I have a sexual problem

What’s happening

Sexual problems have a particular structure. The first time something goes wrong, it was probably a one-off. The second time, you started watching for it. By the third time, the watching had become the problem, and the original issue is being maintained by what you’re doing to prevent it from happening again. The harder you try, the worse it gets, because trying is the opposite of what arousal needs.

The sex stopped working and the trying-to-make-it-work is what’s been keeping it from coming back.

Which version of this is yours?

• I have erectile dysfunction. It happens or it doesn’t and you can’t predict which. → I have erectile dysfunction

• I have premature ejaculation. Faster than you want, every time. → I have premature ejaculation

• I have delayed ejaculation. You can’t finish even when you want to. → I have delayed ejaculation

• I have low libido. You used to want it. You don’t now. → I have low libido

• I can’t orgasm. Alone, with a partner, or both. → I can’t orgasm

• I have painful sex. Penetration hurts and your body has stopped allowing it. → I have painful sex

• I’m afraid of sex. It’s tied up with shame, fear, or previous experience. → I’m afraid of sex

• Am I asexual or just shut down. You can’t tell the difference anymore. → Am I asexual or just shut down

• Porn ruined my sex life. You can finish to porn and not with a person. → Porn ruined my sex life

• I can’t get aroused with my partner. Other contexts are fine. → I can’t get aroused with my partner

• I have performance anxiety in bed. The pressure ruins it before it starts. → I have performance anxiety in bed

• I’m attracted to people I shouldn’t be. And it’s interfering with your life. → I’m attracted to people I shouldn’t be

Why standard sex advice doesn’t fix it

Most sex advice treats the problem as a technique gap. It assumes the problem will resolve once you learn what to do. The problem is rarely about technique. It’s about the loop between expectation and response. Trying harder loads the expectation. Loaded expectation suppresses the response. The response failure loads the next expectation. The loop runs whether or not you’ve read every book.

You can’t fix a sexual problem by trying harder at the thing that’s been the problem.

How we work with it

Strategic therapy works the loop between expectation and response, because that loop is what keeps the sex from working. We identify the specific behaviour you and your partner have been running to prevent the failure, and we change it in a way that removes the pressure your body has been responding to. With nothing left to brace against, the response your body knows how to produce comes back.

The fix is in the structure around the sex, not in the sex itself.