Problem: My wife has Multiple Sclerosis (MS) and is registered blind. I cannot physically connect with her. I recently saw a sexual counsellor and he told me to masturbate, but I feel guilty when I do this.

We haven’t had sex for eight years, but I have normal urges. I also feel that, because I cannot physically love her, it may be that our relationship is spent. I obsess about sex to the extent that it is seriously affecting me.

Advice from Pamela Stephenson Connolly, a US-based psychotherapist specialising in sexual disorders.

Be kinder to yourself. Desperation and despair are no way to live. You are only human, and you need to find a way to fulfil your needs.

If the idea of masturbation bothers you intellectually, remember that moderate masturbation is considered by most leaders in the field of sexual science and therapy to be normative, healthy and entirely acceptable.

Clearly, your quality of life suffers when you are unable to achieve some physical pleasure and release.

You have inherited a position of caring, and this change in your relationship is a form of loss that often leads to depression.

Carers need to care for themselves, too. Without being able to maintain your own physical and psychological health, you cannot be helpful to your wife.

Exercise, and try meditation or yoga to ease stress and reduce obsessions. Try to find an activity or sport that helps you connect socially with others.

Above all, do whatever you can to avoid the underlying resentment that can poison a relationship.