What Men and Women Should Know
Let’s talk about sex. Sexual health is an essential part of overall emotional and physical well-being. But if you’re experiencing a sexual problem, the last thing you probably want to do is talk about it. If shame is keeping you from seeking help, know this: 43 percent of women and 31 percent of men report some degree of sexual dysfunction. Sex therapy is designed to get to the bottom of sexual issues and reverse them.
Working With a Therapist to Address Libido Problems and Other Sexual Health IssuesWhether you work with a psychiatrist, psychologist, or marriage or sex counselor, sex therapy can help with a variety of physical and emotional issues that can interfere with sexual satisfaction, such as erectile dysfunction, low libido, a history of abuse, and others. And it can help you and your partner work through these issues in a supportive and educational environment.
So what does sex therapy really entail? And who qualifies as a sex therapist? Read on to discover the truth about this type of therapy.
What Is Sex Therapy and How Can It Help?Contrary to what some believe, there’s nothing strange, deviant, or kinky going on behind the door to a sex therapist’s office. Indeed, sex therapy is not very different from other forms of psychological counseling. “Sex therapy is a type of psychotherapy that also takes into account possible physical problems. When a couple comes in with a sexual problem, we try to figure out how each of them could be contributing to the issue. We examine behavior, gradually interpret that for them, and come up with solutions,” says Barbara Bartlik, MD, a psychiatrist and sex therapist at Weill Cornell Medicine in New York City.
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What Happens in a Sex Therapy Session?Your therapist will help you work through emotional issues that may be contributing to sexual issues, such as erectile dysfunction, according to Drogo Montague, MD, a urologist at the Cleveland Clinic in Ohio. If performance anxiety is an issue, sex therapy would typically begin with learning about performance anxiety, then move on to teaching a couple how to establish open lines of communication to discuss sexual wants and needs, Dr. Montague explains. The couple may also explore issues causing relationship stress, he adds.
When May Sex Therapy Be Recommended?Sex therapy may be recommended in a variety of scenarios, says Michael Krychman, MD, executive director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach and coauthor of The Sexual Spark. Here are some of the most common scenarios:
Personal Conflict Issues Related to Sexuality This includes, for example, sexual trauma or assault. Dr. Krychman recommends seeking individual therapy first to cope with these issues, then gradually including your partner as needed.
Conflict About the Relationship A common example here would be a partner experiencing sexual boredom. In this case, it’s better to seek therapy alone first so that you can better understand yourself and your own sexual concerns, then incorporate your partner, says Krychman.
Compulsive Sexual Behavior (CSB) Once again, in this scenario it’s better for the person with the compulsive behavior or the partner to see a therapist alone first, then bring in the partner. “Sometimes, personal emotions of betrayal, guilt, or fear may need to be explored before incorporating your partner,” explains Krychman. “The one suffering from CSB may also experience a wide range of emotions, such as fear, shame, and anxiety. Addressing your personal emotional experience is important prior to bringing and dealing with your partner — this may enhance communication.”
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Couple, Marital, and Sexual Problems For instance, with the infidelity of one partner, Krychman typically recommends that the couple tackle the concern or problem together from the start and address the roles they may have played with respect to the issue. “No one is blameless in a dysfunctional relationship, and couples can jointly work together to improve the quality of their experience,” he says.
Personal Coping Difficulties Related to Sexuality This area might include if you’ve just been diagnosed with a sexually transmitted infection and want to learn how to disclose your status to your partner or partners.
You’ll Learn to Be Mindful and More AwareIn mindfulness training, you learn to be present and focused on the here and now, rather than letting yourself get distracted by grocery lists and carpool plans. When using this concept in sex therapy, you learn to block out extraneous thoughts as well as negative thoughts you might have about your body or your performance. Instead, you are guided in thinking only about how your body is reacting to sexual stimulation.
Lori A. Brotto, PhD, executive director of the Women’s Health Research Institute and Canada research chair in women’s sexual health at the University of British Columbia in Canada, has done research on this topic, including a study published in November 2016 in Archives of Sexual Behavior. She has found that there’s significant improvement in responsiveness in women suffering from anxiety-related sexual dysfunction. Dr. Brotto, also author of Better Sex Through Mindfulness, says that the hypothesis behind the results is that the mindfulness skills that the women acquired benefited their sexual motivation and response both directly, “by allowing them to nonjudgmentally focus on sexual sensations in their bodies before and during sexual encounters, and indirectly, by improving mood and decreasing stress and anxiety.”