Rather overwhelmed by this, my mother asked me, ‘Well, what do you do when a man comes to see you with …’ and wiggled her little finger at me.
Feigning ignorance, I raised my eyebrows at her questioningly.
‘You know what I mean, darling … when he’s impotent!’
The combination of embarrassment and half a bottle of wine resulted in the final word being uttered rather more loudly than intended. An elderly couple, who had been enjoying a leisurely lunch at the next table, turned their heads sharply and stared at us in horror. Ironically, it seemed that it was my turn to be embarrassed.
‘Well,’ I said, lowering my voice to a whisper, so as not to shock the neighbours, ‘I begin by trying to find out if the problem is physical or psychological. I ask him whether he can get an erection when he masturbates, whether he wakes up with an erection, how strong his erection is …’
Looking at me in horror, my mother exclaimed loudly, ‘Please will you stop saying “erection”!’
The elderly couple at the next table hurriedly scraped back their chairs, and the husband made furious hand signals to the waiter, indicating that he should bring the bill as quickly as possible. His wife looked at my mother in shock, clearly failing to comprehend how a fellow septuagenarian could allow such profane language to roll off her tongue.
Oblivious to the consternation that our conversation was causing at the next table, my mother allowed curiosity to trump embarrassment and continued to press me for the cure for erectile dysfunction. She was perplexed, she told me, as to how I could even begin to understand the problem, let alone help the poor man to find a solution, without examining his penis.
Wondering whether my mother was still sceptical about the true nature of my work, I began to explain that the problem was generally not in the penis, but rather in the mind. I reeled off a whole host of reasons why a man might have problems sustaining an erection: stress at work, relationship difficulties, lack of sexual confidence or feeling intimidated by women. Once the cause of the difficulty has been identified, I explained, we begin to look for the roots of it, which are quite often to be found in the person’s childhood.
‘Well, that’s just silly, darling; little children don’t know anything about sex!’
‘It’s not about sex,’ I explained patiently. ‘It’s about what our relationships with our parents teach us about ourselves, other people and the world around us. It’s through these early family relationships that we begin to form our impressions about whether it’s safe to trust other people, whether those close to us can help us to feel secure and whether we feel that we are truly worthy of love.’
Frowning slightly as she tried to get her wine-blurred mind around this, my mother slowly verbalised the ideas that were formulating in her head. ‘So, are you saying that if a child’s parents don’t love him enough or they neglect him, he might have problems with sex as an adult?’
Pleased that she seemed to have grasped the concept, I pressed on. ‘For example, if a little boy has a mother who is very strong-minded and intimidates him, or humiliates him in front of others, he might find himself quite scared of women when he grows up. This might lead him to have difficulties getting an erection when he has sex.’
Clearly now sufficiently engrossed in the subject to forget her embarrassment, my mother asked how I would work with a client like that.
‘I try to help him understand that, as an adult, he is unconsciously reacting to the women in his life in the way he reacted to his mother as a little boy. Then I help him to learn new ways of relating to women that are more helpful for him as an adult.’
‘And just by doing that, he can have sex without any, you know, problems?’ she asked incredulously, wiggling her little finger at me again.
I explained that I also set homework exercises to help the client gain confidence in his erections. This elicited a puzzled frown from my mother, so I helpfully elaborated by explaining that they were masturbation exercises.
Evidently unaware of the waiter hovering behind her, waiting to clear our table, my mother exclaimed, ‘Masturbation exercises! Whatever next?’
Suppressing a smile, the waiter collected our empty dishes, while my mother tried to hide her embarrassment by fumbling for something in her handbag. Asking for the bill, I gave the waiter an apologetic shrug and indicated the empty wine bottle, deflecting blame for my mother’s outbursts onto the alcohol.
‘Well, I think I’ve heard quite enough about that,’ she said primly, marching off to the lavatories. Clearly this mother-and-daughter conversation about sex was well and truly over.
My mother’s attitude to my work did not really come as a surprise to me. Like many of her generation, she had grown up believing that sex outside marriage was wrong. Sex was seen as a taboo subject, not even to be discussed with one’s partner, let alone anyone else. These attitudes, in turn, had very much shaped the way in which I was brought up to view sex. It was certainly never talked about at home, and as soon as so much as a passionate kiss was shown on the television, the channel was hurriedly changed.
As a teenager, I naturally began to form my own opinions about sex and, like many of my generation, soon developed a much more liberal approach to it than my parents. Over the next twenty years, I had good sex, disappointing sex, embarrassing sex, exciting sex and sometimes downright dirty sex. I had loving sex in long-term relationships and the odd passionate one-night stand when I was single. There were times when I would lose interest in sex for months on end, and others when it seemed to be the first thing on my mind when I woke up in the morning.
Perhaps because of my openness about my own sex life, my friends always seemed to be very comfortable talking to me about theirs. One winter’s evening, over a bottle of wine in my flat, my friend Emilia and I were discussing the problems that she was facing with her new partner, whom she had just discovered was frighteningly well endowed. The mere thought of sex with him was leaving her feeling rather intimidated. Once I had succeeded in calming her down, the conversation turned to my future career options. Having worked in international politics for thirteen years, I was beginning to get itchy feet. Listening to my disenchantment with my work, Emilia suggested jokingly, ‘You could always chuck it all in and become a sex therapist instead!’ We laughed and moved on quickly, but the seed of an idea had been planted.
Three years later, having taken an evening course in counselling, I decided to take Emilia’s advice and specialise in sex therapy. Little did I realise that my training would mainly consist of having a long, hard look at my own attitudes to sex. I found that, in order to be a good sex therapist, I had to first address my own foibles, taboos and prejudices – a journey that proved rewarding, yet challenging. I had to look back at what I had learnt about sex from my upbringing and how these lessons still influenced me as an adult. Spending two years talking about the most intimate details of one’s sex life with fellow classmates was at times intimidating, humiliating and downright embarrassing. As I lay on the floor of the training room doing a guided visualisation of my vagina with a classmate, I began to wonder whether I had made a wise career choice. In class, we would share our darkest fantasies that had never before been uttered to a soul, we would talk about the sexual difficulties we faced with our partners and we became aware of the sexual topics that made each of us squirm. However uncomfortable this was at times, I soon realised that it was far better to address these issues with fellow students than to find them creeping up on me unexpectedly when I was with my clients. Just as importantly, it gave me a valuable insight into how my clients might feel when they were sitting across from me in my consulting room.
The windows of my consulting room look out over a quiet street and a row of 18th-century alms houses in a leafy southwest