What to expect in sex therapy

What to expect in sex therapy: what a sex therapist does and doesn't do?

I have been asked many times before about ¨ What is Sex Therapy and is it what I need?, so I have decided to write about it and give a better idea of what to expect.

Sex is not an easy topic to talk about for many people, and that may also include some professionals!

However, even with professionals that may relate to topics of sexuality in some way, like your primary care physician, your gynecologist, or your usual therapist, there are some issues that they may not know how to talk about or how to go about them.

Topics like low libido, difficulty reaching orgasm, wanting to add a bit more spice in the bedroom, etc., are not their everyday cup of tea.

Enter Sex Therapy!

Spoiler alert! Sex therapy is still very much like traditional psychotherapy. It still talks about therapy.

Some alternative interventions may be used, according to each therapist´s training background, such as non-verbal exercises, but the therapy, in general, is similar.

One of the main differences is that a sex therapist is trained to talk about taboo topics with absolutely no shame around them, no embarrassment, no judgment.

This is crucial. The clients are embarrassed enough, to only have their therapist avoid talking about the matters at stake.

Having said that, the therapist will ease into the topic, reading the client and how open they are when talking about it, so as to make it as natural and comfortable as possible to begin the sometimes ¨difficult¨ conversation.

So how does a Sex Therapy session start?

As I have told in my Sex Therapy section, just like in most therapy sessions, your therapist will use the first session to better understand the problem the client or the couple came with. They will gather as much information as possible as to

  • What the issue is
  • When it started
  • How often it appears
  • Why it is a problem etc.

If the client is a couple, then both views of the story will have to be heard, and similar questions will be asked.

What to expect in sex therapy. What's next?

Before going into further details of intervening and improving the problem, some background information may be necessary. Information like:

  • family history background
  • medical background
  • past relationships and sexual experiences
  • if it´s a couple, the history of their relationship
  • any trauma that may affect the current issue
  • any attempts to improve the problem etc.

During this exploration, the therapist and client(s) can discover whether there are any other underlying issues present, sometimes more important than the one they came with, which will probably need to be addressed first, or at least be aware of their existence.

So what topics can be covered in Sex Therapy?

Sex therapy can include:

  • Sex education: Anatomy, Information about what sex is, how it works, differences between men and women, different sexual orientations and genders, etc.
  • Getting to know your body, masturbation, what you like, dislike and what creates more pleasure, and how to communicate it
  • Talking about the content of sex, and how to approach some practices and how to maximise pleasure for all parties included
  • Sexual dysfunctions. Some of the most common ones include Erectile dysfunction, Premature ejaculation, delayed ejaculation, anorgasmia, vaginismus, dyspareunia, hypoactive sexual desire disorder etc. (If a medical examination has not been done the therapist will probably advise to get one, to rule out any biological reasons to the problem, before treating the psychological ones)
  • Fears related to any sexual experiences
  • Anxiety related to sexual performance
  • Difficulty reaching orgasm in certain ways
  • Lack of self-esteem related to feeling desired or preventing one from engaging in desired sexual acts
  • Communication issues in couples or of an individual to express themselves with their partner when it comes to sexuality related topics
  • Improving intimacy in couples
  • Infidelity
  • Problems with intimacy after having children
  • Sexual trauma
  • Pornography addiction
  • Fetishes  ETC.

As you can see, there´s quite a broad spectrum of what the therapy content may include, and although other therapists can address some related issues, a sex therapist is specialised in this area and therefore is more up to date with the information, with the common problems, with feeling comfortable talking about all this!

Now this is important: what does a sex therapist NOT do?

Just by hearing the word ¨sex¨ people often create a misconception about what the therapy may include or what it may possibly come to. This is extremely important to talk about, to protect both the client and the therapist! It is not always easy dealing with these topics and some people may come into therapy with the wrong ideas and very far off expectations.

Sex therapy does NOT include:

  • Any sort of physical touch with the therapist
  • Intercourse with the therapist
  • Flirting in session
  • Any implication of any future sexual relationship with the therapist, whether during or after terminating therapy

Sex therapy is under the umbrella term of Psychotherapy. It is as much of a professional relationship as that of any therapist or doctor with their patients.

Furthermore, Sex therapy sessions are not ALWAYS about sex. As I mentioned before, other areas are covered that are important to the client´s wellbeing and that probably affect any sex-related issues.

What approach does Sex Therapy take?

This depends on the therapist and the therapeutic approaches they chose to train in. Sex therapy issues are addressed in the same way as regular psychotherapy issues. Depending on the problem, some therapists may use a more clinical Cognitive-behavioural approach, others may use a Narrative approach, Emotion-focused therapy, or even Mindfulness!

If you have any further questions about sex therapy or you feel you may need help, don´t hesitate to Contact me!

Daphne Christofides

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