I struggle to reach orgasm with my partner. I know my body very well and I know why it doesn’t work. But my partner is deeply insecure. It is very hard to even “guide” him, for he takes it amiss. This has led to a cycle of faking orgasm, and now, of course, I feel totally at a loss.

Guiding a lover and giving genuine feedback is an essential aspect of a satisfying sexual relationship. Contrary to common beliefs, sexuality is not “easy and natural”; it has to be learned. And because everyone has unique needs and responses, it has to be relearned with each partner. Helping anyone – sensitive or not – to maintain confidence while explaining to them what doesn’t work needs to be done extremely positively. When you are engaged in sexual activity, and he does something you don’t like, say: “I was really enjoying [what you did before - be explicit]. More please!”

Confessing to past faking would be extremely risky. Better to move forward. Most importantly, make a sincere effort to learn more about what he likes. In doing so, you will be modelling for him a relaxed and non-defensive style. Try to be open to other possibilities – perhaps a greater level of playfulness between you, a gradual sharing of fantasies, or even some role-playing. If you can both relax and allow for creative exploration, you may discover a surprising sexual connection.

• Pamela Stephenson Connolly is a psychotherapist who specialises in treating sexual disorders.

• If you would like advice from Pamela Stephenson Connolly on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments).