Sex and Intimacy Therapy for Couples


Falling out of love? In a sexless marriage? Our experienced couples counselors help work through intimacy issues and find connection.

Falling Out of Love or Experiencing Intimacy Issues in a Relationship?

Falling out of love, feeling disconnected or any other intimacy issue can make you feel unloved in many ways. Perhaps you find yourself feeling more like a roommate with your partner than a lover. Maybe lack of sex, affection or attention is making you wonder “Does he even love me?” You are not alone. If we had to guess, we would say that intimacy issues are the true cause of most unhappy relationships.

Talking about sexual problems can be difficult enough, but coming to a solution alone isn’t that much easier.  Often couples find themselves emotionally distraught as they face power struggles, intense conflict and deep emotional distance. All of this is supressed or avoided because of the many taboos we have around sex and intimacy. For many, the shame and stigma surrounding intimate issues can prevent any action. 

Is it possible to get the spark back in your relationship? Yes, you can get back to what you had before, but you can’t return to something that was never there. If one partner for example is a clinical narcissist that never loved you or the relationship, there won’t be anything we can do. Whether this is the case or not we will discuss in our initial session. We won’t pursue therapy if we don’t see it as being helpful to you as a couple. 

Note: Relationship issues are similar across all relationship types. When we use terms like “couple” we don’t intend to exclude any groups from our advice. Non-monogomous or polyamorous couples can benefit as much from our relationship counseling as any other normative couple. In fact many of the common obstacles that such relationship arrangements bring can be best navigated with the help of a relationship advisor.

We offer Couples Counseling for:

Intimacy and Sexual Concerns »

Infidelity Repair or Loss of Trust »

Communication and Conflict Resolution »

Family Counseling/Parental Challeges »

Our Clinicians also help with:

  • Preparing for Partnership & Premarital Counseling
  • Life Transitions (beginning, ending or changing your relationship status)
  • Marriage Counseling
  • Relationship Discernment Counseling

Contact us to schedule an appointment or ask a question:

9 + 9 =

Common Intimacy Issues

  • Aging and sexuality, menopause, etc.
  • Absent, delayed or early ejaculation
  • Coping with past sexual trauma or childhood abuse
  • Differences in or low libido
  • Erectile dysfunction
  • LGBTG issues – sexual shame, etc. 
  • Maintaining interest and variety in your sexual relationship
  • Painful intercourse 
  • Sexless marriages
  • Sexual inhibitions

How Important is Sex in a Relationship?

While sex is a small part of intimacy, it does have significant importance within romantic relationships. Not only does it reduce stress and increase pleasure, but it is an important part of emotional bonding. Sexual issues can have an outsized impact on relationship satisfaction. In fact, unhappy partners ascribe 50 to 70 percent of their distress to sexual problems. [4] This is because often sex is the first thing to be impacted by broader relationship issues. 

In fact, you can think of sex as a “red flag” indicator for broader relationship issues that should be helped with couples work. This is because sex is a part of the cycle between emotional connection and physical intimacy. We have found that as couples avoid intimacy, emotional bonds are degraded and in turn less intimacy as initiated. It’s important to seek help in breaking this cycle before permanent relationship damage occurs. 

One way that we can break that cycle is by exploring our other avenues of intimacy. General physical affection, for example, primes us for sexual attention. This is why our couples counselors work with couples on incorporating more touch into a relationship: hugs, kisses, caresses. Some couples need to be told not to touch at all in order to realize how important it is for them.

How to Fall Back in Love

Our approach to reinvigorating the spark is to jumpstart the relationship and then build skills to rethink your relationship as one where you are “always dating.” As you start dating your partner again, you also have to look at underlying beliefs and issues you both have, and not necessarily the specific issue that brought you into therapy.

We understand that often couples “fall out of love” because they get too comfortable with their partner. We often start thinking that we know everything about our partner, because over time we generally know how they act and what they say. The trick is in understanding that your partner is always changing and growing, that thinking of them as someone new and exciting is challenging, but in the long term satisfying.

We’ve noticed that almost every couple that is losing connection finds themselves daydreaming about the start of the relationship when everything was new. We call this “the first 90 days”, after which we stop asking questions and learning about our partner and see them as unchanging. With time it’s our goal to get you back to a similar mindset now.

Some partners that work with us find during therapy that they feel disconnected with themselves and are stagnating or adrift in their own lives. We encourage reconnection with yourself first and foremost, then once you bring your best self to the relationship, it gives your partner something new to latch on to.

One way we do this is by teaching couples to create space for themselves and their differences. In some ways, what makes use different from our partner keeps us interested more than what we have in common.

