This document discusses working with sex in a therapeutic relationship. It explores how sexuality is influenced by childhood experiences, culture and society. It also examines topics like gender roles, sexual dysfunction, pornography and maintaining desire in long-term relationships. The document aims to help therapists understand sexuality and its complex influences in order to better help clients.
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Sex on the Therapy Couch: Working with Sex in the Therapeutic Relationship
1. SEX ON THE THERAPY COUCH:
Working with sex in the therapeutic
relationship
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
2. âThe study of sex is
the study of the
beginning of all life,
and science holds
the key, and yet we
sit huddled in the
dark like prudish
cavemen filled with
shame and guilt,
and the truth is,
nobody
understands sex.â
Masters, 1956
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
3. âItâs a pity that sex is such a dirty little word.â
- D. H. Lawrence
⢠Whether we love it or loathe it, we canât escape
fact that we were created by it, came out of it,
indulge in it and itâs on our minds, for better or
worse.
⢠Sex is a topic of conversation between the sexes
for titillation, entertainment, for something
seriously educational and for something personally
intimate.
⢠It may be overtly public or deeply private, but sex
is always on and in the mind.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
4. ⢠Despite a seemingly liberated culture, there is still
much shame, stereotyping and ignorance
surrounding sexual issues.
⢠This can be true of the counsellor as not all training
exposes trainees to sexual issues and to exploring
their own sexuality and prejudices.
⢠As therapists we must notice our values and
assumptions; develop an understanding and
perspective of our sexuality as a vital force in ours
and clients lives.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
5. ⢠We cannot easily apply the label ânormalâ to
sexuality. Does that mean âusualâ, âordinaryâ,
ânaturalâ, as it âought to beâ or what an expert claims
it âshould be?â
⢠Perhaps itâs what someone thinks or feels is normal
and anything different is a perversion, deviation, or
abnormal.
⢠Sexologists may see some things as âabnormalâ e.g.
obsessive cleansing of genitals.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
6. ⢠Mind-sets inherited
from family, both
spoken and
unconscious
⢠Culture, incorporating
myths & taboos
⢠Peers
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Our Attitude to Sex is Influenced By:
7. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
⢠Attitudes inherited from childhood, or out of
ignorance can cause unnecessary misery.
⢠When you are bringing up a child, you are
potentially raising a future husband/wife/partner.
⢠We take responsibility for bodies (food etc.) &
minds (education etc.), why not sexual
development too?
8. ⢠Theorised that the ability to give or receive intimacy
& to desire âthe otherâ has basis in early attachment
with primary caregiver.
⢠Early experiences of closeness, touch, and learning
emotional regulation come from interaction with a
significant caregiver.
⢠Adult relationships are impacted by, & reflective of,
those formed in childhood. An insecure child
becomes an insecure adult.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
John Bowlby and Attachment Theory:
9. ⢠Each partner brings their own individual working
models of attachment & projects their own needs,
wants, senses of selves & structural defences, onto
one another.
⢠Avoidant: impersonal sex
⢠Ambivalent: prioritises emotional over sexual relating
⢠This can create discrepancies in desires for relational
intimacy & sexual encounters.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
John Bowlby and Attachment Theory:
10. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
⢠Early experiences will impact
intimacy and sex as
attachment anxieties will
reflect in sexual relationships.
⢠Our âsexual scriptâ will be
learnt, either positively or
negatively, and be
incorporated into our
childhood experience and
continue to affect us as adults.
âTell me how you were loved &
I will tell you how you make love.â Esther Perel
11. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Our âSexual Scriptâ incorporates biological and
cultural factors.
There are three main strands:
⢠Development of gender identity as male or female
⢠Sexual responsiveness
⢠The capacity for close, dyadic relationships
(Bancroft, 2009)
A sexual âscriptâ:
12. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
(Bancroft, 2009)
1. Pre-natal stage
2. Childhood
3. Adolescence & Early Adulthood
4. Marriage (or establishment of a stable,
sexual relationship)
5. Early and late parenthood
6. Mid-life
Six Basic Stages:
13. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
SHAME
The main source of failure to achieve
adult sexual satisfaction is an
interference early in life with a childâs
discovery of his/her own body as a
source of pleasure.
