The Ellie Blog

Mental health tips and insights

Happy woman riding on her male friend back on the street. Both dressed warmly for late autumn. Both having a great time, smiling

Problems with Intimacy and Sex: How Couples Therapy Can Help

Intimacy is like the secret sauce in the recipe of a healthy relationship, but keeping it simmering can be tough! With life’s whirlwind, past baggage, or good ol’ miscommunication, many couples find their spark fizzling out. Fear not! In this blog post, we’re diving into the world of couples therapy—a magical toolbox for tackling those intimacy hiccups.

This blog post is based on an interview with experts Erin Pash, LMFT and Heather Reidinger, LMFT. We’re chatting about how therapy can amp up your communication skills, uncover those sneaky root issues, and lay out some fun steps to rekindle that emotional and physical flame with your partner. So, if you and your boo are in the intimacy struggle bus, keep reading to see how a little professional help can steer you towards a more vibrant relationship!

The Interview:


The Experts:

Erin Pash, LMFT

Heather Reidinger, LMFT

Miranda Barker, LICSW

Understanding the Importance of Intimacy and Sex in Relationships

Intimacy is more than just physical closeness. It’s about vulnerability, curiosity, and communication. Erin highlighted that intimacy often diminishes first as life’s responsibilities grow, leading to a range of relational issues. Heather emphasized that talking about sex at all stages of life acts as preventative care for a relationship.

Common Challenges Couples Face

Fear of Judgement and Rejection

Many people find it difficult to discuss their own sexual needs and desires because they’re afraid of judgment or rejection. Erin pointed out that a significant barrier is the culturally ingrained modesty around our bodies and sexuality, resulting in couples struggling to talk openly about their needs. Plus, there’s a huge level of vulnerability that is needed when talking about what you need or want!

Body Image and Postpartum Changes

Heather shared insights on the impact of body image issues, especially post-pregnancy for many people. She noted that many women experience grief over their postpartum bodies, which can affect their intimate relationships. Erin also touched on how body acceptance movements are helping to challenge outdated norms and encourage more open conversations.

Different Levels of Desire and Preferences

It’s rare for couples to have perfectly matched sexual desires and intensity. Erin suggested that mismatched sex drives can be addressed by focusing on the quality of intimacy rather than the quantity, scheduling intimate moments, and incorporating more foreplay into their routine.

How Couples Therapy Can Help

How couples therapy can help with intimacy infographic

Couples therapy? You bet it’s a game-changer when things get tough (and even before then). Here are several ways it can help:

1. Facilitated Communication

Therapists provide a safe, neutral environment where couples can openly discuss their issues without fear of judgment. This structured setting encourages honest communication about deeply personal topics like intimacy and sex.

2. Identifying Root Causes

Therapists are trained to help couples identify the underlying causes of their intimacy struggles. These might be rooted in past traumas, cultural norms, body image issues, or medical conditions. By pinpointing these root causes, couples can actually address them more effectively.

3. Developing Healthy Communication Skills

In couples therapy, we don’t just chat. We craft the language of love. We teach you to voice your dreams, fears, and hopes in ways that honor your partner and fuel progress. Together, we strengthen the bedrock of your bond, turning hurdles into stepping stones.

4. Creating Safe Spaces for Vulnerability

Embracing vulnerability isn’t always easy, but it’s truly rewarding. Couples therapy offers a place for partners to open up, paving the way for a stronger bond.

5. Psychoeducation

Therapists are here to guide you through normal sexual behaviors, debunk the myths, and enlighten you about sexual anatomy and function. Pyschoeducation is a great way to say goodbye to anxieties and misconceptions.

6. Practical Tools and Exercises

Therapy sessions can include practical exercises and homework designed to improve intimacy. For example, therapists might suggest scheduling intimate moments, engaging in extended foreplay, or experimenting with new types of physical closeness–  see some specific tips below.

