A major obstacle for most people in changing the mechanics of how they have sex is a mental block about what “real sex” is. If you think the only kind of sex that’s real is penile-vaginal intercourse, you’re missing the boat on what sex has to offer. This isn’t an easy shift to make, and it can help to talk with a psychologist who is comfortable talking about sex.
Physical Positioning
If you’re looking for ideas about positioning, and if you know what you want to do sexually, but just don’t know how to do it, talking with a physiotherapist or occupational therapist may also help. Not all OTs and PTs are comfortable talking about sex, but they’re experts on how bodies move and how we can maximize what we’ve got to move with. Even if they’re a bit confused at first, they may be willing to help brainstorm ideas with you. If you don’t know where to start you these sex positions images might help spark your creativity.
Sexual Technique
If you can find a psychologist who is comfortable talking about sex they may have some suggestions for you about expanding your sexual repertoire of techniques. There are also hundreds of books, videos, and websites that offer ideas on sexual technique. Keep in mind that there’s no “right” technique, only what works for you and your partner.
Pain and Fatigue
If you’re experiencing pain during sex and you’re not sure what is causing it, you should talk to your primary care provider who may be able to answer questions or refer you to a specialist. In terms of managing pain and fatigue, you can try to time having sex both to a time of day when you’re in less pain or when you’re feeling most frisky (or at least awake). Depending on the medications you're on, talk with your doctor about timing medications to reduce pain during sex. If your pain medication assists with you being able to have longer, pain-free sex, try and take it 20 minutes to an hour before you anticipate having sex.
Triggers During Sex
Whether you’ve been diagnosed with PTSD or not, you might have the experience of being triggered by having sex. For example something your partner says or does, a smell or even taste can make you feel as if you are re-experiencing a traumatic moment from the past. If this happens, it doesn’t mean you won’t be able to have sex with that person anymore. But it probably means you need to talk with your partner, figure out what was happening, and then change parts of your sexual routine so he or she doesn't trigger you in the same way. You can learn how to read theses signals better through working with a mental health professional and discovering strategies to identify the triggers and replace some of the negative thoughts with more neutral thoughts and feelings.
Communicating During Sex
If a brain injury has changed how you communicate, you probably had someone help you in rehabilitation with general communication and speech. And they probably never talked to you about sex. But you can use what you learned in rehabilitation and apply it to sex with your partner. It’s important to let your partner in on what you’re finding difficult so you can find something that works for both of you.
Read more:
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Interview with B.J. and Abby Jackson – Creating a Sex Life after Combat
Interview with Dr. Mitch Tepper – Working to Address Sexuality for Wounded Warriors
