PROBLEM: My sex life has become almost non-existent over the past year. It was never amazing, but it was always nice. We didn’t have very frequent sex, but on the occasions we did it was good. A few years ago, my husband lost someone very close to him from his childhood and he suffered a significant bereavement. He announced that he was going to get a tattoo on his torso of a symbol that was important to him and his friend.

I have never been a fan of tattoos and my husband is quite conservative by nature, so it seemed like an incongruous thing for him to propose. I didn’t comment as it was important to him, and I just hoped that he would find something else to ease his pain. He didn’t, and the resulting artwork – which covers a large section of the front of his body – is much more prominent than I ever imagined.

When we had sex the first time after he got the tattoo, I felt very uncomfortable, and the few times since that we have done it, I have engineered things to make sure it is in the dark and the lights are out. I find the tattoo repulsive. I even avoid looking at him coming out of the shower. I have made excuses, mostly related to my work, and we now sleep in separate bedrooms and there has been no sex at all in recent months. He hasn’t pushed the issue, and brought up the subject of sex in conversation on only one occasion. I do not want to tell him that I find his altered body to be vile. I spoke with a female friend, and she advised me that I was just being selfish and that I needed to get over it. We are going on holiday soon so will be sharing a bed. I want things to return to normal, but I don’t know how this can ever happen.

ADVICE: You highlight two important things: the first that sex has been infrequent in your relationship, and the second that you find aspects of your husband’s body repulsive and that you have moved into separate rooms. Even if you never have sex again, this repulsion needs to be tackled – and shortly you will be forced into facing this when you go on holidays together. It seems that talking about sex and intimacy has always been an issue, and both of you have somehow avoided it – to the extent that you did not speak up about your aversion to tattoos when your husband first put the idea forward. It may well be that you have a reaction to whatever image is on your husband’s body, but it is likely that there is much more to your response, and this may go back to more formative experience in your life.

So, a two-pronged approach is called for; one, that you and your husband engage in proper dialogue about your relationship, intimacy and what is not spoken about; and two, that you seek your own support to look at what influences your sexual response. For yourself, you might start with either reading or listening (on Audible) to Come As You Are by Emily Nagoski. She has much to say on female desire and how socialisation and culture affect it. She has exercises that help to uncover blocks and that draws the unconscious to the surface so that you can explore your desire and its effects for yourself. Of course, it is not always possible to do this process on your own, so you might engage with a counsellor or psychotherapist to help you through this process.

The imminent holiday is a push to engage and, judging from your history of avoidance, this is a good thing

Another exercise that may be of use to you is to complete a sexual messages lifeline – this is where you draw a line that begins at your birth and ends at your age now on which you write all the messages you have received in your life (either implied or spoken) about sex and relationships. This should include your current message of disgust, or distaste, as well as everything to do with your formal and informal sex education and your own experiences of sex. If you encourage your partner to do the same exercise, you might both find a structure with which to have a conversation about sex and intimacy.

Going on holidays is a great opportunity to have these conversations, as you will need time and space. The assumption here is that you do not want your current situation to continue and that you want to improve your, and your partner’s, experience of living together as a couple. The imminent holiday is a push to engage and, judging from your history of avoidance, this is a good thing. At the beginning of these conversations, you might both want to acknowledge what stops you from being honest, eg fear of causing distress to the other person or fear of revealing a side of you that you are not proud of.

It is unlikely you will get anywhere worthwhile in the discussions until these issues are tackled. If this seems impossible, then agreeing to go to couples therapy is a good option, as the therapist can ask the questions that you are unable to broach.