[0:00]

Tania Wellby: Do we need that? Does that work for you? How do you really feel about that? The way that gender, or that kind of dynamic, plays out.

Marie: I’m sitting here today across from someone whose job starts exactly where mine starts to get a little quieter, when my clients get to the bedroom stuff. Half the time it’s mentioned in passing, communication problems, a thing we circle around before we get into the real work, and she sits there on purpose.

As a couples therapist, sex is a part of what couples bring to session, and we talk about it, and there are some times when it needs to get referred to a sex therapist, and that can be a little intimidating for people. Today I have sex therapist Tania Wellby with me. She’s dual qualified. Like me, she’s an accredited mental health social worker, and she’s also a sex therapist. I wanted her take on the stuff that most of us maybe find too awkward to ask out loud, what actually brings someone to sex therapy versus couples therapy, and how do you even know which one you need?

The sexual scripts we’ve absorbed from culture and upbringing without even choosing them, and what it actually means when one person reads their partner’s low desire as rejection, and it turns out to have nothing to do with them at all.

And whether after everything she’s heard, anything can still shock her. If you’ve ever typed a question about your own body or desire into Google late at night and never said it out loud to another person, then this one’s for you. Here’s my conversation with Tania Wellby.

Marie: Welcome to This Complex Life. Today I have with me sex therapist Tania Wellby, and we are going to talk about all things sex and relationships, and maybe a little bit about the difference between sex therapy and couples therapy, and a whole bunch of juicy stuff. So welcome to the podcast, Tania.

Tania Wellby: Thanks, Marie. Thanks for having me. It’s great to be here.

Marie: Most people don’t end up in sex therapy by accident, as therapists, not just the clients. What drew you to working with sex and sexual health and sex therapy?

[2:00]

Tania Wellby: Yeah, it’s a question I’ve definitely been asked many times before. I can’t ever really point it to anything in particular. It’s just something I’ve always been curious about.

But I do have this pivotal memory that I usually point to, and that is when I was doing my undergrad social work degree, and we were talking through psychosocial assessments, having a look at various areas of somebody’s life and trying to understand where support and care should be attended to. And I always remember being quite curious around what their sexual identity is, what their relationship structures are, how they identify in this space. And I distinctly remember the tutor or the lecturer at the time giving me a bit of a funny face.

And one of the others in the class looked at me as if I’d just said something outrageous, like how dare I, that’s none of my business, or that’s not appropriate, or that’s not a priority.

And I always remember that moment, and it always brings me back to just how interesting it is that even then, in a classroom of emerging social workers, there was still that taboo, that stigma, those assumptions being made around sex, sexuality and different relationship structures, that discomfort. And that lit a bit of a fire underneath me, I think, and I’ve just carried that through.

So I don’t really know where that came from, but I always remember it was just, this is something important to talk about. And it’s just something I’ve carried through.

[4:00]

Marie: That’s such an interesting take on it. I think social workers in particular are very good at going to where there’s an underserved community, or love to have that bit of advocacy. As you were talking, I was thinking about my early days as a support worker. There were some people who couldn’t even cope with the idea that people with disabilities had sex, couldn’t handle facilitating them to connect with people just like anyone else would, or engage in paid sex work if that’s what they were choosing to do, or have any sort of sexuality. Some of them weren’t even able to have the privacy to allow for that to happen.

Tania Wellby: Exactly.

Marie: And the first exposure I had was going to a conference on the medical side. Monash has a conference, I think every year or every second year, looking at sex through all different perspectives. They had a sex therapist bring out different therapy tools, sex toys, all these different things they were using with clients or patients post recovery from cancer, from post birth trauma or birthing complications, or as bodies aged and changed, and allowing for various positions for people with disabilities. My brain just exploded. I was like, this is it. I’ve been so fascinated, really tempted to go back and study, but I’m just going to interview as many sex therapists as I can. But it’s something that even now, it’s 2026 at the time of this recording, and people still can’t talk about sex. It’s still so awkward, right?

