Dr Ellen Harley
PhD, MSc, Member of COSRT

Articles by Dr Ellen Harley – Sex and Relationship Therapist & Counsellor

1.    An Overview of Sexual Dysfunction

2.    A Relationship Doctor’s Guide to Self Diagnose Your Relationship Problem

3.    A humorous look at how to keep your relationship happy (circa 1960) - A guide for women

4.    A humorous look at how to keep your relationship happy – A guide for men

5.    Sexual problems in schizophrenia: prevalence and characteristics.  A cross sectional survey

6.   A relationship doctor’s guide to a loving and satisfying relationship

An Overview of Sexual Dysfunction by Dr. Ellen Harley PhD
Date: March 2011
Sexual development is a complex and interactive process involving sexual differentiation into male or female and the development of gender identity, sexual responsiveness, and the capacity for close intimate relationships. All these take place at different stages of a person’s life, from pre-natal, childhood, adolescence, adulthood, to mid-life.  Within the course of this process, difficulties and problems can occur.

In the early twentieth century, the most popular approach to examining sexual problems was the psychoanalytical approach, which viewed sexual problems as symptoms of a disorder of personality development. This contrasts with the predominant Victorian conceptualisation of sexual dysfunction as “moral degeneracy”.
In the 1950’s and 1960’s, more direct behavioural interventions were used to treat sexual dysfunctions. These were based on learning theories and underpinned by the assumption that anxiety was the major cause of sexual dysfunction. In 1970 Masters and Johnson published “Human Sexual Inadequacy” viewing anxiety as central to the development and maintenance of sexual dysfunction. The work of Masters & Johnson shifted the consideration of sexual problems away from the framework of psychopathology to those of learning theories. They divided the sexual response into four phases where dysfunctions can occur: excitement phase, plateau phase, orgasmic phase and resolution phase. They paid little attention to problems of sexual desire.

Another American sexologist Kaplan in 1977 also described anxiety as an important aetiological factor. She put an emphasis on the desire phase thereby making a division between interest and function. This was later reflected in the systems of classification of sexual problem, which is divided into disorders of desire, of arousal and of orgasm.

What is sexual dysfunction?

ICD 10 (World Health Organisation 1992) defines sexual dysfunction as “the persistent impairment of the normal patterns of sexual interest or response”. It specifies that the dysfunction needs to be present for at least six months and is not entirely attributable to any of the other mental or behavioural disorders,  physical disorders or drug treatment.
Sexual dysfunctions can be lifelong (you’ve always had it) or acquired; occur in all situations or just within a certain situation or with a specific partner. Sexual dysfunction can be caused by psychological or physical factors, or combination of both.

What is Paraphilia?

The term ‘paraphilia’ describes sexual activities that are seen as ‘perverted’ or ‘deviated’. The term means an attraction (philia) to something that is outside the normal range (para). Paraphilia describes a sexual behaviour that dominates and directs a person’s sexual practices, which becomes central to the individual’s sexual excitement, in so far that this cannot occur without the paraphilic behaviour. Some of the better known activities are fetishism (objects or part of a body), exhibitionism, voyeurism, paedophilia, sadomasochism.

 What are the different types of Sexual Dysfunction

Sexual Desire Disorders

Sexual Desire Disorders are about the impairment of sexual interest. Sexual desire motivates you to have sex. Desire is experienced more continuously by men across the life cycle, but tends to be more variable in women, and can be influenced by a number of contextual determinants including hormonal and relationship factors. Men with sexual desire problems tend not to initiate sexual expression and women tend not to respond to initiation. Lack of sexual desire can also reflect in infrequent masturbation.
Lack of sexual desire can be the primary problem, or as a result of other sexual difficulties such as arousal and orgasmic problems or dyspareunia.

 Sexual Arousal Disorders

Sexual arousal or excitement is characterised by complementary changes in the genital organs of both men and women. Due to dilatation of blood vessels the penis enlarges and hardens and the vagina reacts by swelling and moistening in order to accommodate the penis. In men, disorder in this sexual phase is termed erectile dysfunction (impotence) when erection is insufficient for intercourse to take place.

 For women, there is a failure of genital response, experienced as lack of vaginal lubrication. Other deficiencies in arousal are shown by an absence of body responses, such as flushing of the face, an increase in spontaneous body movements, and a corresponding increase of heart and respiratory rates.

