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. 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 rea, 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.


For more information, email: info@counselingperspective.com


By Praveen Kaur July 1, 2025
“Girl, if you have five real friends after 60, you’ve made some good choices.” said this voice full of wisdom. I remember that taxi ride very clearly. At that moment, I chuckled and started counting my “close” friends using my fingers, toes and maybe even a few rounds in. That sentence stuck with me for over 20 years. I knew deep down someday I will have to recollect that moment. Friendship is beautiful. It is also layered, unpredictable and at times, bittersweet. It grows, withers, surprises us, quietly fades away and sometimes comes back in new form. This is especially true as we transition through life, careers, motherhood, healing and reinvention, our social circles shift with us. Who you needed yesterday may not be who you need today. If you’ve ever caught yourself wondering “Where did everyone go?” or “Why do I feel closer to someone I just met than people I’ve known for years?”, you are not alone. You’re just evolving. And evolution rarely leaves your social circle untouched. What Is Friendship, Really? By definition, friendship is “a person with whom one has a bond of mutual affection, typically one exclusive of sexual or family relations.” But let’s be real, that doesn’t capture the heart of it. To me, friendship is… A soul who supports you without judgement. A person who calls you out with love and cheers you on even louder. Someone who holds space for your becoming. So I’ll ask you, what’s your definition of friendship? Take a breath. Feel into it. You might find your answer has changed. That’s not wrong. It is honest. There’s no shame in evolving, only alignment with your present truth. When You Change, So Do Your Friendships This part can feel tender: when your inner world shifts, your outer circle often reflects that. Some friends will rise with you and celebrate your growth. Some surprise you by meeting you right where you are. Some will resist your change. And some will quietly fade. It’s not about fault; it’s about alignment. That friend who used to be your late-night rant partner might not be your 6 AM hike buddy. And the colleague who didn’t really “get you” five years ago? He / She might be your biggest fan now. Change is inevitable. Clinging to what was can hold you back from what’s possible. What Role Does Energy Play in Friendship? In the Energy Leadership™ framework , we recognize 7 levels of energy. Each representing a way of thinking, feeling and showing up in the world. These levels can also show us how we relate to our friends especially when change enters the picture. Let’s explore: ⚫ Level 1: Victim Energy "No one understands me anymore." This is where disconnection and self-doubt live. You may retreat or feel abandoned. Friendships can feel draining when this is the dominant lens. 🔴 Level 2: Conflict Energy "They don’t support me like I support them." Resentments build. You may find yourself judging, comparing or feeling the urge to prove yourself. Friendships become power plays instead of safe spaces. 🟠 Level 3: Coping Energy "It’s fine. I’ll just adjust to keep the peace." This is the friend who avoids conflict and over-accommodates. It looks harmonious on the outside but often sacrifices authenticity for the sake of connection. 🟡 Level 4: Service Energy "How can I support you through your change?" Here, friendships are built on empathy and care. This friend holds space for your becoming, even if it’s different from their own. 🟢 Level 5: Opportunity Energy "What if this shift brings us closer or introduces new aligned people?" There’s curiosity and collaboration here. You start to see that every change in a friendship opens doors for deeper alignment or necessary redirection. 🔵 Level 6: Flow Energy "I trust the right people will rise with me." At this level, friendships feel effortless, expansive and aligned with your highest values. There’s no grasping, just grace. ⚪ Level 7: Oneness Energy "There’s no separation between giving and receiving love." This is pure connection. Friendships here are soul-level, transcending ego or expectation. Rare, but powerful when experienced. So How Do You Navigate Friendship During Change? Transitions will test your relationships but they’ll also reveal your energetic patterns. Here’s how to move forward consciously: ✅ Get curious, not judgmental – Notice how you're showing up (what level of energy), and how others are too. ✅ Honor mismatches without blame – Some friendships fade. That doesn’t mean they failed. It means the alignment shifted. ✅ Invite new energy – Stay open to friends who match where you are now, not just where you’ve been. ✅ Say thank you loudly or silently – To the ones who stayed. To the ones who couldn’t. To yourself. ✅ Be the kind of energy you want to attract – Every friendship is a mirror. What are you reflecting? Final Thought: You’re Allowed to Outgrow People Outgrowing isn’t betrayal. It’s evolution. You’re allowed to choose friendships that nourish the version of you you’re becoming not just the one you have been. Celebrate this evolution. So go ahead, count your friends on fingers, toes, even add a few imaginary rounds. But more importantly, ask yourself: Are these people reflections of the life I want to live? Because that’s the circle worth nurturing.  If you want to explore coaching with Praveen, get in touch with us: info@counselingperspective.com
By Lilian Lee-Cutts July 1, 2025
In the course of our adult lives, friendships can shift, drift, and sometimes rupture. In the face of busy, divergent lives and priorities, this is a very natural process, but can be one that causes us confusion, pain, and a great sense of loss. Romantic relationships tend to have a clear beginning, middle, and end and we have the tools from young adulthood to understand the expected transitions. Friendships, however, tend to be more fluid and evolve over time with no set rules of engagement. In addition, each person will have a different perspective on what the friendship means to them, and so it’s no surprise that many people can find themselves struggling with questions like: Why does it feel harder to make friends? Why do I feel disconnected from people I used to feel close to? Is it worth my making an effort in this friendship when I feel I get so little from it? If you have found yourself asking these questions, you are definitely not alone. As a psychotherapist, I frequently encounter the deep pain that can come with friendship challenges in adulthood. Despite societal norms pointing us towards focusing our efforts on romantic or familial relationships during adulthood, our friendships are equally crucial to our emotional wellbeing. They offer companionship, shared experience, and a vital sense of belonging. And yet, they’re often forgotten about in conversations about our mental health. So let’s explore how we, as adults, can navigate our friendships with greaterawareness, compassion, and intent. How to navigate friendships 1. Reflect on your needs Start by asking yourself: What does friendship mean to me now? What feels nourishing and good? Your needs are most likely very different to what they were five years ago, and it is OK to acknowledge that. 2. Practice clear communication It’s not always easy, but expressing how you feel - whether it’s hurt at being left out or asking for more time together – will improve the quality of your friendships. Choose a moment when you both feel relaxed enough to be receptive. 