Therapy and Counseling for Sexual Issues and Accepting Your Sexuality

Accepting Your Sexuality


Colorful mosaic with circular patternsPeople may attend talk therapy or speak with a sex therapist about sex-related issues. Both types of therapist may help people with questions or concerns about their sexuality. Therapy can help people enhance or restore their enjoyment of physical intimacy. It may also help them get to the root of distress or confusion about their sexual feelings or behaviors.

Addressing Sexuality in Therapy

Healthy expression of sexuality comes in many forms. But sometimes, problems with sex or sexuality come up. People with a non-normative sexuality or gender may feel alienated from society. These feelings may cause mental health issues that bring them to therapy. Other people may seek therapy for issues related to sexual intimacy. Worries about sexual issues can profoundly affect a person’s mood, thoughts, and well-being.

People may fear others will think their sexual concerns are inappropriate. They may not wish to talk to partners, family, and friends about these issues. This can cause anxiety, frustration, and shame. These feelings may lead to further distress. If someone feels uncomfortable discussing sex, therapy may help. Finding the right therapist can offer a person a safe place to share. People may share their fantasies, fears, memories, or desires about sexuality.

Sexual Issues Treated in Therapy

Therapists can help people find the source of their sexual concerns. In talk therapy, a therapist may help someone explore their gender or sexual orientation. They may also address emotional barriers in relationships. Doing so can enhance sexual experiences. Therapy for issues related to sexuality may help with:

Worry about sexual orientation may cause someone to seek therapy. Family members worried about a loved one's identity might try to seek therapy for them. They may do this to "fix" their loved one's thoughts or behavior. But therapy that seeks to change a person's orientation is not seen as healthy. Therapy for sexual orientation should help people accept their sexuality. An affirming therapist will help that person process their feelings. They may help the person come to terms with their feelings about sex.

People may also see a sex therapist about physical issues. Physical sexual issues may have psychological causes. Some of these physical issues include:

  • Inability to achieve orgasm
  • Difficulty maintaining arousal
  • Painful sex
  • Vaginismus

A sex therapist can help people find the source of the issue. This method treats the whole person. In doing so, sex therapists can help people improve their sexual experiences.

Therapy for Sexuality

Therapists use a wide range of approaches in sex therapy. Some of these include:

  • Exploring sexual fantasies
  • Mindfulness practices to help people be fully present during sex
  • Education about sex
  • Exploring negative beliefs that impede sexual satisfaction
  • Identifying one’s range of sexual expression

Individuals or couples may attend sex therapy or therapy that discusses sexuality. People in one-on-one sessions may focus on exploring their sexuality. They may also discuss concerns related to intimacy with a partner or sexual thoughts that cause distress.

Therapists may assign “homework” for partners in sex therapy. This can consist of exercises to help a couple reconnect physically. It may help them practice staying in the moment. One exercises is known as sensate focus. Sensate focus helps partners connect through touch.

Therapy and Sexuality: Case Examples

  • Sexual anxiety resulting from childhood. Donald, 47, has feelings of anxiety and depression. He drinks alcohol to soothe these feelings. He decides to seek counseling. Donald hopes this will help him improve his well-being. He also hopes to address the root of his feelings. He tells the therapist he has never had a serious girlfriend. But he wishes to have one. He has had many casual relationships that "fizzled out." These relationships ended when they approached intimacy. The therapist’s questions about his romantic desires cause Donald some embarrassment. The therapist gently inquires further. Donald reveals great feelings of shame about his sexual feelings. After some sessions, Donald addresses these feelings. Some of them relate to his strict religious background. He also links them to a disturbing childhood experience of seeing another boy being molested by a teacher. Donald reported the incident, he tells the therapist. But was never given the chance to discuss or work through his feelings about what he saw. He is finally able to do so. Donald begins to overcome his shame and fear. He slowly begins to accept his sexual desires as a normal and healthy part of life. His low mood and feelings of anxiety diminish. He renews his social life. Donald is then able to date with confidence and a positive outlook.  
  • Uncovering new sexual attractions. Marcia, 34, begins to realize she is attracted to women. She wants to talk about these new feelings with a therapist. She hopes the therapist will help her understand them. She reports she is happily married to a man. She has no desire to leave him or seek a divorce. But she is at various times guilty, excited, confused, anxious, and overwhelmed by the new type of attraction she feels. She tells the therapist she has had fantasies about a woman she works with. Marcia further explains she believes the attraction may be mutual. She is not sure whether to tell her husband or try to ignore the impulses. Therapy helps Marcia examine her feelings. She is able to explore the possible choices before her. She considers the best ways to communicate with her husband. She chooses to tell him about her feelings. In a later session, she reports having a productive talk with her husband. He is not judgmental and supports her acting on her attraction. He asks that honesty and communication remain forefront in their marriage. Marcia does not conclude how best to proceed. But she feels her relationship with her husband has become stronger after their conversation. She expresses confidence and peace with the realization that her attraction is simply a part of her nature. She is also happy that she is loved and accepted.

References:

  1. Gender dysphoria. (2013). American Psychiatric Association. Retrieved from http://www.dsm5.org/documents/gender%20dysphoria%20fact%20sheet.pdf
  2. Masters, W. H., Johnson, V. E., & Kolodny, R. C. (1994). Sensate focus. Retrieved from https://health.cornell.edu/sites/health/files/pdf-library/sensate-focus.pdf 
  3. Sex therapy for non-sex therapists. (2010). Retrieved from http://www.arhp.org/publications-and-resources/clinical-fact-sheets/shf-therapy
 

Last updated: 06-28-2018

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