Body Image & Sexual Confidence | Apex Psychological Services

Understanding Body Image & Sexual Confidence

How we feel about our bodies has a profound effect on how we experience intimacy. Body image concerns — whether related to weight, appearance, ageing, disability, illness, or surgery — can lead to self-consciousness during sex, avoidance of physical intimacy, difficulty accessing pleasure, and a growing disconnection between self and body.

Low sexual self-confidence can affect people of all ages, genders, and body types. It is not about vanity — it is about the deeply personal relationship between how we see ourselves and how safe we feel being seen by others. Psychosexual therapy offers a compassionate, effective space to explore these concerns and build a genuinely more confident, embodied experience of intimacy.

You're not alone: Body image concerns are among the most common factors affecting sexual confidence and enjoyment — and they are highly responsive to psychosexual therapy using CBT and mindfulness-based approaches.

Common Presentations

Changes After Illness or Surgery

Mastectomy, stoma formation, hysterectomy, prostatectomy, gender-affirming surgery, and treatment for cancer can all create significant changes in body image and sexual confidence. Therapy helps people grieve what has changed and find a new, positive relationship with their body and intimate life.

Weight and Appearance Concerns

Cultural messages about ideal bodies, weight-related shame, and experience of being criticised or objectified all commonly affect sexual self-esteem. Therapy addresses the beliefs and patterns that maintain these difficulties.

Disability and Chronic Illness

Living with disability or chronic illness often involves adapting one's relationship with one's own body. Therapy helps people develop confidence and find creative, fulfilling approaches to intimacy within their health circumstances.

How Psychosexual Therapy Can Help

Psychosexual therapy addresses the connection between body image and sexual experience — using CBT to challenge unhelpful beliefs, mindfulness to build present-moment awareness and reduce self-monitoring, and sensate focus to rebuild a pleasurable, accepting relationship with the body.

Individual & Couple Therapy

Individual Therapy

Individual therapy helps you explore the specific beliefs, fears, and experiences shaping your body image and sexual confidence. Using CBT and mindfulness, you will develop more helpful patterns of thinking and feeling about your body during intimacy.

Couple Therapy

When body image concerns are affecting a relationship, couple therapy helps both partners understand the issue, reduces unhelpful dynamics, and builds a more supportive, accepting environment for physical intimacy.

Whether the priority is individual self-exploration or rebuilding intimacy as a couple, therapy is compassionate, non-judgmental, and tailored to your unique circumstances.

What You Can Expect from Treatment

Develop self-compassion : Build a kinder, more accepting relationship with your body
Reduce self-consciousness : Feel more present and less self-monitoring during intimacy
Challenge unhelpful beliefs : Identify and reframe negative thoughts about your body and desirability
Improve intimacy : Experience more relaxed, confident, and enjoyable sexual encounters
Strengthen your sense of self : Build a more secure, embodied sense of your own sexuality

What our clients say

"After my mastectomy I felt completely disconnected from my body and my sexuality. Therapy helped me find my way back — on my own terms and at my own pace. "

— Sandra, 48 Individual therapy

"I had been self-conscious about my body for years — it was affecting every aspect of my intimate life. Therapy gave me tools I still use every day."

— Jamie, 35

"I was so in my head during sex. Mindfulness techniques from therapy have genuinely transformed that — I feel so much more present and confident now."

— Mia, 29

Our Therapists

All our psychosexual therapists are registered members of COSRT (College of Sexual and Relationship Therapists). Our therapists hold postgraduate qualifications in psychosexual and relationship therapy and many hold additional BACP or UKCP memberships. They provide a warm, confidential, non-judgmental space for meaningful, lasting change.

Confidentiality guaranteed: All sessions are conducted in strict confidence in accordance with COSRT's professional code of ethics.

Your First Session

Your first session is a warm, confidential conversation about your experience — what you have been noticing, how long it has been affecting you, and what you hope to achieve. There is no pressure and no predetermined agenda. Your therapist will listen carefully and develop a personalised treatment plan collaboratively with you.

Between Sessions

Psychosexual therapy involves work between sessions as well as within them. Your therapist will discuss any tasks, exercises, or reflections that may support your progress. These are always agreed collaboratively and tailored entirely to your situation and pace.

No GP Referral Needed

You do not need a GP referral to book with us. You can contact us directly for a confidential initial consultation. We are happy to work alongside your GP or other healthcare providers with your consent.

If you are in crisis: Apex Psychological Services is not an emergency or crisis service. If you are experiencing a mental health emergency, please contact NHS 111, call 999, or attend your nearest A&E. Samaritans are available 24/7 on 116 123 (free, any phone).

Frequently Asked Questions

1. How does body image affect sexual confidence?

How we feel about our bodies profoundly affects how we experience intimacy. Body image concerns lead to self-consciousness during sex, difficulty accessing pleasure, avoidance of intimacy, and a growing disconnection between self and body.

2. What conditions lead to body image concerns in relation to sex?

Body image concerns can arise from cultural and media pressure, weight-related shame, significant physical changes (pregnancy, illness, surgery, ageing), skin conditions, disability, erectile difficulties, or negative comments from past partners.

3. Does psychosexual therapy help with body image?

Yes. Using evidence-based approaches including CBT and mindfulness, therapy helps you develop a more accepting, compassionate relationship with your body — and a more confident, present experience of intimacy.

4. I had a mastectomy/stoma/gender-affirming surgery — can therapy help?

Yes. Our therapists are experienced in working with people navigating body image and sexuality following all types of surgery and significant physical change. Therapy provides a compassionate space to process change and reclaim a fulfilling intimate life.

5. Do you offer online sessions?

Yes. Online sessions are available and equally effective.

No referral needed: You can contact us directly without a GP referral or existing diagnosis. We respond to all enquiries within one working day, Monday to Friday.

Fees

Session Fees

Individual Sessions: £90 per session (50 minutes)
Couple Sessions: £130 per session (50 minutes)

Session Frequency

Most clients attend weekly or fortnightly sessions. You and your therapist will agree a frequency that suits your needs.
Both in-person and online appointments are available.

Please use our contact form to arrange a consultation. We respond within one working day.