Understanding the Purpose of Exercises and Interventions

One of the questions I am asked most often is, “What kind of exercises will you make us do?” By the time people seek sex therapy, many have already searched the internet, read books, listened to podcasts or tried exercises they found online. Some tell me, almost apologetically, “We’ve tried everything, and nothing worked.”

That can feel incredibly discouraging.

People often assume they have failed because an exercise did not help. From my perspective, that is rarely what has happened. More often, the intervention came before anyone had fully understood what was maintaining the difficulty.

People rarely come to therapy with the cause of the problem.
They usually come with the symptom.

Exercises are not the therapy. They are tools, chosen carefully to fit the person, the relationship and the problem we are trying to address.

Understanding Before Intervention

The first stage of therapy is not about homework. It is about making sense of what lies beneath the symptom. Three people may describe low desire, yet one developed it after cancer treatment, another through anxiety and another because intimacy has become associated with conflict. The symptom may sound identical, but the reasons behind it are very different, so the intervention needs to be different too.

Creating a Shared Understanding

Couples often arrive feeling trapped in the same conversation. One partner feels rejected, the other feels pressured, yet both are trying to improve the relationship. Therapy helps create a shared language so each person can understand the other’s experience instead of defending their own.

Choosing the Right Intervention

Only once we have developed a formulation do we decide whether an intervention would be helpful and which approach is most likely to support change.

• Helping you notice rather than perform: Sensate Focus, mindfulness and body-awareness exercises encourage curiosity, reduce performance pressure and strengthen emotional and physical connection.
• Working with specific sexual difficulties: Techniques, exercises for erectile, ejaculatory, orgasmic difficulties and interventions for sexual pain are chosen because they fit the presenting difficulty rather than being used routinely.
• Strengthening your relationship: Consent-based communication exercises and behavioural experiments help couples develop new ways of relating to each other.
• Making sense of your body: Psychoeducation explores desire, arousal, anatomy, hormones, medication, ageing and the effects of illness or cancer treatment.

No intervention is a magic solution.
Without the right context, any exercise can increase anxiety or frustration.

Why We Give Blocks in Therapy the Respect They Deserve

Sex therapy is not about finding the perfect exercise. It is about understanding why this particular difficulty has developed in this particular relationship at this particular time.

Exercises help turn insight into experience. We are working not only with thoughts but also with a body that has learned protective emotional and physical responses over many years. Those patterns rarely change through logic alone. They change through repeated experiences of safety, connection, curiosity and new ways of relating.

Progress is rarely linear. An exercise may trigger anxiety, frustration or a complete block. Rather than seeing this as failure, we see it as valuable clinical information.

A block usually tells us that we have reached something important. It may reflect fear, an old wound or a pattern that once served a protective purpose. Sometimes a block tells us something the body has been communicating long before it could be expressed in words. If we simply push past it, we risk overlooking the very thing that needs our attention.

Instead, we slow down with curiosity. Together, we explore what the block is trying to communicate. We give it a language. Only then do we begin to understand the place it has held in your story.

This is often where the deepest transformation begins. As those experiences are understood and no longer need to stay hidden, both mind and body gradually begin to respond differently. New patterns develop, communication deepens, and intimacy becomes increasingly associated with safety, connection and choice.

The goal of sex therapy is not simply to resolve a sexual difficulty. It is to create lasting change that continues beyond the therapy room.

The exercises are not a quick fix. They help people experience something differently until those new experiences gradually become new patterns.

Lasting change is not measured by whether one or two exercises were completed successfully.
It is measured by how differently you begin to experience yourself, your partner and your intimate relationship.

Artwork in this Article

Anonymous, The King and Queen Seated in a Stone Bath, woodcut from Rosarium philosophorum, (Frankfurt, 1550). Wellcome Collection, image L0073563. CC BY 4.0, via Wikimedia Commons.