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Sexuality and Sexual Concerns

P.J. Matt Tilley

Clinical Psychologist
Perth, Western Australia

Many people experience sexual difficulties. It may be a desire for a more fulfilling sex life; or a problem that has been bothering you for a long time; or an identity issue. Whatever it is it can cause difficulties in several areas of our life. It can affect they way you see yourself, and the way you see others around you. It may even make you feel depressed or anxious. In some situations certain people may be more likely than others to experience difficulties in areas of their sex life. Think for example about people who are just starting to explore their sexuality, we know from research that they are more likely to experience feelings of inadequacy, doubt, and embarrassment. For these people and many others, feelings like these may lead to experiences of erectile dysfunction, premature ejaculation, or even anorgasmia (the inability to have an orgasm). Fortunately there are ways to help people who experience difficulties of a sexual nature like these.

Sometimes it's hard to identify why people experience sexual difficulties, but other times the causes are really clear, e.g. sexually transmissible infections (STIs); an on-going argument with your partner; compulsive sexual urges (sexual addiction); negative messages about sexuality; having a hard time coming to terms with your sexuality. The solutions are as varied as the problems, but often sharing a problem with a trained professional can be beneficial. If the difficulty is occurring in a relationship, we often find that part of the solution is the need for improved communication between the people involved, with the goal to improve the intimacy in the relationship.

Intimacy means different things to different people. Some people may struggle to explain it, but say that know it when it happens, or when they feel it. Often it can be demonstrated by an action that the person receiving it will enjoy, or feel shows them love. I believe we all desire intimacy with other people in one form or another. For some, an overt loving gesture is just what makes them feel great; yet other people may shy away from this expression of intimacy, and desire a more pragmatic expression of intimacy or even an expression where no fuss is made at all. It may be the quiet gesture and loving act that makes them feel loved. Whichever it is, people need to feel loved and connected to make their relationships work.

So what are sexual difficulties?

When people talk about having sexual difficulties they are often talking about totally different things. From erectile dysfunction to sexual identity and orientation issues to those that often come with intimate relationships. There are many things that fall under this heading, but generally when ever an individual is experiencing a difficulty related to their sexual self we can see it as a difficulty within the sexual aspect of their life, or being of a sexual nature. Of course this may not be the language you would use, but the meaning will no doubt be the same.

There are many things that people report more often than other times, but sexual difficulties are exactly that - times when our experience of our personal sexuality is challenged. Many authors and researchers write about this area, and below is a quote that I feel captures the sentiment of this area of human experience,

"Sexual problems are no longer regarded as symptoms of hidden psychological defects in maturity or development. Rather they are understood as perennial themes in human drama" - Sandra Leiblum (2007)

Sexual problems can affect both men and women, and often can be grouped together under headings. Below is a list of some of the most common specific sexual problems.

  1. Lack of sexual desire
    • A lack of interest in sexual activity
    • Can affect both men and women
    • Many different causes

  2. Sexual arousal problems
    • Not feeling aroused by or during sex
    • Women may experience a partial or total lack of physical response
    • Usually evident in men when they have a psychological cause for experiencing difficulty getting and/or maintaining an erection

  3. Difficulty with orgasms
    • For some people this may mean they've never had an orgasm
    • Occasional difficulty reaching orgasm
    • Premature ejaculation and/or orgasm

  4. Sexual pain
    • Dyspareunia is pain associated with sexual penetration
    • Can affect men, but usually reported by women
    • Usually reduces the individuals sexual arousal and desire, and interferes with reaching orgasm

  5. Sexual difficulties involve many factors, such as
    • family of origin and early messages about sex
    • relationship problems or conflict
    • communication within relationship
    • physical conditions including pain, illness, or disability
    • life cycle changes such as adolescence, pregnancy, breastfeeding, infertility, menopause
    • past sexual abuse or assault
    • body image
    • life stresses and changes
    • anxiety and/or depression
    • use of medication

Sexual problems are normal, and they impact on our lives in many ways. Once a sexual problem has existed for a while, it can cause feelings of inadequacy and insecurity, anxiety, resentment, disappointment, and this may lead to conflict within the relationship. Resolving sexual problems involves communication, a willingness to look at what the problems are and to do things differently.

If you'd like to speak to someone about a problem with your sexual life please contact P.J. Matt Tilley on 0411 253 165 or email him at .

Main source of information 'The Seven Principles for Making Marriage Work". John Gottman and Nan Silver

Click here to go to Matt Tilley's page

Mt Lawley Counselling Centre
13 Alvan Street
Mt Lawley (Perth), WA 6050

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