To what extent do our past experiences and family background influence our development as sexual human beings? Quite a lot, I would argue. After all, most of us get our first lessons in love from our parents and caregivers.

As a sex therapist I often meet people who have been raised with unhelpful or damaging messages about sex and relationships. Sometimes, clients report growing up in a home where sexuality was never expressed or where it was actively discouraged. Other clients recall a total absence of emotional or physical affection within the family, or they remember as children noticing their mother pushing away their father’s advances. Yet other clients tell me they grew up in an environment that was oversexualised where, for example, inappropriate adult material was readily accessible.

These early childhood experiences can affect us deeply as we enter the complex world of adulthood and sexual relationships. They can become the blueprint – or template – for our own adult patterns of relating.

In psychosexual therapy, a thorough assessment can be useful in getting a feel for the different factors which might be playing a part in creating or maintaining a sexual or relationship difficulty. Some of these factors include what is happening now in the current day – such as illness, medication or relationship conflict. However, more often than not, there will also be some historical influences at play.

One powerful tool I might use in the early phases of therapy involves getting clients to draw a family tree, mapping out key family members and the relationships between them. This is called a sexual genogram. Typically, the tree goes back two or three generations and I ask the client to reflect on how (from their perspective) sexuality and other themes such as gender, romantic love, attachment, intimacy and communication were handled within the family. I ask them to think about the people who most influenced their views on sexuality – and whether conception, pregnancy or abortion was ever discussed at home. I ask them where they learned about pleasure and masturbation. Often, family secrets such as hidden pregnancies, miscarriages, affairs and sexual trauma are revealed in the process.

As a second stage to this exercise, I may then get the client to record all of the significant sexual events they can remember along a timeline, from birth through to present day. I get them to dig deep and try to remember specific milestones, such as when they had their first orgasm, wet dream, menstrual period, school crush, unwanted pregnancy… and what it meant to them to no longer be a virgin. The client makes a note of all the significant sexual relationships they can remember and reflects on how the meaning and their enjoyment of sex may have changed over time.

If the client is open to the process, I encourage them to really get stuck in, and to be as creative as they can – using colour and photographs or magazine cuttings to find symbols for the themes that emerge along the way. When working with couples, I may ask them to share and discuss their projects, thereby encouraging mutual empathy and understanding.

Frequently, individuals and couples that present with sexual issues are caught up in a cycle of blame, disappointment, helplessness and pessimism. Getting clients to map out their own personal sexuality journey in this way can be a great tool for examining the historical and inter-generational influences on a problem. The idea is that clients develop a greater understanding and appreciation of how their past experiences may have helped shape who they are today as adults – paving the way towards self-acceptance and real change.

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