7. Medical and Psychological Referrals

If medical or physical problems are a barrier to intimacy, therapists can provide referrals to appropriate medical professionals. They can also work in conjunction with these professionals to ensure a holistic approach to treatment.

8. Normalizing and Destigmatizing Issues

Couples often feel isolated or ashamed about their intimacy struggles. Therapy helps normalize these issues, making it clear that many couples face similar challenges. This can reduce stigma and encourage more open discussion.

9. Rebuilding Trust

For couples dealing with breaches of trust, such as infidelity, therapy can be crucial in rebuilding that trust. Therapists provide strategies for healing and re-establishing a sense of security within the relationship.

10. Enhancing Emotional and Physical Intimacy

Through guided exercises and therapeutic techniques, couples can learn to connect on a deeper emotional and physical level. This enhanced intimacy can reinvigorate their relationship and pave the way for a more fulfilling partnership.

11. Long-term Strategies for Maintaining Intimacy

Therapists can help equip couples with long-term strategies to maintain and improve intimacy. These include regular heart-to-hearts, communication exercises, and ways to continuously explore each other’s needs and desires as the relationship evolves.

Couples therapy is a valuable resource for any couple looking to deepen their connection and overcome the barriers to a more intimate and satisfying relationship. Match with a couples’ therapist near you at Ellie Mental Health.

Actionable Steps for Couples

1. Open the Conversation

  • Schedule Conversations: Start by setting a specific time to discuss your relationship and any topics related to intimacy—issues, hopes, ideas, etc. Avoid discussing sensitive topics in the heat of the moment.
  • Normalizing Some of the Awkwardness: Understand that discussing sexual preferences can be awkward and uncomfortable at times (especially at first!), but it’s a crucial step toward a healthier relationship.

2. Be Vulnerable and Curious

  • Ask Clarifying Questions: Encourage curiosity by asking your partner to elaborate on their needs and desires. Some ideas for questions and conversation starters can be found here.
  • Share Without Fear: Create a safe space where both partners can share their fantasies and preferences without feeling judged.

3. Address Medical Concerns

  • Seek Medical Advice: If there’s a medical issue, don’t hesitate to consult a healthcare professional. Discussing these issues can often lead to effective solutions.
  • Psychoeducation: Educate yourselves about common sexual health issues that may affect intimacy. Need a place to start? Here are some relationship book recommendations our therapists shared, organized by issue or need!

4. Innovative Approaches to Intimacy Our Therapists Shared

  • Scheduling Intimacy: Plan intimate moments to ensure that both partners can prepare mentally and physically.
  • Sexual Games: Introduce playful elements like dice or cards with different sexual positions to make intimacy fun and adventurous.
  • Extended Foreplay: Set a timer to focus on foreplay and build up the intimacy, ensuring that both partners are fully engaged.

Reflecting on Growth

As Heather pointed out, it’s essential to reflect on the growth and progress made in your relationship. Acknowledge the small steps and celebrate the improvements. Remember, therapy is about uncovering the layers and finding new ways to connect deeply with your partner.

Final Thoughts

In a nutshell, figuring out intimacy in a relationship is like embarking on an adventure that needs a map, some teamwork, and a whole lot of heart-to-heart chats! Couples therapy is like having a trusty guide that helps you tackle the tricky stuff, teaches you how to communicate like pros, and boosts that oh-so-important emotional and physical connection. By diving into the treasure chest of tools and wisdom therapy offers, couples can squash those pesky challenges, spice up their intimacy, and craft a relationship that sparkles! Just remember, the path to a fantastic partnership is sprinkled with respect, curiosity, and a dash of growth. Here’s to striding toward a more loving and unshakeable bond!

About the author

Miranda Barker headshot

Miranda Barker, MSW, LICSW

Director of Content and Production

Miranda specializes in working with people who have been touched by adoption or foster care (birth parents, adoptees, kids in foster care, etc). She enjoys working with people of all ages. Prior to joining Ellie, Miranda spent several years in the non-profit adoption field and then as a child protection investigator and case… Read more