Sex Therapy & Problems in the Bedroom

  • Sex therapy is a service offered by marriage counsellors and sex therapists to couples experiencing issues with sex, physical intimacy or sexual dysfunction.
  • Common sexual issues experienced by couples include a low libido, lack of sex, and disparity between sexual desire. Most of these issues are dealt with by marriage counsellors. A marriage counsellor or sex therapist can help a couple improve their sex life and restore lost intimacy.
  • Sometimes a Marriage Counsellor may refer you on to a medical specialist or a specialised Sex Therapist to check that there are no physical or psychological barriers impeding your capacity to be sexually intimate.

Couples often attend marriage or relationship counselling citing problems with sex or sexual intimacy. In fact, research shows that more than 60% of couples who are seeking couples counselling report significant sexual issues (1). Sometimes couples are concerned they’re not having enough sex or no sex at all, or there may be a disparity in their libidos. Sometimes there are physical problems which cause sexual difficulty, and often there are emotional, psychological or cultural barriers which stand in the way of being sexually intimate. Often a couples problems in the bedroom can be symptomatic of an underlying lack of emotional intimacy between the partners.

Sex and sexuality is a sensitive topic for many people and talking about your sexual needs and concerns with a partner can feel awkward, intimidating or even embarrassing. But most people agree that sexual intimacy plays a vital role in a romantic partnership, with research finding that 71% of those surveyed considered sex to be important in maintaining a healthy relationship (2).

Sex Therapy is a service offered by marriage and relationship counsellors which is specifically focuses on improving a couple’s sexual relationship. There are many misunderstandings and misconceptions about what sex therapy entails and how it can help a couple, and you should make sure that your therapist is a qualified psychologist or counsellor before making an appointment. If you have tried counselling for sexual issues with a marriage counsellor and have not succeeded you may benefit from the services of specialised Sex Therapist.

Sex Therapy is not the same as Sexual Surrogacy. Sex Therapy sessions are always held in an office usually involve talking with the sex therapist or couples counsellor about the problems you are having in your relationship – with a focus on sexual issues. Sometimes even a qualified marriage counsellor will need send you for further assessment to see if there are any physical causes underlying your problems and will be able to refer you to a medical practitioner if there is any doubt.

A marriage counsellor or sex therapist may give you assignments to be completed during the week that will encourage physical or emotional intimacy and thereby enhance the goals of the couples counselling. There is no touching involved in legitimate and ethical sex therapy, unless it is touching between the couple and they are fully clothed during the entire session.

Some Australian universities and colleges offer specific courses in Sexual Therapy or Sexual Health to psychologists and marriage counsellors. Most experienced marriage and relationship counsellors should be able to assist you with your sexual issues as well as any other relationship issues you may be experiencing. Many qualified marriage and relationship counsellors have studied sex therapy and offer a sex therapy service, even if they don’t have specific qualifications in the area. A marriage counsellor who only deals with sexual issues will most likely identify as a Sex Therapist whereas most marriage counsellors also deal with sexual issues as well as other relationship matters. At times a specialist referral will be indicated by a marriage counsellor.


There are many reasons why couples seek help from a marriage counsellor or sex therapist regarding their sex life. Common issues include:

  • Lack of Sexual Desire

    A low libido can sometimes be caused by external pressures such as stress or exhaustion, as a side effect of certain medications, as a physical reaction to menopause, pregnancy or other hormonal changes, or as a symptom of a disconnected relationship. Sometimes a lack of sexual desire is not considered to be problematic for a couple, but more often than not, one or both people in the relationship long to improve the situation and enjoy a better sex life. (This article is electronically protected – Copyright © Associated Relationship & Marriage Counsellors Sydney)

  • No Sex

    Sometimes a low libido or inhibitions around sexual activity will result in a couple having little sex or no sex life at all. It is not uncommon for couples in this situation to go months without sexual intimacy, if not years. This situation fuels feelings of frustration, guilt and embarrassment, and often leads to intense dissatisfaction with the relationship and the risk or fear of infidelity. Couples who are having little or no sex often avoid talking about ‘the elephant in the room’ and find themselves withdrawing further and further away from each other. A lack of sexual intimacy can also result in lost emotional connections between a couple. Recently published in Australia, the Sex Diaries by Bettina Arndt explored the vast degree of sexual dissatisfaction between many couples.

