What Is Sex Therapy?

Sex therapy is a specialized treatment focusing on the resolution of sexual concerns. As in any other psychotherapy situation, talking is the mode of treatment. There are no sexual relations nor nudity in the sessions. The client talks explicitly about his/her problems, and with the help of the sex therapist, learns about the etiology of his/her concerns and explores various options to improve his/her sexual life.

Sex therapy is based on the assumptions that sex is good, that relationships should be meaningful, that interpersonal intimacy is a desirable goal, and that men and women have equal rights to full expression and enjoyment of healthy sexual relationships.

Sexuality is an integral part of a personís well being. An individual bothered by his/her sexual functioning may feel unhappy, inadequate, anxious, angry, etc. For many people, sexual functioning is closely tied in with their total concept of self identity.

On the other hand, sexual concerns are often the result of other problems. In fact, many times the sexual concern is a symptom of something else that is going on in the clientís life/relationship. I always say that sex does not happen in a vacuum. Sex is affected by many things: a bad relationship, low self esteem, past experiences, depression, anxiety, health issues, medications, etc. Therefore, the sex therapist needs to examine other areas of the personís life to determine if and what is the underlying issue(s). In many cases, therapy then focuses on the underlying issue, which upon resolution, may improve the sexual concern.

Sex therapy usually involves both partners when there is a committed relationship. ďIt takes two to Tango,Ē and even if it seems that the sexual problem is generated by one of the partners, it helps if both partners take responsibility for improving the situation. It is also imperative to work (through therapy) on the coupleís communication skills, since most people find it very difficult to talk about sex and even other issues. If you canít talk about things that bother you with your partner, prognosis does not look good. In situations where both partners cannot (or are unwilling to) come to therapy together, the sex therapist works with the one partner on an individual basis.

Homework assignments are often given, allowing the couple (or individual) to work on the concern between therapy sessions. The use of homework speeds the progress and shortens the number of therapy sessions required to solve the problem(s).

There are many sexual concerns that trigger people to seek the help of a sex therapist. Among them are:

  • Sexual Desire (too low or too high)
  • Erection Difficulties
  • Premature Ejaculation
  • Orgasm Difficulties
  • Painful Intercourse
  • Issues of Sexual Abuse (for the victim, the survivor, and even for the perpetrator)
  • Sexual Addiction (also known as Obsessive-Compulsive Sexual Acting Out)
  • Gender Issues
  • Sexual Orientation Issues
  • Paraphilias (also known as Sexual Deviations)
  • Relationship Issues

A qualified and certified sex therapist is a professional who is a highly trained and experienced psychotherapist, is licensed by the state as a psychotherapist, and is certified by the American Association for Sexuality Educators, Counselors, and Therapists (AASECT) as a sex therapist. AASECT (www.aasect.org) has high standards for training in and work experience with sexual concerns and marital and relationship issues. One cannot become certified as a sex therapist by AASECT unless he/she is already an established and experienced general psychotherapist.

Success of treatment depends upon the clientís motivation, the nature of the problem, the underlying issues, the therapeutic goals, and the therapistís skills. It is very important that the client feel comfortable with the sex therapist. All therapy depends upon rapport, trust, and mutual respect. This is particularly true when working with intimate issues of sexuality.