Sex forms a focal point of many powerful internal and external forces in human life. Indeed the grandfather of psychotherapy, Sigmund Freud, saw a healthy sexual expression as central to psychological wellbeing. So while a fulfilling sex life can contribute to overall wellbeing, a compromised sex life can contribute to depression, anxiety, relationship problems or other psychological distress.
Now humans are complex, and the process of fantasy, attraction, love, desire, arousal and fulfillment are rather individual and particular. Similarly motivations for sex are many an varied including emotional closeness, reassurance, self-esteem enhancement, stress reduction, partner manipulation, protection from partner's negative affect and behavior, power exertion, physical pleasure, nurturing one's partner, and procreation. So it is all rather a jigsaw, depended on many personal and interpersonal factors.
So while we can surf the web and get any amount of information on virtually any aspect of sexuality, the topics of sex and intimacy continue to be difficult for many to talk about or resolve by themselves. Sexual issues may well be intertwined with emotional, psychological, relational, cultural or even medical issues. For this reason, your therapist is likely to take a holistic approach, viewing any particular issue as just one aspect of your overall wellbeing.
Two important aspects of sexuality is sexual orientation and gender identity. While attitudes to sex, sexuality and gender identity have changed considerably over the past few decades, exploring these areas can still be a confusing process. These issues can be especially difficult for those who discover their sexuality or gender identity later in life, when they are in a relationship, or have been brought up with particular family, religious or cultural beliefs.
At some point in life, most people experience some sexual issues. Sometimes these will persist and become distressing. Sometimes these are best resolved in individual therapy, sometimes as a couple, sometimes as a combination of these. It is not uncommon for couples to come in together for a few sessions then one or both partners decide to do some individual work (or vice versa). More common issues include:
The internet and mobile phone apps have created wide availability and diversity of pornography and sexual opportunities providing an environment where pornography and problematic sexual behaviours are an increasing concern for many men and women of all ages, both in and out of relationships.
Indeed the technological changes may be viewed as a new sexual revolution, similar to the sexual revelation of the 1960s. Like all revolutions this is creating considerable social upheaval, both in the older generation, particularly in established relationships, and in the millennial generation of digital natives. In this time of change, many people are finding themselves in confusion and distress with few road signs to guide them. Indeed, many therapists are still catching up. That said here are some general guidelines of where to seek help: