Sex doctor: Bring back desire...

We'll happily pop off and see an ear, nose and throat specialist when we've got tender tonsils, but we won't call a relationship or sex therapist if we've having trouble with our heart or parts. Why not? It's a never-ending source of frustration for me.

So, knowing that many of you would rather do almost anything than lie on a therapist's couch (most therapists don't make you do that, by the way), here is a taster of the type of things you might be told if you did go to a professional a combination of core principles, strategies and wise words. I hasten to add, by the way, that these come from the lips of "active" therapists rather than the clichd, old-fashioned types who simply sit there, offer nothing and say, "What do you think?" It's meant to work on two levels: to let you see how non-threatening and helpful the process can be if you do choose to go along and to get you to "think like a shrink" in case you don't already.

Basically, all a therapist does is try to get you to drop those defensive strategies that stop you seeing the truth about yourself and others. Once you've done this, you're able to understand and challenge yourself, your partner and your key issues.

*Be sensitive to your partner's efforts. If they greet you at the door stark naked and you walk straight past, throwing a "What's for dinner?" over your shoulder, they will be devastated, not to mention thoroughly pissed off. If you're both actively trying to solve a problem, reward every single effort your partner makes, no matter how small.

*Assess your relationships. How healthy are your intimate relationships generally? Are you well liked at work? Do you have close friends and get on well with your family? How do you relate to people? It's useful to know whether your problems are specific to your relationship or something one or both of you struggle with generally.

*Take a close look at your parents. Like it or not, how you relate to other people, most particularly your partner, is nearly always based on how you related to your family while growing up. We tend to take on the role of our childhood selves when in a romantic relationship, or turn into one of our parents. Look at yourselves and each other for astute observations.

*It's what you do that's important, not what you think. Don't get hung-up about any naughty thoughts you have or have had. Fleeting thoughts about what it might be like to sleep with your best friend/partner's worst enemy/the dog don't mean anything. We are defined by our sexual behaviour not our impulses. Don't try to analyse, explain or justify what appear to be out-of-character flashes of lust. We all have bizarre thoughts.

*Pick your time to talk and use the right language. Discussions have most impact when you're both in a positive mood. Remember that listening is more important than talking; talk about how you feel rather than how they make you feel "I feel upset" rather than "You make me upset" ask for what you want more of, rather than focus on what you're not getting, and throw in compliments, whatever you're talking about.

*Ageing doesn't destroy sex, attitude does. An 18-year-old recovers rapidly from an orgasm and is physically capable of having another a lot faster than a man in his forties, for instance. But, as US psychiatrist Emanuel H Rosen says: "It can take half a century to get your heart and judgement involved. Genital prime and sexual prime are entirely different." It's often said that women reach their sexual peak in their thirties. This has nothing to do with our physical make-up and everything to do with our attitude to sex. Women tend to be more relaxed about their bodies and know more about what they need to orgasm in their thirties than they do in their teens, plus they have the confidence to tell a lover what they like. Is it any wonder they enjoy sex more? So while our bodies might be physically past their peak, it's possible to reach your sexual prime in your forties, fifties, sixties...

*Be the first to reach out and touch. It doesn't really matter what you do, or even if it's sexual or not, so long as one of you reaches out to break the drought, you're on the way to being "fixed". Increase the amount of physical contact you have and you'll nearly always benefit as a couple.

*Sex is critical. When it's good, it only accounts for a quarter of your enjoyment of the whole relationship. When it's bad, it can poison the other three-quarters. Don't believe couples who tell you sex is over-rated: it's under-rated. Sex is one of life's greatest pleasures and the most profound way to show how much we love someone. Neglect it at your peril.

Adapted from 'The Sex Doctor', by Tracey Cox (Corgi, 7.99).

Visit LoveHoney for relationship tips and advice from Tracey Cox. Every week, Tracey answers questions from visitors to the site.