Orgasmic Disorders

Orgasmic dysfunction occurs when orgasm either does not happen or is markedly delayed. In addition to absence of ejaculation men may suffer from problems such as premature ejaculation, when ejaculation occurs before or very soon after the beginning of intercourse, with minimal sexual stimulation. Retarded ejaculation may occur in men.  This is a situation where it becomes difficult or impossible to reach orgasm and ejaculate.

What causes  Sexual Dysfunction?

The causes of sexual dysfunction are complex and tend to be inter-related. They can be broadly divided into three categories:

·         Physical and health factors

·         Psychological factors

·         Relationship factors

 Physical and Health Factors

·         General Health

In men, the most common biological causes of erectile dysfunction are high blood pressure, diabetes, endocrine disorders, heart diseases, multiple sclerosis, trauma or fractures to the pelvic area or spinal cord. Other risk factors which affect all categories of sexual dysfunction include smoking and alcohol abuse.

 In women, problems such as multiple sclerosis, diabetes, pelvic vascular disease, urinary tract infections and alcohol abuse are known to affect arousal and orgasmic response. Ageing, with all its associated effects on the human body, can have a negative effect on sexual functioning.

·         Hormonal and Endocrine factors

:Loss of interest in sex is a common complaint amongst men suffering from high levels of prolactin in the body. This condition also affects women in terms of desire level and reduced sexual activity and can contribute to infertility. Certain medications, such as antipsychotics, can raise prolactin levels as a side effect.

Circulating levels of androgens and oestrogen affect sexual function in both men and women. Perimenopausal and menopausal women have reported loss in sexual interest  which could be due to significantly lower androgen levels and also a host of relationship and psychosocial factors associated with menopause .

·         Medication

Certain medications which act on neurotransmitter systems involving dopamine and serotonin are associated with sexual dysfunction. A wide variety of medications are implicated. These include medication for the treatment of psychosis, diabetes, highblood pressure, asthma, heart problems, depression, and for reduction of cholesterols.

Psychological factors

Genital responses are associated with erotic sensations that increase arousal and ultimately lead to orgasm. The willingness to have intercourse, the ability to relax and to concentrate on sensations is vital in the process. A person needs to feel comfortable about his/her body and the physical changes that occur. Additionally he/she needs to feel safe enough to allow these changes to happen in front of another person. When in a sexually aroused state a person becomes more vulnerable, anything that interferes with the comfort and security during a sexual encounter is likely to impair sexual responses. Low mood, anger, anxiety, hostility, resentment all cause disruption in normal sexual functioning. Psychological disturbances occur in mental illness, stressful situations. Experience of childhood sexual abuse, trauma, cultural and religious beliefs can lead to negative feelings about sex. These psychological factors can at the same time contribute to relationship difficulties.

Relationship Factors

Sometimes sexual problems tend to reflect relationship difficulties. A vicious cycle may develop where relationship difficulties contribute to sexual dysfunction, which in turn perpetuate or worsen the relationship problems. Relationship problems can be due to poor communication, inability to resolve conflict, boundary issues, and cultural differences between partners. All of these lead to pervasive hostility and avoidance. Sometimes issues can affect one partner predominantly rather than the relationship as a whole. This, for example, may be due to a partner being either mentally or physically ill, suffering from a sexual dysfunction, having an affair or being extremely possessive and suspicious.

How to treat sexual dysfunction?

An experienced sex and relationship therapist will be able to identify the underlying causes of what contribute to the problem and direct you to appropriate help. Likewise your GP should be able to do that. If the sexual difficulties are a result of physical and health problems then your GP will treat this or refer you to relevant specialists. If the problems are related to psychological, emotional and relationship difficulties, then sex and relationship therapy will be necessary. 

 There are various therapy approaches to treat sexual dysfunction. These include cognitive behavioural therapy, systemic and solution focused methods. Sometimes individual sessions can be incoporrated into the couple therapy, and indeed may be necessary for the therapist to gain more insight into the problem, and to help individual partners to make important changes that can positively impact on the couple relationship as a whole.                                                                                    

 Copywrite:Dr Ellen Harley   5/03/2011

A Relationship Doctor’s Guide to Self Diagnose Your Relationship Problems
Date: 5th March 2011
Are relationship problems common?

