If it raises any questions or points of view as you read I’d love to hear from you, even if only for an informal chat.

It’s an industry journal aimed at practicing Hypnotherapists, and therefore my article contains a few assumptions regarding the readers’ knowledge of the subject.

Below is what I submitted, the published piece is slightly edited.

Hypnotherapy and sexual dysfunction: An exploration with reference to Come As You Are

This article combines a book review with an exploration of a subject intimately pertinent to us all, and in my view, worryingly underexplored.

I qualified as a hypnotherapist in March 2023, and while my training was excellent, I feel benefit could be had from exploring differing sorts of anxiety and how they present in more detail. Could we be better prepared for what we meet in practice if we zoned in a little closer?

Sexual dysfunction is a growing issue in today's world, affecting individuals of all ages, genders, and backgrounds. Unpleasant, unfulfilling, or an absence of sex can have profound effects on one's quality of life, relationships, and overall well-being. While the causes of sexual dysfunction are multifaceted and often complex, the modern age has introduced factors that may contribute to the current epidemic of sexual dysfunction. Technological influences for example - who of us can often say our smart phone is more than arms’ length away?

I’ve encountered and successfully treated several clients with health anxiety, in fact it has become something of a ‘bread and butter’ flow of clientele for me. It seems there’s something of a momentum around the topic following Covid; cases are rising, the conversation is becoming more mainstream, and therefore more people are seeking help. 

My most interesting general anxiety case so far, however, was a young woman with sexual dysfunction. Among many thoughts the case provoked, I wondered how many people suffer from this in silence due to the taboo nature of talking about sex. I would love to help make this conversation more mainstream and assist more clients toward overcoming it, the way I was able to with Sadie*.

Sexual dysfunction can manifest in various forms, including but not limited to erectile dysfunction, premature ejaculation, low libido, and difficulty achieving orgasm. While there are numerous therapeutic approaches to address sexual dysfunction, I feel hypnotherapy is able to help from many angles. In the following paragraphs, we will delve into the world of hypnotherapy in relation to sexual dysfunction, drawing insights from a book I very much enjoyed, "Come As You Are" by Emily Nagoski.

Published in 2015, this book has been instrumental in changing the way we perceive and understand human sexuality. Nagoski, a sex educator and researcher, presents a comprehensive, scientifically based perspective on sexual functioning and pleasure.

The central premise of "Come As You Are" is that there is no single, universal model of sexual normalcy. Instead, Nagoski argues that each person's sexuality is unique, influenced by various factors, including biology, culture, upbringing, and personal experiences.

Throughout the book she uses the metaphor of sexual "accelerators" (the things that turn us on) and sexual "brakes" (the things that inhibit our desire) to explain how people's sexual experiences vary. We all have accelerators and brakes, but what hits these pedals is unique to each of us.

Understanding these mechanisms is crucial in addressing sexual dysfunction because it helps individuals and therapists identify the root causes of a clients specific issues, whilst assuring them that they are ‘normal’ in their functioning. Sprinkled through is the assertion that ‘We are all made of the same parts, organised differently.’

As someone who considers herself quite well-informed and sexually well-adjusted, I was surprised by just how much I learned, as well as how reassuring and affirming I found it. During my work with Sadie, it was of boundless help, particularly in explaining the stress bucket in relation to sexual arousal.

She avoided sexual intimacy and had tried CBT without significant progress.

Hypnotherapy can be a valuable tool in addressing sexual dysfunction because it operates at the subconscious level, targeting the psychological and emotional aspects of sexual difficulties.

Sadie’s past experiences were the main focus of the first part of our initial consultation, but I was able to reassure her that it wouldn’t be necessary to rake through the unpleasant memories in future sessions; this was something she had found unpleasant and unhelpful in therapy previously, and wished to avoid if possible. I affirmed that hypnotherapy is solution-focussed and forward-looking, and that we therefore would not need to thoroughly unpack her past.

During my explanation, I was able to help Sadie understand why sexual dysfunction can be rooted in traumatic experiences or negative associations with sex. I showed how her past encounters would have led to some powerful ‘templates’ in her hippocampus, as well as an over-sensitivity in her amygdala. I drew my normal diagram, and focussed on how her amygdala raises the warning flag at the mere thought of sex or intimacy, as it has learned these are bad things, and to avoid them. I explained that a full stress bucket would put her into ‘fight or flight’ and that when this response is in play, any non-essential functioning (such as sexual arousal) goes by the wayside.

I explained to Sadie that hypnotherapy can assist individuals in processing and healing from past traumas by accessing and reprogramming the subconscious mind, and that together we would create a safe space for exploring and accepting her authentic sexual self, thereby reducing her inhibitions and increasing sexual satisfaction.

We worked together for eight sessions following the initial meeting, over three months. We began weekly and later reduced the frequency to fortnightly.

