These days, many couples find it hard to fit sex into their busy schedules. And it is perfectly normal for people to go through periods when they are just not in the mood for love making. However, if you lack desire for sex for emotional or physical reasons, you may want to consider sex therapy. Seeking treatment for sex problems has become more socially acceptable today, but it is still not easy for many people to talk to a professional about such an intimate concern.
"There are probably a lot of people out there who could use therapy but do not come because they're embarrassed. They may go through years of needless pain or dissatisfaction," says Alexandra Myles, MSW, a sex therapist in Massachusetts.
Before you decide to see a sex therapist, take the time to explore whether it is really what you need. Myles and other therapists recommend that you:
Many people come to sex therapy after individual psychotherapy fails to help them with their sexual problems.
"The obvious thing is that you are dealing with the human body so you cannot just talk about how you feel. You have got to work on the physical level as well," says Myles. Sex therapy generally addresses the emotional issues underlying sexual problems and employs behavioral techniques to deal with the physical symptoms.
These behavioral techniques involve physical exercises that clients do on their own outside of the therapy setting. "Nothing should happen in the therapist's office of a sexual or physical nature," Myles emphasizes. (Sex therapists should not be confused with sexual surrogates, who may have physical contact with their clients as part of therapy.)
One popular technique used in treating many sexual problems is called sensate focus, in which couples caress or massage each other without sexual contact. The goal is to help both partners learn to give and receive pleasure and feel safe together. As the partners become more comfortable, they can progress to genital stimulation.
As a result of performing this exercise, many couples discover new ways to experience pleasure other than sexual intercourse. "Some of my patients find that they become better lovers," says Dennis Sugrue, PhD, a sex therapist in Michigan.
Other exercises treat specific problems such as women's inability to have orgasms and men's erectile problems. Performing these exercises often evokes strong feelings that are then explored through psychotherapy. People who have experienced sexual trauma or are confused about their sexual identity may need to spend more time working through their feelings. For couples, who make up the majority of clients, the focus is on improving communication and developing greater intimacy.
When looking for a sex therapist, it is critical to find a practitioner with the proper credentials to deal with this sensitive subject area. A sex therapist should be an experienced therapist with training in sex therapy from a reputable program. Start with a search for a licensed social worker, psychologist, psychiatrist, or psychiatric nurse. For example, the American Association of Sex Counselors, Educators, and Therapists (AASECT) offers a certification program for professionals interested in becoming sex therapists. These types of programs include instruction in sexual and reproductive anatomy and treatment methods. Other topics covered include sexual abuse, gender-related issues, and sociocultural factors in sexual values and behavior.
You can obtain referrals for sex therapists from AASECT and other professional organizations, like the American Psychological Association. You can also ask get a referral from your doctor or therapist.
In looking for a sex therapist, it is particularly important to find someone who you trust and respect. Do not be afraid to ask questions about the therapist's background, philosophical orientation, and experience with your problem.
"A sex therapist can be very influential," says Gina Ogden, a certified sex therapist in Massachusetts, "because there are fewer people who you can talk with about your sexual issues." She warns against therapists who have rigid ideas of what human sexual response should be. Myles agrees, "Sex is such a subjective experience. You cannot impose your own beliefs on a patient."
If you see a therapist who says or does anything suggestive, or that involves nudity, end the relationship right away. "Sex therapy is strictly talk therapy. There should be no 'show and tell'," asserts Seifer, a former president of AASECT.
Most sex therapists today, according to Dennis Sugrue, "look at the whole person and try to help men and women redefine what it means to make love." The effects of aging or physical problems "do not mean that a couple cannot experience the pleasure and joy of being physically intimate with each other."
American Association of Sex Educators, Counselors, and Therapists
American Psychological Association
Canadian Mental Health Association
Mental Health Canada
Althof S. Sex therapy: Advances in paradigms, nomenclature, and treatment. Acad Psychiatry. 2010;34(5):390-396.
Meston C, Rellini A. Sex therapy for women's sexual concerns. The Sexual Psychophysiology Laboratory website. Available at: http://homepage.psy.utexas.edu/homepage/group/MestonLAB/HTML%20files/Resources_fsd_therapy.htm. Accessed June 19, 2013.
Sexuality/sex therapy. Good Therapy website. Available at: http://www.goodtherapy.org/sex-therapy.html. Updated May 14, 2013. Accessed June 19, 2013.
Last reviewed June 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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