Sexual Concerns Counselling in Melbourne

Sexual difficulties are far more common than most people realise: 55% of Australian men and 60.5% of Australian women report experiencing at least one sexual problem in any given year (PubMed — Sexual Dysfunction in the Australian Population). Despite this prevalence, most people never seek professional help — shame, embarrassment, and the assumption that nothing can be done keep many suffering in silence. At my practice at 96 Elgin Street, Carlton, I provide a space where sexual concerns can be spoken about frankly and without judgment — because these are real difficulties that deserve professional attention.

What kinds of sexual concerns do people bring to therapy?

Sexual concerns cover a broad range. In my Melbourne practice, I work with people experiencing:

• Low or absent sexual desire — whether affecting one or both partners, and whether chronic or situational. Lack of interest in sex is among the most commonly reported sexual difficulties in Australia.
• Mismatched desire between partners — a persistent difference in sexual appetite that, if unaddressed, can become a source of resentment, rejection, and distance
• Erectile difficulties and arousal problems — often compounded by performance anxiety, which creates a self-reinforcing cycle that is hard to break alone
• Sexual pain — including vaginismus and dyspareunia, which frequently have both physical and psychological dimensions and benefit from psychological support alongside medical treatment
• Performance anxiety — fear of sexual failure that intrudes on sexual experience and makes genuine intimacy difficult
• Compulsive sexual behaviour — including problematic pornography use. This area now has its own dedicated section on this website, but it is worth noting here that compulsive patterns are a legitimate and treatable concern
• Sexual identity and orientation questions — including coming out, uncertainty, or navigating identity within a relationship or a particular cultural context
• Impact of trauma on sexuality — past sexual experiences that were unwanted or harmful, and the ways these continue to shape current sexual and relational life
• Sexuality within LGBTQIA+ experience — including the specific pressures, minority stress, and relational dynamics that can affect sexual wellbeing in LGBTQIA+ individuals and couples

Why is shame such a significant factor in sexual difficulties?

Our culture simultaneously overvalues sex and offers almost no space for honest conversation about sexual problems. Sex is everywhere in media and advertising, yet talking about sexual difficulty with a doctor, partner, or anyone else is experienced by many people as deeply shameful. This creates a painful double-bind: the problem is too significant to ignore, and too shameful to discuss.

Shame tends to make sexual difficulties worse. Performance anxiety escalates when a person is monitoring themselves critically during sex. Desire difficulties deepen when they become loaded with self-reproach. Avoidance of sex — which often develops as a self-protective strategy — gradually increases distance in the relationship, creating new problems on top of the original one.

Therapy provides the first thing many people with sexual concerns have never had: a space to speak about the difficulty without judgment, without the complexity of a partner’s reactions, and with a trained professional who takes it seriously. In my experience, being heard without shame is itself therapeutic — and it is the necessary starting point for any further work.

What does a psychodynamic approach to sexual concerns involve?

My approach draws on Lacanian psychoanalytic and psychodynamic thinking, which means I am interested in understanding the deeper psychological context of sexual difficulties — not just managing symptoms. Sexual concerns rarely exist in isolation. They are typically connected to relational history, attachment patterns, self-image, and past experiences — including, where relevant, experiences of sexual harm.

This is not a moralistic approach. I am affirming of all sexual orientations, gender identities, and relationship structures. What concerns me is your distress and your freedom — the freedom to have a sexual life that is aligned with what you actually want, rather than one shaped by anxiety, shame, or compulsion. I see clients at my Carlton, Melbourne practice and via secure video call. Sessions are self-funded at $120; no referral is needed. Book a session or message me on WhatsApp.