Liam Butler interviews Dr Courtney Clyne

Liam Butler interviews Registered Clinical Psychologist and sex therapist Dr Courtney Clyne.

05 December 2013

Dr Clyne's qualifications include a B.A., B.A.Hons., Masters, PhD in psychology, and P.G.DipClin Psych. She has a community public sex therapy practice in Nelson www.sextherapynelson.co.nz.

Question One

How did you get interested in this aspect of healthcare?

I became interested in offering sex therapy to people living in Nelson when I learned that it is not an area that is covered by public services. Unfortunately referrals for assessment and treatment of sexual dysfunctions - mild moderate or even severe - are declined by community services.I believe that sexual functioning is an important area of general functioning; it is not an area to be ignored, pushed under a rug, or forgotten. If left untreated, sexual functioning issues can affect other areas of general functioning, including relationship satisfaction, over all happiness, and stress levels, to name a few. It's time for people suffering from sexual dysfunction or issues of intimacy to have access to help. With an empathetic, respectful approach, my therapeutic style is gentle but direct. Humour and fun are essential, particularly in such a sensitive area that some find uncomfortable to talk about.

Question Two

Often older people grieve the problems caused by an age related disability. How can grief affect an older persons' sexuality?

Grief is a very powerful emotion and is often accompanied by other emotions (anger, anxiety, loneliness, guilt and so on). People's sexuality, including desire for and interest in sex, is affected significantly by powerful emotions, and this is especially the case with grief. Even if the loved-one passed away some time ago, there can be a "stuckness", if you will, in the person's ability to move forward with their lives, especially with establishing new intimate relationships. For those who are trying to move on, grief accompanied by guilt (guilt of "cheating" or of moving on) can often interrupt sexuality and sexual functioning. Men, for instance, who are stuck in grief, can lose their erectile functioning, believing there is something wrong with their masculinity or ability to "perform". In such cases, if one can treat the grief, the sexual functioning often returns. With respect to elderly in particular, this group is of higher risk of experiencing grief and associated sexuality repercussions.

Question Three

How can Cognitive Behavioral Therapy help older people?

CBT is an evidence-based practice that combines both practical skills and also thinking skills for helping people with mental health symptoms. Issues of sexuality and sexual functioning have been found to respond very well to CBT approaches. Age is not of relevance; there is no reason why CBT would work any more effectively or any less well with older people. One of the main focusses of treatment may be to unsettle age-related beliefs about sexuality and sexual functioning; whilst there may be hormonal and physical changes over time that are related to age, this does not mean that a healthy and satisfying sex life isn't possible - it certainly is with the right knowledge and access to information!

Question Four

Medication and Medical Problems can cause sexual dysfunction. What suggestions do you have for older people who have such problems?

This is a complex problem and it depends almost entirely on the individual's way of coping with change in sexual functioning. For instance, men who have had a prostate operation are 80% likely to develop secondary erectile dysfunction. Does this mean these men can't have a healthy and satisfying sex life? No! It just means learning a different approach to sex and intimacy, and redefining "sexuality". Research on this particular issue has begun in an Australian University and preliminary findings are very promising indeed! The researchers found that men who have successfully completed the online treatment ("success" meaning have entered into the treatment with a plan to help themselves and to use the suggestions made on the treatment programme) enjoyed a much improved sex life, that was better than before they had their operation! Treatment success is definitely possible with the right knowledge and attitude.

Thanks,
Dr Courtney Clyne

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