Sadie’s progress was quite quick, reporting a ‘lightness’ in her first full session; simply learning about the primitive mind greatly reduced her feelings of inadequacy and guilt. It’s this that makes me wish I could distribute Come As You Are freely to the world – it proves that education is so lacking and yet so vital to our wellbeing around this topic!

Once these barriers to self-esteem were removed, we moved forward week to week focussing on what Sadie was doing to manage her stress bucket. She grasped the importance of this straight away, and was an ideal client in the way she applied herself to working on her ‘Four Positives’ – thought, interaction, action and purpose.

We also spent time imagining what she wanted her future to look like with regards to sex and intimacy. Initially this was challenging for her, as she had never given it thought before. By having seemingly light chats about film and TV, I was able to draw out of Sadie that she liked 90’s and 00’s Hugh Grant rom coms, and I asked her what aspects she was drawn to. This was a solution-focussed and fun way to create a picture of what Sadie wanted for herself, which I used in trance.

Over the three month period Sadie’s aversion to sexual intimacy diminished, and she became more open to the idea of sexual experiences. Imagining what she wanted led to fantasising about what she desired, and along with reduced shame and improved communication skills, by the end of three months she felt confident to continue the work alone. Before long Sadie was able to enjoy a fulfilling sex life with a new partner, and her overall well-being and emotional resilience naturally improved many-fold into the bargain.

The Intersection of Come As You Are and Hypnotherapy

This was Sadie’s specific experience, but one I know could be shared by so many. Given the prevalence of traumatic sexual experiences highlighted a few years back by the Me Too movement, this is certainly an area we could give more time to promoting hypnotherapy for. If you haven’t yet read Come As You Are, it’s a marvellous starting point for improved knowledge of the subject.

Nagoski’s book aligns with many of the principles underlying hypnotherapy. She emphasizes the importance of understanding one's unique sexual response and reducing the pressure to conform to unrealistic societal standards. Hypnotherapy, in a similar vein, encourages individuals to explore their inner thoughts and feelings without judgment, promoting self-acceptance and authenticity.

Come As You Are emphasizes the importance of reducing performance pressure in sexual relationships. Hypnotherapy can help individuals overcome performance anxiety, reframe negative beliefs about sexual performance, and build self-confidence. Effective communication and emotional intimacy are central to Nagoski's approach. Hypnotherapy can assist individuals and couples in developing better communication skills and connecting on a deeper emotional level.

The concept of the sexual "brakes" and "accelerator" aligns with the principles of hypnotherapy by acknowledging that sexual dysfunction is often a result of psychological and emotional factors. Hypnotherapy can help individuals identify and address the specific "brakes" in their sexual response system, such as anxiety, guilt, or past trauma, and learn to make more of their "accelerators," whatever leads them to desire, arousal, and connection.

Hypnotherapists can employ various techniques to address sexual dysfunction effectively. Here are some commonly used approaches, some of which I used to great effect with Sadie.

Guided imagery creates positive, sensual mental scenarios that help individuals relax and become more in tune with their desires. This technique can also be used to reframe negative sexual experiences or memories.

Cognitive Restructuring: Cognitive restructuring involves identifying and challenging negative beliefs and thought patterns related to sex and sexual performance. By replacing these with positive and empowering beliefs, individuals can overcome performance anxiety and other sexual difficulties.

Sensate Focus: Sensate focus exercises encourage individuals to focus on sensory experiences rather than performance goals. This approach helps couples build intimacy, reduce anxiety, and improve sexual communication.

Hypnotic Suggestion: Suggestions can be tailored to address specific sexual concerns, such as increasing libido, overcoming erectile dysfunction, or enhancing orgasmic ability.

Nagoski's book, "Come As You Are," and hypnotherapy share a common emphasis on self-acceptance, authenticity, and the importance of understanding one's unique sexual response. By integrating the principles and insights from Nagoski's work into hypnotherapy, therapists can provide a more comprehensive and effective approach to addressing sexual dysfunction.

Conclusion

Sexual dysfunction is a complex and multifaceted issue that can have a profound impact on an individual's overall well-being and the quality of their relationships. While there are numerous therapeutic approaches to address sexual dysfunction, hypnotherapy provides a unique and promising avenue for exploring and resolving the psychological and emotional aspects of this condition.

Emily Nagoski's book "Come As You Are" provides a valuable foundation for understanding human sexuality, emphasizing the importance of individuality and self-acceptance. When integrated with hypnotherapy, the principles of "Come As You Are" can enhance the effectiveness of therapeutic interventions, helping individuals overcome sexual difficulties and achieve a more fulfilling and authentic sex life.

Let’s all talk a bit more about sex, too. We know that shame and secrecy are huge barriers to overcoming any difficulties our clients (or we ourselves) may be facing, so let’s get to work de-mystifying this fascinating and vital area of human experience.”

*Name changed for confidentiality, though I did have Sadie’s permission to share her story.