Let’s talk about sex. Sexual health is an essential part of overall emotional and physical well-being. But if you’re experiencing a sexual problem, the last thing you probably want to do is talk about it. If shame is keeping you from seeking help, know this: 43 percent of women and 31 percent of men report some degree of sexual dysfunction. Sex therapy is designed to get to the bottom of sexual issues, like shame, and reverse them.
Working With a Therapist to Address Libido Problems and Other Sexual Health Issues
Whether you work with a psychiatrist, psychologist, or marriage or sex counselor, sex therapy can help with a variety of physical and emotional issues that can interfere with sexual satisfaction, such as erectile dysfunction, low libido, a history of abuse, and others. And it can help you and your partner work through these issues in a supportive and educational environment.
So what does sex therapy really entail? And who qualifies as a sex therapist? Read on to discover the truth about this type of therapy.
Sex Therapy Is Like Other Forms of Therapeutic Counseling
Contrary to what some believe, there’s nothing strange, deviant, or kinky going on behind the door to a sex therapist’s office. Indeed, sex therapy is not very different from other forms of psychological counseling. “Sex therapy is a type of psychotherapy that also takes into account possible physical problems. When a couple comes in with a sexual problem, we try to figure out how each of them could be contributing to the issue. We examine behavior, gradually interpret that for them, and come up with solutions,” says Barbara Bartlik, MD, a psychiatrist and sex therapist at Weill Cornell Medical College in New York City.
You’ll Explore the Psychological Side of Sex and Sexuality
Your therapist will help you work through emotional issues that may be contributing to sexual issues such as erectile dysfunction, according to urologist Drogo Montague, MD, a professor of surgery at the Cleveland Clinic Lerner College of Medicine in Ohio. “Sex therapy typically begins with learning about performance anxiety and then moves on to teaching a couple how to establish open lines of communication to discuss sexual wants and needs,” he explains. “The couple may also explore issues causing relationship stress.”
You’ll Learn to Be Mindful and More Aware
In mindfulness training, you learn to be present and focused on the here and now, rather than letting yourself get distracted by grocery lists and child carpool times. When using this concept in sex therapy, you learn to block out extraneous thoughts as well as negative thoughts you might have about your body or your performance. Instead, you are guided in thinking only about how your body is reacting to sexual stimulation.
Lori A. Brotto, PhD, the executive director of the Women’s Health Research Institute and the Canada research chair in women’s sexual health at the University of British Columbia in Canada, has done several studies on this topic, including a study published in the November 2016 issue of Archives of Sexual Behavior. Her research has found significant improvement in responsiveness in women suffering from anxiety-related sexual dysfunction. Dr. Brotto, author of Better Sex Through Mindfulness, says that the hypothesis behind the results is that the mindfulness skills that the women acquired benefited their sexual motivation and response both directly, “by allowing them to nonjudgmentally focus on sexual sensations in their bodies before and during sexual encounters, and indirectly, by improving mood and decreasing stress and anxiety.”
Physical Issues Won’t Be Ignored in Sex Therapy
If there is a physical issue such as vulvodynia or impotence due to radiation for prostate cancer, the therapist will refer you to a medical specialist, who will work in tandem with the sex therapist.
Expect Some Sex Therapy Homework
While nothing sexual in nature will happen at the office, the therapist may offer some ideas for things you can try at home. “The therapist may suggest you try something called sensate focus exercises, which are designed to help you attune more to your partner,” says Dr. Montague. The exercises are typically done in stages, starting with touching or stroking anywhere on the body, except the breasts and genital areas. The goal is to experience the sensation of touching rather than trying to reach orgasm. Eventually, the exercises can lead to intercourse.
It May Help to Bring Your Partner to Sex Therapy But It’s Not Necessary
“Sex therapists can be very helpful in helping to guide one person to help themselves or their partner to overcome self-defeating behaviors. Or we can work one-on-one and then work with the couple together as a unit as well,” says Dr. Bartlik, coauthor of Integrative Sexual Health.
You Keep Your Clothes On When You Work With a Sex Therapist
One thing is certain: Under no circumstances should you have to take your clothes off in a sex therapist’s office or should the therapist be touching you. “Sex therapists don’t touch their patients unless they are gynecologists or urologists and a physical exam involved,” explains Bartlik.
Be Picky When Shopping for a Sex Therapist
This person will help you with your most intimate secrets so it has to be someone you trust. You will need to feel safe being vulnerable and taking risks. First, start by considering what gender therapist you and your partner feel most comfortable with.
If you are LGBTQ, make sure the therapist is trained and knowledgeable in a way that makes you feel valued. A University of California, Santa Barbara, study published in the journal Psychotherapy Research found that “basic counseling skills and relationships were key determinants of the quality of LGBT clients’ therapy experiences.” Also important were variables such as the therapist’s professional background and attitude toward the client’s sexual orientation or gender identity. Client variables existed as well, such as their stage of identity development, health status, and social support. Environmental issues, such as the confidentiality of the therapy setting, were a factor, too.
“Usually, there will be some indication on the therapists’ website that they have experience in this area. I put on mine that I am inclusive so patients know that I am paying attention and know what to do,” says Bartlik.
Where to Find the Right Sex Therapist for You
Ask to see accreditation. A sex coach is not a sex therapist. Sex coaches may do more physical touching, demonstrating body parts. “They don’t have the same licensure that sex therapists do. Anyone can hang up a sex coach shingle,” says Bartlik. Compared with sex therapy, sex coaching is less stringent and not regulated, according to Bartlik.
Sex therapists often hold degrees in marriage and family therapy, social work, theology, psychology, or medicine. You can find licensed sex therapists in your area from the American Association of Sexuality Educators, Counselors, and Therapists.