A Therapist’s Missed Opportunity: Sex, Intimacy, and Sensuality for One

Woman standing on dockTherapists working with individuals miss an essential component of their clients’ mental, emotional, spiritual, and physical well-being by not inquiring about sexuality, intimacy, and sensuality. Much to my chagrin, I have heard seasoned and admired therapists admit to not doing so. It seems many therapists consider sex, intimacy, and sensuality up for discussion only if the presenting problem is related to a relationship. Our cultural messaging distracts and dilutes us into believing sex, intimacy, and sensuality exist only in a relationship of some configuration. The cultural message has created a taboo and an ingrained belief that talking about, thinking of, and celebrating ourselves as sexual beings outside of a relationship does not have value.

Sex, intimacy, and sensuality for one is about enjoying, relishing, and leveraging our bodies, minds, and beyond to increase mental, emotional, spiritual, and physical health. Opportunity to support our clients in discovering a new way to interact with their bodies and minds is lost when we assume that sex, intimacy, and sensuality are not vital components of our single clients’ health and well-being. It is essential to understand a client’s relationship with his or her body, sexual health, interests, and experience to fully understand the client’s worldview and state of being.

I have worked with a number of women who report putting their sexuality on hold, as if “those days are over” or sexuality just isn’t a “fit” at this point in their lives. It is essential as therapists to investigate a client’s interest in finding what more there could be. There may be medical, hormonal, psychosocial, or cultural dynamics at play in the lives of clients who imply that the sexual part of them has terminated or is not for them anymore. It should be noted that cultural messages may lead us to not investigate or consider a person’s exploration of sexuality with a partner or partners unless that exploration is in the context of a relationship, which, according to those cultural messages, tends to require a commitment and monogamy.

Sex, intimacy, and sensuality are not for others—rather, they’re for us as individuals. Not only do they not require a bedroom, they don’t require a partner. As human beings, it is imperative that we indulge in self-care such as rest, real food, enough water, and exercise. In or out of relationships (and that gray area in between), self-care needs to include “relating with self and others care” in which we strive for effective communication, intimacy, and, for many, being mindful of maintaining a healthy, balanced sex life, intimacy life, and sensual life. I insist it is equally important to ensure that single clients of all genders are equally as mindful of a healthy, balanced sex life, intimacy life, and sensual life as our partnered and married clients.

It should be noted that we tend not to investigate and celebrate a person’s exploration of his or her sexuality with a partner or partners outside of our culture’s definition of a relationship, which tends to require commitment and monogamy. As clinicians, it is important for us to question our own definitions and worldview when it comes to commitment and monogamy. If our beliefs impede our unconditional, positive regard and clinical judgment, we need to consider who may serve our clients better.

It is important to ask yourself, as a clinician: Why aren’t I asking and encouraging my single clients’ sexuality, intimacy, and sensuality as a means to a balanced, enriched, intimate lifestyle? What is it about my own worldview of those in and outside relationships that compels me to inquire about sex, intimacy, and sensuality only with clients who are in relationships?

Steps to begin introducing “sensuality for one” into your practice:

  • Intake forms: What components of your intake forms encourage clients to identify as a “single” person versus a person in a relationship? What can be altered to add dynamic to these components to reflect a client’s relationship with self? For example, an intake form could ask: “What do you do with alone time?” “What activities do you engage in alone?” “What activities do you enjoy most/least when you are alone?” This could provide a wonderful facilitation of understanding and expanding your clients’ experience.
  • Intake questioning: Have you asked a client outside of a relationship how his or her life is enhanced by being out of a relationship?
  • Leveraging data: Once the work with a client has momentum, we can return to the intake and expand the client’s intimacy, senses, and sensuality. How could you leverage intake-form responses such as: “I love to go to yoga classes alone,” or, “When I hike with others, I feel a disconnection from the mountains that I have when I am alone”? In addition, if the client has a visceral reaction to “alone time,” you have insight into his or her experience.
  • History taking/genogram: What messages has the client received about relationships? About not being in a relationship? What threads exist in the client’s history that are worth exploring to enhance being out of a relationship?
  • Self-care conversation: Is self-care explored beyond food, exercise, and balance? How are clients caring for themselves or not caring for themselves? Is care focused on self for self’s sake?
  • Relationship history: Is the history focused on former lovers and the periods between relationships? And what are we using to define relationship?
  • Psychoeducation: Beyond “sex, intimacy, and sensuality for one” implying masturbation, what pearls of wisdom are we sharing about how to increase tender, loving care for self?
  • Goal setting: Often times in goal setting, I hear clients outside of relationships wanting to “work on themselves” so they are ready for a relationship with someone else down the road. How can the goals enhance the clients’ current experiences and their relationship with themselves?

