A close up of an ice cream cone that fell on the ground, all the ice melting away. That's a big setback if you were expecting a nice treat.
Illustration by Marta Pucci

Common Setbacks in Sex Therapy

Photo of Dr Katherine Hertlein
Reviewed by Dr Katherine Hertlein,
created by Blueheart
created by Josh Green
created by Sophie Browness
Date published:
Last updated:
Photo of Dr Katherine Hertlein
Reviewed by Dr Laura Vowels,
created by Blueheart
created by Josh Green
created by Sophie Browness
Date published:
Last updated:

Therapy isn't an upwards trajectory, (we won't say rollercoaster ride) it's a squiggly spaghetti road that goes in all directions. But it's always taking you to somewhere so much better than before, it's all worth it. And it's much easier when you know what to expect and try and remember these tips.

How can you deal with setbacks in therapy?

You’ve finally done it - you’ve started working on your sex life with therapy and now you’re on that journey. Great! But perhaps things aren’t as straightforward as you’d been hoping? Or maybe it’s as difficult as you thought it might be... If you’re struggling or feeling like you’re facing a setback, you’re not alone and there are ways to address this. 

Expect the unexpected

The point of involving therapy is that if you could solve it on your own, you would have by now! The scope of the problem has moved outside of your understanding or awareness and that’s why it’s a struggle. So it makes sense that you’d come up against things that are new and scary while you’re solving the problem. It helps to expect this so that if and when it happens, you’re prepared for it and don’t beat yourself up about it. People often feel guilty or ashamed for having ‘failed’ at something that’s seen as ‘fundementally human’ as sex. But as you’ll learn, there is no failure in sex. Growth isn’t linear and you can expect a lot of detours, pauses and re-dos along the way.  You won’t just skip through your sessions perfectly and feel more horny every day. That’s just not how it works, and knowing that going in, will help arm you for those days when you might feel like nothing’s working.

Don’t should yourself

You might find that as you start to work through some exercises, things go slowly, or even stay in the same place for a long time. You might feel ‘stuck’ - and perhaps your initial hope starts to fade and you begin to wonder if anything will ever work for this impossible problem. You will, at some point... think about giving up.

It’s worth taking a step back and looking at the assumption that comes with this difficulty. It may start with the idea that there is somewhere you ‘should’ be. Maybe you’ve felt something like: ‘We should be….

  • Orgasmic
  • Having sex a certain number of times a week
  • Having really great head over heels tip top sex
  • Having sex AT ALL
  • Feeling really good about doing the exercises 
  • Feeling happier together every day 

….by now.’ 

What you’re doing here is using an external measure to indicate how well your sex life is doing. 

You’re ‘shoulding’ all over everything. This external measure might come from what you think is happening in the sex lives of others. It might come from what you hoped your sex life with your partner would be like. Maybe it’s coming from your partner and their ideas about what sex should be? Wherever this idea has come from, it’s made up! And it’s distracting you from what’s actually happening now, you’re evaluating instead of doing. 

Cast your mind back to the core ideas of Sensate Focus, focusing on the sensation only and managing your distraction negative thoughts. It’s not only when you’re in a sexual situation that you can benefit from this technique. These demands – the pressures of ‘should’ and ‘good vs. bad’ – are the barriers to sexual healing. Holding yourself up to even the smallest goal, even when you’re meeting it, creates anxiety and fear.

There is no set time for you to be ready for any stage of your plan, it’s your pace. 

Return that focus to what’s going on inside yourself. What do you notice about touch on your hands or your body? What feelings arise at different points in your SF practice (including before and after)? These are all valid and worthy of your attention, and looking at the external outcomes of sex is a distraction. 

“Am I doing it right?”

What if you feel like you might not be getting things right? Maybe you’re really struggling to focus on touch, or you’re noticing yourself slipping into this evaluative mode of thought that we’ve just talked about, and it’s really getting in the way. But remember, everything you’re learning takes practice, it won’t come naturally right away. You have to keep going, keep showing up. 

