‘Issues around sex and young people are changing’

Dr Roberta Babb is a Highly Specialised Clinical Psychologist, Forensic Psychodynamic Psychotherapist and Organisational Consultant. Recently, she was an expert on the BBC Three programme ‘Sex on the Couch’. Debbie Gordon (Assistant to the Managing Editor) asked her about her work and the series.

The programme was billed as a chance for couples to ‘lay bare their most intimate secrets to the sex therapists in a specially constructed clinic, as they battle to get their relationships back on track.’ We asked Dr Roberta Babb about her background building to her involvement.

What do you do at Third Eye Psychology?

I launched Third Eye Psychology in 2016 to bring together an integrated practice of clinical, forensic and organisational psychology. This reflected my work then, and still does today. I am pleased that my varied career has allowed me the unique opportunity to bring psychological approaches and ways of thinking to a range of individuals and contexts. 

The core of my work has always involved:

  • Psychological therapy/psychotherapy (individuals, couples and groups).
  • Court reports for individuals involved in the Criminal Justice System. They often relate to issues associated with compulsive sexual behaviours, illegal activities, formulations and risk.
  • Consulting to corporate organisations around issues relating to organisational change, leadership/management and team development.
  • Executive coaching.

What has your career been like so far?

I have been fortunate to have had a varied career in psychology, which started in the Prison Service as a Trainee Forensic Psychologist in 2002.

In 2016, I partnered with a specialist colleague and set up a psycho-therapeutic service called ‘Regulate’ for gang-affected young people at risk of, and from serious youth violence. In 2018, we were successful in bidding for funding from the Mayor of London's Young Londoners fund for three years and started offering the programme in Spring 2019.

This Spring, I also appeared on TV as an expert in the ongoing debate on the causes and solutions to knife crime. I spoke about the psychological elements of, and other contributing factors to, serious youth violence. This has also coincided with my role as a psychologist talking about relationships and sex, and working with clients in the TV series, Sex on the Couch. 

I care a lot about education, and I enjoy teaching and training. I have always wanted to extend learning opportunities to people that where interested in psychology, those who perhaps did not think that psychology could be a career for them, or those who struggled to progress in their career in a satisfactory way. A significant part of my work now includes.

  • Clinical Supervision (Individual and Group).
  • Team reflective practice groups.
  • Mentoring – Psychology students and early career psychologists (in particular from Black and Asian Ethnic Minority Backgrounds)
  • Guest lecturer at the University of Essex and University of East London on the Clinical Psychology Doctorate Programme.
  • The development and delivery of workshops and training for psychological professionals (unqualified and qualified) as part of a continuing professional development (CPD) programme. 
  • The development and delivery of psychologically informed leadership training for medical professionals and other professionals in both the public and private sector. 

Why is sex and relationship therapy important?

Humans are relational beings, and issues associated with relationships and sexual experiences can have a significant effect upon an individual’s sense of self, relationships and life satisfaction. In my clinical work with both adult mental health and forensic clients I see the impact that relationship and sexual problems can have upon people’s lives, and how stuck and unhappy people can become when the issues are not resolved.

Intimate relationships and sexual experiences are two things that can enhance our sense of self, our worth and our life experiences. However, they also have the potential to do the opposite, which can lead to emotional distress, low self-worth and low life satisfaction – which is why there are important interventions.

Relationship and Sex Therapies are important because they offer a safe and neutral space where people can think about their relationships in detail using their past experiences to understand current issues. This can help individuals develop personal and relational insights which can empower them to change things in their lives. These changes can help increase the likelihood of them experiencing different and more satisfying personal, relational and sexual experiences in the future. 

Therapy which also focuses on sexual behaviour and physiology, and the relational, physical and cultural context is also important. These are issues which are not often spoken about openly or freely. Experiencing  difficulties in these areas can be distressing for people and leave individuals feeling different, alone, shamed, and often internalising the difficulties, which can lead them to blame themselves for the issues.

Sex therapy can help individuals and couples move past physical and emotional challenges which can feel quite concrete, and help them to develop different ways to improve their communication which can help them have satisfying relationships and pleasurable sex lives. 

How do you use psychological theory and research to destigmatise issues around sex in young people?

