Love, Sex, and Relationships in Therapy: A Holistic Approach

Cheryl MacDonald
A man and a woman are laying on a bed.

As a therapist and tantric practitioner, I've learned that when people come to discuss their relationships, they're often bringing layers of complex emotions and unmet needs. Over the years, I've seen how love, sex, and relationships are so deeply interconnected that you can't address one without impacting the others. Whether you're working on relationship issues alone or with your partner, considering all three together can be the key to significant change.

In therapy, treating these aspects as a whole is where the real transformation happens. It's not about fixing what's broken; it's about helping you create a life and relationship that feel fulfilling, both emotionally and physically.


Why Love, Sex, and Relationships Must Be Treated As A Whole


Emotional and Physical Intimacy 

One couple I worked with felt stuck in their relationship. What seemed like communication issues was actually an emotional disconnection directly tied to their lack of physical intimacy. One partner felt shut out emotionally, and as a result, the other was pulling away sexually because he didn't know how to express his feelings. Addressing both their emotional and physical intimacy together led to real shifts in their relationship.

Sexual Health and Relationship Satisfaction

Clients often think their sexual struggles are purely physical, but these issues usually point to something deeper. I worked with a couple whose physical relationship had fizzled out over the years. Avoiding the topic entirely, they didn't realize that the emotional disconnect was affecting their sexual health. Bringing their sexual well-being into the conversation revealed unmet needs, allowing them to rebuild that aspect of their relationship.


Individual Growth vs. Couple Dynamics

Individual growth is just as important as relationship growth. Many clients come to work on their relationship as an individual. Thai could be because their partner doesn’t want to come to therapy; it’s something they can’t or don’t want to discuss with their partner or they’re recovering from divorce or a break up and want to get rid of unhealthy relationship patterns. One client of mine kept attracting the same types of men, which ultimately led to her having negative experiences. Through therapy, she realized her relationship with love and sex had been shaped by unhealed early experiences. By focusing on her own personal healing, she was able to have healthier, more fulfilling relationships.

The Benefits of Holistic Therapy for Love, Sex, and Relationships


Integrative Therapy Approaches

Training in Dr. Tammy Nelson's integrative approach, which treats emotional and sexual intimacy together, has shown me how sexual challenges often mirror our emotional struggles. I worked with a couple married for nearly 20 years who loved each other but the physical spark had gone. It was so important to explore both the emotional and physical aspects of their relationship, and this helped them rebuild intimacy from the inside out.


The Role of Tantra in Strengthening Bonds

Tantra is an invaluable tool for couples looking to reconnect on a deeper level. When people hear the word ‘Tantra’ they immediately think about sex, but there is so much more to it than that.Tantra is actually a spiritual practice that aims to integrate the body, mind, and spirit and includes a range of teachings, meditation and rituals. I remember working with one couple, who felt like they’d lost the closeness they once had after years of marriage. They weren’t sure how to get it back, and the pressure to “fix” their sex life felt overwhelming. I introduced them to some simple Tantra-inspired exercises — not focusing on sex itself, but on breathing together and being fully present with each other. Using small, intentional practices can help couples to find their way back to intimacy. It wasn’t magic; it was simple mindfulness.


Working On Yourself NOT Just Your Relationship

One client loved her partner deeply but felt her own needs were constantly on the backburner. Through therapy, she realized that being in a relationship didn't have to mean neglecting herself. We explored her desires, her personal boundaries, and the importance of loving herself as an individual, which ultimately strengthened her relationship. She found that attending to her own needs made her feel more balanced and was better able to be there for her partner.


How Therapy Can Help Individuals Address Love and Sexuality


Unpacking Your Personal Beliefs About Love and Sex

We all have core beliefs about love and sex, often stemming from our upbringing. One of my clients grew up in a strict household where sex was never discussed and surrounded by shame. As an adult, he struggled to enjoy sex due to this subconscious guilt. In therapy, we unpacked these core beliefs, where they came from and allowed him to question and rewrite these narratives. This shift opened up new possibilities for intimacy in his relationship.


Healing Sexual Trauma and Shame

Sexual trauma can have profound effects on relationships, and it's something I approach with great care. One client that I worked with experienced trauma in her teens had never felt comfortable discussing it. In therapy, we worked through her deep-seated feelings of shame and fear, helping her reconnect with her body in a gentle, safe way using Somatic practices. Seeing her move toward self-acceptance and opening up to relationships and intimacy was very emotional.


Improving Self-Esteem and Sexual Confidence

For some clients, the root issue is a lack of confidence. One client came to me feeling self-conscious about her body and unsure how to communicate her desires. We focused on encouraging her to love her body and soul; and building her self-esteem and sexual confidence. Gradually, she began to see herself differently, becoming more confident not just in the bedroom but in every area of her life.


