ABSTRACT
This chapter explores why sex is hard to talk about whilst arguing its centrality in the work of couple psychotherapists. It outlines how couple therapists can explore safely and assess successfully a couple’s sexual relationship and describe what is really meant by a ‘psychosexual assessment’. There is evidence that most patients would like to have an opportunity to discuss their sexual concerns but embarrassment to do so, reluctance to initiate the conversation, or anxiety that their doctor will dismiss or judge them prevents their doing so. Expressing sexual desire can cause anxiety and, if the therapist avoids the subject, may reinforce the clients’ belief that their thoughts are unspeakable. The therapist who is comfortable about talking about sex in an open, inclusive way can provide a model for the couple to internalise. The therapist can model making mistakes and recovering, mirroring an aspect of resilience in talking about sex that the couple may lack.