Issues around sex and young people are changing and the nature of sexual activity amongst young people is also changing. Exposure to sexual content from a young age, combined with the availability of, and accessibility to sexually explicit material, may have contributed to making sex supra-normal and creating issues that people did not face 20 years ago. This is an evolving and constantly changing area, and we do not fully understand the impact these changes (especially with technology and the internet) may have. However, what we do know, is that in order to destigmatise the issues we need to be open, and curious and help people of all ages navigate the complexity of an ancient problem.

The process of stigmatisation consists of two fundamental elements: the recognition of the differentiating 'mark' and the subsequent devaluation of the person. Having conversations about sexual health and relationship principles rather than specific behaviours can be less shaming and reduces the stigma.

A person-centred approach is important when exploring and addressing issues around sex and young people. Using Socratic questioning and other technical questioning styles can encourage young people to talk and share their experiences in safe spaces such as groups. It is in these contexts that systemic therapy principles and Yalom’s therapeutic factors (such as imparting information, universality, normalisation and interpersonal learning) play an important role as there is a lot of variance in what is considered to be normal within this area. Normalising anxieties around sex and the confusion young people can have about their bodies is also important.

Part of the process of destigmatising issues around sex for young people involves accurate information sharing. Sexual psychoeducation is crucial as there is a lot of misinformation associated with sex among young people through social learning which is disseminated through a variety of channels including peer relationships, the internet and social media. Cognitive Behavioural Principles can also be helpful in supporting young people to re-frame and challenge unhelpful thoughts around issues associated with gender, body image, identity, sexuality, sexual behaviour and sexual health. CBT principles can also be used to counter the distorted perceptions about relationships, body image and sex some young people may have gained from pornography, social media, and from using dating sites. With regard to the impact of the internet and social media, addiction theories can be useful to help young people understand how and why some sexual behaviours can become problematic and compulsive and negatively impact their ability to develop healthy relationships and have healthy and satisfying sexual experiences offline.

Using a trauma-informed approach and using attachment theory principles also helps to destigmatise issues around sex for young people. They help explore and address the stigma elements of the ‘differentiating mark’ and ‘devaluation of the person’ regarding sex, sexuality and engagement in sexual behaviours. Young people benefit form learning about healthy and unhealthy relationship issues, early childhood experiences, trauma, and the impact of sexual violence (from both sides – being a recipient of, and as someone who has engaged in sexual violence). 

How did you find making the programme?

I found the experience of making the programme interesting, and enjoyable. I feel privileged to have had the opportunity to be part of something that is actively helping to give a real insight into the world of therapy and also common issues in relationships that may appear to be about sex, but which are often about communication difficulties and more painful issue which have yet to be resolved. 

As a clinician who often works with clients over several years, I also found it useful to witness the significant and meaningful change that couples can experience in a much shorter period of time. While all couples on the series were offered follow-up sessions after filming was complete, it is clear from the three sessions viewers will see that the couples were able to really improve their situation during the course of the episode. It certainly helped me to develop as a clinician, because even with the solution focused structure I used, I found that I was still able to work in a psychodynamic way. It felt like a nice integration of two ways of working which are often seen in opposition.

I was also impressed by the couples I worked with, and their dedication and commitment to openly engage with the therapy discussions, therapy process and homework tasks within a context that is usually private. They all made significant progress by changing little things in their lives – which again highlighted to me that simple interventions can be extremely effective.

How did you overcome the presence of the cameras during therapy sessions?

The production team were extremely thoughtful about the development of the set and worked with myself and the other therapists to ensure that the set looked and felt like a genuine and authentic therapy clinic. Prior to filming I had a detailed conversation with a senior member of the production team who asked about my therapy room, including what it looked like, what I had in it and how I had decorated it. They were also interested in why I decorated my room the way I did, and how that linked to aspects of my psychodynamic therapeutic modality.  I was asked about what I felt were important things to have in a therapy room, as well as what may be unhelpful or create an uncomfortable environment. 

Once on set, it was clear that the production team had considered what I and the other therapist had said. The set was beautifully designed and felt like a real and comfortable place. As a result, it was easy to develop an attachment to the set and use it as a secure base from which to engage in the therapeutic work. 

The camera crew never interfered in therapy sessions, and remained behind the scenes from the second a client entered the studio. Cameras were well hidden amongst plants, room decorations or mounted on the wall. They didn’t look like cameras at all, and it was easy to forget that they were there – I was only really reminded of their presence when I heard them move within their casing.

-       Find out more and watch the programme.

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