psychosexual therapy in blackheath and online

Psychosexual Therapy in Blackheath Village and Online

Restoring intimacy and understanding through compassionate, expert support

Sexual and intimate relationships are fundamental to human connection, yet they're often the most difficult aspects of partnerships to discuss openly. Whether you're experiencing physical difficulties, emotional barriers, or simply feeling disconnected from this vital part of your relationship, psychosexual therapy offers a safe, non-judgmental space to explore and address these challenges.

At Heathwell, we recognise that sexual wellbeing is deeply personal and complex. You might be a couple struggling with mismatched desires, individuals dealing with performance anxiety, or partners trying to rebuild intimacy after a difficult period. Perhaps you're navigating changes in your sexual relationship due to life transitions, health issues, or past experiences that continue to impact your present.

We understand that talking about sex and intimacy can feel uncomfortable or embarrassing, even with a professional. Our approach is gentle, respectful, and entirely confidential, creating an environment where you can explore these sensitive topics without shame or judgment.

Sexual difficulties don't have to define your relationship. With the right support and understanding, couples can rediscover intimacy, overcome obstacles, and develop a more fulfilling sexual connection.

If you're ready to address these challenges together, we're here to guide you through this important journey.

What is psychosexual therapy and how can it help?

Psychosexual therapy focuses specifically on the psychological and emotional aspects of sexual difficulties and intimate relationships. Unlike medical treatments that address only physical symptoms, psychosexual therapy explores the complex interplay between mind, body, and relationship dynamics that influence sexual wellbeing.

Rather than simply offering techniques or exercises, we help you understand the underlying factors affecting your sexual relationship—from anxiety and past experiences to communication patterns and relationship dynamics. This deeper understanding creates the foundation for meaningful, lasting change.

People seek psychosexual therapy for various reasons, and you might recognise some of these concerns:

  • Experiencing anxiety or fear around sexual intimacy

  • Dealing with differences in sexual desire or frequency

  • Struggling with physical difficulties that have psychological components

  • Working through the impact of past trauma on current intimacy

  • Navigating changes in sexual function due to medication, health conditions, or life stages

  • Addressing sexual identity or orientation questions within relationships

  • Rebuilding intimacy after infidelity or betrayal

  • Managing the sexual impact of neurodivergence, including ADHD or autism

  • Exploring sexual preferences or fantasies in a safe environment

  • Working through religious or cultural conflicts around sexuality

What to expect

Psychosexual therapy sessions are typically 50 minutes long and can involve individuals, couples, or both depending on your specific needs and preferences. Some people benefit from individual sessions initially, whilst others prefer to work together as a couple from the start.

It's entirely normal to feel anxious about discussing intimate topics with a therapist. Many people worry about embarrassment or judgment, but our therapists are trained to discuss sexual matters with the same professionalism and sensitivity as any other aspect of mental health.

Sessions are conducted in a comfortable, confidential environment, whether in person at our London practice or online from the privacy of your own home, where you can speak openly without fear of judgment. We move at your pace, never pushing you to discuss anything you're not ready to explore.

We welcome all sexual orientations, gender identities, and relationship structures. Whether you're in a traditional monogamous relationship, exploring polyamory, or questioning aspects of your sexual identity, our approach is inclusive and affirming.

Our approach

Our therapists are COSRT accredited and trained in psychosexual therapy, ensuring you receive expert, professional care. We integrate various therapeutic approaches tailored to your unique situation, drawing from established methods to address both the psychological and relational aspects of sexual difficulties.

Our therapists understand how past experiences, relationship dynamics, and life circumstances can impact intimate relationships. We take a holistic approach that considers the whole person and their unique context.

Getting started

Contact us to arrange an initial consultation with a therapist of your choice. In the consultation you can ask any questions you may have, and the therapist will understand what you need for both of you to decide if you are a good match. After the consultation there is no obligation to continue. If you want to continue, the therapist and you will arrange the practical next steps and arrange a time to meet. 

