This series tells fictional stories using made-up names of the journey people experience through counselling. Drawn from our counsellors’ extensive experience every client’s story is unique; what remains the same is our desire to helping you with who you want to be.
At the start
When Steve & Jen came to sex therapy, they were at a loss. Ever since their marriage 2 years ago, sex had always been painful – and now Jen had been diagnosed with vaginismus, a condition where the vaginal opening contracts too much to allow comfortable sex.
Sex therapy is quite different from counselling. Its purpose is to deal with the psychosomatic causes of sexual dysfunctions – in other words, the psychological and emotional factors that make sex difficult, painful or impossible.
So to start with, we talked in detail about their history from childhood.
Jen’s parents both worked when she was a child so after school and in the holidays she would go to her grandma’s house. Her grandma was much loved, however Jen picked up many negative ideas about sex from her. She considered sex to be dirty, not fun and painful – it was only to be within marriage and necessary for producing children.
Of course, these messages weren’t conveyed outright. They were ideas that Jen picked up and understood over time, and they shaped her expectations of sex.
Jen went off to university from an all-girls school. Suddenly, there were men around her who were interested in her. Something seemed to be going on that she didn’t understand: people seemed to be choosing to have sex with others they weren’t married to… Jen couldn’t quite compute her inherited understanding with the world around her.
She got together with Steve after university. At first, sex was ok, but over a few weeks it began to get more and more painful. It became a constant challenge and struggle in their marriage.
Steve & Jen have come to sex therapy because they want to find a way of having sex comfortably.
After covering their history, I make a treatment plan for them. This is another way sex therapy differs from normal counselling. In sex therapy, clients engage in a programme of exercises that begin to rewrite their relationship with sex, usually over the course of several months.
Jen & Steve are both surprised to discover that this plan starts with no sex at all. The plan begins with booking time with each other every week to engage in lots of physical, non-sexual contact.
One of these exercises I asked Jen & Steve to do is the sensate focus exercise. It’s about paying attention to the sensations in your own body as you touch your partner. So, when Steve strokes Jen’s stomach, what does her stomach feel like? How does it relate to what he sees? And for Jen, what does it feel like when Steve touches her? And then they swap over, with Jen stroking Steve’s stomach.
The sensate focus exercise is non-sexual, not intended for arousal, nor is it a massage. It is essentially a ‘selfish’ exercise.
Each time they complete the exercise, they can talk through with each other their experience and they take notes to share with me at our next session.
This feels very strange at first for Jen & Steve, but when we discuss the outcome of the exercise, they are surprised by the impact it’s had. It has built intimacy and connection between them that they have not experienced before. Jen also admits that knowing it wasn’t allowed to be sexual has helped her to relax and feel safe when Steve touches her.
It’s about trust all along the way. Trusting that your partner will not do something that you don’t want them to do.
As we continue to see an increase in the trust and intimacy between Steve & Jen, and carry their treatment plan forward, I meet with Jen individually. It allows us to explore together the impact of her background on her experience of sex. We begin to unpack and process her experiences and her emotions, creating space to reshape her thinking.
Progression through the treatment plan continues, always at the pace that Jen & Steve are both comfortable with – in both body and mind.
We begin to introduce some sexual elements to their relationship again. Steve now begins to understand the difference between intercourse and sexual intimacy. While intercourse describes the physical sexual encounter, sexual intimacy starts with complete trust and non-sexual physical intimacy.
Jen & Steve are finding for the first time that their sexual relationship is satisfying and enjoyable – even without necessarily having intercourse.
Over the course of their treatment plan, Steve & Jen have seen what they thought was impossible become possible.
And yet the most precious outcome for them is not that they can now comfortably have sex – but that they are enjoying a deep intimacy and trust in each other, of which sex is a part.
One thing clients realise over the course of sex therapy is the sheer complexity of sexual dysfunctions. It’s not a quick thing to fix. It’s wrapped up in so much history and emotion. It is far more complex than my clients ever foresee.
Journeying together with clients in unpacking and overcoming all the psychological and emotional barriers to a functional sex life – and seeing couples enjoy a wonderful intimacy and trust together – is tremendously rewarding.
Psycho Sexual Therapy (PST) is available for couples and individuals who face a wide range of sexual difficulties. This can be diagnosed issues, such as vaginismus or erectile dysfunction, or relational struggles caused by challenges in their sex life.
This story was told by Chris, a Relate Counsellor qualified in Psycho Sexual Therapy.