This is a miserable state of mind where everything feels hopeless, we feel useless and unworthy, and if something does go well we worry that it can't continue, or we don't deserve it anyway. We have no confidence in ourselves.
The roots of these feelings are in early life, and began as shame for not being "good enough", and a longing to be different so we could really belong. We were often criticised by a loved carer, or compared badly with other people. Unfortunately this happened when we were too young to know that it was unfair, and even wrong, so we believed what we were hearing about ourselves.
The way to restore this is to:

1. Understand how it happened, and realise the injustice of it.
2. Begin to believe that you can feel differently, and imagine what you would be like if you were self confident.
3. Watch your thoughts, and notice how your own thoughts remind you how worthless you believe you are.
4. Wear a rubber band on your wrist and snap it each time you catch yourself with those thoughts.
5. Ask for help from a therapist used to dealing with this problem. Cognitive Therapy is often a good way forward.

First we want to understand the causes of the tightening up of the vagina, so a full discussion is important before embarking on any treatment. Also talking together allows the woman and the therapist to get used to each other, and builds a trust between them, which is necessary in this type of work.

Some of the common causes for this troublesome condition are:
· Lack of knowledge, wrong beliefs, strict upbringing,
· Past infection, trauma, or injury in the genital area,
· Difficult relationship with your partner,
· Concerns about intimacy or commitment,
· Difficult childbirth or genital surgery,
· Sexual trauma.
All these can be discussed and helped before doing any physical work.

Sometimes there are deeper reasons, and therapy, counselling or hypnotherapy would help with these. There may have been Sexual Abuse which would need extra time and care to recover from.

In treatment, the vagina has to be taught to become less tense, by accepting touch on the outside at first, then gradually a cotton bud, finger or small trainer on the inside. Larger Vaginal Trainers can then be introduced. When the vagina can accept all sizes of trainers, it is usually able to relax sufficiently to have intercourse, and Sex Therapy helps with this.

In men, hormone levels usually go down very gradually from a peak in late teens onwards. In some men, a quicker drop in their late fifties leads to symptoms like the menopause in women. These can be hot flushes, aches and pains in joints, loss of energy, including libido, and a sense of slowing up mentally.

The Sexual Response in Men is affected. Erections come less easily and less often. They are less hard, and once they have gone down are more difficult to get back. Orgasms are less intense and rhythmic spasms of the muscles are over quicker. The amount of semen is less and the refractory period after orgasm is longer. While the need to ejaculate is less intense, sexual satisfaction amongst older men is often said to be good. The ability to continue being sexual certainly remains an important part of the older man’s self-image..

The frequency of sexual activity goes down with age but is very varied. Men who start having sex early in life are more likely to go on till late in life. The amount of sexual activity depends on having or getting a partner. The longer a couple have been together the less sex they have.

In women, the sexual peak occurs between 30 and 40 years of age. Lowering of hormone levels, and other body changes, happen when egg production stops, usually between 48 and 58 years of age. This is the menopause. There may be hot flushes, night sweats, aching in the joints, and less physical and mental energy and well-being. Other ageing changes include less sensitvity to arousal and orgasm and a general lessening in the sexual response.

Some women get dryness in the vagina, which can become sore and itchy. Some have less desire for sex, and can feel much less sexy in a number of ways. It is very common to gain a bit of weight, and this can make a woman feel less attractive.

Oestrogen, however, continues to be produced in the body fat stores and may help the effects of the menopause. Where loss of oestrogens is quite bad, extra hormones may be used. This is HRT or Hormone Replacement Therapy. Continuing having sex helps to keep the vagina soft and wet, and even if sensation is less, most women say that they feel very satisfied.

Georgia and Frank, partners for 12 years, both in their early 40's, came for help because they had not been having sex for 6 months, due to Georgia's loss of interest, which she could not explain. Neither was having an affair, there were no particular stresses outside of the ordinary, on either of them, but Georgia had simply gone off sex. The therapist asked, among other questions about the relationship and health, if anything significant had happened 6 months to 2 years ago, to which Georgia replied that her father had died 9 months before.

It emerged that Frank and Georgia were on holiday in Canada when they received a call to return home as soon as possible, as Georgia's Father was very ill in hospital. This was a huge shock to both, as there had been no indication of illness when they had left for the trip. By the time they arrived at the hospital, sadly, Georgia's Father had died. She was in a state of shock for some days, and desperately distressed that she had not said 'Goodbye' to him. She then got on with the practicals of helping her Mother to arrange the funeral, and sorting out papers and his clothing etc. All of these were done rather quickly, and Georgia did not give herself time to really grieve.

When loss is experienced by a person in a relationship, it can profoundly affect both the grieving person and the relationship. Feelings may be all over the place, behaviour may be uncharacteristic, emotions may be exaggerated or supressed to a state of numbness caused by the shock.

This situation will be heightened particularly if the death is of a child of the partners. The grief may tear the couple apart, when in reality both may desperately want and need more support from the other.

Death of a parent, friend or relative may bring all sorts of questions about the meaning of life into focus. This experience may be too much for a couple to handle without help. A person outside of the situation may be able to help each to talk out their confused and painful feelings.

Aging will affect us all unless we die young from accident or illness. It is a natural process of slowing down in all areas, and although we can delay some of the symptoms by sensible use of anti-aging nutrients, exercise, and other techniques, it is wise to prepatre for it earlier than we need so when it happens it is not a shock, but like a guest we have been expecting!

We suggest you visit Optimal Health which is a web site with a fund of useful information.

Organisations specialising in help for the aging and elderly are Age Concern, and Help the Aged.

Depression is a mood which can affect us all, and we would not be human if we never felt it. It is normal to feel depressed after illness, even flu, or bereavement, or if something sad happens. Sometimes it is a sign of stress. The feeling can last a few weeks, or months, depending on the cause, and gets better on its own.

Depression is also a very serious illness which affects many people at some time in their lives. It shows in a variety of ways, and you do not have to feel sad or down to be ill with depression. Common signs are:

• tiredness or lethergy
• lack of interest and low motivation
• poor sleep, particularly waking early
• loss of appetite or enjoyment of food
• feeling generally unwell
• bouts of uncontrollable weeping or tearfulness
• feelings of meaninglessness or wishing to take your own life

Like other illnesses it is curable, with the right treatment.
You may like the idea of medication to calm things down and help you sleep, and cope better generally. Therapy can also be helpful in finding ways for you to manage better. As a therapist, I like to use both, as the medication helps my side of the work.
Much depression will even get better on its own given long enough, but if you decide to take that route, remember that it is the most common cause of suicide. People die of it, so do seek help.

This section is about personal problems which make life difficult.

The range of problems we can have with ourselves is wide, and your own particular issue may not be listed below. Remember we are adding to this site on a regular basis.

In the meantime, you can contact usor mail a question to the forums and we will try give you some ideas.

Sometimes there is an organisation or specialist group who may be able to help, and for many people a few therapy sessions can make a big difference.

Babies are born quite relaxed, but learn to fear, to be anxious and to be stressed. Later in life, we can learn how to relax again- sometimes a vital part of dealing with a sexual or relationship problem. Your therapist will assess any difficulties you have with relaxing, as well as help you identify the situations when you are most likely to become anxious or tense. You can learn how to breathe deeply, and then through a systematic programme of taped exercise, identify tension and how to release it immediately. Relaxation training is effective, and is often a good start in therapy where you may want to make an 'early gain'.