We offer psychosexual therapy from our clinic in Blackheath, Southeast London, as well as online. The clinic is easily accessible from Lewisham, Greenwich, and Central London, just a 10-minute train journey away.

Everything discussed in psychosexual therapy remains strictly confidential. Our goal is to help you develop a healthier, more satisfying intimate relationship that aligns with your values and desires.

Our specialisms

  • Sexual difficulties affect many people at some point in their lives, yet they're often suffered in silence due to shame, embarrassment, or simply not knowing where to turn for help. Individual psychosexual therapy provides a confidential space to address personal sexual concerns without the complexity of involving a partner.

    You might be experiencing physical difficulties such as erectile dysfunction, premature ejaculation, vaginismus, or painful intercourse that have psychological components. Perhaps you're struggling with low libido, difficulty reaching orgasm, or intrusive sexual thoughts that cause distress. Sometimes the issue isn't about function but about enjoyment, feeling disconnected from your sexuality or unable to experience pleasure.

    Sexual difficulties often have roots in anxiety, past experiences, relationship patterns, or life circumstances. Medication, health conditions, stress, depression, or major life changes can all impact sexual wellbeing. Our approach looks beyond symptoms to understand the whole picture of your sexual health.

    We work at your pace, helping you understand the factors affecting your sexual wellbeing and developing strategies that work for your unique situation. This might involve addressing anxiety, exploring past experiences, learning relaxation techniques, or simply having a safe space to talk openly about sexuality without judgment.

    Individual therapy can also be helpful preparation for couples work, allowing you to gain clarity about your own needs and concerns before involving your partner in the therapeutic process.

  • Sexual intimacy is one of the most vulnerable aspects of any relationship, yet it's often the hardest to talk about. When things aren't working sexually, it can affect every part of your connection, leaving you feeling rejected, inadequate, or increasingly distant from each other.

    Our psychosexual specialists understand that sexual difficulties are rarely just about sex. They're often connected to communication, trust, stress, past experiences, or the natural changes that happen in long-term relationships.

    We provide sensitive, non-judgmental support for:

    • Loss of sexual desire or significant differences in libido between partners

    • Erectile dysfunction, premature ejaculation, or other male sexual concerns

    • Vaginismus, painful penetration, or other female sexual difficulties

    • Performance anxiety that's affecting your ability to be present and enjoy intimacy

    • The impact of past trauma on your sexual relationship

    • Navigating how desire changes over time in committed partnerships

    A holistic approach to sexual wellbeing

    We work with both individuals and couples, recognising that sexual difficulties often require addressing personal and relational factors together. Our approach is grounded in clinical expertise but delivered with warmth and respect. We create a safe space where you can explore these issues without shame or judgment.

    Sexual wellbeing is a fundamental part of relationship health, and with the right support, most couples can find their way back to satisfying physical and emotional intimacy.

  • Infidelity, emotional affairs, or other forms of sexual betrayal can devastate intimate relationships, destroying trust and creating deep wounds that affect every aspect of the partnership. The betrayed partner often experiences trauma-like symptoms including intrusive thoughts, hypervigilance, emotional numbness, or intense anger and sadness.

    Sexual intimacy is often one of the most challenging aspects to rebuild after betrayal. The betrayed partner might feel disgusted by physical contact, unable to stop thinking about the affair during intimate moments, or completely unable to be vulnerable with someone who has broken their trust. Even when they want to reconnect sexually, their body might not cooperate due to trauma responses.

    The partner who had the affair might feel guilty, ashamed, or frustrated by their partner's ongoing pain. They might struggle with their own complex feelings about the affair, including grief for what they've lost or confusion about what they really want. Sexual intimacy might feel tainted by guilt or comparison with the affair partner.

    Both partners often feel confused about how to move forward. Physical affection might feel loaded with meaning and expectation, making even simple touches feel complicated. Questions about what is acceptable, what feels safe, and how to rebuild without pretending the betrayal didn't happen can feel overwhelming.

