Sexual health is an essential part of emotional and physical well-being. It’s also one of the hardest topics to talk about, even in therapy. A lot of people carry questions and struggles about sex for years before saying anything. You don’t have to.
Some reasons to consider sexuality counselling:
- you’re concerned about sexual desire, arousal, or libido
- you and your partner have different levels of desire and don’t know how to talk about it
- sex has become painful, uncomfortable, or something you avoid
- something from the past is getting in the way of intimacy
- you’re dealing with specific issues like premature ejaculation, erectile dysfunction, or trouble reaching orgasm
- you want to explore or talk about aspects of your sexuality you haven’t been able to talk about elsewhere
Understanding Sexual Health and Well-Being
Sexual satisfaction is an integral component of romantic relationships and a vital part of overall life satisfaction. When something gets in the way, it usually affects more than the bedroom. Confidence. Connection. Self-image. The relationship itself.
These issues are widespread. Most people don’t bring them up because they feel embarrassed or uncomfortable. But sexual concerns can only be resolved once they’re addressed. The conversation has to happen somewhere.
There are practical solutions that can improve a wide range of sexual concerns, whether the cause is psychological, physiological, environmental, or some combination.
Our approach is sex-positive. There’s nothing you can bring into the room that will shock your counsellor. No judgment. No pathologizing. No assumptions about what you should want. Just a space to talk about it honestly.
Counselling can help you understand:
- what’s actually driving the difficulty
- how stress, shame, or old patterns are showing up now
- why physical and emotional issues often get tangled
- how to start talking about sex with a partner
- what a sexual life that actually fits you might look like
By better understanding your own sexuality, you can meet it with less judgment and more curiosity.
How Counselling Can Help
Sexuality Counselling can help you:
- Identify and work through physiological and psychological factors
- Discuss emotions underlying sexual issues, with or without a partner
- Communicate clearly and directly about sexual wants and needs
- Learn mindfulness techniques that support sexual presence and experience
- Address and overcome barriers to intimacy
Most people wait a long time before asking for help with sex. There’s no need to. It’s more common than you think. And more workable than it might feel.
Our Therapeutic Approaches
We draw on a range of evidence-based approaches, grounded in a flexible, collaborative, and client-centred way of working that adapts to what is most helpful for you.
This allows us to shape our work around your needs, experiences, and goals, drawing from different therapeutic modalities as needed. Learn more about our approach to care.
Mindfulness-Based Approaches
Mindfulness can change a lot about sexual experience. A lot of what gets in the way of sex is mental, not physical. Anxiety. Distraction. Disconnection from your own body. Mindfulness practices help you stay present, which tends to shift how sex feels.
Gottman Method
The Gottman Method offers practical tools for talking about sex with a partner, which is often where sexual difficulties actually live. It includes specific approaches to desire discrepancy, sexual communication, and the small everyday habits that build or erode intimacy over time.
PACT (Psychobiological Approach to Couples Therapy)
PACT is a couples therapy approach that brings together attachment theory and nervous system science. For sexual concerns in a relationship, PACT looks at how each partner’s nervous system responds to the other. The goal is more secure functioning as a foundation for intimacy.
Polyvagal Theory
Polyvagal theory looks at how your nervous system shifts between different states, from activated to calm to shut down. For sexuality, this matters because arousal happens in a specific kind of calm. Your body needs to feel safe enough to get there. Polyvagal-informed work helps you notice what gets in the way, and what helps you get there.
Emotionally Focused Therapy (EFT)
EFT looks at what’s happening emotionally underneath sexual difficulties, especially in relationships. Often, sex issues are really about attachment. About feeling close. About feeling safe enough to be vulnerable. EFT helps couples work with what’s underneath the difficulty.
Compassion-Focused Therapy
Shame is one of the quiet forces behind a lot of sexual struggles. Compassion-focused work helps you meet the parts of yourself that have felt judged or confused about sex, with more kindness than you’ve been offering them.
Attachment-Based Therapy
Attachment patterns shape how you approach closeness, including sexual closeness. Attachment-based work looks at how those patterns were formed. It also looks at how they show up in your current relationships. Understanding your own attachment style can shift a lot about intimacy.
When you’re ready, we’re here. Some people come because of a specific concern. Others because they’re curious, or because a relationship has shifted. Whatever brings you, we can start there. Book when you’re ready.
Meet Some of Our Counsellors Who Work With Sexuality
Eskay Ilori
Sabrina Roach
Some of the most common concerns we face are related to sex and intimacy. I provide a non-judgemental space for clients of all backgrounds and preferences, including Ethical Non Monogamy, polyamory, kink, BDSM, Digisexuality etc. Other concerns include sexual pain, erectile dysfunction, desire discrepancy, gender dysphoria, and sex after trauma.
Frequently Asked Questions About Sexuality Counselling
Sex therapy is a more specialized term. Sexuality counselling at River’s Edge is in the same spirit. We focus on sexual concerns and what’s happening in that part of your life. If what you need is highly specialized sex therapy involving close medical coordination, your counsellor may suggest a specialist. For most sexual concerns, counselling here is a good fit.
Either works. Some clients do sexuality counselling individually. Some bring a partner. Some do both at different points. Your counsellor can help you think through what fits your situation.
Only as detailed as serves the work. Your counsellor isn’t going to push for specifics you’re not ready to share. Some sessions involve very specific conversations. Others focus on emotional patterns around sex without going into that level of detail. You set the pace.
Yes. Sex therapy is useful for adults of any age, gender, identity, or sexual orientation. We also work with clients across relationship structures, including monogamous, ethically non-monogamous, and polyamorous. Some of our therapists are kink and BDSM aware, meaning you can bring those parts of your life into the room without having to explain or defend them. Your sexuality is treated as a part of you to be understood, not something to be fixed or questioned.
Physical and emotional sides of sexual concerns often affect each other. Counselling can be a useful part of addressing physical issues, especially when there’s a psychological or emotional component. Your counsellor may also suggest working in coordination with a physician or pelvic health specialist when that makes sense.