Systemic therapy techniques for sexual difficulties

Sexual activity carries a myriad of expectations, hopes, restrictions, and taboos that help to shape our sexual lives and the sexual lives of our clients. This chapter describes some of the theoretical principles underpinning systemic approaches and, through a series of case examples, their application in psychosexual therapy. Systemic theory holds that problems arise not in individuals but in systems. Within a systemic formulation, beliefs and behaviours are not considered to be right, wrong, or dysfunctional. It is essential to remember that during therapy the therapist also becomes part of the system. In psychosexual therapy, many clients may come with a belief that their sexual problems are physical in origin and with strong ambivalence about seeing a therapist. The Co-ordinated Management of Meaning approach (Cronen & Pearce, 1980) is one way of teasing out the impact of these wider contexts with clients.