Creating a safe place to talk is one of a sex therapist’s biggest jobs. We have to help couples defuse and reprocess comments, feedback, and criticism about a number of sensitive subjects, including each other’s sexual functioning and skills, as well as bodily tastes, smells, and appearances.

Sometimes, a simple request for a particular change in behavior that was not meant to hurt a partner’s feelings can poison the sexual relationship for years to come.

I try to create a space filled with empathy and humor and a renewed sense that it is worth the risk of talking and rebuilding trust.

There are many different ways to create a renewed sense of safety between two people. The first thing I do is assess a couple’s strengths, using what I call a smart relationship quiz.

Frankly, if a couple has low marks on some of the items of my quiz, particularly “My partner is my best friend,” and the “I trust my partner not to zing me,” they will likely need general couple therapy to work on basic issues of trust before we can wade into the potentially treacherous waters of sexual feedback.

But if a couple has a lot of strengths in their emotional bond, we can safely reprocess all kinds of sexual feedback that has missed the mark and unintentionally wounded someone. It always amazes me that people’s capacity to remember painful comments is so much more powerful and vivid than their memories of nice feedback.

Of course, my memory works the same way. I can tell you something insulting that a boyfriend said to me long, long ago. I can tell you where we were, geographically, what we were doing at the time, and maybe even what clothes I was wearing and how I had styled my hair. So I understand how negative memories fester. And I can understand the wish to protect yourself from more pain.

But when it comes to couple and sexual therapy, participants have got to trust their therapists as well. Unraveling really painful feedback is not just an intellectual process. A therapist has to help you drop down into the sad and upset feelings in your psyche. Apologies from a partner can seem shallow and unbelievable if the process is just a talking back and forth.

Something different and much deeper happens if a couple can be led to re-experience the pain that their partners caused earlier, while in session with the support of therapist, and with their partners witnessing and empathizing with how painfully their comment was.

These processes of forgiving are the essence of transformational therapy — and they are gratifying for the couple and for me.