Shame is a wound made from the
inside, dividing us from ourselves
and others
14. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Shame leads us to:
⢠Withdraw
⢠Attack self
⢠Attack another
⢠Avoid
15. ⢠Self-abuse to self-love; taboo to
some, celebrated by others
⢠Maligned and mythologised
⢠Noted in utero from 17 weeks
⢠Scientifically regarded as normal
and harmless
⢠When faulted, children may develop
sense of shame and fear which can
impact anything to do with sex
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
AND THEN YOU GO BLINDâŚ
16. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
⢠Sex therapists see it as part of human sexual
development, as a source of pleasure without
risk.
⢠It is used in sex therapy to help men and
women deal with sexual problems.
⢠Can play a specific role in sexual evolution as
getting to know self intimately is a rehearsal
for getting to know another similarly.
17. Teens and sexual health in an online world
Perils of Pornography
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
18. 60% of teens face
sexting pressure
How teens âsextingâ
photos end up on
paedophile websites
Brain scans prove porn
is as addictive as drink
and drugs
Vast majority of UK
teens have seen
sexual imagery
online, or
pornographic films
In 2012 there were
19,000 reports
relating to child sex
abuse online (CEOP)
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
19. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Wrecking
Ball
Grappling with sexuality: Precocious in acting
out, but vulnerable and immature in relating
Yet want love and intimacy,
so what else can they do?
But wreck itâŚ
20. Tasks of growth for a child would be to gain
independence, without rejection, of parents i.e.
to be able to present selves in adult world
To develop a strong identity, a sense of who
and what they are, which includes their sexual
identity
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
21. ⢠Exploring sexual conditions of worth.
⢠Formulating a positive sexual identity.
âTo know and love oneself âas isâ is a
prerequisite to know and love another.â
Jacques Lacan
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Sexual satisfaction starts with self:
22. Remove the taboos and shame:
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
23. ⢠Factors that can derail sexual development &
detract from adult enjoyment include:
- trauma
- abuse
- difficult early sexual experiences
- unusual developmental pathways
e.g. early/late puberty
- high degree of family guilt &
inhibition around sex
⢠It is not unusual for clients with low libido to have
history of abuse, flashbacks, dissociation & aversion
to sexual experience.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
24. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
⢠For reproduction
⢠To boost or to maintain self-esteem
⢠To relieve tension
⢠For material gain
⢠To connect intimately with another
⢠For excitement and to take a risk
⢠For pleasure and to feel good
⢠A hostile assertion of control or dominance
Functions of sex are complex:
25. ⢠Physical e.g. illness, alcohol, drugs
⢠Pregnancy
⢠Ageing
⢠Loss of self-esteem
⢠Anxieties and stress
⢠Loss of status or change in circumstances
⢠Betrayal of trust
⢠Sexual boredom
Causes of Sexual Issues:
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
26. ⢠Withdrawal of sex when there is no alternative way
to express anger or disappointment.
⢠It can be way of unconsciously exerting power and
control in response to the lack thereof outside of the
bedroom.
⢠It can be done in a mechanical way so as to maintain
a âsafeâ emotional distance.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Sex can be used in potentially
destructive ways:
27. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
⢠The result of conflicting needs and motivations can
be a partner who mourns the lack of intimacy and
trust which impedes feeling safe & thus enjoying
sex. Instead sex becomes associated with negative
feelings such as fear, jealousy, guilt and anger.
⢠Problems may thus arise when two people are
using sex to fulfil different functions at any one
time.
28. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Sexuality of the Middle-
Class, Midlife Woman
Related research to be found on
www.indabacounselling.co.uk
The Sexuality of the Middle-Class, Midlife Woman:
Research on the Nature and Significance of Sexual
Satisfaction Within a Long-Term Relationship
29. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Male gender stereotypes:
⢠If a sexually functional man has a willing
partner he is attracted to, he will engage in
sex whenever the opportunity is offered.
⢠All a man needs to achieve & sustain an
erection is to think about or to âwant to haveâ
sex. Women on the other hand, need
sufficient foreplay including, but not limited
to, direct genital stimulation.
⢠When there is a mismatch in libido, invariably
it is the man who has higher sex drive & the
woman needs cajoling.
30. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Male gender stereotypes:
⢠What men enjoy most is the thrill of the
chase, & if a woman wants a man to
commit she should play hard to get & for
him to âwinâ her.
⢠Men & women play distinctive, gender
defined roles within the relationship. The
man is the provider, protector & leader. He
woman is the nurturer, home maker &
supportive partner.
