on social media
• Understand jealousy and interactions with ex-partners on social media