Common Issues

The most common (but non exclusive) range of issues that present in my clinic

More commonly known now erectile dysfunction. Defined as 'the inability to maintain an erection long enough for successful activity to take place'. Can be of physical origin but more likely psychological, and can be interpersonal the causes of which, will be determined at assessment. Referrals to physicians, who are also expert in human sexuality, can be made if necessary and always with your understanding and permission.

Anorgasmia, as it is known, is the inability to experience orgasm either by self or partner stimulation. A structured programme with plenty of tasks given to undertake at home make this treatment highly successful.

This is rare and is usually of physical origin. Often what you may really mean is you have lost your sexual desire for someone. Or maybe stress, loss or depression has brought about a loss of sexual desire. Counselling can identify causes and offer remedies.

Falling out of erotic love for a partner does happen; there are many reasons why this may occur. Therapy is about identifying what these reasons might be and 'working through' them by enhancing what works in your relationship then breaking down and rebuilding the inhibitors.

Known as dyspareunia for women. This may be of physical origin but more often a combination of physical and psychological. Therapy entails identifying and or ruling out physical reasons and working on the psychological issues that make sex feel painful. Loss of natural lubricant can further complicate the condition. Or, for men it maybe either Peyronies, or a number of other causes. Referrals to physicians, who are also expert in human sexuality, can be made when necessary and only with your full understanding and consent.

Vaginismus, the muscles around the vagina are the strongest muscles in your body. When these tighten up, for whatever reason, sexual intercourse becomes impossible. A sensitive programme of therapy is implemented with exercises to do at home with maybe (but not always) the use of 'vaginal trainers'. These are non-invasive tools that help you to relax and build your confidence.

Premature ejaculation is when you ejaculate before successful intercourse has taken place. There are a number of reasons why this might occur which can by physical, psychological or interpersonal or more often a combination of all three. Premature ejaculation can often be a precursor to erectile dysfunction too.

A grey area, if you like and have lots of sex are you addicted? Not necessarily so but is SEX constantly on your mind? Are you engaging in risk taking behaviours, which which are likely to cause relationship problems. The criteria for addiction are as follows: You are preoccupied with thoughts about the behaviour. You constantly ruminate about it. You cannot reliably stop The behaviour has harmful or potentially harmful consequences, such as: health and financial risks, professional misconduct, impaired parenting, damage to marriage and other primary relationships. It tends to be used to anaesthetise painful feelings such as shame, low self esteem, core loneliness, anger, stress and guilt.... and this occurs unknowingly.

Becoming a frequent issue that presents in the clinic with the rise in internet use and its wide availability and access, but the criteria of addiction is the same for internet or otherwise You are preoccupied with thoughts about the behaviour. You constantly ruminate about it. You cannot reliably stop The behaviour has harmful or potentially harmful consequences, such as: health and financial risks, professional misconduct, impaired parenting, damage to marriage and other primary relationships. It tends to be used to anaesthetise painful feelings such as shame, low self esteem, core loneliness, anger, stress and guilt.... and this occurs unknowingly.

An exploration of your relationship history will help you identify whether this might be the case. The Greek philosophers (esp. Plato and Aristotle) wrote a great deal about the types of love we may have for each other and Diana uses this great knowledge during this assessment.

Communication is an essential part of a healthy and robust relationship. Communication skills are taught and practised. Couples learn to talk about feelings, task sharing and sex. You will be able to talk more comfortably, ruling out misperceptions, confusion and any resulting resentments.

When couples have got into distress, communication becomes negative and 'attacking'. This never solves anything, it just hurts more and more. Couples are taught to communicate effectively and learn how to negotiate becoming more tolerant of each other.

Violence in relationships is never OK. It has to stop immediately. You will not be judged if you bring this issue to me. You will be helped and taught other ways of expressing anger and managing extreme emotions.

Sexual orientation is not always set at puberty and individuals can drift from heterosexual desires to same gender desires any time in life. If this is troubling you then do please come and discuss it.

Sex has become boring you do not know how to address it with your partner. Sex has always been boring and you can't admit it to yourself. I offer an open environment for you to learn how to make your sex more lively, enjoyable and rewarding.

Sure, so long as it is not affecting anyone in an adverse way. Like for instance yourself, financially or your relationship and family. Or you may have become used to 'unusual' sexual behaviour, which is leaving you feeling dissatisfied and possibly socially isolated. Talking about it may help clarify matters.

Surely telling someone is better than telling no one at all. Rape, most certainly is devastating. It cuts across culture, class, age, gender, and power. Darkened alleyways may be deemed unsafe, but with rape, so might our own homes, our own families, our own friendships and marriages become just as dangerous a place to be. Estimates indicate that 1 in 4 women have been raped. There are no figures yet for men.

These estimates become difficult to validate when many rapes are not reported. It has been suggested that only 5% - 8% of adult sexual assaults are reported compared to 61% of robberies and 82.5% of burglaries.

Here, you will not be pressurised to report, but listened to and supported. However, if you choose to report you will be supported throughout the process. Partners and families of victims of rape and sexual violence may also need to talk. There is no doubt that it affects them too, although in a different way.

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