Sexuality is a broad term used to describe a complex array of feelings, beliefs, and behaviors related to how we express ourselves as erotic animals. In general, the expression of healthy sexuality has to do with the ability to exquisitely and respectfully pursue pleasure by being playful, spontaneous, and engaged. It also involves an awareness of and an ability to cultivate the sexual relationships we have with ourselves and with others. By contrast, unhealthy sexuality typically involves a fearful approach that manifests as guilt, shame, control, avoidance, pain, or displeasure. Unhealthy sexuality often comes from the perspective that our bodies are somehow shameful and should be hidden and controlled.
Like our physical, emotional, mental, and spiritual health, our sexuality is a normal and necessary part of the characteristics that make us unique. As with other parts of our personality, our sexuality must mature through our lifespan and be nurtured in ways that are appropriate to our age and context. We must learn what it means to be sexually vibrant and expressive in ways that are congruent with our individual sexual orientation, gender identification, and innate rhythms of sensual and erotic exploration.
Problems with sexuality can result from a multitude of sources. These sources can range from everyday circumstances, such as stress at work or conflicts in relationships, to more extreme problems stemming from traumatic events. For many individuals and couples, problems with sexuality can be a normal and even expected result of living in a complex world. For instance, although most couples experience an initial period of heightened sexual exploration and pleasure at the beginning of their relationship, it is not uncommon to see this pattern diminish or even deteriorate over time. Often this is not a function of trauma or illness, but rather a reflection of inattention to the maintenance of the couple's sexual health. For other couples, the areas of sex and money became metaphors for unresolved power and control dynamics within their relationship. Addressing these underlying dynamics may provide resolution to the issues of power and control that are disguised as sexual problems.
Sexual problems can also arise from defect issues. For example, early or current insults to our sexual identity formation, such as incest, rape, or sexual assault can instill a sense of fear or powerlessness around sexuality that can result in two major sexual disturbances. One of these discrepancies is a withdrawal from sexuality as an authentic expression of the self, and the other is an over-identification with sexuality as a source of interpersonal power and control, rather than as a source of pleasure and intimacy. In either case, sexuality becomes a reaction to trauma rather than an unencumbered, delightful, and integrated expression of a well-developed sexual identity.
Another major obstacle to healthy sexuality is the impact of cultural bias and oppression, such as racism, sexism, ageism, sexist language, and homophobia. For example, many religious and cultural belief systems teach that the only purpose of sexuality is that of procreation. This eliminates the possibility of our sexuality being a source of pleasure in its own right. As a result, when sexual feelings do arise, we may feel a sense of guilt or shame. Religious and cultural belief systems can also be limiting in terms of definitions of "normal" sexuality and sexual orientations. When we fall outside of the culture's definition of "normal" we may experience alienation, identity crises, depression or other emotional symptoms, and a sense of shame for being different.
Finally, problems with sexual function can be the result of physical illness or disease. Sexual problems can be related to the side effects of medicines, the complications of medical treatments, or the impact of drug or alcohol abuse. In these situations it is important to consult with a qualified medical provider who will be able to identify whether the problem is physical or related to other issues.
In conclusion, if our sexual health and development are affected by environmental stressors, negative interpersonal patterns, trauma, or limiting cultural beliefs and biases, then we run the risk of developing unhealthy attitudes and behaviors about sexuality. These attitudes and behaviors are not set in stone. Everyone has the ability to make changes so that they may access the power and pleasure of healthy sexuality. The purpose of consulting with a therapist who specializes in human sexuality is to find support while you discover, clarify and expand your unique style of sexual expression.