Therapy is no magic wand for relatioships

My husband and I have had some money and job worries recently, and our sex life has suffered.

He wants us to try joint therapy, but I worry that it will put too much stress and pressure on the situation, and make us feel like the spotlight is on us. Will it make it better?

While it is admirable that your husband is being proactive about improving your relationship, the trouble with putting an essentially healthy – if slightly stressed and sexless – relationship under the microscope is the intractable tendency to focus on what is wrong, as opposed to what is right.

In an ideal world a good therapist would get you to look calmly and objectively at your relationship to learn how to reduce conflict, encourage open communication. and help you appreciate what is working well in your relationship. Here on planet Earth, couple counselling often involves a great deal of wailing and gnashing of teeth because troubled couples wait an average of six years before seeking help, by which time their relationship is in such dire distress the therapy room becomes a battleground.

It is unusual for a man to be the one to suggest couple therapy and it might be worth asking your husband what he expects to get out of the process. In therapy, women tend to try to understand what is happening in the couple dynamic, whereas men tend to be more solution driven. They want therapy to “fix” whatever it is that they perceive to be broken in the relationship, but therapy is not a magic wand.

You don’t say how your sexual issues have manifested, but stress, anxiety, panic, and depression can cause a whole host of sexual disorders. Though stress has a negative effect on both sexes, in women it tends to have a greater effect on desire, whereas in men it tends to impact the body’s physical response to arousal. Stress and anxiety reduce testosterone in both men and women and elevated levels of adrenaline and cortisol divert blood flow from extremities such as the genitals towards the heart and lungs. This diminishes libido and arousal in women and in men leads to erectile dysfunction or premature ejaculation.

Regular therapy won’t help to sort those issues out. Instead, you need to see a therapist trained to address your sexual difficulties. Most men are terrified of the idea of sex therapy because they think they will have to have sex in front of, or even with, the therapist but really, all you do is talk about your sexual problems and then go home and do some “homework” with each other. Lots of couples love it because the weekly sessions are an incentive to have sex, because if they don’t they have nothing to say at their next appointment.

Since money is an issue and therapy costs about €60 a session, you have nothing to lose by trying to tackle your sexual difficulties with stress-reduction techniques. You can master practices such as yoga, mindfulness meditation or running, simply by downloading free apps such as Yogify, Headspace, and Couch to 5k.

Yoga is particularly beneficial for sexual health; in a study by Dhikav, Karmarkar, Gupta, and Anand (2007), 38 men suffering from premature ejaculation experienced significant improvements in their condition.

You might also want to try the following therapeutic exercise. A study by Matthew Andersson and Colleen Conley from the University of Iowa (2013) found that writing about difficult life events and emotions in the third person (using ”he” or “she”, instead of “I”), gave traumatised people the opportunity to make sense of what was happening to them from a safe distance. Setting out your own situation from a different perspective might encourage you both to be a bit gentler with yourselves.

Most importantly — although sex is important, you can sustain physical intimacy in other ways such as cuddling skin to skin or taking turns to give oral sex.

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Stress, anxiety, panic, and depression can cause a host of sexual disorders