Avoid the Pursuer-Distancer Cycle

Successful relationships take a balance of connection and separateness. One of the most common patterns that we see with couples at Acuity is the pursuer-distancer cycle. If unchecked it can contribute significantly to relationship breakdown as the cycle escalates. This situation is helpful to mention because it is perfect for our style of couples therapy.

Are you out of balance with connection and being separate?

Many couples find themselves stuck too far on one side of the spectrum. Either they never connect, or they are together too much and there is no “mystery” in the relationship. You can see this best when you watch a couple at a party. If both partners immediately separate themselves and never connect over the course of the night, they likely don’t have an interest in getting updates from the other and may be too distant. If both partners come to the party and are inseparable, talking with the exact same people and hearing the exact same things, they can’t really enjoy the party as individuals.

So what does pursuing – distancing look like in a relationship overall?

Well, if one partner is anxious about the relationship (why some call this cycle anxious-avoidant) they tend to pressure the other partner to do certain things to prove their commitment. This can overwhelm the other partner who feels  that everything is fine and lead them to withdraw to avoid such confrontations. The more this partner withdraws, the more the other pursues. This cycle can continue indefinitely if not noticed.

Distancers tend to avoid conflict and see being pursued as a difficult situation.

The reason that this happens tells us a lot about relationships. People that tend to distance themselves in these situations tend to be more closed off than their partner, or more independent and inward looking.

Pursuers on the other hand want attention and affection from their partner.

They tend to be more verbal and expressive with their feelings and can get frustrated when their partner is not the same. Pursuers crave connection and secure assurances from their partner. 

One of the steps to break this cycle is to realise it is there.

The next is to develop ways to balance how one pursues and distances. This may mean finding ways to meet one’s emotional needs not exclusively from a partner, or make room for emotional connection when situations require it, and more distance in other cases. Every couple is different and every solution varies. Our therapists can help you find your unique path forward. 

Frequently Asked Questions for Intimacy/Sex Therapy

Should we come in separately?

If you feel that you are the one in the relationship that is always pushing for communication and your partner is the main issue, then why should you come into therapy together?

Well to start you can’t be sure that your own communication is perfect (you may be oversharing or overbearing for one), but also know that a relationship is a system. How one partner acts and reacts changes how the other partner acts in the relationship and vice versa. You have to work on the system as a whole and not piecemeal.

Will you take sides?

Generally no. We understand that both couples need to be challenged in a relationship. While sometimes one partner can contribute more to relationship issues, the solution takes work from both sides. At times we may ask more of one partner to reconcile for a past wrong, but we work hard to keep our counseling simultaneously challenging and unbiased.

Can’t we just experiment in the bedroom more?

Oftentimes listicles on Buzzfeed of HuffPost suggest “trying new things” in the bedroom as an answer to sexual disconnection. While in certain cases this can help, for the vast majority of couples a more holistic and emotional approach is what works best. Needless to say, if you feel unloved in your relationship, asking your partner to be as emotionally detached as the characters from 50 Shades of Gray won’t be a lasting solution…

That being said, we are kink positive. If you’ve done the deeper emotional work and want to explore new areas of intimacy (non-monogamy, kink) we are supportive of that as long as both couples go into that arrangement understanding the implications. Our relationship focused therapists can even connect you with other sexperts and sex workshops in the area if you are interested.

Which therapist is right for us?

Let us help you find the right therapist. Many of our therapists specialize in anxiety, so view our profiles online to learn more about specific counselors specializing in anxiety treatment or speak with our Client Care Coordinator, who can help you with a personalized match to the right therapist for your needs. 

Finding the RIGHT therapist is the most important piece of reaching your goals.

How long does Therapy take?

Counseling works best within the framework of a safe and trusted therapeutic alliance. Since it takes time to build this relationship with your therapist, we recommend committing to weekly sessions for at least 8 weeks. Research shows that consistency adds to the positive outcomes of therapy. Once you reach your 8-week goal, you and your therapist can discuss a frequency of sessions that will support your continued success.

I’ve never done therapy before...What can I expect in my sessions?

The unknown of anything new can make it scary. Especially if you’ve never been to counseling before. Let us show you the “roadmap” so you know what to expect:

1st Session:
This first meeting is an introduction for both you and your counselor. Your therapist will explain the therapy process and go over the specifics of informed consent. From there, your therapist will gather additional information about your history, current circumstances, as well as struggles and personal strengths, which will help them to define a treatment plan that aligns with your goals. 

This is also the chance for you to learn more about your therapist. We encourage you to ask questions and get to know them; the relationship you build with your therapist will be the most important part of your work together. 

