Why Sexual Problems Aren’t Just Physical: A Relational Perspective

By Natasha Tanic (Psychology BA – Freelance Writer)

“Someone who avoids sex may not be indifferent but might fear vulnerability … In therapy, you can gently unpack sexual problems and learn not to blame the past but to understand how it influences us today.”

While certain health conditions, medication side effects, and hormonal changes can undoubtedly impact sexual life, we have to consider a broader perspective. When we treat sex issues solely with medication, we leave out something essential: the relational and psychological factors that often sit underneath.

When Sexual Problems are a Sign of Something Deeper Going On

While its primary purpose is profoundly biological, sex is far from being a simple biological thing. Hence, sexual problems are rarely just about biology. Have you ever asked yourself whether stress, the way you feel about yourself, your past experiences, or the tension that’s built up in your relationship over the years might have something to do with why intimacy feels so hard?

Emotional and Relational Factors That Impact Sex

Sometimes, problems like premature ejaculation, difficulty with arousal or orgasm, or pain during sex have nothing to do with biology, hormones, or technique. Sometimes, they result from our deeply ingrained, unresolved issues, like shame, anxiety, disconnection, or fear of vulnerability. These are not a sign of failure; they’re signals that something in your emotional or relational world needs attention and care.
Maybe it’s not a medication you need. Perhaps it’s psychosexual therapy.

Attachment Styles

The way we grow up and the messages we receive about sex play a huge role in our adult sexual lives. Understanding how our attachment styles may contribute to issues we experience is sometimes key to healing our sexual lives.
People who were raised in a nurturing family environment with secure connections tend to develop a healthy sexual identity in adulthood. They feel comfortable in their bodies, openly communicate their needs, and have set their boundaries. These people were typically raised with respect for privacy, age-appropriate conversations about sex, and affectionate family dynamics.
On the other hand, growing up in a family where affection was lacking and sex was a taboo topic often leads people to internalise shame so that they may experience difficulties with intimacy later in life.
Psychosexual therapy can be a safe place to reflect on how your family expressed love and affection or handled sexuality. Unpacking these things from your past may provide valuable insight into your current sexual and relational patterns.

Body Image Issues

How we feel about ourselves can profoundly affect how we experience intimacy. If you are self-conscious, you may find yourself fixating on what you see as flaws during sex. Perhaps you can’t help but stress over the shape of your body in bed, so you insist on turning off the lights, hiding certain angles, or avoiding intimacy altogether. This can cause distance in your relationships.

When we’re struggling with body image, this can affect not just our self-esteem but also sexual desire and arousal. Body image is about how we perceive our shape and believe we appear. In the era of unattainable beauty standards, it’s easy to fall into the trap of constantly comparing ourselves with others and feeling unhappy, insecure, and self-conscious. This insecurity automatically spills into the bedroom, impacting our confidence and intimacy.

The good news is that with psychosexual therapy, you can discover the real reason behind such problems, learn to overcome negative and self-critical thoughts and begin to work on building a better relationship with your body.

Trauma and Fear of Intimacy

Emotional, physical, or sexual trauma may have a tremendous influence on how we trust people and feel safe in intimate relationships. When we don’t process it, trauma stays in the body. So, even if we want intimacy, our body might react with fear, tension, or numbness, as every touch can trigger memories and sensations, feeling flooded or paralysed. This can make sex unsafe instead of relaxing and calming. You might be ashamed and guilty but cannot explain your difficulties to your partner. Over time, this can breed emotional distance, making both partners feel hurt and disconnected.

Unspoken Resentment or Communication Issues

Communication breakdown, unresolved resentment, frequent conflicts, or a loss of trust can all lead to emotional disconnection. That disconnection often shows up in our sex lives. When we’ve been hurt, and the issue hasn’t been addressed, resentment can quietly build, making it hard to feel safe, open, or connected with our partner. This emotional distance inevitably impacts intimacy, turning what could be a source of closeness into a place of tension or avoidance.

Stress, Anxiety, and Burnout

It can be challenging to adapt to major life changes like having a baby, losing a job, or experiencing grief, as they disrupt our sense of stability and security. Transitions in life can cause an escalation of stress and divert attention from sexual desires, and sex and intimacy may decline.
Addressing these issues in therapy can help you learn healthy means of dealing with and restoring the passion in your relationship.

A Psychodynamic Approach: Uncovering What’s Behind the Surface

Someone who avoids sex may not be indifferent but might fear vulnerability. Others may use sex to feel close while struggling to connect emotionally. These behaviours are usually a result of our early relationships in which we learned what was “safe” to feel and express.
In therapy, you can gently unpack these issues and learn not to blame the past but to understand how it influences us today.

How Therapy Can Help?

If you experience sexual problems, you may want quick answers. That’s natural and understandable. But sex can be complex, and instead of searching for a quick fix, we might try to understand what our sexual problems are telling us.

Talk therapy offers a secure place to slow down and reflect on unhealthy patterns, emotional blocks that affect closeness, past trauma, and fears or beliefs around sex and intimacy. You don’t need to have all the answers. Psychosexual therapy can be a great place to explore what feels difficult and discover new ways to connect with yourself and others. Our therapists at Cynefin Therapy will guide you while you’re exploring your emotions, thoughts, and sexuality. Reach out today to learn how we can help you.