I completed a training in Psychosexual and Relationship Therapy in 2011 and have been working with clients who have sexual difficulties since then.
The following are fictional examples of what you might want to discuss, how we might work together, and what the outcome could be:
A man in his early 30’s is looking for a girlfriend, he has little sexual experience, has experienced loss of erection prior to and during penetrative sex.
I suggest an exercise for him to do at home called stop start, which is done with masturbation. This helps the client to realise that if he loses his erection, he can easily get it going again. This enables him to become more confident and less anxious about losing it.
He practises the exercise at home throughout the duration of our talking therapy sessions.
We explore his adolescent experiences and his parents’ attitudes towards anything sexual. He identifies a couple of experiences which had created some anxiety about being a sexually assertive man. We continue to work together whist he finds himself a girlfriend and before long he is confidently having good sexual experiences with her. He rarely loses his erection but if he does, it does not worry him anymore, and between them his erection can be revived without difficulty.
A couple are planning to get married, the man is a clever and successful business man. However, in his intimate relationship he is far less confident. The woman is also a high flyer who is confident and more sexually experienced. Together I guide them through a fair amount of analytic work on their histories and we explore how their relationship works. Although she appears very confident and relaxed, underneath we find that she is quite anxious and controlling. He finds her very controlling and is a little scared of her.
When we unpick the dynamic in their relationship, he finds he could be more penetrative in and out of bed and they were much happier as a result.