2nd Session and Future sessions:
In your weekly sessions, you and your therapist will use evidenced based therapies such as CBT, Mindfulness or ACT, to help you address your symptoms of worry, stress and anxiety. For anxiety rooted in trauma, or related to obsessive compulsive disorder (OCD), your therapist may recommend treatment with EMDR.

Closing Sessions:
Our goal is for you to find relief from your anxiety and be ready to “graduate” from therapy. In the last few sessions with your therapist, you will review your initial goals, the progress you have made, and solidify your new skills for managing anxiety in your life. At your last meeting together, you’ll have the time for the meaningful goodbye with your therapist.

How much does Counseling cost?

We strive to create access to high quality mental healthcare for everyone. Our therapists’ rates vary by experience and specialized training. We will make every effort to find the right therapist for you. 

Acuity Counseling accepts most major health insurance plans for Individual Counseling. Individual counseling is typically covered by health insurance. 

Couples counseling is different.

Since the focus of treatment is working on the relationship (not the individual), we cannot directly bill health insurance for couples counseling.You may still be able to use your health insurance for couples counseling. You will be responsible for the cost of the therapy, at the time of service. We will then provide you with a bill to seek reimbursement from your insurance carrier if covered by your plan. 

We are in-network with:

We do not participate in EAP Plans

  1. Even if we are not in-network with your insurance, your insurance company may still cover a portion of your sessions. In this case, we are happy to submit a claim for you and have the reimbursement check from your insurance company sent directly to you.

Why don’t you only use Cognitive Behavioral Therapy (CBT)?

While we use CBT as an aspect of our therapeutic approaches, we know that every individual is different. No one responds to any method perfectly, so by employing many techniques we are able to provide the most personalized support. Cognitive Behavioral Therapy is talked about in relation to mental health so often because it has a large body of research behind it and is easy to replicate across all cases. This is why you may hear it called “evidence based,” which it certainly is. However, we use other evidence based therapies in conjunction with CBT in our therapies.

How can I evaluate whether therapy is working?

Acuity is unique because we use research backed questionnaires to assess your mood, goals and progress. From time to time we may share with you your progress on these reports, “you report being angry 30% less days than when you started therapy,” and then ask what your goals for the future may be. We have found that by having clients set their own goals and following up regularly we can achieve better results.

Is medication used in conjunction with your therapy?

Some conditions for some people are best treated with the help of medication. If we find it necessary after our initial assessments, we will discuss types of medication, your comfort with it, and the pros and cons of medication with you. If you so choose, we can refer you to the appropriate psychopharmacologist in the area. If you are already on medication, we will coordinate treatment with your primary provider.

How long does therapy take?

Counseling works best within the framework of a safe and trusted therapeutic alliance. Since it takes time to build this relationship with your therapist, we recommend committing to weekly sessions for at least 8 weeks. Research shows that consistency adds to the positive outcomes of therapy. Once you reach your 8-week goal, you and your therapist can discuss a frequency of sessions that will support your continued success.

Break-free and begin your journey to

Your best

There is a future life where trauma does not control your day. Imagine yourself feeling calm, confident and ready to handle new situations with ease. The tools to living the life you have always envisioned are here, at your fingertips.

Acuity Counseling can help.


Schedule your therapy session online

Reach out directly to our Client Care Coordinator for questions, matching, and scheduling:

Online Counseling

Our services are also available online through Zoom. Telehealth/Online counseling gives you the opportunity to explore your challenges in life without complicating your daily schedule.


If you have questions and would like to talk about any of our counseling services, please reach out for a complimentary phone consultation or send us an email.

First Session Within 72 Hours of Calling

We book you an appointment within 24 hours of contacting us (usually less) and make sure your first appointment is soon after.

Seattle: 206-922-2376

Bellevue: 425-549-3242

Bothell/Woodinville: 206-910-9476

for Billing questions call:



Use our Online Scheduling Tool or call our office to schedule your appointment, or for any changes regarding scheduling.

Schedule by phone: 206-910-9476


Counseling services are often covered in full or in part by your health insurance company. Acuity Counseling proudly accepts most major health insurance plans.


First Choice





Sound Health & Wellness

We do not participate
in EAP Plans

Acuity Counseling Locations




Falcon View
12900 NE 180th St, Suite 160
Bothell, WA 98011
(206) 910-9476

Plaza 600 Building
600 Stewart St, Suite 1228
Seattle WA 98101
(206) 910-9476

–Coming Fall 2021–
221 N Wall St.
Spokane WA 99201

(206) 910-9476

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