All The Questions You've Ever Wanted To Ask A Sex Therapist: Answered
The Debrief: A sex therapist gives us the down low on all things down low
Illustration by Kelsey Wroten
Ever wanted to ask a sex therapist loads of questions without actually making an appointment to see a sex therapist?
We got highly qualified sex counsellor Denise Knowles of Relate in a room and grilled her on the subject of all things sex - from not orgasming to the weirdest things she's seen in her time helping people bonk properly - but the main thing we learned was hey, sex therapists aren't that scary. If you're having an issue in the bedroom (or anywhere else you like to have sex) that you can't resolve yourself, go and see someone because a) it's really helpful and b) they're really friendly.
What's the most common problem people come in with?
A few years ago it was things like painful intercourse and erectile dysfunction but increasingly it's that people have gone off sex. Originally this tended to be more common in women, but now it seems to be both genders. They’re finding their libido is not what it used to be or there is a discrepancy between their libido and the partner's. There are many reasons for this - one of them being lifestyle, as it's changed a lot over the last few decades.
What sort of lifestyle changes lead to people not wanting to have as much sex?
Technology is a big one. I get couples telling me they spend the evening with one on their tablet, another on their phone - then they say they don't find the time or the energy to have sex and devote time to each other. I mean, they clearly do have time, but they've chosen to spend it on their iPad! We're also constantly connected, so it's become increasingly difficult to switch off and really focus on the person in the room. Stress levels are higher, people have started to work more shifts and flex-hours, or work from home, which is different to the usual 9-5, and that affects sex too. If your head is constantly thinking about work, or you're constantly getting emails through that you have to deal with, you're not likely to want to have sex.
Another thing is communication and how you feel about yourself - communication isn’t just the words we use, it's how we look at each other, how we touch each other - not sexual touching, the day to day kisses and hugs. The playfulness that there may or may not be in the relationship. How people feel about themselves can have a great impact too, if you're feeling overweight or down or you're taking medication that's having an impact on you, that can cause you to not be that interested in sex.
What are the weirdest things you've seen as a sex therapist?
After 25 years of doing this, nothing is weird to me! You get fetishes, and things like one partner coming to us to try and convince their partner to get involved in BDSM when they really don't want to - and we really, really don't believe in forcing someone to do something they don't want to do!
One of the things that does genuinely surprise me is couples who don't kiss. I find that bizarre. I'll ask them how often they kiss one another, and they'll say 'Oh we give one another a peck on the cheek' and it's like 'OK but when did you last have a really good snog?' and they can't remember. That's a bit of a warning sign.
What are the other warning signs we should look out for in a relationship?
If you notice you’re not having sex, that's a really big sign. If you’re not kissing, and you notice you’re not cuddling one another on a regular basis, that's also a bit of a warning. Withdrawing from day to day intimacy can lead to problems. Conversely, I’ve worked with a lot of couples where there’s lots of kissing and lots of cuddles but one of the things that then comes out is that it feels more companionable than anything else. Feels too matey. If you have that creeping in, then that’s a warning sign.
On the subject of sex though, a couple I worked with told me they couldn't remember when they stopped having sex, that it just got less and less, so it's important to keep an eye on it. If it starts to create an issue, then bring it up in a nice way. Say something like 'I notice we haven’t had sex for a while how do you feel about that?'. Put it on the agenda, and don’t hide it away.
What's a normal amount to have sex?
Oh the million dollar question! The amount of sex a couple has doesn't fulfil a particular quota, but it does have to be satisfying for both of them. It might well be both are happy with once a week, somebody might like once a fortnight or once every other month. It only becomes a problem if it causes an issue with one or other of the partners. If neither partner is dissatisfied then absolutely there's no problem - why would I as a therapist be saying 'You’re only having sex once a week? That's not enough!'. It's very unique to the couple, which is why it's important to say when you're not satisfied - and make sure you keep your partner's needs in mind too.
Is it normal not to come every time you have sex?
Yes! It happens even in the best sexual relationships! While orgasm is obviously very pleasurable and desirable, it’s not the be all and end all. Our focus on orgasm as a society has become too intense; there's this idea if you're not coming all the time then there must be something wrong with you, or with your relationship.
I've seen lots of cases where the man thinks there's something wrong with him, not being able to have an orgasm. It's not solely the man's responsibility, just like it's not solely the woman's - you can’t make a woman have an orgasm if her mind isn’t there, or something's not quite right.
One of the things that's really important is to be able to relax and get in touch with all the sensations involved in sex. If you’re not able to and you’re thinking about the bill that has to be paid tomorrow, or you don’t feel sexy, or you’re thinking too hard about coming, then it might just not happen. The fact is that it does happen occasionally with all of us, and it's only a potential issue if you're never coming. Or never have come with a partner. Then maybe you need to look at why - you could come in to a see a sex therapist, as that could help you work through the underlying issues. It might be psychological, you might have had a bad experience, you might have had a bad smear test, you might just have received too many messages that it's just not a thing you should be doing.
I have sex dreams about other people - does this mean there's something wrong?
No! Sex dreams about other people doesn't indicate there is anything fundamentally wrong with your relationship, but I guess it depends who the sex dream is about (is it recurring and to do with that ex you're still secretly in love with? Maybe worth thinking about...) and whether it's a nightmare or not! The use of fantasy is totally normal in waking life though, and can really help with arousal. Not to mention fun.
What if you don't have time to masturbate? Or can't? Is that bad?
Masturbation, especially for women, is an important part of knowing yourself, but obviously it’s not like you’ve got to do it. It's not life and death! It’s important because it teaches you to relax, lets you share what they like, and crucially can build confidence. If you're not sure where to start, or haven't before, then you may need a bit of guidance, and there are a lot of urban myths like 'good girls don’t' and 'why do i need to if i’ve got a partner' but it’s all rubbish. It's worth devoting some time to, but it's not make or break for a relationship by any means.
So there you have it. You don't have to wank if you don't want to, you should try and kiss the person you're going out with all the time, and put your goddamn iPad away. Happy boning.
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