Couple relationship problems are common and by no means rare. Demographic variables, such as divorce rates, may be the most statistically reliable index of marital distress. For first marriages this is about 40% to 45% in the United States, the UK and Australia, but this only represents a portion of all couples experiencing problems and it does not reflect couples who are cohabiting.  Available data suggests that the rates of relationship problems and breakdown are substantially higher for cohabiting couples than for married couples. Married couples may not divorce despite problems due to the need to stay together for their children, or social and financial reasons. Therefore the prevalence of relationship problems is thought to be considerably higher than reported divorce rates. These high rates suggest that relationship problems are very common, indeed, perhaps statistically the ‘norm’.

 Why do relationship problems occur?

Relationship problems can occur at different stages in the relationship, such as childbirth, childrearing, conflict with adolescent children, children leaving home, caring of elderly relatives, retirement and ageing. Negative life events, such as physical or emotional ill health, financial problems, redundancy or work stress can also trigger relationship problems.

 Apart from these external environmental factors, individual vulnerabilities of each partner also play a role in the development and maintenance of problems. Individual characteristics refer to upbringing, childhood and adolescent experience, and personality factors. These traits are very much influenced by family of origin, attachment style and ability to cope with negative feelings and conflict. Each partner brings into the relationship his/her individual characteristics which impact on couple interactions.

 Life events and stresses, individual characteristics of partners and couple interaction all interact together and become a rich minefield for problems and conflict to occur.  Experiencing conflict is normal in any relationship. It is more important to know how to constructively  resolve differences.

How do I know when I have problems in my relationship?

You feel unhappy in your relationship. You feel that your partner no longer understands you.

You experience feelings of frustration and resentment and guilt. You may even entertain the ideas of leaving.
You may just experience a vague sense of dissatisfaction in your relationship. Most of the time you know something is wrong, but cannot pinpoint exactly what and where and how.
Your sex life will most likely suffer. You may not be in the mood. You may not be aroused even if your partner tries to please you sexually. You may not be able to achieve orgasm. You may experience pain during intercourse. You will generally feel the loss of quality in your sex life.

 How do I know what these relationship problems are?

Generally speaking, there are four areas in a relationship where problems are most likely to occur. They are: intimacy, communication, power and role.

1.                  Intimacy

Intimacy is a process where a person feels understood, validated, respected and cared for. There are different aspects of intimacy: emotional, social, intellectual, sexual, recreational and spiritual.

Ask yourself the following questions:

Does your partner listen to you when you need someone to talk to?

Do you often feel distant from your partner?

Can your partner understand you hurt and joy?

Do you feel neglected at times by your partner?

Do you sometimes feel lonely when you are together?

Do you enjoy spending time with other couples?

Does your partner disapprove of some of your friends?

Are you satisfied with your sex life?

Would you say sex is an important part of your relationship now, or not really?

Would you say you enjoy sex generally, or not particularly?

Is sex more important to one of you than to the other?

Are you able to tell your partner when you want sex?

 How many times have you answered ‘yes’? This would be an indication of whether you have problems in the area of intimacy in your relationship.

2.                  Communication

Problems in communication are almost universal in unhappy relationships. Communication problems in relationships tend to happen in two main areas: confiding and problem solving.

Confiding is the extent to which partners reveal themselves to each other, including thoughts, feelings and experiences. Ability to confide and self disclose contributes to a sense of intimacy in relationships, which is fundamental to relationship success.

 Problem solving refers to how a couple deal with conflict and how do they negotiate to achieve a common goal.

Ask yourself the following questions

          - do you confide in your partner

          -  easily or with difficulty?

          -  even about your most personal feelings?

 Do you tell your partner about things that worry you or get you down?

          -  do you just touch on it or do you go into detail?

 Is there anything you wouldn’t tell your partner?

          -  what? why not? because of what your partner would say or do?

 Have you confided in your partner recently about anything?

          -  what was that?

 What kinds of things make you irritable with each other? What do you tend to disagree about? (Do you have a go at each other when you are niggled, or do you bottle it up? What about your last quarrel, what happened? How often does this happen – say over the last month?)