    Recovery after betrayal is possible, but it requires patience, commitment from both partners, and often professional support. The process involves grieving what was lost, rebuilding trust through consistent actions over time, addressing the underlying issues that contributed to the betrayal, and gradually rebuilding intimacy in ways that feel safe for both partners.

  • Sexual trauma, whether recent or from the past, can have profound and lasting effects on intimate relationships. Survivors may experience a range of difficulties including anxiety around physical touch, flashbacks during intimate moments, difficulty trusting partners, or complete avoidance of sexual situations.

    Trauma affects each person differently. Some survivors experience hypervigilance during intimate moments, feeling constantly alert to potential danger even with trusted partners. Others may dissociate, feeling emotionally disconnected from their body during sexual activity. Physical symptoms such as pain, tension, or involuntary responses can also develop as the body's way of protecting itself.

    The impact extends beyond the survivor to their relationships. Partners often feel confused, helpless, or worried about causing further harm. They may struggle with their own needs whilst wanting to be supportive, or feel guilty for having sexual desires when their partner is struggling.

    Recovery is possible, but it requires patience, understanding, and often professional support. Trauma-informed psychosexual therapy recognises that healing happens at your own pace and never involves pushing you beyond what feels safe. We work to help you reclaim your relationship with your body and sexuality in ways that feel empowering rather than re-traumatising.

    This might involve addressing trauma symptoms, developing coping strategies for difficult moments, improving communication with partners about boundaries and needs, and gradually rebuilding positive associations with physical intimacy. We also work with partners to help them understand trauma's impact and learn how to provide appropriate support.

    The goal isn't to return to how things were before, but to develop a new, healthy relationship with intimacy that acknowledges your experiences whilst allowing for connection and pleasure on your terms.

  • Questions about sexual orientation, gender identity, or sexual preferences can arise at any stage of life, often bringing confusion, excitement, fear, or all three simultaneously. Whether you're a young adult just beginning to understand your sexuality or someone later in life experiencing new attractions or questioning long-held assumptions about yourself, this exploration can feel overwhelming.

    You might be questioning whether you're gay, lesbian, bisexual, or another sexual orientation entirely. Perhaps you're experiencing attractions that don't fit neatly into categories you've known, or finding that your feelings have evolved over time. Gender identity questions can be equally complex - you might be questioning your gender, exploring non-binary identities, or considering transition.

    Sometimes these realisations occur within existing relationships, creating additional complexity. You might worry about the impact on your partner, fear losing important relationships, or feel guilty about potentially changing the nature of your partnership. These concerns are natural and valid.

    Sexual identity exploration in therapy provides a safe, non-judgmental space to examine these questions without pressure to reach immediate conclusions or make dramatic life changes. We help you explore your feelings, understand your experiences, and consider what your discoveries might mean for your life and relationships.

    This work often involves examining past experiences, current feelings, and future possibilities whilst considering the impact on existing relationships and life circumstances.

    For those in relationships, we can also provide couples support to help navigate these discoveries together, exploring what changes might mean for the partnership and how to maintain connection whilst honouring individual growth and authenticity.

  • Differences in sexual desire between partners are extremely common, yet they can create significant stress and conflict in relationships. When one partner consistently wants sex more often than the other, both can end up feeling frustrated, rejected, inadequate, or pressured.

    The partner with higher desire might feel unwanted, unattractive, or constantly rejected, leading to resentment or attempts to pressure their partner. Meanwhile, the partner with lower desire might feel inadequate, guilty, or defensive, sometimes avoiding affection altogether to prevent expectations of sex. This can create a cycle where the problem becomes worse over time rather than better.

    Desire discrepancy isn't just about frequency, it can also involve differences in the type of sexual activity preferred, timing, spontaneity versus planning, or the level of emotional connection needed before physical intimacy feels appealing. These differences can feel personal but are often about natural variation in sexual response and needs.

    Many factors influence sexual desire including stress, health, medication, relationship dynamics, past experiences, and life circumstances. What feels like a personality conflict might actually be about external pressures, unaddressed relationship issues, or individual challenges that can be addressed.

