I had a letter published recently in Therapy Today that commented briefly on the previous month's edition of the same journal that contained several articles pertinent to psychosexual work. It was as if the mysteries of psychosexual therapy had hit the big time and had made it to mainstream print in the counselling and psychotherapy press. Not before time might I add. But these professional journals are for exactly that, professionals, who have a sense of the workings of therapy per se (even if by all accounts they might not dare to mention sex in the consulting room!). What about the layman, the un-initiated, the ordinary man and woman who contemplates the idea that they might have a problem that involves sex and begins wondering who to turn to for help and what that help involves? In my experience clients who seek me out, even those who don't mention explicitly the nature of the sexual concern in the first phone call, have registered my specialization and are relieved to talk about more intimate personal matters than perhaps originally envisaged. The majority have a specific sexual concern, say erectile dysfunction, genito-pelvic pain/penetration disorder, a relationship problem that involves sex or a sexual compulsion; none of these are exclusive by the way, they can exist in varying forms and combinations with each other. So for example penetration disorder can be part of a couple's sexual and relationship concerns. Invariably however clients tend to focus initially at least on their genitalia as if it were not a part of their holistic selves; so it is very common for men with rapid ejaculation to expect that focus will be primarily on their penis for the duration of treatment and that there will be an outcome of cure. Those men that realise that perhaps their initial expectations were a little too high are those that engage in a profound sense to confront their anxiety and thus their confidence. And couples say who have not had sex in years soon realise that confronting the sexual concern needs to be 'attached' to an increased understanding of the functioning of the relationship!

So I hope that I have clarified something here for those considering help with psychosexual concerns. Sex, by its importance in our lives and therefore discussing it when it's not working properly can be the powerful catalyst that releases the unconscious material that is often holding us back. If your concerns seem to be primarily sexual ones but you have a feeling from what you know of yourself and your life that there might be a 'bigger picture' i.e not just about your penis or vagina then sex therapy can be an extraordinarily potent path to growth, excitement and FUN!

One of the facets that distinguishes sex therapy from traditional talking therapy can be the inclusion of homework, practical exercises and relapse prevention plans for example. Positive outcomes inform me that this integration is the essence of psychosexual work.