What is Sex Therapy?
January 21st, 2008 | Email this to your Friendswritten by Chris Reynolds, MS, LPC
Click here to contact Chris and/or see his GoodTherapy.org Profile
Sex therapy is simply therapy that specifically addresses sexual problems. A sex therapist can be considered a specialist in the general field of therapy in the same way that a urologist is considered a specialist in the general field of medicine. Though the practice of sex therapy varies widely, most of these specialists have the following in common.
Sex therapy is typically a short term (6 to 15 weeks) solution focused intervention. Solution focused means that there are concrete goals with which to gauge progress, that there is a conscious utilization of client’s strengths, and that homework assignments are utilized to encourage active steps toward one’s goals.
While more general relationship issues are an integral part of sex therapy, they are not the primary issue. Sex therapists treat the sexual problem directly as opposed to assuming that if a couple resolves their other relationship issues, their sexual functioning will eventually improve. Since relationship issues are an integral part of sex therapy, and often one of the dynamics that perpetuates the sexual problem, couples who meet their goals in sex therapy invariably improve functioning in other areas of their relationship as well. When relationship issues are the primary problem (difficulty negotiating conflict, difficulty negotiating value systems, difference in attachment styles, etc.), then more traditional couples therapy is more appropriate.
Sex therapy is a process grounded in the science of sexuality, called sexology, not in the ideology or morality of our culture. Our world is filled with judgments about what sexual behavior is “normal” or acceptable. As long as nobody’s basic rights are being violated, a sex therapist strives to be nonjudgmental, with the intent of helping a couple meet their goals from within their own value system. A sex therapist can provide information about what behaviors are statistically common and uncommon, and can help a client explore their own value system, but cannot decide for the client what behaviors are morally acceptable.
One of the assumptions of sex therapy is that physical intimacy is a natural process and drive for couples. If there’s a problem with how this drive plays out in the relationship, it’s further assumed that “roadblocks” have developed that are impeding the couple’s natural process. The role of sex therapy is to identify and assist with the resolution or management of these roadblocks such that the couple is free to do what comes naturally. Common (and simplified) examples of roadblocks include anxiety related to sexuality, feelings of rejection, or other emotions that impede a man or woman’s ability to be intimate. Specific medical problems can lead to the formation of roadblocks if a couple is not able to adjust to changes in sexuality that accompany the medical problem. Difficulty with sexual communication is probably the most common roadblock, but one that couples overcome regularly in sex therapy.
Sex therapy is talk therapy. There is no sexual touching during sessions. Typically there will be assignments given that will expose a couple’s roadblocks and provide an opportunity for resolution. Since the experiential part of improving one’s sex life always happens outside of sessions, it’s critical that couples are able to complete the exercises. Though sex therapy is typically a very successful intervention, consistently not completing homework assignments is the number one cause of treatment failure.
Sex therapy is almost always done in the context of a couple’s relationship, with both partners involved in the therapeutic process. One of the sayings in sex therapy is that “it doesn’t matter who brought the problem to the relationship, the solution always lies with the couple.” It’s also invariably the case that both partners have a role in maintaining whatever roadblock exists, and thus it’s important that both partners be an active part of the solution. In certain situations it’s appropriate to do sex therapy in the context of seeing an individual; this is the case if someone does not have a partner, or if a person’s struggle with their own sexuality is significant enough that they need to get some resolution personally before they can be available to their partner. In any case, a sex therapist can help the client identify the setting that’s likely to be most beneficial.
©Copyright 2008 Chris Reynolds, MS, LPC. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Chris and/or see his GoodTherapy.org Profile
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January 23rd, 2008 at 7:00 am
I found this blog to be fascinating. Sex therapy is one of those topics that I hadn’t given much thought to. Having an outline of the anatomy of sex therapy (no pun intended) is very helpful. I think it will dispel a lot of myths about the practice.
January 23rd, 2008 at 7:02 am
I didn’t realize that sex therapy was successful with so few sessions. I guess once the walls of communication are broken down, progress moves quickly. It seems like intimacy is still a taboo subject so sometimes even couples don’t talk about it. Once a couple becomes more accustomed to talking about their intimate relationships, it makes sense that their relationship progresses at a quick pace. It must be rewarding to work in a line of therapy that sees such great results. But, I’m sure it may be difficult to break into such a field given the sensitive nature of the subject.
January 23rd, 2008 at 7:04 am
I have found that my clients do well, too. If the couple is committed to finding a solution, the couple generally does very well. And, generally an uncommitted couple won’t come in for therapy. It’s hard enough to talk about sex with someone you know. But, to go to a perfect stranger and admit you have a dysfunctional sexual relationship takes a lot of guts. So, if someone is willing to lay all of those sorts of issues on the line, they are generally very committed to finding a solution. Thus, the high success rate in a relatively short amount of time.
January 23rd, 2008 at 7:07 am
What happens when intimacy is not a physical drive for one member of the couple? Is sex therapy adapt at figuring out the cause of this dysfunction and then turning it around? I have found that some of my clients could take or leave sex. It just really isn’t that important to them. Some of them have had traumatic experiences, but not all. Many of them seem to resist the emotional effort an intimate relationship takes. And, then there are some whose lives are so busy that they just want to get some sleep! But, there is the occasional client who comes in with none of these issues but still just isn’t interested in an intimate relationship. Perhaps the problem is more hormonal than emotional.