 Do arguments ever become violent at all – where one of you throws things or hits the other? (Is this often? Has this happened in the past? When was that?)

 Are you able to come to some agreement over problems?

Do you and your partner manage to spend any time alone together?

What is it like when you are alone together? (Relaxed? Quiet? A bit boring?

Tense? Fun? Arguing?)

Do you do anything together or just sit? (Do you have much to say to each other?)

 Answer these questions truefully and honestly, then read your answers again and you will have a general idea whether you have a problem in the area of communication and problem solving in your relationship.

3.                  Power

In this context the concept of power includes responsibility, discipline, control, role negotiation and decision-making.  If one partner consistently feels that he/she has been undermined and feels unequal in the partnership, it can lead to low marital satisfaction and higher levels of conflict between partners.

 However, an imbalance of power may not automatically generate dissatisfaction. Perception of power in a relationship depends on what the individuals feel, rather than their actual abilities to exercise decision making or control.  It may suit an individual not to have to make decisions.

Ask yourself the following questions:

Do you think you are better or worse than your partner? In what ways?

Do you think you are intelligent? (if no, do you wish you were?)

Do you think you are attractive? (if no, do you wish you were?)

Do you think you are sociable? (if no, do you wish you were?)

Do you think you are educated? (if no, do you wish you were?)

Do you think you can cope well on your own? Financially? Emotionally?


 Who is primarily responsible for the decision of:

1. Self        2. Partner        3. Both

Where you live?

The number of children

Children’s discipline?

How money is spent?

How leisure time is spent?

Frequency of sexual relations?

Again if you have answered these questions truefully and honestly, this will give you a good idea if there are any power differential between you and your partner. Ask yourself how do you feel about it.

4.  Role

In the years gone by, roles within marriages were clear. The wife’s job was to provide nurture and social support inside the home, while the husband was to cope with outside environment, to provide and to protect.

Societal changes, for example, the increase of females in workforce, sharing the benefits of increased income and greater status, have resulted in the change of role attitude (what one thinks should happen). When changes in role attitude do not reflect in role behaviour( what actually happens), then problems may occur. When circumstances force a change in role behaviour, which is not accompanied by a change in role attitude, problems may result. For example if a woman harbours a belief in traditional wife role of staying at home (role attitude), she wouldn’t be very happy if her partner loses his job and she has to go out to work (role behaviour). Matched role behaviour and attitude between partners is associated with marital satisfaction.

 Ask yourself the following questions:

Within your relationship, do you have very clear roles?

     -  male/female,  parent/child,  equal roles

Are these roles rigid or do they interchange?

Is this how you expect things to be?

Are you happy with the way things are? If not, what would be your ideal?

 The answer to these questions will give you an idea of the discrepancies between your role attitude and role behaviour. The bigger the discrepancies, the more unhappy and frustrated you will feel.

How do  I sort these relationship problems out?

Now that you have some ideas about which area witnin your relationship that needs looking at, you can start working on improving it. However when these problems are deep seated and entrenched, and are far more complex involving different strands of your life, then you will need expert and professional help. Seeing a sex and relationship therapist can help you tease out these complexities, to develop an understanding and awareness to your difficulties, and to identify and practise on changing your thinking and your behaviour, so that your relationship and your sex life can be satisfying again. The therapist will see both of you together, as well as individual sessions, in order to do a thorough assessment.. You will have a session together to discuss the formulation of the problems, and the treatment plan.

Copywrite Dr. Ellen Harley  5/03/2011

A humorous look at how to keep your relationship happy (circa 1960) - A guide for women
Date: March 2011

1.    Have dinner ready. Plan ahead, even the night before, to have a delicious meal ready, on time for his return. This is a way of letting him know that you have been thinking about him and are concerned about his needs. Most men are hungry when they come home and the prospect of a good meal (especially his favourite dish) is part of the warm welcome and needed.

2.    Prepare yourself. Take 15 min to rest so you'll be refreshed when he arrives. Touch up your make up, put a ribbon in your hair and be fresh looking. He has just been with a lot of work weary people.

