Resolving Sexual Issues with Sensate Focus

Sensate Focus is an efficient method involving the people in the intimate relationship (a couple if there are two people in the relationship, or more for polyamorous relationships). But it can also be used with one person, and this is called Self-Sensate Focus.

Each phase of the Sensate Focus is designed to help reduce the anxiety of the ‘performance’ of penetration for a more pleasure-centred process. It is a good method to help clients who struggle with unreliable erections, vaginismus (vaginal muscles contracting so hard that penetration is impossible), dyspareunia (pain during penis-in-vagina penetration) and anodyspareunia (pain during receptive anal sex).

First, it is important for therapists to assess the nature of the sexual problem (medical, psychological, or both) and the intimate relationship(s). For example, if there are significant problems in the relationship(s) such as unresolved resentment, frequent conflicts, acute anger, unresolved post-trauma symptoms, ongoing infidelity or lack of trust, the therapist may need to address those issues before launching into Sensate Focus.

Sensate Focus is a method that can easily be adapted, so you might read different versions of it in different publications. Here is one typical way to guide clients through the method.

For the purpose of clarity, I would like to stress that psychosexual therapy is a talking therapy with no touch. The exercises suggested in Sensate Focus are for clients to do in their home, and they can then talk about that experience in their therapy sessions.

Sensate Focus – Phase 1

This is the beginning of sensual exploration, with eye gazing in silence. It is usually uncomfortable for people. Emotions often come up, such as longing, sadness but also love.

The next part of Phase 1 is for clients to explore each other’s bodies, avoiding the typical erogenous zones, taking turns with caresses and massages and listening to partners’ feedback. The point of this is to become curious about the rest of the body. It helps reconnect with eroticism but without the pressure of ‘performance’, penetration or ‘successful’ sex.

Phase 1 can be lengthy because it is important to communicate to clients that there is no rush and it is good to take time with sensuality.

Sensate Focus – Phase 2

In this phase, clients can slowly move into touching each other’s erogenous zones. The important part of this process is to tell clients that this is not for the purpose of arousal or orgasm, but simply an exploration to notice how it feels to touch and be touched. Often, many thoughts and feelings will emerge, especially anxiety-provoking thoughts like: ‘is my penis big enough?’, ‘does my partner like my body?’, ‘what does my partner think of me?’. The therapist can address these thoughts as they come up, and guide clients to discuss these anxieties with each other, asking the questions to their partner(s), seeking clarification and reassurance.

Sensate Focus – Phase 3 

This phase invites clients to move from exploration to arousal. It is when clients can learn to take their responsibility for their own arousal (and pleasure) – taking turns, or one partner guiding the other(s) where and how to touch for arousal. This must be done without judgements. The partner(s) doing the touching only needs to follow the instructions, without questioning. Again, this phase is not about ‘performance’ or ‘success’ but only about enjoying the feelings of sexual pleasure.

Sensate Focus – Phase 4 

This is when clients can ‘play’ with each other, staying connected with their own arousal, but guiding each other simultaneously with being pleasure-focused, rather than goal-focused. This phase is to emphasise the celebration of mutual sexual pleasure.

Sensate Focus – Phase 5 

This is the phase typically called ‘containment’, which is when penetration is explored. Containment typically means penile insertion with no thrusts. By the time clients reach Phase 5, the goal of penetration may not be as important because they have discovered how to enjoy a good sexual time without it.

After Phase 5, clients can be more confident with penetration, but with the caveat that sex is not a problem that gets ‘fixed’. Rather, sex is an ongoing mindful pleasure activity that needs consistent exploration, patience and attending to, with consistent erotic conversations.

Phase 5 may also be modified for people in relationships who have no penises, or for people who do not want penis penetration as part of their sex life. ‘Containment’ may be done with oral sex (penis in mouth / tongue on clitoris), masturbation (penis in hand / finger on clitoris / finger in anus), or using sex toys.

There can be much creativity involved in Phase 5. Therapists can then suggest that this creative phase is the beginning of a lifelong continuation of erotic awareness and play with people in their intimate relationship(s).