Introduction

Abstract

Sexual feelings and sexual expression form a regular part of the experience of most human beings and, while therapists and theorists have disagreed about the centrality of sexual experience in human psychology, none have suggested it to be an unimportant part of human life. Sexual feelings can bring pleasure or suffering, can occasion murder or marriage, yet, in our culture, in therapy or out of it, sex remains a difficult subject to discuss with any sense of balance. Discourses based on suppression and silence have given way, first, to ones based on hygiene and good sense and more recently to discourses characterised by conflicts between hedonism and repression. None of these attitudes to sex leave much room for the personal exploration and expression of sexuality. Instead, powerful external and internal social injunctions dominate sexual expression. For these reasons, although patients may not volunteer it, sex is often a problematic issue in their lives combining with and compounding other difficulties. This means that, whatever overt problem a therapist may be treating, sexual matters can suddenly appear and require attention.