3.    Be a little gay and a little more interest to him. His boring day may need a lift and one of your duties is to provide it

4.    Clear away the clutter. Make one last trip through the main part of the house just before your husband arrives. Gather up school books, toys, paper, etc.  and then run a dust cloth over the tables

5.    Over the cooler months of the year you should prepare and light a fire for him to unwind by. Your husband will feel he has reached a haven of rest and order and it will give you a lift too. After all, catering for his comfort will provide you with an immense personal satisfaction

6.    Minimise all noise. At the time of his arrival, eliminate all noise of the washer dryer or vacuum. Try to encourage the children to be quiet. Be happy to see him

7.    Greet him with a warm smile and show sincerity in your desire to please him

8.    Listen to him. You may have a dozen important things to tell him, but the moment of his arrival is not the time. Let him talk first- remember, his topics of conversation are more important than yours.

9.    Make the evening his. Never complain if he comes home late or goes out to dinner, or other places of entertainment without you. Instead try to understand his world of strain and pressure and his very real need to be home and relax

10. Your goal. Try to make sure your home is a place of peace and tranquillity where your husband can renew himself in body and spirit

11. Don't greet him with complaints and problems

12. Don’t complain if he is late home for dinner or even if he stays out all night. Count this as minor compare to what he might have gone through that day

13. Make him comfortable. Have him lean back in a comfortable chair or have him lie down in the bedroom. Have a cool or warm drink ready for him. Arrange his pillow and offer to take off his shoes. Speaking in a low soothing and pleasant voice

14. Don’t ask him questions about his actions or question his judgement or integrity. Remember, he is the master of the house and as such will always exercise his will with fairness and truthfulness. You have no right to question him

*The Good Wives Guide - this is an actual extract from a home economics book printed in  1960. HOW TIMES HAVE CHANGED!!!!

A humorous look at how to keep your relationship happy – A guide for men
Date: March 2011

1.    The woman always makes the rules

2.    The rules are subject to change at any time without prior notification

3.    No man can possibly know all the rules

4.    If the woman suspects the man knows all the rules she must immediately change some or all of them

5.    If the woman is wrong, it is because of a misunderstanding which was a direct result of something the man said or did wrong

6.    The man must apologise immediately for causing said misunderstanding

7.    The woman has every right to be angry or upset at any time

8.    The man must remain calm at all times unless the woman wants him to be angry or upset

9.    The woman must not under any circumstances let the man know whether or not she wants him to be angry or upset

10. The man is expected to mind read at all times

11. The man must be ready at all times

12. The woman is ready when she's ready


It is suggested that if a man understands and accepts these rules and abide by them, then his relationship will be very happy and problem free!

Sexual problems in schizophrenia: prevalence and characteristics. A cross sectional survey
Date: March 2011
Article appearing in Social Psychiatry and Psychiatric Epidemiology Journal

Dr Ellen Wan-Yuk Harley(1) Contact Information, Dr Jed Boardman(2) and Professor Tom Craig(2)
(1)      St. Leonards Community Mental Health Team, Sussex Partnership NHS Foundation Trust,
(2)      Health Service and Population Research, Institute of Psychiatry, King’s College London, De Crespigny Park, London, SE5 8AF, UK


Objective  To determine the prevalence and characteristics of psychosexual problems in people with schizophrenia, and to compare the subjects’ and researcher’s perceptions of the presence of these problems.
Methods Cross-sectional survey of 137 people with established schizophrenia or schizoaffective disorder, aged 18–65 in one geographical area of southeast England, using a semi-structured interview format.
Results A total of 74% of men and 82% of women reported at least one ICD-10 defined sexual problem. Arousal problems were associated with physical health problems in men. Orgasm problems were more common in people in relationships. The researcher was about three times more likely to record a sexual problem than the respondents were to report one.


People with schizophrenia report sexual dysfunction that is similar in nature but which occurs at a higher rate than is reported in the general population. There are gender differences and differences in the perception of psychosexual problems between those with schizophrenia and the researcher.