How Therapy Supports Couples in Navigating Love, Sex, and Relationships


Reigniting Desire

Dr. Nelson's practices for reigniting desire have been transformative for many of my clients. Couples often end up feeling like "roommates" rather than romantic partners. We start by helping them reconnect emotionally, then explore practical ways to reignite physical desire. It's about creating a safe space where desire can naturally revive, not about forcing intimacy.


Communicating Your Needs and Boundaries

Communication is everything in relationships, including discussions about sex. Many couples avoid these conversations for years. Couples therapy will provide a space to practice talking about needs and boundaries. Once they begin, couples often find their connection deepens in their everyday life in unexpected ways, because of that opening up and honesty.


Tantra-Inspired Practices for Connection

Sometimes, the simple practices create the most powerful changes. Incorporating Tantra-inspired exercises focusing on touch, breath, and presence can help to create a sense of closeness that couples may have thought was gone forever.


Why Address Love, Sex, and Relationships Holistically

Understanding that love, sex, and relationships are interconnected helps everything make more sense. Emotional disconnection can lead to physical distance and vice versa. Looking at the bigger picture rather than fixing one problem at a time allows for finding balance.


Our sexual well-being is closely tied to our emotional and physical health but often gets overlooked or ignored. Focusing on your sexual well-being can impact every area of your life. A healthy, fulfilling relationship—whether with yourself or a partner—is the foundation of a happier, more balanced life.

Integrative Therapy that addresses love, sex, and relationships holistically is where real, sustainable change happens. By integrating techniques from various therapy styles or Tantra practices, you can create opportunities for lasting change—not just in your relationships but in every area of your life.