And it’s all useful stuff. If you think you’re not doing what you’re supposed to in the tasks, that’s not a failure or a waste. It’s something you can talk about, and that can be made into something helpful. The fact that you’re noticing that you find this stuff hard is great because you can start to talk about this with your partner during your communication sessions. It’s totally fine to say to your partner:

“I really struggled to focus today, I was so distracted by work.”

“I kept worrying about you having a good time, even though I know that’s not the point.”

“I kept feeling bored by the touch, I thought it would be more fun.”

“I wanted to go further than just touch!”

Noticing that you have expectations of yourself and of sex and that they’re being challenged by the session means that your usual way of approaching sex is being challenged, which is exactly what we want. This isn’t necessarily going to be comfortable, but noticing these challenges means you can start to understand them and work with them better. 

“I’m not doing my homework”

It’s very common in Sensate Focus for people to stop following the exercises (or never even start!) and instead go back to their previous sexual dynamic. Or maybe still do the exercises but to not follow the suggestions - for example, to try to get their partner aroused or reaching orgasm, or to touch each others’ genitals when that’s still being avoided, or to delay sessions until late at night when they’re too tired. Perhaps both of you are engaging in this kind of rule-breaking, or one is and the other is chastising the first one! Wherever this is originating from, what can you do to address it?

  1. Get away from blame. It’s extremely tempting to lay blame at the feet of one (or both) partners. Try as much as you can to resist this, because it only serves to close down communication. Defensiveness or shame make it harder to not only connect with your emotions and understanding what’s blocking engagement with SF, but also to connect with each other and work together. 
  2. Understand that this is normal and there will be reasons behind it that are completely understandable - even if it doesn’t feel that way!
  3. Revisit the basics of SF - the purpose, activities, ideas and expectations, as well as reminding yourselves of what you’re NOT trying to achieve here (pleasure, orgasm, relaxation, etc.).
  4. Agree a schedule between you for sessions. This can include times, days (it can be helpful to have it at the same times and days each week, but this depends on the flexibility of your schedule), and location.
  5. Notice and share your difficult feelings around sex and SF, and work together to see how you can manage them. Noticing what’s going on within yourself and taking it seriously is part of radical self-responsibility. Let’s talk more about how to do this. 

Difficult feelings

Painful or uncomfortable feelings are very common when you’re addressing challenges with something as personal as sex and relationships. Being open to them and what role they’re playing in your dynamics with each other and with sex is crucial. 

  • Being with difficult feelings - this is a skill many of us need to practice to get better at it. A good way to start is by noticing when you’re trying to avoid a particular feeling. This might be through distractions (this could be anything, but typically is something quite passive and automatic, like compulsive social media use), avoidance (not engaging with things that trigger those emotions) or rationalising (telling yourself you shouldn’t have that emotion, that it’s not ok to have that reaction, that it’s not justified, etc.). 
  • Notice and name the feelings - identify how they feel in your body, what physical sensations you experience, and try to name them. 
  • Accept your feelings - accepting doesn’t mean giving in to them, but it does mean acknowledging they’re there and that they have something important to tell you. It might be really difficult to handle feeling frustrated with your partner or angry with yourself, but taking that feeling seriously might help you do something productive with it. 
  • Share these feelings - find someone you trust to share them with. This could be your partner, if that feels right for you. It might be good to start the conversation by asking the other person to not try to ‘solve’ the feeling, or the problem associated with it. This goal-focused approach is what we’re trying to get away from. If you share with your partner, it might prompt them to share their difficult feelings too, and help you connect and be with these feelings together. 

Your emotions are valuable information, there to help you build a picture of yourself and your experiences with sex. The more you can be with them (and with your partner’s feelings!), the more you can understand what needs to be addressed to overcome barriers in SF. 

So a setback isn’t a setback? 

Try not to be disheartened by any setback you meet along the way.  They can be a great opportunity to review what’s happened so far, reflect on how you’re feeling and revisit the core ideas of SF and their purpose. It’s not a reason to give up. Remind yourself of why you’re here, and keep going. However you’re doing, you’re doing great. 

If you feel ready to get back in touch with sex again, check out how with the Blueheart app here.

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After just 2 weeks, Blueheart users reported to feel 105% happier with their amount of intimacy, 70% more physically connected, and 30% less distressed about their issue.
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