Have you ever thought about seeing a sex therapist for help with a sexual problem?
If the question makes you feel uncomfortable, you’re not alone. The idea of discussing the intricacies of one’s sex life with a stranger can be awkward, especially if you find sex difficult to talk about. And sex therapy can have an air of mystery around it. What, exactly, goes on during the sessions?
Simply put, sex therapy is a form of psychotherapy designed to address sexual problems for individuals and for couples. For many, it provides a safe, structured way to cope with a number of sexual problems. Therapy may help you see your situation in a healthier way and learn new skills you can apply at home.
To get the most of sex therapy, it helps to consider the components that work together. Your reasons for seeking therapy, your therapist, your relationship, and your commitment to the process are all essential.
(Note: Before starting sex therapy, see your doctor for a full medical checkup. Many sexual problems have physical causes. For instance, erectile dysfunction (ED) can be an early sign of heart disease or diabetes. Painful sex for women could be related to endometriosis or hormonal changes during menopause.)
Now, let’s take a closer look.
Your reasons
Why might you consider sex therapy? There could be several reasons.
Therapists can help clients:
- learn more about their sexuality, including the anatomical aspects of sex
- build communication skills so they can talk to partners about sex
- develop strategies and techniques to improve a couple’s sexual relationship
- work through sexual orientation or gender identity questions
- cope with past sexual abuse or trauma
- learn to manage unwanted sexual behaviors or compulsions
Your therapist
Sex therapists are trained professionals. They may be psychologists, physicians, social workers, or other clinicians. Usually they have graduate degrees and special training in sexual issues and counseling. Ask about their credentials and licensing before you start. Your doctor can also make a referral or help you choose a therapist who specializes in your specific situation.
For sex therapy to be successful, it’s important that you feel comfortable with your therapist. Most therapists understand that conversations about sex can be awkward and intimidating. They are trained to put you at ease and ask gentle questions to allow you to open up.
Not every therapist/client relationship works out though. If you don’t feel a rapport with your therapist, it’s okay to move on and see a different provider. Don’t be discouraged if it takes some time. The right therapist is out there for you.
Your partner
If you are part of a couple, you may or may not decide to have your partner come to the sessions, too. That decision is entirely yours.
However, keep in mind that sexual problems are often a couple’s problem. Sexual dysfunction in one partner can deeply affect the other partner and the relationship dynamics. For example, if one partner lacks interest in sex, the other partner may worry about the relationship or wonder about an affair. Or, if one experiences pain on penetration, the other may feel frustrated or frightened of causing any further pain.
It’s hard to talk about sex, and even couples who have been together a long time may need to work on their communication skills and nurturing their relationship. A therapist can help each partner understand the other’s perspective so they can go back to working as a team.
The environment
Sessions usually take place at the therapist’s office. Many therapists design their consultation spaces to feel welcoming, relaxing, and safe.
You might also have your therapy session online, using a secure video chat program. This setup is especially suitable for people who cannot travel to their appointments or feel too uncomfortable talking about sexual issues in person. While most telehealth sessions are still “face to face,” there is some degree of distance between you and your therapist.
The sessions
So what happens when the session begins? That depends on your reasons for seeking therapy. But some themes are common:
- Sex therapy is talk therapy. Your sessions should not include any physical contact or sexual relations, with partners or with the therapist.
- There could be difficult, personal questions. Your therapist will likely ask you about your physical health, your relationship with your partner, your upbringing and sexual education, and your attitudes about sex. You might also be asked about your sexual orientation, your gender identity, and any past sexual trauma or domestic violence. It’s important to answer these questions honestly. Remember that you are in a safe space, and your therapist will understand if you feel reluctant or embarrassed to talk. Take the time you need. If you feel like you can’t talk openly with that therapist, consider seeing a different one.
- There might be exercises and “homework.” Some therapists use role playing activities to help partners communicate. Or they might teach you ways to relax or manage sexual dysfunction in the bedroom. For example, a man with premature ejaculation might learn techniques for delaying orgasm.
Nowadays, many therapists explore mindfulness with their patients. Mindfulness allows you to focus on the present moment and let go of any distracting thoughts. You might be asked to try mindfulness techniques during sex, keeping your attention on pleasure and intimacy rather than the issues you’re struggling with.
Sensate focus is another common sex therapy technique. This approach, practiced at home, moves from non-sexual to sexual touching with the goal of fostering trust and intimacy between partners. Other “homework” assignments might be reading or watching educational materials about the physical, emotional, and psychological aspects of sexuality.
The results
When will you start seeing results? The answer varies for everyone. Your therapist will suggest how often you should meet and for how long. However, sex therapy is most beneficial when you put in the effort. Keep an open mind and follow through with the suggestions, exercises, and homework. It may take time, but changes in your sexual health, relationship, and overall well-being could make the journey worth taking.
Resources
American Psychological Association
Weir, Kirsten
“CE Corner: Sex therapy for the 21st century: Five emerging directions”
(February 2019)
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