3. Embrace flexibility As life happens around us, some friends can go quiet for months. Babies, burnout - it’s all very real. Whilst this can be confusing or hurtful, a bit of grace and compassion goes a long way and gives the friendship opportunity to evolve to a place of greater understanding and depth. 4. Make the time Adult friendship isn’t sustained by chance. It’s easy to get wrapped up in life’s demands while time continues passing by. It becomes a necessity to be intentional about making time for your friends. Some ways to do this are by scheduling regular check-ins as you would in work. Dedicate some time out of your busy schedule to call or message a friend as often as you can. 5. Recognise your patterns Whether you realise it or not, the way you respond to friendships has a lot to do with your attachment style. For example, a person with a secure attachment style is capable of forming nurturing friendships and working through any conflicts that may arise. However, those with more insecure attachment styles may find it harder to let go of friendships that are no longer working and will tend to take any perceived hurt personally. Final note We also need to recognise that not all friendships are formed - or maintained - on equal footing. If you’re LGBTQ+, neurodivergent, disabled, or from a minoritised background, your social landscape may look very different. You may have spent years finding your people, or building a chosen family to replace what blood ties could not offer. Those friendships carry a different kind of emotional weight and often, a depth that comes from shared survival. Similarly, if you struggle with anxiety, depression, or trauma, then the energy that goes in to maintaining friendships can feel daunting. You might feel the need to disappear for a while, or struggle to reply to messages. That doesn’t make you a bad friend, it makes you human and in need of a self compassion practice. If you are finding adult friendships difficult, and want to speak to Lili: info@counselingperspective.com 
By Aki Tsukui June 2, 2025
What does it mean to truly know who you are? During Pride Month, we celebrate the beauty of diverse identities and the courage it takes to live authentically. But beyond the labels and roles, there is a deeper essence waiting to be seen—a core self that exists beneath the surface. At Elemental Wellness, we believe that reconnecting with this essence is both a sacred and scientific journey. And breath is the bridge. The Breath: A Portal to the Subconscious Yin Breathwork, rooted in Leonard Orr’s Rebirthing Breathwork, offers a gentle yet profound way to access inner truth: not through thinking, but through feeling and presence. This form of conscious, connected breathing helps shift our awareness from the everyday, thinking mind (conscious) to the deeper, quieter terrain of the subconscious. Why does this matter? Because the subconscious holds the stories, emotional imprints, and beliefs we’ve absorbed, often unconsciously, from culture, family, and lived experience. These inner patterns shape how we see ourselves and how freely we live out our identities. Through slow, circular breath, Yin Breathwork helps bypass habitual thought loops and opens the door to neuroplasticity: the brain’s natural ability to rewire. When we breathe with intention and softness, we create a relaxed yet alert state, similar to light meditation or REM sleep, where old emotional imprints can surface and be gently released. Science Meets Soul: The Nervous System and Breath From a physiological perspective, breath is one of the few automatic functions we can consciously control. When we slow and deepen our breathing, we signal safety to the brain through the vagus nerve, activating the parasympathetic nervous system, our body’s natural state of rest and repair. This matters deeply for identity work. If we've lived in fight-or-flight, bracing against judgment, discrimination, or internalized shame, our nervous system may associate authenticity with risk. But breath offers another way. It teaches the body that it is safe to soften, to open, to be seen. Over time, regular Yin Breathwork can help regulate the nervous system, reduce anxiety, and increase emotional resilience. It becomes a quiet revolution within: an unlearning of fear and a return to inner freedom. Identity: A Living, Breathing Process We often think of identity as something to define or declare. But what if identity is not fixed, but fluid? What if it’s something we remember , layer by layer, breath by breath? In a Yin Breathwork session, there is no need to force answers. We simply lie back and breathe, allowing what wants to emerge to rise. The experience can feel meditative, emotional, or quietly powerful. As tension releases from the body, insight often follows about who we are beneath the roles, the expectations, the old stories. Rather than striving for authenticity, we relax into it . This isn’t a quick fix. It’s a return to the self—a remembering of what has always been there. And in that remembering, healing happens Pride as a Return to Wholeness Whether you're navigating your gender, sexuality, cultural heritage, or your evolving sense of self, Yin Breathwork offers a sanctuary—a space to return to your body and your truth. There’s no performance. No pressure. Just breath. Just presence. Just you. This Pride, instead of stepping out, we invite you to step in. To soften. To listen. To discover who you are beneath the noise gently, fully, and unapologetically. Yin Breathwork isn’t about changing yourself; it’s about remembering who you’ve always been. Join us for a Yin Breathwork session and reconnect with who you truly are. For booking: info@counselingperspective.com