Dr Margaret answers e-mailers' embarrassing problems in this biweekly problem page.

Psychosexual counselling can work wonders

Dear Dr Margaret
I have searched high and low for an answer to my problem. Why is my husband so uninterested in sex? He is healthy, I'm not that ugly, he doesn't have erection problems, his penis is not a funny shape or anything. We've been married for just under a year. I have used every approach I can think of. He's just not prepared to deal with the problem and assumes I will get used to sex once every 6 months (if I'm lucky). Can you give me some much-needed advice since I intend to stay married to this guy for ever, but not like this? I've told him that to me having sex reconfirms how much we love each other and makes me feel wanted and special. He thinks that's rubbish.

Dr Margaret replies:
I think you would have everyone's sympathy, because it's really hard to deal with a relationship/sexual difficulty if your partner won't even acknowledge the problem. It sounds a complicated problem, but I think Relate could help. Relate is a charity founded over 60 years ago to provide 'marriage guidance', but they now offer couples - married and unmarried - counselling and sex therapy. The organization is the largest trainer of psychosexual therapists in the UK; experienced Relate couple counsellors have to train for a further year to work as a psychosexual therapist so you know you are getting someone good. Obviously it would be best for you and your husband to go together, but they would see you on your own and give you advice if he refuses. For a list of Relate centres at which psychosexual therapy is offered, phone 01788 573241 or look at www.relate.org.uk.

I have had some other queries about psychosexual counselling so here, to answer some of your questions, is part of an interview with Anita Bryce, one of Relate's most senior therapists. The interview was with the Impotence Association (www.impotence.org.uk) and the full interview is published in their newsletter One in Ten.

People Relate sees
"The majority of people I see are couples, although I see single people as well. For men, one of the most distressing sexual problems is impotence (erectile dysfunction). Women present with pain during intercourse, vaginismus, and difficulties with orgasm. Just under 50% of the women I see present with loss of desire and I am now seeing an increasing number of men with this problem, including young men."

Practicalities
"Couples and individuals can contact their nearest Relate centre to enquire about an initial assessment. This will be a 1-hour session with a therapist for history-taking and exploration of the problem. On average, a session will cost £35. However, each centre has its own payment scale. Some centres operate a bursary scheme and are able to subsidise sessions for those clients who are unable to pay the full cost."

What's involved
"Once a thorough assessment has been made, a treatment plan can be specifically designed for the unique sexual problem presented. Tasks are set by the therapist to be carried out at home. This helps to diminish performance anxiety and encourage more positive communication between the couple. Sessions are attended on a regular basis over a number of weeks. In our latest research (an analysis of cases seen between 1998 and 1999), 53% of male clients and 73% of female clients reported increased enjoyment of sexual activity."

If you have any comments on psychosexual counselling or the other issues raised here, please contact Dr Margaret via info@healthpress.co.uk. We also welcome suggestions for other topics to cover on the site in general or in 'A Problem Shared'.

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