Nurturing Intimacy and Sexual Health in Mental Healthcare
Written by: Kim Berrio. BSc, BScN, RN Psychotherapist
Over time, something that is often not openly spoken about has become abundantly clear: our mental health is deeply intertwined with our sexual health and our capacity for intimacy. Yet, in the traditional mental healthcare setting, these vital aspects of our lives are often overlooked, dismissed, or treated with a level of discomfort that can leave people feeling unheard and unseen.
But it doesn't have to be that way. Let's talk about why creating spaces for sexual health, intimacy, and emotional safety is not just an add-on, but a fundamental part of truly comprehensive mental health care.
The Missing Pieces: Why We Need to Talk About It
Many mental health conditions can impact our libido, our ability to connect with others, and our self-perception. Medications often have sexual side effects that go unaddressed. Trauma, a significant factor in many mental health challenges, frequently has deep roots in violations of intimacy and sexual safety.
Ignoring these elements creates a huge gap in care. How can we help someone heal if we're not acknowledging the full spectrum of their experience? For too long, conversations about sex and intimacy have had hushed tones or seen as "too personal" for the therapy room.
Intimacy: Beyond Just Physical Connection
Intimacy is so much more than just sex. It's about genuine connection, vulnerability, and the ability to truly see and be seen by another person. It involves:
● Emotional Intimacy: Sharing your deepest feelings, fears, and joys.
● Intellectual Intimacy: Connecting over ideas, values, and beliefs.
● Experiential Intimacy: Sharing activities and creating memories together.
● Physical Intimacy: This can range from holding hands to sexual expression, all within a context of consent and mutual respect.
When mental health challenges make us withdraw or feel disconnected, our capacity for intimacy can suffer. There is enormous benefit in understanding these different facets of intimacy and exploring how you can cultivate them in your life, both within romantic relationships and other significant connections.
Sexual Health: A Holistic View
Now, let's talk about sexual health. It's about a state of physical, emotional, mental, and social well-being in relation to sexuality. What does this mean? Well…
● Autonomy and Agency: You have the right to make choices about your own body and your sexual experiences.
● Pleasure-Positive Approach: Recognizing that sexual health includes the capacity for pleasure and satisfaction.
● Inclusivity: Understanding that sexual health applies to everyone, regardless of gender identity, sexual orientation, ability, or relationship status.
● Addressing the Impact of Trauma: Acknowledging how past experiences can affect present sexual function and desire, and providing support for healing.
In the therapy room, we can proactively open these conversations. We can ask about sexual side effects of medication, explore the impact of trauma on sexuality, and validate diverse experiences of desire and intimacy.
What This Looks Like in Practice
Here is what you can expect when you enter into a room that honors your emotional and sexual safety:
● You Lead the Way: You (and only you) are the expert on your life. Therapy sessions should offer you an open door to talk about intimacy if it ever feels relevant. “We go only where you want to go."
● The "Whole Person" View: Therapy sessions should cover all bases and won't ignore how your mood or medications affect your body. Talking about your libido and energy levels as vital signs of your well-being, not just "side issues."
● Zero Judgment: Whether you're navigating trauma or exploring your identity, therapy should provide a shame-free environment. The therapeutic goal is to help you dismantle the "shoulds" society has placed on your body and your choices.
● Active Consent: Safety is a continuous conversation. Continuous safety check-ins throughout the session helps to ensure you always feel in control.
● The Bigger Picture: We know that your struggles don't exist in a vacuum. Sometimes, it can be helpful and validating to look at how cultural expectations and systemic pressure might be impacting your sense of safety and self-worth.
For those of you seeking mental health support, remember that you have a right to holistic care. If these aspects of your life are impacting your well-being, don't hesitate to bring them up with your provider. If they're not receptive, it might be a sign to seek someone who is.
Ultimately, good mental healthcare embraces the whole person – mind, body, and spirit. By integrating discussions about sexual health, intimacy, and emotional safety, we move closer to providing the compassionate, comprehensive care that everyone deserves.