[6:00]

Tania Wellby: You know what, that’s okay. There are elements to that awkwardness that I’m still learning to embrace. It’s important to name it. It’s a thing. It’s not necessarily something that’s inherently negative to try to avoid in the work. But it’s about how we regard that awkwardness. What is it actually telling us? And not taking it to a shaming, stigmatising space, but just being like, yeah, it can be a little vulnerable, it can be a little hard to talk about something so personal, so tender. I think that’s often the discussion that’s really important to have.

Marie: Has doing this work, and what it’s exposed you to, changed things for you in your own personal life?

Tania Wellby: Yes, definitely. It’s deepened my understanding of the complexity of relationships, of identity, and how that shapes how we navigate life. It’s so massive. You talk about sex therapy, sexual health, and it can be limited to just a very contained idea of what that is. But actually it’s so much more holistic, so much broader and deeper. So I’ve drawn on a lot of that, and it’s just made me feel a bit more confident, comfortable, accepting of how complex it is. And instead of seeking a resolution or answers, it’s more about continuing to be curious and keep wondering and exploring. So it’s definitely changed the way I approach my personal relationships, doing this work, most definitely.

[8:00]

Marie: What kinds of things bring people to see a sex therapist? Are they always in relationships? Is there a common thing that brings folks in?

Tania Wellby: It’s pretty broad. In terms of relationships, I’d say a hundred percent people would be presenting with some kind of need, whether that’s with themselves, within their partnerships, family, friendship relationships, or relationship with community. So relationships are really a massive part of the work. Of course how that actually manifests for each individual or relationship coming into the space looks very different, given their lived experiences and backgrounds and what they’re bringing to it. But yeah, it’s mostly relationships, connection. How can we understand a little bit more about that? How can we nurture that a little bit more? How can we repair what might have been ruptured or fractured or dinged up a little bit in relationships?

Marie: When they’re up late at night Googling on their phone, what are they typing in?

Tania Wellby: I’m not sure I would know, Marie. I’m actually quite curious about that. I do wonder what people are searching. I think that’s sometimes the nugget of the work, what actually is the need, what is that question you deep down type into Google because you really want to know about yourself, or you’ve identified something there. I think that’s perhaps a bit of the power in this space, trying to get to the base of that.

[10:00]

Marie: I would suspect it would be, and people don’t say this on intake, especially for me being a general couples therapist. People aren’t going to feel as comfortable calling my admin person saying we want to talk to Marie about our sex lives. They just know communication problems is often the catch-all phrase. But I’d be thinking it’s dissatisfaction with their sex life, either one person wants more than the other, or they both want more but they’re not having it. I would suspect it’s around quantity and then quality perhaps.

Tania Wellby: Yeah, that’s true. Frequency of sex, a mismatched sex drive, is often a common one. Sexual trauma, experiences of wanting to rebuild and reconnect with their own body. A lot of experiences of sexual anxiety and pain. A lot of support with dating, actually, just being able to date, meet people and be themselves, form connections. That’s quite a common one, and working through a lot of the anxiety that pops up in that space.

Marie: You made the point about sexual trauma, and it had me thinking about when people are looking for a therapist, they often don’t know what to look for, and you’re dual qualified. So you’re an accredited mental health social worker, which allows you to provide treatment for mental illness, and a sex therapist. I think that’s an interesting distinction, that some people can get someone trained in multiple modalities, who’s able to treat both the mental illness and mental health side, as well as the sex side. If someone’s thinking, I don’t even know where to go, you’ve just opened up this whole world of sex therapist as someone to talk to. It’s not like a paid sex worker or something. I think there’s a lot of misconceptions about that. What are some things people should be looking for when they’re thinking about what kind of professional is right for them?

