Today, I would like to demystify the concept and process of sex therapy from questions I have received and conversations I have had with different people.
So, what is sex therapy?
In simple terms, sex therapy is a form of mental health care in which sexual function and dysfunction issues are addressed. Generally speaking, to be a sex therapist, you must first complete your basic education up to a Masters level, at which point you can specialise by aligning your work (e.g client population), research, publishing and any/most of your contributions in the field towards matters of sex and sexuality.
What sort of person would need a sex therapist?
Anyone who is experiencing inexplicable sexual outcomes: If a man is ejaculating too quickly, unable to attain or sustain an erection to his satisfaction or experiencing some other outcome that he is not happy with, he could probably benefit from the support of a sex therapist. If a woman is experiencing low sexual desire, painful intercourse or some other experience that she is not happy with, she could benefit from the support of a sex therapist.
Do you have sex with clients for ‘demonstration’?
NO, I do not engage sexually with clients in any way because I am trained professional. Being a professional means that I must adhere to a code of conduct and follow a code of ethics, both of which would be violated by sexual contact with a client. It also means that I ought to have (and continue to seek) enough academic information to help my clients understand what’s truly going on with them and how to go about resolving it. I also refer to other professionals for further investigations if there is a suspicion that the root cause of their dysfunction is in something else e.g. a medical condition like diabetes. If I’m doing my work correctly, they will not need any ‘demonstrations’ and even if they want to, it’s my professional and ethical responsibility to help them redirect those desires elsewhere. To be clear: no sexual contact between a professional sex therapist and client must ever take place.
What can a person who comes to you expect?
They can expect to be treated ethically with empathy, compassion and professionalism. I already know that by the time you are coming to see me, you may be uncomfortable or self-conscious about disclosing very personal information, so I go out of my way to make sure that you not only know that you are safe with me, but that you experience that safety with me. We call that UPR: Unconditional Positive Regard. I like to link it to “unconditional love” because they function in much the same way, except that in my office it’s a ‘professional requirement’. This means that no matter what you disclose, I will always hold you in the highest light. Even when I must bring things to your awareness that may cause you to feel uncomfortable, confused or maybe even embarrassed, I will always seek to see you in your highest/best possible light, because it is in that light that your healing will occur. In other words, when you don’t feel judged by me you are less likely to judge yourself, which makes it so much easier for you to do the necessary work to create a life that you’re happier with. This is the bedrock of your therapeutic process. Without this, no amount of expertise will be useful to you.
How does the actual sex therapy take place?
There are different ways but in general, I will take a sexual history. This history will include questions such as When was your first sexual encounter? How was that experience for you? What were your ideas about sex growing up? Is your current partner your first partner? Do you masturbate? and more. I would also ask about the ‘problem’ itself; when it started, how it manifests, any triggers or changes depending on different contexts, and much more. These questions help me understand what is in your heart and mind with regard to sex, as well as what could be getting in the way of the sex life you actually wish to have. I also like to learn more about you and your current partner(s) from your perspective. Why? Because sex happens within a context and so understanding that context is critical. If your current partner was forced on you through marriage, or they lovingly courted you in a way that met your standards, or they are emotionally distant and cut off, or they are present but absent, or nothing you do seems to please them, or they continually violate your (non) sexual boundaries. Whatever the case, I will assess it so I can understand what’s going on. This will then greatly advise my suggestions and recommendations to you.
How long does it take to get relief?
This is hard to know because every client is different, and so is every therapist. I am a short-term therapist, meaning that I generally see clients for about 1-12 sessions which is on average three months or so. In reality, it can even extend to 6 months. Other methodologies like long term therapy can last for 1-2 years because they use a different approach. All are valid; just find a therapist that you feel safe with, that you feel understands you and that you feel confident in then get started and commit to the process. I have seen clients for one session and they got what they came for. I have seen others for 3, 5, 12, even 20 sessions. The thing to ask yourself before every session is ‘what am I hoping for today?’ and after every session is ‘did I learn something useful to me today?’ If you feel like your sessions are not quite serving your needs, it’s important that you communicate that with your therapist. Remember: this is a relationship so they should be open to hearing about areas that aren’t quite working for your as much as they will be happy to hear of your progress and success. Be honest and open about both with your therapist.
Any last-minute advice?
Well, I would boil it down to three simple things: 1. Respect your therapist. Maintain healthy boundaries (they are a professional, not a friend or potential lover), show up on time, pay on time and adhere to their policies e.g. cancelation or termination 2. Understand that it is a process.
Therapy is a process and processes take time. Expecting a magical, pill-type intervention for a psychological issue is simply not realistic. Withholding critical information (which is fine, if you don’t yet feel safe) while expecting that your therapist will be able to adequately help you is also not realistic. Your therapist will not magically fix your sex life for you if you are unwilling to look at the things that show up in therapy so do your part and allow the process some time to work. 3. Do the work. There are things that your therapist may ask you to do as homework; do them. There may be some uncomfortable truths to face; find your courage and face them with the help of your therapist.
Do whatever is necessary to get you the help you came for. I usually tell my clients, “worry about the ‘what’. Let me worry about the ‘how’.” You don’t have to carry this burden on your own anymore, and you don’t even have to know ‘how’ you’re going to get better. You only need to know ‘what’ is important to you and ‘what’ you’re hoping to get from therapy, so work on gaining clarity on that. I think these three things are sure to get you an outcome you can be happy with.
I hope that this information has been useful to you. Over the next couple of weeks we’re going to talk about the process of sex therapy (male & female perspectives) as well as challenges of sex therapy. If you would like to me address any questions or curiosities on those topics, or on any topics, please write me as soon as you read this so I can respond adequately. Until then, I wish you a beautiful, sexually awakened week ahead.