Image of Balanced Minds Logo

Sex & Compassion Focused Therapy

Dr Jane Vosper

How’s your sex life going? (Blushing cheeks, looking to the side, “ummmm….”). For many people sex is an integral and important part of life, linking with identity, connection, joy, pleasure and fun… but many of us really struggle to talk about it. I’ve been talking about sex non-stop for the last 14 years in sexual health services in the NHS… and I still feel a bit embarrassed!

Despite the sexual revolution in the 1960s, there is still a huge taboo around sex and it can be really hard to find a way of comfortably talking about experiences. Given the taboo and ongoing embarrassment associated with talking about sex, it’s not at all surprising that people can feel very ashamed and alone when sex is not working out. 

Compassion focused therapy & sex
Who is our “compassionate other” when it comes to sex? We’re lucky when we have someone in our lives who will engage with our distress about sex (that good friend who’ll listen kindly) … but how about someone who is wise enough about sex to help us take compassionate action? Is it any wonder that self-compassion for sexual problems is so difficult?
 
Compassion Focused Psychosexual Therapy (CFPT) allows a structured way of formulating shame and self-criticism specific to sexual problems. In working with people struggling with sex, again and again we hear harsh inner voices of people telling themselves they are useless and will never be worthy of a partner because their body doesn’t work properly. CFT offers formulation and skills to work with this self-criticism and work towards building a compassionate response… moving towards actions that will help.
three system model

CFPT also offers a way of understanding the complex interplay of emotions and sexual functioning. All of us using CFT as practitioners or clients (or both) start to see the world in terms of those three blobs… red, blue and green. 

It turns out those three blobs (otherwise known The Three System Model) can be really helpful in understanding the link between emotions and sex. When it comes to sex, we might initially think about our Drive System: that dopamine/testosterone fuelled “go get a mate” system that feels full of action and spontaneity.  

However, for humans and other pair bonding species, the Soothing System is also really important in sex: that oxytocin release associated with connection (whether long term or just in that moment). When this system is active it can signal to the body there is enough safeness to enjoy sexual sensations and really be “in the moment”. 

That balancing of systems we talk about with CFT also holds for sex. As for the Threat System: many people can make the link between “performance anxiety” and sex not working quite so well, however mapping out the Three Systems can give a much more nuanced understanding of what might be going on. For example, thinking about the Threat System: anxiety can decrease or increase sexual arousal (the “thrill” of something risky or the power play that might happen in BDSM). Sexual arousal can decrease disgust and anger pretty much always decreases arousal (“make up sex” is only fun if you’ve genuinely “made up” and let go of that argument).
 
What else can CFPT offer … how about the tricky brain? When it comes to sex our brains really are very very tricky! Much like our emotional systems, our sexual and reproductive systems have evolved over time to adapt to the precarious world we live in. Alongside ancient motivational systems, we also have our newer brains, creating and repeating so many weird and not always wonderful stories about sex. We’re probably the only creature who would refuse to have sex with a willing partner because we’re embarrassed about our body image. Our sexual feelings are certainly “not our fault” … however it is our responsibility to try to understand them.
 
For the last few years, we’ve been developing a model of therapy which integrates CFT ideas with psychosexual approaches. So far, we found this helpful for a variety of presentations, from common problems such as pain during penetration and low desire, to more complex problems such as compulsive sex and sexual difficulties following trauma. 
 
We’re continuing to explore and develop ideas, through practice, supervision and research.  If you’re curious to find out more (and not feeling too embarrassed) you can read more here:
 
Vosper, J., Irons, C., Mackenzie-White, K., Saunders, F., Lewis, R., & Gibson, S. (2021). Introducing compassion focused psychosexual therapy. Sexual and Relationship Therapy, 38(3), 320-352.
Sex & Compassion Focused Therapy - Balanced Minds

Interested in CFT and Self-Compassion?

If you’re interested to learn more about what compassion is, some of the difficulties that come with it, and how to practice becoming more compassionate with yourself and others, subscribe to our mailing list where you’ll get updates on our latest blogs.

You can also develop your compassionate mind through our self-help books, audios, courses and self-compassion app

And if you’d like to work with one of our experienced CFT therapists, you can find more info here