You’ve talked about the kids, work, and arguments over a plate of food. The session is drawing to a close, and the phrase you prepared in the car is still there: “In bed, something got lost.” You look at your partner. You wait for the therapist to ask the question. Everyone stands up.
Does this imaginary scene sound familiar? You can ask for help to start talking about sex. The therapist’s office is also a place where you can say that you’re at a loss for words, that you’re afraid of hurting someone, that desire has become a minefield. I prefer this honest request to forced bravery: you’ve come here precisely to seek support.
What Lies Behind “We Don’t Make Love Anymore”
Take this phrase as a starting point, then explore what it means to you. Perhaps what you’re missing are long kisses, your partner taking the initiative, or the freedom to get close without having to go all the way. You may want to rekindle your sex life, yet at the same time fear hurting your partner by bringing up the subject. Articulating this conflict gives the therapist a focal point to work on.
A qualitative study published in April 2026 in the Journal of Family Therapy interviewed seven adults aged 35 to 55 about ten couples’ therapy journeys. All of them wanted the therapist to address sexuality; it had been brought up in half of the therapy processes. Their accounts mention the fear of hurting their partner, of being perceived as critical, or of exposing themselves. These experiences are those of this small group of people who were in heterosexual relationships.
“I felt pretty lonely because my sexuality wasn’t taken seriously. ”
Anna, a pseudonym for one participant, describes how her sexuality was addressed in a way she considered superficial, in the study by Karoline Møller and Anne Grasaasen. Translated from English.
What stands out most to me is that sense of loneliness. Even when sexuality isn’t discussed during sessions, it can still dominate your thoughts. You have the right to ask that it be brought up, even when your couple is seeking counseling for other issues.
Let the therapist take the first step you’re afraid to take
Before the session, jot down what you’d like to say. A few words are enough: “fear of rejection,” “forgotten pleasure,” “caresses that have become rare.” Keep this note to yourself, or offer to read it aloud. Choose a specific situation you’d like to understand better: what you suggested, what you heard, what was left unresolved. This will give you a starting point, rather than a list of every disappointing evening.
Right at the start of the session, mention that you’d like to talk about your sex life. You can work with the therapist to determine the pace and conditions of the discussion. Your immediate need might be to explain a source of discomfort, understand a disagreement, or schedule another appointment to discuss this topic.
Ask for guidance on the conversation itself. You could say: “I’d like to talk about our sex life, but I’m worried it might sound like a criticism. Can you help us get started?” Or, more simply: “This is important to me, and I’m having trouble bringing it up.” ” “Help me put this into words without sounding accusatory” is already a request in and of itself. You can then explore what you’d like to change in your sex life.
Use your own words, and clarify what they mean
“Intimacy” can refer to a kiss, a confidante moment, a caress, or penetrative sex. The word is gentle; its meaning sometimes needs to be clarified. Ask yourself what you want to bring up today. “I’d like us to kiss without rushing” and “I’m not feeling as much pleasure during our sex” open up two different conversations.
The study reports that participants expected vocabulary tailored to their own: clear words with which they felt comfortable. Some preferred to start with closeness or intimacy. Their stories suggest finding a common language, rather than imposing the most explicit words right away.
You can ask: “When you say ‘sexuality,’ what do you mean by that?” Then clarify your own usage. Talking about masturbation, orgasm, erection, or penetration can be helpful when that’s actually the topic at hand. Crude language isn’t a sign of honesty. A simple phrase that you both understand is better than a term used just to sound sophisticated.
Also pay attention to words that attribute an intention to the other person. “You’re pushing me away” already contains an interpretation. “Yesterday, when you pushed my hand away, I felt rejected” describes a situation and how you felt; your partner’s response is still to be heard. The therapist can help you explore the gap between your interpretation of that gesture and the meaning your partner assigns to it.
Make room for each person’s desires, including disagreements
One partner wants more sex. The other would like to be able to receive a caress without anticipating what comes next. These requests deserve to be expressed separately. An expressed desire leaves the other person free to respond. Therapy can accommodate disappointment, frustration, and tenderness without turning any of these emotions into a sexual debt.
Be specific about what you expect from the conversation: to understand the other person’s feelings, to share your own, or to ask for help with a recurring issue. “I’d like for us to rediscover pleasure” can open up several avenues. “I’d like you to explain to him that he needs to make an effort” immediately positions the therapist on one partner’s side. You can express a desire for change while still allowing each person to speak and set their own boundaries.
Someone may also want to slow things down: “I’m willing to talk about desire, but I don’t want to share that memory today.” ” Ask for a break when the discussion becomes too distressing. The therapist must be able to acknowledge this boundary and explain how they propose to proceed. The International Society for Sexual Medicine notes that sex therapy is based on dialogue and that sessions do not involve any sexual contact between the therapist and clients.
Embarrassment about talking about sex and fear of retaliation call for different responses. In cases of intimidation, coercive control, or violence, your safety comes first. Consult with a professional—through a secure channel and without your partner present—to assess whether working together is appropriate. You don’t have to disclose this risk in front of your partner to justify your need for help.
Before leaving, mention what still needs to be addressed
Sometimes an important revelation comes up at the end. In that case, consider what can be done in the time remaining and what you’d like to revisit. “I just shared something difficult. How should we wrap up this session, and when can we come back to this?” This question allows you to explicitly request a follow-up, rather than leaving without knowing when you’ll be able to revisit that revelation.
You can also bring up the topic of going home: do you want to continue the conversation, give yourself some time, or wait until the next session? Saying, “I need to let what we’ve just discussed sink in,” expresses a specific preference. Your partner may have different expectations; that’s why it’s important to put them into words before you leave.
When sexuality is consistently left out of the discussion, ask the question directly: “Is this a topic you can help us with?” Ask the professional to describe their training, their approach, and the options for referral. The ISSM specifically lists education and communication strategies among the tools of sex therapy.
Any pain or physical symptom should also be reported to a healthcare professional. You can mention this during your session while arranging for an evaluation. The guidelines for describing sexual pain and seeking guidance will help you prepare the information to share and identify potential professionals to consult.
In a few words
At the next session, you can simply say this: “I’d like our sex life to be part of this, and I need you to help us talk about it.”