[12:00]

Tania Wellby: That’s a really interesting idea, and it’s also something that’s come across to me quite recently, am I talking to the right person, am I shopping around, and wondering if I’ve landed where I need to be. So yeah, that definitely does happen. I often try to break it down. I think the way you just phrased that was quite helpful, making that distinction that we can approach this in lots of different ways. But sometimes it’s helpful to make that distinction that when we have those presenting issues, like mismatched sex drive or an experience of sexual trauma that I’d like to address, sometimes it’s also about clarifying these other core, underpinning, predisposed, or concurrent mental health issues or experiences that might be contributing to how this plays out in your sex life, or your relationship, or your relationship with your body. It’s often helpful to make that distinction, that it’s separate but very much overlapping, and to clarify that both the approach, the tools and techniques, or the way we hold it, might be a bit different. Sometimes it’s a bit of coaching, a bit of hand-holding around tools and techniques in the sex therapy space, and then a lot of unpacking, processing and safety work around other trauma or mental health stuff that might be playing in there as well.

Marie: So metaphorical hand-holding. Tania’s not holding your hand in session, just in case that wasn’t clear. What I hear you saying there is, it’s almost like with our physical health, sometimes we don’t know who the right specialist is. We might go because a particular part of our body hurts, and I know, say I went and had some treatment done for my lower back, but it’s not the back that’s actually the issue, it’s my glutes or my hamstrings, there was another part where the pain was referring. So I think it’s really overwhelming for some people to seek mental health support or relationship support. It can take a bit of investigating, and it’s okay to try a few different approaches. How closely do you work with couples therapists? So when someone’s thinking, it’d be great if we had the same ideas of frequency, or sex is something we’d like to work on, but we’ve got all this other stuff first. But someone else’s priority might be the sex, and the other person’s saying no, this other stuff is what’s getting in the way. When should someone see a sex therapist versus a couples therapist? Are there any ways to navigate that?

[14:00]

Tania Wellby: We move as fast as the slowest person, if that makes sense. We have to address what’s getting in the way of being able to experience and build and cultivate that erotic space, and what that means for each person in the relationship. Before we can get there, sometimes it’s very much about addressing those blocks, reservations or triggers that might be impacting that sense of safety and stability, to be able to then build on what pleasure, play, desire and arousal looks like. I’ll often break it down and say, if there’s this trauma, this need, or this concern coming up here, it’s really important to address that first. Maybe that’s through individual sex therapy, maybe it’s still through couples work, so it might be a collaborative approach to understand what that looks like, and being flexible and creative around it. But ultimately it’s about triaging, what is the block, and being able to address that before any of the cultivating and capturing the fun stuff, what that looks like.

Marie: I interviewed Sarah Aston in the past, who I think we met at one of her trainings, if I’m not mistaken.

Tania Wellby: Yeah.

Marie: We talked about sexual scripts, and I think that’s a really important one to revisit, because some of what you’re saying, the barriers and challenges, some of it is also shaped by sexual scripts. How I’ve understood sexual scripts is it’s almost like a blueprint we don’t always sign up for, but it’s what we absorb through popular culture, through media, through what’s spoken about or not spoken about in our home. For example, coming from being a teenager in the nineties or early two thousands, there wasn’t a lot of diversity in what we saw in relationships. The queer guy was always the funny side character, and it was male and female sex, anything was penetrative, penis in vagina, that was it. He wants it, she withholds it, it’s a commodity to be traded or given. It was a very rigid script, and it’s been challenged and grown for me enormously. Some people might not even know that what they’re thinking is a script they don’t have to follow. Does this show up in your work?

[16:00]

Tania Wellby: Yeah, a lot.

Marie: What are some of the common ones that you wish people would rip up and start again?

Tania Wellby: Gender is a huge one. As you were saying, all of that definitely shows up. But particularly for gender, how a man shows up in the space versus a woman, what their roles and responsibilities are, and how that give and receive dynamic takes place. Being able to challenge that, and encourage people to gently challenge that, to consider, if we weren’t concerned with the outcome or achieving or fulfilling those roles or scripts or responsibilities we’ve inherited from culture, from intergenerationally within our home, what would that look like, let’s be curious about that. It comes up so often, and it’s one of the most rewarding parts of this work, being able to say, do we need that, does that work for you, how do you really feel about that, the way that gender or that dynamic plays out. Let’s think about that. Does that really satisfy you? Let’s question that without shame, without feeling like, oh, I don’t know, I don’t have the answers. It’s not really about that, it’s just about being able to question it. I think there’s a lot of power in that. It comes up a lot, and I love it when it does, because I’m like, ooh yeah, let’s do it.

