People seek out sex therapy for all kinds of reasons. Perhaps you have a sexual dysfunction, such as an erectile disorder, pain during sex, or lack of arousal, and it distresses you.
Maybe you are still a virgin, and you don't feel good about it.
At the opposite end of the spectrum, maybe you feel that you have begun to use sex compulsively, and you are not comfortable with it.
Sometimes, couples have different levels of desire. This is called “desire discrepancy.”
Sometimes, there are sexual problems caused by medical issues, like infertility, or diabetes, or arthritis, or chronic pain, or cancer.
Some sexual problems are a symptom of alienation and anger between a couple.
Some sexual problems are caused by past traumas, like rape or sexual abuse.
Other negative childhood experiences, such as being an adult child from an alcoholic home, or physical or emotional abuse, cause sexual problems too. I call these kinds of sexual problems Developmental Sexual Trauma, and I have written extensively about this.
Sex therapy is talking therapy. You can do it alone, if you don’t have a partner, or you can do it with your partner.
Some people mistakenly call sex therapists searching for a sexual surrogate — a person who will actually have sex with them, to help them get over a hang up by having a physically reparative experience.
No legitimate sex therapist will have sexual contact with you or behave in a sexually seductive way.
Sex therapists are experts in sexuality. They are trained and licensed mental health professionals — psychologists, social workers, psychiatrists, or marriage and family counselors — who have intensive training in human sexuality .
They are specialists, the way a dermatologist is a specialist in diseases of the skin.
But sex therapy, unlike regular psychotherapy , is not just talk. And it is not a medical procedure that can be performed on a patient.
Sex therapy cannot work if the patient or couple is passive, pessimistic, or doesn’t cooperate.
One big obstacle is avoidance. Having sexual problems, singly or in a couple, often is so threatening that it’s difficult for the patient(s) to begin the process of working on it.
What happens in the session with your sex therapist is only part of the sex therapy process. The treatment depends on going home after the session and doing things differently than you did previously.
You could call this “homework”, or you could call it an attitude adjustment, or you could think of it as learning new information and applying it.
Remember Albert Einstein’s words: “Insanity is doing the same thing over and over again and expecting different results.”
Sex therapists know how frightened clients feel when they step into our office for the first time. We strive to create a safe and accepting environment in which to explore your sexual questions.
We are much more comfortable directly addressing sexual material than a generalist psychotherapist is. We will gather a huge amount of sexual information and ask many specific sexual questions.
Sex is bio-psycho-social. Most of us are not physicians, but we work with physicians to assess whether or not there is a biological component to the problem.
Part of our training involves doing something called an SAR. A Sexual Attitude Reassessment, or Sexual Attitude Restructuring is an intensive, several days long process that helps us become acquainted with and comfortable with the wide range of variation of existing sexual attitudes, behaviors, practices, and even sub-cultures.
Whatever your issues are sexually, you should be able to feel safe talking about your ideas and feelings with your sex therapist. If you go to see a sex therapist and you don’t feel accepted, find someone you feel more comfortable with.
Every week, the sex therapist will suggest different exercises, or readings, or inner explorations and/or journal writing. If I am your sex therapist, I am not going to tell you all about what’s going on with you sexually. I’m going to try to make you curious about it.
But it will be easier for you to explore and be curious and get new ideas once you have begun sex therapy, because I have special tools and resources and knowledge at my disposal.
So I’ll give you some new ideas and resources each time I see you. It might be a questionnaire or a technique to explore you and/or your partner’s sexual likes and dislikes http://www.sexsmart.com/index.php/sex-advice/18-sexsmart-body-maps
Or it might a video that will show you different sexual techniques, or suggestions for erotica, or a book that does a great job of deep-diving into your issues, or a website that helps you connect to other people who feel the way you do.
I know what the research is on your specific problem.Most people who have sexual problems feel embarrassed or abnormal, but you will feel better when you understand how normal you actually are.
On each visit, you will discuss what happened during the past week or weeks. You will explore what happened and why.
If you’re part of a couple, it isn’t unusual for each of you to have a different narrative about what happened and why. Together, we create a plan which will prevent the same problems from recurring the following week.
In certain cases, there are treatment protocols to work on specific sexual dysfunctions. A good example of a protocol that works is treatment of pre-orgasmia in women.
In other cases, there is no protocol that is the state of the art, perfect treatment your problem. The sex therapist has to be a sleuth, to figure out the genesis of the problem, and create a specialized plan of action for you.
To be at least an adequate sex therapist, you have to be a trained couple therapist. Many times, probably most times for couples, feelings of disappointment or hurt or betrayal have made the problem much worse than it needed to be, because, unfortunately, couples wait until they are really distressed and alienated before they seek help from a trained sexual health professional. Try not to do this!
Sex therapists do not assume that a couple’s sexual problems will automatically resolve when the couple is more intimate emotionally. That simply is not true.
We also know that sex is not automatic or “natural.” Sexuality is learned. Each person’s sexuality depends on his or her own personal experience in life.
You have to learn to be comfortable with your own sexuality. What you see in the movies or on TV or by watching porn has nothing to do with how real people have sex, particularly once the relationship is not new.
Some problematic sexual responses, ones that are not caused by ill health, are actually bad habits. If a sexual problem causes you distress or makes you feel insecure, seeking sex therapy makes sense.
Working with a sex therapist, exploring and doing things differently, you can begin to change bad habits and enjoy new pleasures.
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