    In therapy, we help couples understand the complex factors influencing each partner's desire and develop strategies for bridging differences whilst respecting both partners' needs. This often involves improving communication, addressing underlying relationship issues, managing external stressors, and finding creative solutions for maintaining intimacy even when desires don't perfectly align.

    The goal isn't necessarily to make both partners want sex equally, but to find ways of managing differences that feel fair and satisfying for both, maintaining connection and intimacy even when sexual frequencies differ.

  • Sexual performance anxiety can affect anyone but is particularly common among men experiencing erectile difficulties and women dealing with pain during penetration. The anxiety often becomes self-perpetuating - worry about sexual performance creates tension and stress that actually interfere with natural sexual response, confirming fears and making the problem worse.

    You might find yourself constantly monitoring your sexual response during intimate moments, checking whether you're aroused enough, worried about whether you'll maintain arousal, or anxious about your partner's satisfaction. This mental preoccupation prevents the relaxation and present-moment awareness that natural sexual response requires.

    Performance anxiety often begins with a single difficult sexual experience, perhaps stress, fatigue, or alcohol affected your usual response. Instead of recognising this as normal variation, the experience creates worry about it happening again. This anxiety then becomes the primary factor interfering with sexual function, creating exactly the problem you're trying to avoid.

    The anxiety can extend beyond physical performance to include worry about technique, body image, lasting long enough, or satisfying your partner. Social pressures and unrealistic expectations from media or past partners can contribute to these concerns.

    Treatment for performance anxiety focuses on breaking the cycle of worry and sexual difficulty. This often involves education about normal sexual response, techniques for managing anxiety, and approaches for reconnecting with physical sensations rather than anxious thoughts during intimate moments.

    We might work on relaxation techniques, mindfulness approaches, communication with partners about pressure and expectations, and gradually rebuilding confidence through positive sexual experiences. The goal is to return to natural, relaxed sexual response where pleasure and connection take precedence over performance concerns.

  • Major life changes often bring unexpected challenges to sexual relationships, as bodies, circumstances, and priorities shift in ways that can significantly impact intimacy. These transitions are natural parts of life, but they can leave individuals and couples feeling unprepared for their sexual implications.

    Pregnancy and childbirth bring profound physical and emotional changes that affect sexuality. During pregnancy, physical discomfort, fatigue, body image concerns, or anxiety about the baby can impact sexual desire and comfort. After childbirth, hormonal changes, physical recovery, sleep deprivation, and new parenting responsibilities often dramatically affect sexual relationships. Many couples find their sexual connection feels completely different, and they need to rediscover intimacy together.

    Menopause represents another significant transition, often bringing changes in hormone levels that can affect desire, arousal, and physical comfort during sex. Vaginal dryness, reduced sensitivity, or pain during penetration can develop, whilst emotional symptoms like mood changes or reduced confidence can further impact sexual wellbeing.

    Ageing affects sexual function for many people, with changes in arousal time, sensitivity, or physical flexibility. Medical conditions, medications, or physical limitations might require adaptations to sexual practices. These changes can feel like losses, particularly in a culture that often equates sexual worth with youthful function.

    Illness, whether temporary or chronic, can significantly impact sexuality through physical symptoms, medication effects, fatigue, pain, or emotional factors like depression or anxiety. Couples might struggle with how to maintain intimacy when one partner is unwell, feeling guilty about sexual needs during health crises or unsure how to adapt their sexual relationship to new limitations.

    In therapy, we help individuals and couples navigate these transitions with realistic expectations and creative solutions. This might involve grief work for sexual changes that feel like losses, practical problem-solving for physical challenges, communication support for discussing changing needs, and exploration of new ways to experience intimacy that work within current circumstances.

    The goal is to help you adapt your sexual relationship to life's changes rather than simply accepting that sexuality must decline, finding ways to maintain connection and pleasure even as circumstances evolve.

Meet our psychosexual therapists

couples therapist and marriage counsellor in lewisham and greenwich
Psychosexual counselling and therapy online

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