Marie: But we don’t even know we have them, because we all have one.

Tania Wellby: Yes.

[18:00]

Marie: So we all have an idea, or a blueprint, or a map, and I think that’s what catches some people off guard. I remember when I’ve done episodes on money, and sometimes I test some of the questions on unsuspecting family members. I remember asking one of my family members, what’s your money story? They said, I don’t have a money story. It’s not a bad thing, we all have one, we all have a belief about it. So just like with sex, we’ll have a script, an idea of what something means, and your idea might have a lot more moving parts than someone else’s. But when you said, what would it be like if it didn’t go to completion, maybe prioritising male orgasm would be an example there. But one of the things my brain went to as you were talking is, when I work with conflict, one of the things I use is what we call the vulnerability cycle. We look at how something happens that activates a response in you. Let’s say you might roll your eyes, I take that as how rude, and then when I feel disrespected, I might get really snappy. So then I get snappy to you, and you see the snappiness as rejecting, no matter how hard you try, Marie’s always snappy. And when you feel rejected, you storm off, and I see you storming off as further validating the disrespect, and the cycle goes on and on. I imagine that happens with sex too, where these scripts, if someone says, babe, I’m not really up to it tonight, and you’ve got this idea in your head that a guy should want it all the time, if he doesn’t want it, there’s something wrong with me, and that becomes such a big vulnerability piece. Do you see things like that play out, where people will wholeheartedly believe, and maybe even tell their friends, he or she doesn’t want me, they think I’m ugly, and the other person might have no idea. It could be a side effect of medication, it could be that they’re a morning person, they could be self-conscious about their body, something might be hurting, they could be constipated. Who knows, it could be anything.

[20:00]

Tania Wellby: Yeah, absolutely. What I hear quite a lot is, you know what, it’s just not about you. So if I’m working with a couple, and they’re talking about a desire or sex drive mismatch, and there are feelings of rejection, and one person tries to initiate and goes gently, and they’re being very respectful and kind to each other, but then it’ll often get to a point where the conflict shows up in terms of, it’s just not about you. And that’s a really hard thing to conceptualise in the relationship dynamic, because really that person is just wanting to talk about their own relationship with their own body, their own sexuality, their own trauma, their own attachment style, and actually just wanting some space where that’s processed or fleshed out without it becoming a relational issue. So sometimes all that rejection plays out, but it’s also about taking a step back and allowing this person, or both people, to actually talk about the relationship in a way that’s quite self-serving, and really talk about themselves and what’s showing up there, and how those parts are relating to each other in the relationship dynamic. I hear that a lot. It’s just not about you, this is actually about me. Those feelings of rejection, it then becomes about, we’re no longer engaged with that person and what they’re sitting with and what they’re carrying, and it becomes the relationship thing. So it’s often an invitation to slow that down a little bit and make a distinction between what’s going on in the relationship in terms of the impact, but actually where it really comes from, that’s just about the individual person being like, hey, this is my thing, this is what’s showing up for me, and I get that it has an impact on us or you, but if we just engage with us, then we have a bit more clarity.

[22:00]

Marie: And I think where people get that conversation wrong is how they actually have the conversation. Working with couples, I’m in a privileged position to see it happen live, when someone says, but I’m telling you how I feel, and I have to say, actually, none of what you said is a feeling. So often I’m having to pause people and get them to explain how they feel, using I feel, when, and I would like, or I need. Because if you say, you don’t love me and you’re always rejecting me, that’s going to activate the other person, because they feel criticised. They’re either going to say, that’s not true, or here are all the other ways I’ve shown you I love you, and it starts a fight.

Tania Wellby: Yeah.