  • Dissatisfaction with Sex

    Sometimes one or both people in an otherwise loving relationship find that they are unable to enjoy their sexual activity. This may be a result of certain emotional, psychological or cultural barriers which are impeding a person’s capacity to enjoy physical intimacy, or it might be because a discomfort with physical intimacy has restrained healthy sexual experimentation and led to a stale sex life. A person might have trouble achieving orgasm, or may orgasm too quickly. A marriage counsellor or sex therapist can advise or refer on for help with these issues and help you determine what might be causing the problem.

  • Erectile Dysfunction

    Or problems maintaining an erection or getting an erection. This is often a physical problem which might need medical attention. A sex therapist or marriage counsellor will be able to refer you to a doctor if necessary.

  • Disparity of Sexual Desire Between Spouses:

    Married couples often present to marriage counselling with a disparity in sexual desire. One party to the relationship wants more sex, the other wants less. One is happy with the status quo, the other is dissatisfied. For most people, sexual intimacy is an extremely important aspect of their relationship and for some, it is an essential component of a healthy and happy relationship. Like any other aspects of your marriage or relationship, getting the right balance of sexual intimacy for your relationship requires negotiation, commitment and compromise and these discussions can benefit greatly from the input and mediation of an experienced marriage or relationship counsellor.

  • Sexual Identity

    If one person in a relationship is confused about their sexual identity, this can have obviously have a massive impact on their ability to be sexually intimate with their partner. If you think you might be confused about your sexual identity, you might wish to attend counselling individually to help you work through your feelings and understand your sexuality better.


John and Melissa were married when they were in their mid-30s. Although John knew that Melissa had a difficult childhood with an abusive father he did not fully understand the impact on her until she began working with a therapist in individual therapy and she began to withdraw into herself. Although Melissa had been sexually active and highly sexual when they were first married, the more involved her personal therapy became, the less she seemed to want to have sex. Finally, completely frustrated, he suggested that they see a marriage counsellor and talk about their sexual problems.

When they first began working with Terry, Melissa was quite open about being in individual therapy and that she was working on issues about her childhood and her father. However, when she began talking about sex, she began to have problems talking. Terry gently asked if her father had forced her to have sex and Melissa tearfully nodded her head. Shocked, John suddenly understood what the problem was and felt angry at what she had gone through.

Terry was able to help John not only understand what Melissa was struggling with, but also model communication skills for them and help them improve their emotional intimacy. One of the assignments she gave them was for John to touch and massage Melissa every place on her body except her genitals and breasts. The goal of the assignment was to make it acceptable for Melissa to relax with being touched intimately without feeling pressured to be sexual. When they returned the next session, Melissa reported that removing the underlying sexual agenda from being touched had helped her relax and she had actually felt an interest in sex that she had not felt in quite some time. She expressed that she continued to still feel some reluctance to fully be sexual, but that she felt this was a good step in the right direction.

After several months of patient and slow progression, John and Melissa were able to resume their sexual relationship. They continued to see Terry occasionally while Melissa continued her individual therapy for check-in and to re-establish and reinforce their connection.


If you and your spouse are experiencing problems in your sexual relationship, you may benefit from talking to one of our professional, ethical and qualified marriage counselling associates. Some of these therapists have a specialisation in sex therapy and all of our marriage counsellor associates are experienced working with common sexual issues.

If you would like to schedule an appointment or receive further advice, please contact Associated Relationship & Marriage Counsellors Sydney.


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