How Holistic Sex Therapy Helps Men with Sexual Functioning

Man wearing t-shirt and sweats looks out window of high-rise building, hands clasped behind headNo matter how comfortable you may be with your sexuality, the idea of sex therapy can be intimidating. Many of the people I work with in sex therapy struggle with sexual functioning or desire, issues that often come loaded with complicated emotions such as anxiety. These things can be difficult to talk about, let alone try to do something about—even when it is understood that the person you’ve enlisted to help you is a compassionate and nonjudgmental professional.

For men in particular, socialization related to sexuality can add to these complexities. Although not uncommon, the experiences of premature ejaculation or erectile dysfunction can bring deep feelings of shame—even in committed relationships with partners who are understanding and patient. Many men are socialized to believe sex should be easily enjoyable and they should always be in control. When it doesn’t work out this way, some may feel intensely inadequate or weak. Men in these situations may question their worth as partners and even as human beings. If a partner isn’t understanding or patient, these feelings can be amplified.

As a sex therapist, I am trained in specific techniques that men can utilize to resolve a variety of sexual concerns. However, these techniques are often insufficient in addressing premature ejaculation and erectile dysfunction. Given the complexity of these issues, holistic sex therapy can play an important role.

It’s natural to seek out strategies that focus on physical functioning—the most obvious symptoms of sexual issues—but sex is more complicated than that. There are thoughts, narratives, emotions, and processes associated with the act of sex. These elements can greatly affect desire and pleasure. They can also impact bodily control and responses.

Sensory issues must also be addressed. The body tells its own story. Sometimes this story matches up well with the mind’s story about a problem, other times not so much. In these situations, people can benefit from learning about the activation cycles of their bodies—knowledge they can then incorporate into their sex lives.

It’s natural to seek out strategies that focus on physical functioning—the most obvious symptoms of sexual issues—but sex is more complicated than that. There are thoughts, narratives, emotions, and processes associated with the act of sex.

Holistic sex therapy is also about identifying cultural and social narratives surrounding sex. Not only can this exploration help people understand some of the roots of what they experience, it can also help them learn about ways their sexuality has been impacted, and how their bodies respond to these ingrained stories. Through sharing and understanding, validation can lead to healing and growth. It can also lead to sexual confidence that reflects acceptance of these influences while also challenging them.

Religion and spirituality can also play a role. These two elements can be related, of course, but they can also be very different. In fact, they can even contradict each other. Certain forces of religion, when deeply embedded, can overtake a person’s ability to sexually express themselves. Meanwhile, spiritual meaning can be difficult to ascertain.

In holistic sex therapy, self-esteem work is also relevant. When people recognize the barriers that are leading to their sexual issues, they may have to rediscover what they value about themselves.

Certainly, relationship issues can be a factor as well. Many men masturbate with no problems but struggle with sexual function with partners. Sometimes, this can be related to feelings about partners and their expectations, which may or may not be based in reality. When men unpack this in therapy, they’re typically better able to see what’s getting in the way of arousal, control, and desire.

Sound like a lot? Well, that’s because it can be. Sex can be complex, especially when you delve beyond the presenting physical issues and explore emotions and cultural influences. It’s rarely just one thing. Although many people tend to think of sex as primarily a physical act, there’s a lot more to it. Therapy that doesn’t explore these often hidden aspects does a disservice to the people who seek it.

© Copyright 2017 GoodTherapy.org. All rights reserved. Permission to publish granted by Michael J. Salas, MA, LPC-S, LCDC, CSAT, CST, therapist in Dallas, Texas

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Della

    Della

    January 23rd, 2017 at 6:30 AM

    It is like both sexes have been made to believe that good sex just always works out, and they forget that no, sometimes even this aspect of a relationship has to have a little help every now and then

  • Bo

    Bo

    January 23rd, 2017 at 11:25 AM

    No matter what problems I had I am not sure that I could ever be comfortable discussing my sex life with a therapist.

  • Vale

    Vale

    January 23rd, 2017 at 2:40 PM

    This is so important when looking at sex and sexual issues that different couples encounter. We like to think that we are immune to cultural and societal issues when it comes to effecting our sex lives, but there are so many ways that it can have an effect without us even knowing it. I know that for me I have some definite issues with body image and how I could never measure up to what I think that guys are looking for, that I will never look like that. So I know that in certain cases this has held me back from being able to experience something deep and meaningful because instead of thinking of all the things I have to offer I instead focus on the ways that I think that I am lacking.

    Not a great recipe for a strong relationship.