By Aki Tsukui February 4, 2026
When we hear the word intimacy , we often think of sex: touch, desire, romance. Yet true intimacy lives far beyond these moments. It is felt in silence, in a shared glance, and in the quiet courage it takes to be fully present with yourself, with another, and with life itself. Real intimacy does not begin by reaching outward. It begins within. In the rhythm of your breath. In the pulse of life moving through your body. In the willingness to meet yourself honestly and gently. Meeting Yourself The deepest intimacy is the relationship you cultivate with your own heart. To meet yourself is to witness your thoughts, contradictions, joys, and aches without judgment or urgency. Can you stay present with fear rather than turning away? Can you allow sadness to settle in your chest and still honor it as meaningful? Can you sense the subtle movement of breath and energy within you? In moments of stillness and awareness, we often discover how much of ourselves we have learned to hide: emotions pushed aside, sensations ignored, patterns inherited and carried unconsciously. Yet every doorway to genuine connection already exists inside you. When you reclaim your inner world, you reconnect with the source from which all intimacy flows. Being Felt Emotional intimacy is not something we explain; it is something we allow. It lives in presence in the unguarded moment, the pause that stretches, the vulnerability that remains uncovered. To be emotionally intimate is to let the quiet pulse of your inner life meet another without the need to justify or repair it. Breath becomes a bridge, gently moving awareness between your inner world and the shared space. In this soft surrender, the heart remembers that it is safe to open, to soften, to simply be. Being Known Psychological intimacy asks for the courage to see and name the patterns that shape how we move through the world: our fears, defenses, and habitual ways of relating. “I withdraw when I feel unseen.” “I hesitate to ask for support because I fear being a burden.” These patterns rarely belong only to us. They often arise from family systems, ancestral histories, and cultural conditioning, unseen forces carried across generations. When we begin to recognize these influences, compassion naturally deepens. We stop judging ourselves and instead meet our patterns with curiosity and care, honoring the lineage that lives within us. Meeting Beyond Roles Spiritual intimacy emerges when roles and narratives fall away. It is found in the space between breaths, in shared silence, and in the quiet recognition of essence meeting essence. It may appear while sitting together in stillness, in a gaze that needs no explanation, or while walking side by side through ordinary moments that suddenly feel sacred. When attention softens and awareness deepens, intimacy arises naturally. Breath, presence, and a wider systemic awareness allow us to meet one another with greater freedom, depth, and reverence. Intimacy Beyond Another You do not need another person to access this depth of closeness. Intimacy can be cultivated entirely within. In moments of stillness, you may begin to honor every layer of your being. As your breath deepens, its rhythm may echo the larger cycles of life. Subtle currents of energy become more perceptible, as does the quiet presence of ancestral threads shaping your experience. When inner intimacy is nurtured, relationships transform. Connection is no longer about filling a void, but about resonance: two beings meeting from wholeness rather than need. The Sacredness of Vulnerability To be intimate is to be seen and being seen can feel risky. Old wounds, inherited fears, and unmet needs often surface, making closeness feel uncomfortable. Yet vulnerability is the doorway. Breath and embodied awareness gently anchor you in the present, reminding you that you are alive, supported, and connected. As presence meets presence, intimacy deepens naturally. Intimacy as a Way of Being Intimacy is not something to earn or achieve. It is a state of presence, openness, and deep respect for life. It lives in meeting yourself with compassion, keeping your heart soft even in the presence of fear, holding space for another without expectation, and recognizing the sacred thread that runs through all connection. As you move through the days ahead, you might gently notice where intimacy is already presentin your breath, in moments of quiet honesty with yourself, in the spaces between words. There is nothing to strive for and nothing to fix. Intimacy is already here, waiting to be met. Warmly, Aki Tsukui
By Esther Oon-Bybjerg February 4, 2026
Chemistry is often treated as a decisive force in romantic life. When it is present, people feel justified in leaning in. When it is absent, even after a pleasant and promising date, interest tends to stall. Chemistry appears to offer clarity, but what it actually provides is something narrower: an early signal, powerful in its immediacy, yet limited in what it can reliably tell us. Most people recognise this tension intuitively. They know chemistry matters, but they also sense that it does not explain everything that makes a relationship viable or sustaining. And yet, in practice, chemistry is frequently asked to carry more authority than it deserves, shaping decisions about who to pursue, who to dismiss, and how long to remain invested. What is chemistry? In relationship research, romantic chemistry is recognised as a multifaceted, emergent experience. It can include attraction, emotional connection, interactive engagement, and a sense of mutual responsiveness. Importantly, chemistry is not viewed as a fixed trait residing in one person, but as something that arises between two people through interaction. When researchers examine how people themselves describe chemistry, however, a more specific pattern emerges. A recent qualitative study published in Behavioral Sciences, found that while participants acknowledged chemistry could involve multiple elements, the most commonly cited and immediately recognised experience was an instantaneous spark - a felt sense of connection, intensity, or attraction early in an interaction, rather than a gradual assessment of compatibility or emotional safety (Devenport et al., 2025). Why the spark feels so convincing That immediate spark carries weight because it is physiological as much as psychological. Early romantic chemistry is associated with activation of the brain’s reward and motivation systems, including increased dopamine and norepinephrine, which are neurochemicals involved in focus, pursuit, and salience. The body feels energised, attention narrows, and the other person begins to stand out in a way that feels meaningful. This response is not irrational. From an evolutionary perspective, rapid bonding had adaptive value. From a learning perspective, our nervous systems are shaped by repeated relational experiences. Attachment research helps explain why this kind of activation can feel meaningful so quickly. Our nervous systems learn through experience what closeness feels like, and over time they become efficient at recognising familiar patterns. When past intimacy involved emotional intensity or heightened engagement, the body may respond swiftly to similar cues, even before conscious evaluation has a chance to catch up. (Mikulincer et al., 2020). 