Now armed with a handful of tactics to begin implementing the concept of sex, intimacy, and sensuality for one into our practices, it is my hope that clinicians begin to view themselves and their clients as sexual beings regardless of relationship status. Sex, intimacy, and sensuality are enriching, vital components of all of us, requiring differentiation from the cultural messages in order to maintain mental, emotional, spiritual, and physical well-being.

© Copyright 2012 GoodTherapy.org. All rights reserved. Permission to publish granted by Denise Onofrey, MA, LMFTC, therapist in Englewood, Colorado

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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  • judy

    judy

    November 21st, 2012 at 11:52 AM

    honestly I would be taken aback if I visited my therapist for an issue that was not relate to my sex life and she still enquires about it.maybe it’s the social conditioning but yes I can see what you mean.it can go much beyond just the usual attributes related to sex.we as individuals have so many sides to us and sex is one of them,there is nothing wrong in enquiring and discussing about that aspect!

  • Abram

    Abram

    November 22nd, 2012 at 3:01 PM

    Theres so many people who have problems stemming from issue of sexuality.And here sexuality need not be with regard to their sex lives.It could be an individual aspect too.I think this is a great topic that is brought up and is often left alone in therapy because it can really take over a person’s mind even.

    Imagine someone who has a pron problem but is not really addicted to it.If the person has frustration or another issue and he goes to therapy and if the therapist does not enquire about it then that is certainly a missed opportunity right there!

  • Denise Onofrey

    Denise Onofrey

    December 5th, 2012 at 8:01 AM

    Hello Abram – In response to your example of a client’s porn use. It is essential that clients understand their responsibility to being forthcoming and honest with their therapy. Trust takes time but once a client feels their therapist is trustworthy and the therapeutic relationship has been established, I encourage clients to share facets they know are essential to understanding their experience. -Denise

  • marian

    marian

    November 23rd, 2012 at 3:59 PM

    Why don’t these therapists realize that intimacy and sex are an integral part of any relationship, and no matter what the problem that the couple is talking about with him, there could be underlying issues that they are afraid and embarassed to admit to. Sex cold be at the core of many problems that couples face, yet they aren’t working with someone confident wnough to guide them through the process of figuring all of that out.

  • Denise Onofrey

    Denise Onofrey

    December 5th, 2012 at 7:57 AM

    Hi Marian – the question you pose is an important one. Why is it that therapist’s don’t honor client’s sex, intimacy, and sensuality? It’s important for therapists to consider their own worldview on these topics in order to gain insight to their approach. – Denise

  • Vanessa

    Vanessa

    November 25th, 2012 at 5:09 AM

    What a shame that a couple would end up having to work with a therapist who is kind of ot of touch with the reality of most relationships and missing something that could be so critical to help heal what is causing so much underlying trouble in the relationship.

    You put your heart and soul out there when working one on one with a therapist, hoping to get the guidace that you need and deserve to build a stronger foundation for your relationship. Instead you may receive sub par work that leaves you still with just as many questions and unresolved issues as you had when the therapy started.

  • Denise Onofrey

    Denise Onofrey

    December 5th, 2012 at 7:51 AM

    Hello Vanessa – Yes, I agree. I encourage any readers who are clients to advocate for themselves and broach the topic of sex, intimacy, and sensuality with their therapist if the their doesn’t inquire. – Denise

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