Marie: But you’re allowed to have your feelings, lead with that would be my tip. I feel rejected, I feel uncared for when you’re, it could be anything, it could be, when you’re training for a marathon you’ve got no energy left for me. It’s actually just saying that, and I would like some reassurance, I would like to make a plan for us to spend some time together. Actually phrasing it in a way that says, this is how I feel, this is the situation, here’s what I would like or need, is going to get a better result.

Tania Wellby: Yeah, I’d agree with that. In that back and forth, let’s just sit with some of that discomfort, that vulnerability of really how you’re feeling.

[24:00]

Marie: Because like you said, if it’s not about you and that’s all stuff happening for the other person, that still has an impact on the other, and they’re allowed to say, I’ve been feeling a little more rejected lately, and the solution might not be let’s just have more sex. It could be, I just want you to know this. And sometimes when people jump to problem solving is when it also goes pear shaped. Sometimes it’s as simple as the other person saying, I see that this has impacted you, thanks for sharing, it must be hard. And both those things can be true at once.

Tania Wellby: Exactly, yeah.

Marie: That kind of respect, that ability to be curious and be a safe space for your partner, really takes the heat out of that argument.

Tania Wellby: I often talk about soothing. When those parts show up, there’s that expression of vulnerability, and there’s a default that most of us would want to fix it, resolve it, make it go away, minimise it. Oh, that sounds so terrible, I promise I’ll never make you feel like that again, that sort of thing. But actually, I still sit with that, and sometimes it’s really about being able to say, let’s acknowledge it, let’s validate that it’s actually there, it’s real, and offer some compassion and soothing around it. Sometimes that helps bring it all back down to base.

[26:00]

Marie: Is there anything a client can say that would shock or surprise you?

Tania Wellby: Honestly, Marie, I really don’t think so. I’ve discovered this in my work, that I actually lean more towards the edgy stuff, I’m very curious and quite comfortable working with people that might be displaying behaviours that are quite concerning, quite harmful or antagonistic. I find that to be a really important and rewarding part of this work. You definitely can hear some pretty shocking things in that space. I want to lean into that more. It makes me even more curious, I was like, wow, why, how, what is that like for you? So yeah, bring it on.

Marie: I love that. I’ve chatted with other people in the past about this kind of work, especially in a sexual health space. I really believe that we need to have done the work outside of the room so that the first time we’re exposed to something isn’t met with surprise or shock. There might be nuances, cultures change, and in particular cultures, if there are particular fetishes or particular groups, there might be something new or trendy happening that we’re not across, and that’s different. But it shouldn’t be confronting. I want listeners to know that if you go with someone who’s a trained sex therapist, and is either a registered provider or has the training to back it up, they will not be shocked or surprised, and you can talk about anything, from something you feel is boring and vanilla, to something that’s covered in sprinkles.

Tania Wellby: Yeah.

Marie: It’s all okay to talk about, and yes, it will feel awkward, and that’s okay too. And if it doesn’t, that’s fine.

[28:00]

Tania Wellby: Also true. And I just wanted to reiterate that it comes up a lot that sometimes people feel like the way they want to tell their story isn’t kinky, or what’s the word I want, it’s just not enough to warrant coming in, like, oh, this is just a bit boring. Or you probably have people coming through with way worse stories or something like that. It can go the other way, and I always want to invite that. There’s always something here to talk about. It’s not a scale, it’s not a hierarchy of what’s more important than anything else.

Marie: I think you’re so right.

Tania Wellby: Really inclusive of everybody’s story.

Marie: I get that a lot. People are like, oh, I’m not unwell enough to need this. And it’s, you’re not taking it away from someone else, it’s okay. Also, that’s life. Some people might need support after having a baby, after having surgery, hormone changes, body changes, sexuality might be fluid or might change, medication side effects, an injury, a disability. I have never once looked at my caseload for the day and thought, oh, all of these boring clients.

Tania Wellby: Yeah.

Marie: It’s not, we don’t feel that way. We look at each story with such compassion, and that, for that person, matters to them, and it doesn’t take away from anyone else’s suffering. If they weren’t there, someone else isn’t going to suffer less.