1Chemistry, then, is neither imagined nor accidental. But it is also not a verdict. It is a signal that arrives early and speaks loudly. When chemistry starts doing more than it should Problems arise when chemistry shifts from being an opening signal to becoming the deciding factor. When people over-index on chemistry, two familiar patterns tend to emerge. In one, the absence of chemistry limits pursuit. Dates can go well. Conversation can flow. The other person may be emotionally available, respectful, even aligned with what someone says they want. And yet, without chemistry, interest stalls. Many people describe this not as rejection, but as resignation: “I know they’re good for me, but I don’t feel anything.” The relationship does not end; it simply never begins. In other cases, the opposite happens. A relationship starts with strong chemistry. People invest quickly and overlook early warning signs. That initial pull shapes the decision to begin the relationship and continues to guide it even if doubts surface. Concerns are registered, but they carry less weight. Over time, it becomes clear how much chemistry has been steering judgment from the beginning. Because the nervous system is activated, the mind works to maintain coherence, often finding reasons to persist rather than pause. In both cases, chemistry is doing more work than it should either preventing people from staying curious enough for other forms of connection to develop or pulling people forward too quickly. What chemistry can and cannot tell you Research consistently shows that long-term relationship satisfaction is far more strongly predicted by responsiveness, repair after conflict, and emotional attunement than by early intensity alone (Overall & Lemay, 2021). Chemistry does not reliably predict these capacities. Chemistry can tell you that your system is activated, your attention is engaged, and something feels compelling or familiar. What it cannot tell you is how conflict will be handled, whether needs will be met consistently, or whether emotional safety will deepen or erode over time. From a nervous-system perspective, this distinction matters. Stephen Porges’ work on Polyvagal Theory describes how the autonomic nervous system continuously scans for cues of safety and threat, shaping whether we feel socially open, vigilant, or withdrawn. When systems are accustomed to high arousal, intensity can be misread as connection and calm can register as disinterest. In such cases, chemistry reflects nervous-system conditioning more than relational compatibility (Porges, 2022). 2The consequences of over-indexing on chemistry often appear later, in hindsight. When chemistry dominates judgment, it can obscure both warning signs and possibilities. Chemistry as one voice among others A more grounded way to relate to chemistry is to treat it as one voice in a larger conversation. It deserves attention, but it should not be allowed to dominate the discussion or determine the outcome on its own. Qualities such as emotional safety, mutual responsiveness, values alignment, and repair after conflict tend to speak more slowly. They require time and exposure to reveal themselves. When chemistry drowns them out, decisions are made with incomplete information. Wanting chemistry is not the problem. The issue arises when it is allowed to outweigh every other form of relational information. Chemistry can open the door, spark curiosity, and make connection feel alive, but sustaining love depends on quieter, more consistent signals - emotional presence, repair, respect, and reliability over time. The goal is not to mute the spark, but to place it in context. Chemistry speaks loudly, but wisdom often emerges only after the initial intensity had time to settle.  References Devenport, L., et al. (2025). Exploring lay understandings of romantic chemistry. Behavioral Sciences, MDPI. https://www.mdpi.com/3592440 Mikulincer, M., Shaver, P. R., & Ein-Dor, T. (2020). Attachment orientations and emotion regulation in close relationships. Current Opinion in Psychology, 25, 86–91. Overall, N. C., & Lemay, E. P. (2021). Attachment, responsiveness, and well-being in romantic relationships. Current Opinion in Psychology, 43, 110–115. Porges, S. W. (2022). Polyvagal theory: A science of safety. Frontiers in Integrative Neuroscience, 16, 871227. https://doi.org/10.3389/fnint.2022.871227 3
By Praveen Kaur January 9, 2026
Welcome to 2026 (You’ve Already Landed) By the time you’re reading this, we are already in 2026. No countdown. No confetti. No dramatic soundtrack. Just you living, showing up, doing your best. Whether you realised it or not, you crossed into this new year carrying something with you. Not a suitcase. Not a planner. A carry-on . The Invisible Luggage We All Bring Your carry-on isn’t visible but it’s always with you. Inside it might be: • Expectations you didn’t consciously choose • Emotional habits you’ve perfected over time • Unfinished conversations (with others… and yourself) • Coping strategies that once helped but now weigh you down And also… because let’s be fair • Resilience • Hard-earned wisdom • Boundaries you finally learned to set • Strength you didn’t know you had Not everything in your carry-on is a burden. But not everything belongs on this journey either. We Don’t Usually Check Our Carry-On Most of us keep moving. We assume: • “This is just how I am.” • “This has always worked for me.” • “I’ll deal with it later.” But over time, the carry-on gets heavier because we get busy “chasing”. What once felt manageable becomes: • Emotional fatigue • Reactivity • Quiet resentment • A sense of being constantly ‘on’ And we wonder why rest doesn’t quite restore us. A Gentle Question for 2026 Pause for a moment and ask yourself: What am I still carrying that I no longer need? Awareness is the first step. Not everything has to be unpacked all at once. What remains unchecked often: • Shapes our reactions • Influences our relationships • Determines how safe, calm or overwhelmed we feel Letting Go Isn’t Losing, It’s Choosing People don’t struggle because they’re broken. They struggle because they’re overloaded . Letting go doesn’t mean dismissing your past. It means honouring it without letting it run the present. In 2026, growth may look less like adding tools and more like: • Unlearning • Softening • Creating space What Deserves Space in Your Carry-On? As this year unfolds, consider revisiting your inner luggage. What’s worth keeping close? • Self-compassion • Curiosity • Honest communication • Support (yes, including professional support) What might be ready to stay behind? • Guilt that no longer teaches • Hyper-independence that isolates • Expectations that were never yours to carry Mental and emotional wellbeing isn’t about arriving lighter overnight. It’s about learning to: • Check in with yourself regularly • Notice when the load feels too heavy • Ask for support before exhaustion sets in Therapy, coaching and nurturing workshops offer a space to gently unpack without judgement, without rushing and without needing to have it all figured out. Moving Through 2026, Intentionally You are allowed to move forward differently this year. Not faster. Not harder. Just more consciously . So, as you continue into 2026, take a quiet moment to ask: What’s in my carry-on and am I ready to travel lighter? Because sometimes, the most meaningful shift isn’t a new destination. It’s what you choose to carry with you along the way.