Next Article – Friendship and social relationship in people with mental health problems: being prepared

I am available for sex and relationship clinical supervision as well as supervision and advice for anyone undertaking sex and relationship research. I am also fluent in Mandarin and Cantonese
A relationship doctor’s guide to a loving and satisfying relationship
Date: 17th May 2011
Relationships can be hard work sometimes, but with the right tools it could be easier to work through problems. Sex and relationship expert Dr Ellen Harley guides us through various tips which could help us work on relationship issues in a constructive manner.
In this article
•    Be appreciative of the company of your partner
•    Promote feelings of love and intimacy
•    Listen to your partner
•    Learn to resolve conflict and solve problems
•    Learn to forgive and to trust again
•    Renegotiate key responsibilities within your relationship
•    Give each other space
•    Learn to have good sex
It is indeed a blessing if you found someone you want to share your life with and who feels the same. An intimate relationship has to be nurtured for it to grow and flourish. Below is a list of ‘tips’ that can ensure relationship satisfaction. I gathered from research evidence and actual experience from my patients (who said it works!):

Be appreciative of the company of your partner
One of the most poignant remarks I have ever heard came from a newly widowed patient of mine –‘I don’t just miss having someone to do things with, I miss much more of having someone to do nothing with’. Relationships are not about continuous excitement and passion, it is about feeling comfortable and secure in your partner’s presence. Try to enjoy the ordinary routine things that you do together – take a leisurely long walk, watching a TV programme together, try out a new recipe, sharing a joke, talk about your day at work. That said, you should still make an effort to do something special together and plan time for enjoyable activities without distraction.

Promote feelings of love and intimacy
Remember how you met, what attracted you to each other in the first place. For every negative thought you have about your partner, counterbalance that thought with a positive one.Romantic and thoughtful gestures like writing love letters and giving small presents to each other can encourage positive and pleasurable feelings. Show your love for your partner through caring actions that can speak louder than just words. Words are also important, pay your partner compliments and praise when appropriate.Physical affection is extremely important, and often works best when it is taken out of the sexual arena. Spontaneous kissing and hugging, stroking, holding hands are ways of showing love,affection and intimacy. Don’t be afraid to feedback to your partner how much you appreciate and enjoy these gestures.
In therapy I often ask each partner to write down the following:
•    3 things that your partner can do to make you feel good
•    3 things that you think you can do to make your partner feel good
You will be pleasantly surprised when you compare notes.

Listen to your partner
There is ‘listening’ and there is ‘hearing’. The difference being that listening makes your partner feel respected and validated. It is important to listen to your partner without being judgemental, do not prematurely interrupt or interpret or talk about your own point of view.
 Learn the following techniques:
Mirroring – Repeat back to your partner what was actually said, not what you thought was said, by repeating key words that were used. In order to do this you have to really concentrate and listen to what your partner is saying.
 Validate –This doesn’t mean you have to agree with your partner, but that you try to put yourself in your partner’s shoes and to understand things from your partner’s perspective. For example- ‘What you said makes sense to me, because you are worried about losing your job and that we may not have enough money, you feel that it is unwise to spend too much on our next holiday’
Empathise- This is about trying to understanding your partner’s feelings. For example ‘ I can imagine that you must feel insecure and anxious about our financial future’You should urge your partner to give feedback, to check out whether you have correctly understood what was said.

Learn to resolve conflict and solve problems
All relationships have conflict. Couples who compromise, negotiate and work out problems together, tend to be happier and more satisfied. Couples who shy away from dealing with conflict and anger can end up with more pain and resentment within the relationship.The ability to really listen to and communicate effectively with your partner goes a long way to help resolve conflict. One of the most common mistakes made by couples is to ‘mind read’ and make assumptions of each other’s beliefs and behaviour.
Try not to be critical and place blame on your partner. Do not judge or explain your partner’s actions with your own standard. Be very clear that you may not like or agree what your partner has done, but that does not necessarily mean that you do not like your partner as a person. One good technique to use when putting your point across is to start your sentence with ‘I’ , not ‘you’ . Try using a three-part statement as below:
I feel (x) when you (y) because (z)
For example, instead of saying ‘you never help with the housework’, try ‘I feel overwhelmed by the amount of housework when you do not help because I don’t have time to relax’.Other obstacles to resolving conflict are: bringing up the past; making threats, setting ultimatums, bribery and blackmail; using sarcasm, playing the victim, or distracting from the issue at hand by sidetracking and talking about other irrelevant topics.Be mindful of not just words, but non-verbal signals (eye rolling, sneering, sighing) that can convey hostility, contempt and disgust. All these emotions are destructive in a relationship and can destroy intimacy. Another intimacy killer is the emotional withdrawal in the face of conflict or argument (sulking). This not only gets in the way of communication, it also builds up resentment and frustration between partners. Instead of winners and losers, try to find a middle ground through a process of negotiation and compromise.