(Monique Viljoen-Platts, 2013)
31. ⢠Therapeutic space gives room for self
understanding & self development, a space to
transition through changes with the self
structure.
⢠It allows one to develop an authentic ability to
give and receive verbal, physical & sexual
intimacy, & understand meaning behind needs
you hope to be met by your partner.
⢠If one changes self, one can change
relationships & intimate encounters.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
32. Perel believes the key to sustaining desire is
reconciliation of 2 fundamental human needs:
The need for
security,
safety,
predictability
The need for
adventure, risk,
the unexpected,
surprise, journey
A paradox as these very things that nurture love
can be the very ingredients that stifle desire
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
Esther Perel: The Secret to Desire in a Long Term Relationship - Full video
33. People are drawn to their partner when:
⢠They are separated, allowing each to get back in
touch with the imagination of desire and longing.
⢠When they see the other in the spotlight, thus
radiant, confident and somewhat elusive, mysterious.
⢠In this space lies the erotic & the move to that other.
⢠The mystery is not so much about travelling to new
places but instead looking with new eyes.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
We need to reconcile love and
desire in order to maintain eroticism
34. Ask questions of self as opposed to the other:
⢠I turn myself off when âŚ
⢠I turn myself on whenâŚ
Use erotic intelligence as more than animalistic
biology.
(Esther Perel, 2013)
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
35. Health Benefits of Sex:
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
⢠Sex relieves stress
⢠Sex boosts immunity
⢠Sex burns calories
⢠Sex improved cardiovascular health
⢠Sex boosts self-esteem
36. ⢠Sex improves intimacy
⢠Sex reduces pain
⢠Sex reduces prostate cancer risk
⢠Sex strengthens pelvic floor
muscles
⢠Sex helps you sleep better
(Boots WebMD, 2013 www.webmed.boots.com)
Health Benefits of Sex:
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
37. âWe consider sexual intimacy as primarily relational,
secondly physical. Bodies rarely have problems
finding sexual pleasure if the confusion in the mind is
laid to rest.
Being sexually alive has little to do with the right
body shape, or the right partner. It is about oneâs
self-concept, self-embodiment and attitude to life,
and the ability to reprogram internal messages from
the image-makers of the past.â
(Duffel & Lovendal, 2002, p. 222)
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
38. ⢠Develop respect for a range of lifestyles & an
ability to observe & reflect on gender roles in
our world.
⢠We may be uncomfortable learning about
clientsâ intimate lives, feeling an intruder or
voyeur.
⢠We may feel naïve, lacking basic knowledge, so
CPD is necessary.
Therapeutic Considerations:
Š Stephanie Jeans 2013
www.indabacounselling.co.uk
40. Š Stephanie Jeans 2013
www.indabacounselling.co.uk
The therapistâs value is not in âthe fund of
information, rather as a source of attuned
curiosity.â
(Anne Power, 2013, Therapy Today)
41. References:
Bancroft, J., 2009. Human sexuality & its problems (3rd Ed.). London: Longman Group Ltd.
Bowlby, J., 1997. Attachment. London: Pimlico.
Duffell, N., & Lovendal, H., 2002. Sex, love & the dangers of intimacy: A guide to passionate relationships
when the âhoneymoonâ is over. London: HarperCollins Publishers.
Hakim, C., 2012. The new rules: internet dating, playfairs and erotic power. London: Gibson Square Books
Ltd.
Jeans, S. J., 2012. Sexuality of the middle-class, midlife woman: research on the nature and significance of
sexual satisfaction within a long-term relationship. http://www.indabacounselling.co.uk/resources/Sexuality
Kahr, B., 2007. Sex and the psyche. London: Penguin Group.
OâLeary, C. J., 2012. The practise of person-centred couple and family therapy. New York: Palgrave McMillan.
Orbach, S., 1999. The impossibility of sex. London: Penguin Group.
Perel, E. http://www.ted.com/talks/esther_perel_the_secret_to_desire_in_a_long_term_relationship.html
Power, A. 2013. When passion cools. www.therapytoday.net
Schnarch, D., 2003. Resurrecting sex: Solving sexual problems & revolutionizing your relationship. New York:
HarperCollins Publishers.
Š Stephanie Jeans 2013
www.indabacounselling.co.uk