Tania Wellby: Sometimes when the presentation is, from the outset, looking pretty basic, or pretty light, or whatever, that’s often what I find particularly challenging. It’s just, okay, there’s got to be something underneath this. A lot of the work is being able to tease that out, which can be really challenging from my perspective as the therapist. So I really welcome it, I think it’s really important to show up.

[30:00]

Marie: And perhaps as a final question, is there one thing you wish people outside of your field understood about sex or sex therapy?

Tania Wellby: It often is talked about as a niche, a real specialty, and it is. But at the same time, that can box it into something quite specific, and I find that as a result, it limits engagement, it limits networking. It gets siloed into, okay, this is just sex, sexuality, sex therapy, sexology, that’s for the experts over here. Whereas actually, maybe in our discussion today, we’ve been able to highlight that it’s about relationships, which we all engage with. It’s about culture, it’s about upbringing, it’s about vulnerability and mental health and physical health history and storytelling and communication. So in doing this work, I’ve learned that yes, I have this very specific passion for this area, and I’ve learned a lot, but it’s also really deepened and broadened my understanding of life, people, humans doing their thing. So I really want to highlight that as well, that yes, this is a specific area I’ve chosen to focus on in my work, but in doing that, it’s really broadened out. I’d like to share that with a lot of practitioners and people learning a bit more in this space, to actually think about how that connects in a really broad way, and doesn’t silo us into anything in particular. When we start to understand sexuality and relationships, we’re actually talking about a whole person, a whole culture.

Marie: So there’s a lot of intersectionality, don’t silo all the poor sex therapists out on their own island.

Tania Wellby: It’s often that we get drawn in for a specific piece, but then we end up talking about the whole person and what they might be needing.

[32:00]

Marie: I’ve been asking people this a lot lately, this is more personal, but what’s something that makes you hard to live with or work with? Because we’re talking about relationships, and I guess one of the things we all need to reflect on is we’re not perfect people either. There are some things we do that make it really hard for other people.

Tania Wellby: Yeah, that’s interesting, because I was just having a chat with somebody in my life about this last night. It’s interesting, there’s heaps, I think there’s heaps for me to share there. But something that’s particularly coming to mind at the minute is my ability to see nuance, to remain curious and be open and explorative, can almost sometimes be like, you know what, Tanya, let’s just rein it in a little bit. Sometimes we just want structure, predictability, what’s familiar. Exploring and keeping things open perpetually actually offers a fair bit of stress and anxiety, and it’s hard to contain. So I have to be reminded sometimes that although that can serve me and my relationships in my personal life and professional life really well, it can also be something I have to be mindful of, that it can be a bit much, it can be a lot to hold. I have to check that, and be mindful about how that can serve as a bit of a limitation at times. It can be quite challenging in my personal life too, to be like, this is a good thing, this will, and then they’re just like, yeah, but this is scaring me, I’m not into it, I don’t know, thank you. So I have to be mindful of that. That’s a great question, I love that.

Marie: So sometimes not therapising people?

Tania Wellby: Yeah, that’s a very simple way to put it.

Marie: Yeah, I get that too, and people are like, that’s your therapy voice, and I’m like, ugh.

Tania Wellby: Yeah, okay, totally.

Marie: I get that, because not everyone appreciates or has the capacity or feels comfortable analysing everything. Whenever I’m with another therapist, like I’ve got a couple of close friends, we can talk for hours and go super deep, and then go really silly, back and forth. In other friendships, they’d feel interrogated by that.

Tania Wellby: Yeah.

Marie: I love that so much, Tanya, and if people want to work with you, we’ll put all your details in the notes.

Tania Wellby: Yeah, great.

Marie: Thanks so much, and I think, we have the Ask Marie section, so if people want to ask a question, we may be able to get Tania back on to answer some of your specific questions.

Tania Wellby: That’d be great, love that.

Marie: Thank you.

Tania Wellby: Thanks.