Many people wait a long time before they speak about sex, desire or intimacy. Some feel embarrassed. Others assume the difficulty is theirs alone, or that it will settle without help. Psychosexual therapy offers a structured, confidential space to look at these concerns with a qualified professional.
If you are considering it, this article explains what the work involves, who it tends to help and how it can be accessed online. If you would like to talk about your own situation, you can request an appointment.
What psychosexual therapy is
Psychosexual therapy is a form of psychotherapy that focuses on sexual wellbeing and the emotional, relational and psychological factors that shape it. It draws on the understanding that sexual experience is connected to mood, self-esteem, past experiences, relationship patterns and physical health.
The work is collaborative. You decide what you want to talk about, at what pace, and what you are ready to explore. A psychosexual therapist does not tell you how your sex life should look.
For more on the service itself, see the psychosexual therapy page.
Common concerns it can address
People bring a wide range of questions to psychosexual therapy. These can include:
- Difficulties with desire, or a difference in desire between partners
- Erectile difficulties, and anxiety about sexual performance
- Pain or discomfort during sex
- Changes in sexual confidence after illness, stress, bereavement or a major life change
- Concerns about intimacy, communication and physical closeness in a relationship
- Questions about sexual identity, orientation or past experiences
Some of these concerns have a physical component. A psychosexual therapist can help you think about when to involve your GP or another medical professional, and will not try to replace medical assessment.
How the sessions work
Psychosexual therapy usually begins with an initial conversation about what has brought you to therapy and what you hope will change. From there, the work may involve exploring thoughts and feelings around sex, looking at patterns between partners, and considering practical steps that can be tried between sessions.
The pace is set with you. Some people want to focus on one specific concern. Others find that several connected issues become clearer as they talk.
For couples, sessions may explore communication, expectations and the way each partner experiences closeness. You can read more about the approach on the couples and relationships page.
Why performance anxiety matters
Worry about performance can become a pattern in its own right. Once a person begins to monitor themselves during sex, attention moves away from connection and pleasure, and the worry itself can make difficulties more likely. Therapy can help to loosen that cycle by making the anxiety easier to understand and by reducing the pressure around sex.
We explore this in more depth in our related article on performance anxiety.
Is it right for me?
You do not need to have a diagnosis, a particular relationship status or a clear explanation before you begin. Many people come with uncertainty, and part of the work is making sense of it.
If you are based outside the United Kingdom, please check whether online therapy is available and suitable in your location before booking, as this varies by jurisdiction.
Working online
The practice is online only. Sessions take place by video, which allows you to speak from a private space of your choosing. For more on privacy and what to expect from online work, read is online therapy safe and confidential?.
About the practice
Justin Duwe is a BACP Accredited psychotherapist and sexologist with more than 21 years of clinical experience. He is the author of The Truth About Chemsex. You can learn more on the about page.
Taking the next step
If you would like to explore whether psychosexual therapy could help, you can request an appointment. There is no obligation to continue after a first conversation, and you can take the time you need to decide.
This article provides general information and is not a substitute for medical advice. If you are concerned about your physical health, please speak to your GP.