What is Psychosexual Therapy?
Psychosexual therapy is a talk-based therapy that helps you (and a partner if attending with you) understand and work through sexual difficulties, whether the cause is psychological, physical, relational, or a mix of all three. If you're struggling with a sexual problem, you're far from alone. Relate, the UK relationship charity, found that more than a third of British people have experienced a sexual problem at some point in their lives. Yet despite how common these issues are, sex remains one of the hardest things to talk about, even with a partner.
That's where psychosexual therapy comes in.
Talking therapy, nothing more
Psychosexual therapy is talk-based. There is no physical examination, no touch, and no nudity. I won't ask you to undress, and intimacy or sexual acts only ever happen in the privacy of your own home, never in a session.
This is worth saying clearly, because television and film often give the opposite impression. Psychosexual therapy is a space to talk, to understand what's going on, and to work through it together.
What does "psychosexual" actually mean?
The word breaks down into two parts. "Psycho" comes from the Greek for mind or soul, and points to a focus on thoughts, emotions and behaviour. "Sexual" covers the instincts, physical processes and intimate experiences connected to sex and attraction.
Put together, psychosexual therapy looks at how your emotional, psychological and physical experiences affect your sexual feelings and behaviour. It's an integrated approach that brings together psychosexual therapy, relationship therapy and broader psychotherapy, which is why it requires specialist training beyond a standard counselling qualification, including an understanding of how the body works and how medication or medical conditions can affect sexual function.
Most sexual problems are relational
Most sexual problems are relational, so coming with your partner, if you have one, is often recommended. Although a sexual difficulty often shows up as a physical symptom, the root cause is frequently psychological, relational, or a combination of both. A sexual issue can also be a sign of an underlying emotional block within a relationship rather than a problem with either person individually. Working through this together, with both physical and emotional threads in mind, is often where the real progress happens. But many single people come for help or prefer to come without their partner and that’s perfectly OK. We can still effectively work with your problem. I can help you learn strategies for managing sexual difficulties. Even though sex is a universal part of being human, it can often feel like one of the most personal, private parts of life and some people and couples feel ashamed about talking about sex. Most of us simply want reassurance that what we're experiencing is normal.
What we might explore together
Psychosexual therapy gives you the chance to talk about anything that concerns you sexually, whether that's about yourself, your relationship, or both. Sessions might cover:
What's troubling you, and how long it's been an issue
Patterns or "predisposing factors" from your past that may be contributing
How the issue is affecting you emotionally and within your relationship
Practical, gentle exercises you can try at home, alone or with a partner, to help build understanding, communication, and intimacy at your own pace
Common difficulties psychosexual therapy can help with
I work with a wide range of sexual difficulties, including:
Desire discrepancy — when partners have different levels of sexual desire, which is one of the most common reasons couples seek help.
Erectile dysfunction — difficulty achieving or maintaining an erection, which can have physical, psychological, or combined causes.
Premature ejaculation — ejaculation that happens sooner than a person or couple would like.
Delayed ejaculation — difficulty reaching ejaculation, even with adequate stimulation.
Genito-pelvic pain/penetration disorder (GPPPD), including vaginismus — pain or difficulty with penetration, often linked to involuntary muscle tension.
Anorgasmia — difficulty reaching orgasm, despite arousal and stimulation.
Sexual trauma — flashbacks and difficulties staying present in sexual situations.
Shame — shameful feelings around sex that make it difficult to enjoy a full sexual experience.
Compulsive Sexual Behaviours — acting out compulsively and breaching trust in relationships.
Fetishes and paraphilias — that are causing you or your partner distress.
These difficulties can be primary (lifelong), secondary (developed after a period without the problem), or situational (occurring only in certain circumstances or with certain partners). Understanding which of these applies to you is often a key part of working out what's going on and what might help.
Why these problems happen
Sexual difficulties rarely have a single cause. They can be:
- Psychological — anxiety, low self-esteem, depression, stress, or past experiences
- Physical — illness, surgery, medication, hormonal changes, or chronic conditions
- Relational — communication breakdowns, unresolved conflict, or mismatched expectations
These factors often feed into each other. A physical health issue might affect how desirable someone feels, which lowers mood, which in turn affects desire. Because of this, I take a broad view of what might be contributing to a difficulty rather than assuming a single, isolated cause. Where a physical cause seems likely, I may suggest a check-up with your GP alongside our work together, since conditions like erectile dysfunction can sometimes be linked to issues such as diabetes or cardiovascular health.
What you can expect from working with me
I have an MSc in Psychosexual and Relationship Therapy from Tavistock Relationships and am registered and accredited with the College of Sexual and Relationship Therapists (COSRT). COSRT is the UK’s only professional body dedicated to Psychosexual and Relationship Therapies. There's no touch and no physical examination in any session. We'll talk, and I may suggest exercises you can try at home, at your own pace, either alone or with your partner if you have one. These are designed to help rebuild the space for intimacy, which is often the very thing that's gone missing by the time people seek support. If you are single, they offer you the chance to explore sexual scripts and recalibrate your body’s responses.
The aim isn't just to resolve a single symptom. It's to help you explore and optimise your sexual self and relationship, build your confidence and self-understanding, and improve your sexual enjoyment and satisfaction more broadly.
You don't have to be in crisis to seek help
You don't need to wait until things feel unbearable. Whether you're navigating a long-standing issue or something that's recently emerged, psychosexual therapy offers a confidential, accepting space to talk it through and find a way forward, whatever that looks like for you.
Sources: This article draws on guidance published by the College of Sexual and Relationship Therapists (COSRT), Tavistock Relationships, Relate, Harley Therapy, and Counselling Directory.