Lift Up Your Everyday

Relationships and intimacy

Occupational therapy advice for relationships and intimacy

Do you or your partner have a long-term illness, health condition, injury or disability that's affecting your relationship and intimacy?

Almost half of people 18 and over in the UK say their sex life has at some point been affected by illness, a health condition, injury or disability.

Read our findings

We're here to support you.

While these may impact your relationship at times, with the right advice and guidance they don't have to be a barrier in your relationship and intimacy. Occupational therapists play a crucial role in helping people maintain their wellbeing and can help you work through challenges that you're facing.

Expert advice to help improve your relationship and intimacy

1. Understand yourself

If you're not able to enjoy or participate in sex as much as you'd like to because of a disability, illness or neurodivergence, it can lead to a mixture of emotions, including anxiety, frustration, guilt, loneliness, resentment and feelings of rejection. If you're feeling this, understand that it's completely natural.

In some cases, working on how you communicate what you want and need, improving your concentration and focus, or understanding your physical barriers may help. An occupational therapist can help you understand where these feelings are coming from and work with you to find practical solutions.

2. Think about what the challenges are

Think about your personal challenges around your relationship and intimacy and what the cause might be. Maybe it's a physical disability or related to your mental health? Is it a negative past experience? Write a list of things you're finding difficult.

3. Don't assume you can't have sex

If you or your partner has a long-term illness, health condition, injury or disability, don't assume you won't be able to have a sexual relationship if you want one. While these things may impact your relationship, with the right advice and support, such as from an occupational therapist, they shouldn't be a barrier to positive relationships and intimacy.

4. Talk with your partner

The best way to improve your relationship and intimacy is through good communication with your partner. Talk with them about what you both want and need in the bedroom and out of it, and what your concerns are. If you find these kind of conversations difficult, try role-playing the conversation in the mirror to build your confidence.

If you and your partner are struggling, you may want to consider counselling or couples therapy to help improve your communication. Charities such as Relate, Women's Aid or LGBT Foundation can support with this. These charities can also provide advice if you're in an abusive or coercive relationship.

5. Go at your own pace

Always take a relationship at your own pace and don't do anything you don't want to or don't feel ready for. Share your concerns with your partner and don't feel ashamed of talking about sex and your relationship. This is particularly important if you have been in an abusive or traumatic relationship in the past, as you may be vulnerable to flashbacks or find it difficult to be touched. This also applies if you struggle with sensory processing or touch sensitivity for any other reason. If you don't feel you can talk to your partner in the first instance, consider joining a peer-support group - either online or in person. Some NHS trusts and local authorities run these, so have a look to see what's available in your area.

6. Manage your energy levels

If you experience fatigue, for example because of a condition such as ME or because you've recently returned from a stay at hospital, be kind to yourself. You may find you have better days or better times of the day, and you may need to manage your energy levels around that. Look at our managing your energy levels guide or speak with an occupational therapist, as well as discussing with your partner what you can and can't cope with right now.

7. Embrace trying new things

Using toys and aids in the bedroom can be a great way to boost intimacy between sexual partners. If you're recovering from surgery or have upper limb weakness, consider using grip aids to help you use them properly.

8. Make yourself comfortable

For some people, finding the right position for sex will be as simple as moving your body. Others, for example those with physical disabilities, may need equipment such as bed controls, hoists, or wedges to help with positioning. You may want to consider getting a larger bed to give you the space you need to be intimate without causing discomfort. An occupational therapist will be able to advise on the type of equipment and positioning that could help.

9. Sex after surgery

Having sex for the first time after surgery can feel overwhelming. It's not only about your physical recovery, but also your or your partner's concerns about what having sex will be like. Or perhaps you're struggling with self-image. Try different positions to find ones that don't cause you pain or damage. Do always make sure you follow any post-op advice from your consultant. Talking with others in a similar situation could help, for example, through a patient participation group. You can find these through NHS Choices or the Patient Association.

10. Don't feel pressured to have sex

While sex is important, it's perfectly possible to have a loving and intimate relationship without it, if that's what you and your partner want. There are plenty of ways to feel intimate without having sexual intercourse. Kissing and cuddling, or using smells and touch, are all great ways to improve a feeling of closeness with your partner. And don't forget about self-care too - whether or not you have a partner.

Don't ever let someone pressure you into doing something you don't want to do. A caring partner will understand and support you.

Lauren shares her expert advice on relationships and intimacy

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Who are occupational therapists?

Occupational therapists help people of all ages overcome challenges and completing everyday tasks or activities – what we call ‘occupations’.

Occupational therapy is a science-based, health and social care profession that’s regulated by the Health and Care Professions Council. Occupational therapy helps you live your best life at home, at work, and everywhere else. It’s about being able to do the things you want and have to do. That could mean helping you overcome challenges learning at school, going to work, playing a sport, or simply doing the dishes. Everything is focused on your wellbeing and your ability to participate in activities.

Find out more about occupational therapy

What are occupations?

An occupation is any activity that we need, want or like to do to live and to look after our physical and mental health, and our emotional and spiritual wellbeing. We do occupations from the moment we're born, on our own or with others.

An occupation isn't just your job or activities of daily living. An occupation can be self-care, such as washing, eating or sleeping; productive, such as work, study, caring or domestic activities; and leisure, such as playing sports, hobbies or socialising.

We're all different and so are the occupations that matter to us. They vary depending on our environment, interests and values, talents and skills. Our occupations also change throughout our lives.

Who is RCOT?

We are the Royal College of Occupational Therapists. We’ve championed the profession of occupational therapy and the people behind it for over 90 years. More than 36,000 occupational therapists are members of our organisation. We’re here to help achieve life-changing breakthroughs for our members, for the people they support and for society as a whole through occupational therapy.