Let's Talk about Sex, Intimacy and Occupational Therapy!

Sexual activity and intimate social participation are often considered meaningful occupations. Healthy intimate relationships and satisfaction with one’s self as a sexual being have the potential to contribute to quality of life and wellness. While sexuality and intimacy can play a very positive role in individuals lives, there is also the potential for sexuality to have grave consequences and be used as a vessel of power.

Considering the powerful impact of sexuality on individuals' lived experiences, occupational therapy professionals should be prepared to address sexuality and intimate occupations with their clients. Occupational therapy professionals are perfectly situated to address sexuality and intimacy occupations, due to our training in activity analysis, therapeutic use of self, cultural competency and trauma informed care.

What is sexuality?

Sexuality encompasses concepts beyond heteronormative penetrative sex. Sexuality can be understood as sexual expression, sexual activity, sexual decisions for example abstinence, sexual communication skills, and understanding one’s sexual self-concept. When considering sexuality in this manor, one can understand how sexuality is one of the few occupations which is relevant throughout lifespan. We have evidence of infants masturbating in utero, know it is important for adolescents to learn sexual limit setting, and know it is common for individuals at end of life to want to share physical touch with their loved ones.

What is intimacy?

Intimacy is understanding it is not a euphemism for sexual activity. Intimacy is separate from sexuality. Managing intimate relationships involves executive functioning skills, such as planning and organising skills, communication skills, emotional regulation, sensory regulation, self-awareness and positive self-concept. Often a strong, intimate relationship is a precursor to a healthy and satisfying sexual relationship, particularly for couples who have been together long term. Intimacy can be enhanced through prioritising pleasant shared time together, maintaining respectful communication, affirmation and advocating for one’s relationship needs and giving effort towards meeting the relationships needs of their partners.

"Occupational therapy professionals are perfectly situated to address sexuality and intimacy occupations due to our training in activity analysis, therapeutic use of self, cultural competency, and trauma informed care."

Who might have concerns related to sexuality and intimacy?

Everyone!

Regardless of diagnosis, gender, sexual orientation, gender identity, age, religion, race, many individuals will find meaning in how they desire, choose, and are empowered to be sexual and intimate.

Occupational therapists can work with individuals with a range of diagnosis and many of these individuals will report a desire to improve their performance and satisfaction with sexual activity and intimacy social participation. Examples include, but are not limited to poly-traumatic injuries, post-traumatic stress symptoms, anxiety, cancer, erectile dysfunction, or sexual trauma.

Occupational therapists can help clients explore their physical, cognitive, and emotional barriers to engaging in sexual activity or intimate occupations. After establishing awareness of the contributing factors, they can make recommendations to assist with mitigation of those barriers and providing suggestions for affirming and enjoyable sexual and intimate activity.

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Interested in learning more about how to address sexuality and intimacy in your occupational therapy practice?

Here are a few tips and recommendations:

1. If you don’t feel competent, generate an open discussion with your clients and hear from them how their sexuality and intimacy is impacted by their illness or experiences. Our clients are our most important stakeholder, they can guide us in the right direction.

2. If you don’t feel comfortable, generate an open discussion with your colleagues, classmates, professors, loved ones, or children. Give yourself practice having professional and productive conversations around the topics of sexuality. Practice makes perfect and gives us confidence.

3. Visit author Kathryn's website, www.sexintimacyot.com, to sign up for the mailing list and be kept up-to-date with learning events and advocacy efforts. Check out the Social Responsibility page, for free resources and content.

4. Take a look at two books Kathryn has written/edited: Sexuality and Intimacy: An Occupational Therapy Perspective and Sex and Intimacy for Wounded Veterans: A Guide to Embracing Change.

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Image credits: Institute for Sex, Intimacy & Occupational Therapy For access to images, contact kathrynellis@sexintimacyot.com.