Weloveplugs with Silva Neves: A Sex Therapist Interview

The topic of sex still remains taboo throughout society today, with the resulting problem of people experiencing sex-related issues, yet not seeking out or having adequate access to support.

In this interview, I talk with Silva Neves, a psychotherapist specialising in psychosexual and relationship therapy, couples therapy, and the treatment of compulsive sexual behaviours. I ask Silva about his work, including the influences drawing him into the field, his views surrounding cultural attitudes around sex, and what it means to him to be ‘sexually affirmative’.

Interview with Sex Therapist, Silva Neves

What were the main influences drawing you into the world of sexology? 

After completing my original psychotherapy training, I realised that there was hardly any time allocated to learning about human sexuality, yet, many of my clients complained about sexual problems.

For that reason, I decided to do a further postgraduate training in psychosexual and relationship psychotherapy. I always had an interest in human sexuality because I believe it is at the centre of our core sense of self as people, it informs our longing, wanting, pleasures, and our sense of aliveness, yet, it is largely unspoken about. 

In your clinical experience, which sexual problems tend to be shrouded in the most shame?

Anything to do with sex is loaded with shame, unfortunately. At the moment, watching pornography is shrouded with shame because of so much information out there about it being ‘bad’, ‘wrong’ and causing adverse consequences and being addictive, which is not reflected in research in the science of sexology. Many people, especially men can feel a lot of shame for doing normative behaviour of watching pornography.

Compulsive sexual behaviours is another area where people feel a lot of shame, again, because of so much misinformation out there, mistaken for a pathology or an addiction.

Cheating, in general, is misunderstood and criticised with people’s morality. I think that female sexual presentations are also loaded with shame because female sexuality is often dismissed and criticised too, as a result of pervasive misogyny. 

How do you perceive current attitudes in the UK towards the topic of sex? 

The current attitudes towards the topic of sex in the UK is variable because we have such a diverse population. In the population that is heavily religious, the topic of sex can be a difficult topic to have, it is full of shame and the conversations of sexuality diversity are not welcome.

In the population that is non-religious and more liberal, the topic of sex is embraced and can be exciting because I think the UK is one of the leaders of the promoting good sexual health. We have great sex-positive broadcasters and sexual health champions who do a great job in making sure the sex conversations are ongoing. 

What are some of the greatest learning curves you have faced working with sexual issues?

My learning is ongoing. The field of sexology is exciting because there is new research happening all the time, and we have more and more great thinkers in the field. It is a fast-moving field and there is always more to learn. The psychology and mental health world has got sexual behaviours so wrong in the past. Homosexuality was pathologised until 1990! And there were some very dodgy ideas about masturbation, female sexuality and so on.

We’ve come a long way. But we need to keep learning and keep educating others. My other greatest learning curve is to never assume. Every sexual problem is very unique to the person because of the meaning they may make about their sex life. 

Who or what inspires you most in the field of sexology?

I am inspired by many people in the field of sexology. I can’t name them all here. Jack Morin is one of my favourite authors, as well as Esther Perel, Chris Donaghue, David Ley, Justin Lehmiller and Karen Gurney. I’m also very lucky to have many wonderful colleagues and clinical supervisors whom I trust very much. My other inspiration, as I said in the last question, is my passion to keep learning and educating others as we must make sure that we don’t make more mistakes pathologising human sexuality unnecessarily. The world needs more sex-positive thinkers!

Are there any experiences you can share which you found particularly striking in your work?

I hear a lot of stories of traumatic experiences from clients, particularly sexual abuse. I have been working with sexual trauma for many years now, and I am too aware of the kind of horrible things human beings can do to others. Equally, I am in awe of the human psyche’s ability to heal from horrendous trauma, with the right treatment. 


What are your views surrounding the porn industry?

I think the porn industry has never presented itself to be anything more than adult entertainment. And it does just that. How people think about it, demonise it, shame it, and invent some public health panic about it is really quite different from what the porn industry actually is.

Of course, there is a dark side to it with exploitation, but in the bigger picture, it is actually a small part of the porn world. Just like there is a dark side to the food industry (and arguably more dangerous), yet there is no campaign to close all the shops and grow food in our garden.

There is a big dark side to the pharmaceutical industry yet we continue to take medications when we need them. If people want to make sure that they are watching ethical porn, the best way to do it and pay for porn from the good production studios, because they have good self-regulation and look after their performers. Unfortunately, young people do watch porn for sex education but this reflects more how we let young people down with poor sex education rather than porn being bad.

There are so many studies in sexology that keep finding that porn hasn’t got any effect on mental health or sexual health (no causation). Porn is a very rich industry which responds to the public demand. If there are some unusual things available, like ‘Alien sex’ (second top search in 2019), it is because there is a demand for it. Porn doesn’t offer what is not on demand. So, it’s a pretty good window to see what is in humans’ sexual fantasies! Some people like porn, others don’t. It’s all fine. If you don’t like it, don’t watch it. Full stop. But whether you like it or not, porn is here to stay. 

According to a 2009 report, the proportion of men who had paid for sex within the past five years had doubled over a decade. What are your thoughts around this?

Men who pay for sex do it for many reasons. Some do it simply for an uncomplicated sexual release. But many pay for sex for a safe connection. I have seen many men who pay for having a conversation, being seen, being heard, feeling wanted and desired by the sex worker before or after they have sex. It reflects that many men are actually unhappy because of a lack of human connection.

Men today are still trapped in the ‘get on with it’ culture. Men are afraid to express their vulnerability for fear of being perceived as ‘weak’ or not manly enough. Many men pay for sex because it is the only time when they can have sex without any anxiety. Many men fear having erection problems for example, rather than risking feeling bad about themselves with dates or even partners, they pay for a sex worker because they have a guarantee that sex workers won’t reject them. There may be an increase in men paying for sex perhaps because there is an increase in accessibility. It is now possible to pay for sex virtually too. 

Cleveland Clinic reports that 43% of women and 31% of men report some degree of sexual dysfunction. Do those figures surprise you in any way?

Those figures don’t surprise me at all. In fact, I think they might even be an under-estimate. Sexual functioning is dependent on many things, mainly our physical health and our mental health. Sex can easily be affected by having a stressful period, or grief, or feeling low, overworked, daily grind, and so on, as well as being ill or taking medications.

These life adversities happen to all of us, so all of us at some point in our lives may have a temporary or sustained period of time with sexual problems. I think it is important to encourage the public to talk more about it as part of a normal part of life, rather than something shameful that people are hoping not to experience. Because when people do experience a sexual problem, they might delay seeing an appropriate professional for a long time, which is sad.

You write that you employ a “sexually affirmative approach” in your work. What does being sexually affirmative mean to you?

For me, it means to be sex-positive. That is to say that I affirm the wide spectrum of gender, sexuality and relationship diversity as a positive stance, and I do not pathologise any of it. I see in my work that many people suffer from trying to fix in the tight box that society prescribes for it, which is heteronormative (heterosexuality and monogamy as being the gold standard).

When people are given the choice that all the other ways of sexual expression and relationship set-ups are just as valid, it gives people freedom to live the life that fits best with them. (as long as it is legal and consensual). Many people live their lives with ‘should’- thinking  inherited from childhood and society because they don’t know that other ways of being are possible. When people give up their ‘should’, transformation can happen.