Psychosexual Issues

What are psychosexual issues?

Psychosexual issues are sexual issues that are psychological in origin rather than physiological. They may come about as a result of stress, anxiety, depression, trauma and other causes.


Sexual problems can vary in severity and intensity. Some can be minor and temporary whereas others may have been around for a long time.

Examples of psychosexual issues

  • Loss of sexual desire
  • Painful intercourse
  • Difficulties with orgasm
  • Arousal disorders
  • Erectile dysfunction
  • Premature or delayed ejaculation
  • General breakdown in a couple’s sexual relationship
consultation taking notes

Treatment for psychosexual issues

Therapy will help you understand the origins of your difficulties. Usually the focus will be on unravelling the underlying causes rather than the sexual difficulties themselves. That said, there will also be some guidance on strategies that can help you better manage the difficulties you’re experiencing.


Following your initial assessment, we will spend some time developing a psychological formulation of your difficulties so we can create a unique treatment plan. In some cases, we may refer you to a psychosexual therapist if we think this would be helpful.

Frequently asked questions

You should seek support for psychosexual issues if you find that you are struggling with your sexual performance or you are experiencing a lot of anxiety when it comes to sex and intimacy. If this area of your life is causing you stress or concern, it’s always beneficial to seek professional help as these kinds of difficulties can become an obstacle to enjoying an intimate relationship.

Cognitive Behavioural Therapy (CBT) is typically the most effective therapy, as well as seeing a psychologist who has specialist training in dealing with psychosexual issues.

Whilst it’s always helpful to first see your GP to exclude any physiological issues, there are some signs that could indicate that your difficulties are psychological. If, for example, you are able to achieve sexual pleasure on your own, it is unlikely that there is something physiological at play. But if you find that you have a lot of anxiety when having sex with a partner then it is more likely to be psychological.

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Dr Adí Hannah Sela

Dr Adí Hannah Sela is a Counselling Psychologist working as a private practitioner and a lecturer on a professional doctorate program. She earned her Professional Doctorate in Counselling Psychology at the University of East London, where her research interests lay in disordered eating and motherhood. Dr Sela’s prior training took place in Israel where she trained as a CBT therapist and received her Bachelors Degree in Psychology. 

As a psychologist, Dr Sela works flexibly with her clients’ needs; integrating tools from a wide array of evidence-based therapies in order to tailor therapy to each individual. Dr Sela draws from many modalities including: Gestalt Therapy, psychodynamic therapies, Compassion-Focused Therapy (CFT) and Acceptance and Commitment Therapy (ACT), and Cognitive Behavioural Therapy (CBT). Dr Sela believes that as humans we experience and express emotions not only through spoken word, and as such she offers artistic methods of exploration where appropriate.  

Dr Sela works with couples, adults and young people.  Dr Sela specialises in working with eating disorders (and disordered eating), body image disturbances, low self-worth, low mood, issues of control (e.g., OCD), gender dysphoria, identity struggles, motherhood, trauma, social anxiety, and other forms of anxiety.  

Dr Sela is fluent in English, Hebrew and Spanish.