  • Michael Salas

    Michael Salas

    March 29th, 2017 at 11:53 AM

    Vale, I think that you’re right. We focus on sex as it should be at the peak of erotic desire. However, most of our fantasies don’t feel as satisfying when they become reality. Yet there’s still an expectation, which can create a lot of incongruence and shame.

  • thomas

    thomas

    January 24th, 2017 at 8:47 AM

    While some of you would be hesitant can I even tell you how much of a difference in my own life this has made for me and really for my marriage? I think that before we started we had become so bogged down in what w thought that sex SHOULD be that we had a hard time enjoying one another when it didn’t live up to these unrealistic ideals that we had both developed. Going through this kind of therapy together while we thought that it might be a little uncomfortable, and for a bit it might have been, but then we both got very committed to it and became invested in what we needed to do to save our marriage. If you are feeling conflicted I would encourage you to at least give it a try.

  • anonymous

    anonymous

    January 24th, 2017 at 4:00 PM

    i am just wondering if you really think that most men are interested in all the behind the scenes stuff or of they are mostly worried about performance issues at that time?

  • Carter

    Carter

    January 25th, 2017 at 7:11 AM

    And how do I make sure that the person I have chosen will address all of the aspects that need to be addressed?

  • Ronnie

    Ronnie

    January 26th, 2017 at 2:00 PM

    Been trying to work up the nerve to do this for a while now but just can’t seem to get over that little hurdle that requires me to make the first appointment.

  • Gayle T

    Gayle T

    January 29th, 2017 at 9:53 AM

    and women with their sexual functioning too?

  • Michael Salas

    Michael Salas

    March 29th, 2017 at 11:55 AM

    Gayle,
    Absolutely, but in different ways. Men are often held to expectations that they perceive others have on them and also the expectations that porn sets forth. Women may have sexually repressive issues surrounding pleasure, etc. Most heterosexual men haven’t dealt with shame around experiencing sexual pleasure. But a really relevant issue that maybe I should tackle in another article.

  • Bette

    Bette

    January 30th, 2017 at 10:29 AM

    I have tried talking to my doctor about this but she has been of little help. She has me on an antidepressant which I will readily admit makes me feel so much better day to day but has been terrible for the libido. I don’t know what’s worse- being depressed or not having really any physical feeling for my husband at all anymore. It all feels like such a chore and I don’t want him to know but I am sure that he sense it.

  • Bryan

    Bryan

    February 26th, 2019 at 12:12 PM

    A lot of the problems we have in this society regarding sex is that we put the cart before the horse. How can you possibly engage in the most intimate act you can engage in with another human being without even knowing them? Well, that is what you do if you have sex with a man or a woman on a first date, after 3 dates, or even after a month. The key to GREAT sex is communication, and the plain fact is that most people are not comfortable discussing sex in GREAT detail with a stranger. Yes, you must discuss it in DETAIL. Men and women are not inherent Don Juans. We are ALL different in terms or what we like and what we don’t like. Most of all, sex is so deeply tied to our emotions. By having sex with someone too early on in a dating situation, we delude ourselves into believing that we are closer than we actually are. Our bodies are inundated with oxytocin, the bonding hormone that naturally happens after we have engaged in an act that is nature’s way of producing offspring. I hate to single out women, but I really believe this is the source of why so many young women end up having relationships or flings with “Bad Boys.” Women especially have bodies that are full of oxytocin after having mated with a male that they feel a natural need to bond with the male, no matter how much of a jerk he is or how ill-equipped of a dad he might be. Yes, birth control might have been used, but that doesn’t change how our bodies hormonally react after intercourse. People begin to believe that they are closer than they actually are. The best way to avoid these issues is to wait to have sex until the relationship not only has commitment, but a large level of emotional intimacy, communication and trust. You MUST talk about this stuff. You should also take the time to go get tested for STD’s and STI’s. An alarming amount of Americans still feel you can’t get herpes thru oral sex.

  • Jose

    Jose

    February 26th, 2019 at 12:17 PM

    We also need to keep in mind that 1 in 7 (and that is just what is reported) men are sexually assaulted or abused. That will mess up a sex life with a partner. Also, it is not just women who have eating disorders or who feel shame and disgust with their own bodies. Lastly, unless you have been raped or molested, never, ever discuss past sexual experiences with partners or the number of partners you’ve had sex with…..even if he asks. It just leads to bad things, and it has nothing to do with the present. There are ways to indicate what you like and don’t like without referencing some hot stud you had a one night stand with (that your man could never compete with) on spring break when you were 22.

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