Sexual issues: How to manage

Tools to have a satisfying sex life

Typical reaction to sexual problems

Most couple therapies will focus to a certain degree on giving the tools to react productively to a sexual difficulty. A lot of the times, the couple comes in with one of them being the « patient » and the other will be tagging along. Sometimes, the partners agree on those positions initially given and other times it is a point of conflict between them.

Who really has a problem?

Frequently the person who tags along during the therapy has strongly reacted to the problem by feeling culpable and blame themselves for it. For example, a man will have difficulty with his erection and the partner will think that they are either unattractive or incompetent in bed. This puts pressure on the partner to reassure their spouse’s low self-esteem. Inevitably, this creates performance anxiety for the next sexual encounter which diminishes sexual arousal and pleasure, thus perpetuating a vicious cycle.
The person who tags along can also have frustration towards the designated « patient ». If one partner has lower sexual desire than the other, this builds up over time as their sexual needs are not met as they wish. Often, the initial reaction of blaming oneself turns towards the other when the situation doesn’t change. Unfortunately, these negative reactions only hinder the issue further down more difficulties.

Co-constructing a sexual problem

When couples perceive sexual issues as sporadic and temporary in time, this can reduce the factors that maintain the problem in the first place.  A defeatist attitude or dramatizing the sexual difficulty generally increases the problem. The partners don’t see each other as collaborating but combative.  One’s behavior creates a bad reaction in the other, especially in emotionally fused couples.
For many people, sexuality is an aspect of their life where they are fragile and vulnerable. When there is a sexual issue that doesn’t rub their ego the right way by feeling incompetent and less desirable; it generates a reaction that threatens the well-being of the relationship.

  • How do you feel when your partner isn’t as sexually aroused as you want them to be?


  • How do you react when the other refuses your sexual advances?


  • Do you believe that sex should be natural and simple?


  • How do you perceive sexual issues in a relationship?


  • How important do you consider sexuality when evaluating the satisfaction of your relationship?


  • Do you consider yourself responsible for your partner’s sexual pleasure?


  • Who is responsible for YOUR sexual pleasure during sex?

The answers that you give to the questions above strongly correlate with your reaction to sexual difficulties. People who take sexual problems as a personal attack or blame the other for the issue only fuel the problem.

Productively managing sexual difficulties

  1. We try to understand OUR part of responsibility in the issue, without taking all the blame or devaluing ourselves.
  2. We ask questions to our partner about their perception and how they feel about the situation.
  3. We manage our emotions and reflect on what the other person tells us.
  4. We maintain an open and HONEST discussion about the issue.
  5. We collaborate together rather than attack each other in our insecurities and fears.
  6. We talk about it with lightness and humour by seeing it as an opportunity to make our relationship and sexuality better.
  7. We consult a health care professional such as a sexologist & psychotherapist when we aren’t capable of dealing with the issue ourselves.

Learn more about the author

Francois Renaud M.A.

Sex therapist & psychotherapist in Downtown Montreal
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