Learn to forgive and to trust again

Loving and hurting go hand in hand. Only people we love have the power to hurt us, and vice versa.It is useful to remember that none of us is perfect, that we are fallible beings, and can intentionally or unintentionally hurt others. We may forget anniversary dates, make a thoughtless comment, make nasty remarks when angry. Some people have affairs which is often a symptom, not the cause of a relationship in trouble. At such times you will feel betrayed and hurt, and no longer feel that you can trust again, in case you get hurt again. Sometimes you may be able to forgive but unable to forget. This is the moment when you are likely to make decisions that you may regret later.It is important to share with your partner your feelings of hurt and vulnerability. Talk things through using listening and conflict resolution techniques mentioned in this article, and share any emotions that you both experienced. Think about how your own behaviour may have contributed to the problem and take responsibility for it. Are there any mitigating circumstances on your partner’s part? You may need to seek professional couple counselling if you are unable to sort this out between yourselves. Remember, you chose your partner and had made a commitment to share your lives together. If you cannot forgive and cannot trust your partner then you will not be able to have the future that you planned to have when you first decided to get together. There may be other important issues to consider: children, other family members, financial and other practical implications. Ask yourself: Is your relationship worth fighting for? If it is then fight for its survival, bearing in mind that things will not be the same again, but can be just as good if not better.There are exceptions. If you experience abuse (be it emotional, physical or sexual), or the presence of addiction or serious mental health problems in your relationship, then you must seek professional advice and assistance.

Renegotiate key responsibilities within your relationship
Often we enter a relationship with some ideas and expectations of what our role will be. This perception of our role is usually influenced by how our parents functioned within their relationship, or by what we learned from our peers and social experiences. For example, some of us may feel that partners should share household chores, childcare and finances regardless of their gender; some may believe that it is the men who should be the main breadwinner and women to care for domestic issues. Couples who have very clear and rigid roles expectations and behaviours will find it harder to cope with any unexpected role change. Change of roles can occur throughout a relationship due to external factors. For example, if a husband is made redundant then his wife may unexpectedly find herself having to find a job or be the main breadwinner. This couple will need to be flexible and adaptable in order to manage this role change through discussion and negotiation.

Give each other space
The flip side of Intimacy is that it can create conflict. It is understandable that when you spend time together you expose each other to potential disagreements and disappointments. Different individuals may define or handle intimacy differently. People can have different preference to the amount and intensity of intimate contact. We need to be separate as individuals in order to be close and together as a couple. So try to give each other space, spend time doing enjoyable things independently from your partner , for example, learning something new, indulge in hobbies and other recreational activities, time out with your own friends etc. That way you can develop your own individuality and increase your self confidence and self worth. You will be more interesting and appealing to your partner.

Learn to have good sex
Generally speaking sex and intimacy are close bedfellows and they enhance each other. If your relationship is good then sex usually is good. Many things can get in the way of sexual intimacy, for example unresolved conflict, demands of childcare, other stresses and worries in life, boredom and predictability of sexual activities. Factors that can have an negative effect on sexual desire and function include relationship difficulties, physical and mental health problems, cultural, religious and early life experiences (please see my other article: An overview of sexual dysfunction). It is important to understand what sex means to your partner. Some of us see sex as a way of becoming intimate, while others can only become sexual when they feel intimate and trusting towards their partner.There is no rule of thumb to dictate how many times you make love for it to be ‘normal’. Often people miss the quality, not quantity of sex. The aim is to improve the quality, not to increase the frequency. Make an effort with your physical appearance and keep healthy habits. Try to introduce elements of surprise in your sex lives – use of sexual aids, body massage, try different positions. Sometimes the introducing a temporary sexual ban can be stimulating.
There are relationships that are asexual –meaning sexual intercourse no longer happens. This is not a problem provided both partners are agreeable to this, and maintain other kinds of intimacy, such as being physically affectionate, emotionally committed and involve with each other’s lives.

Do you have any comments/more tips? Leave me a message.                see next page