We always hear that we could have a better sex life. But, how often do we actually go 'under the covers' to better understand our desires and most embarrassing questions?
How do you decide who you're going to trust with some of your most intimate experiences?
Most people do their best to try to fix issues in a relationship when it's not going well. But sometimes, seeking professional help in this area can be fraught with risk as some therapists aren't able to deal with these intimate issues effectively.
There need to be two separate and parallel conversations when couples come to sex therapy. The first conversation is about the relationship's emotional health, and the second conversation about the sexual health within the relationship. Many people think that if the relationship gets better, then the sex will too, or vice versa. Both thoughts are a myth.
It is essential to encourage couples to speak openly about their erotic needs, which seldom happens outside of the therapist’s office. When these are brought out into the open, discrepancies between each other’s inner erotic worlds can be discovered. Exploring uncomfortable desires more deeply can open the door to a greater understanding of themselves, increased empathy for their partners, and potentially healing their sex lives and relationships.
To set the record straight about sexual health therapy, it is “talk therapy” and not having sex in the office.
Sex Therapy Deals With Some of the Following:
Helping couples with discrepancies in their erotic needs
Problems related to painful intercourse or erectile disorders
Sexual difficulties following cancer treatment or childbirth
Breaking of relationship contracts and infidelity
Problems underlying the cessation of sex in a relationship
Religion-based shame around sexuality
Failure to have an orgasm
Helping parents guide their children or teenagers about sex
A great sex therapist will encourage couples to speak openly about their erotic desires and fantasies, which seldom happens outside of the therapist’s office unless their sexual behaviors and fantasies interfere with their lives.
I recently had a couple who’d opened up their relationship – both having boyfriends and girlfriends outside their marriage. But this wasn’t why they were here. Most therapists would see their problems because they opened up their relationship. But, as did I, they understood that opening their relationship merely highlighted their existing relationship problems, not adding to them. Therapists shouldn’t make assumptions. Sure, their open marriage is a potential problem, but not an intimacy disorder in itself.
Sex therapists need to make more room for sex and intimacy in many different ways. Many couples have a secure base for their love for one another and can have multiple intimate attachments outside.
Look at families – millions of parents worry they won’t love their second baby as much as their first. But they do. The world over, there’s the capacity for second, third, and fourth love attachments with our children. It can be the same for our intimate partners.
But, obviously, problems arise if the couple hasn’t had an open dialogue negotiating their monogamy. And that’s where a good sex therapist can come in and help.
How do you Choose the Right Therapist?
A good sex therapist can help you build confidence in your sexual skills and develop new techniques, but also help you recognize that sex is about so much more than “performance.” Sex therapy can help you learn tips for managing anxiety in the moment and staying mentally present during sex, which is just as important as sexual technique.
Shop around and consider an AASECT(The American Association of Sex Educators, Counselors, and Therapists) certified sex therapist. They will have received extra education in areas of sexual dysfunction, sex and gender identity concerns, trauma, and partner intimacy issues. Compared to general therapists, they will have more experience with diagnosing male and female sexual dysfunctions.
The therapist doesn’t have to have fully advanced training to help you. Still, they should have more than their normal training – participated in a workshop that focused on working with couples and expanded their sexual health knowledge.
As a trained sex therapist myself, I educate other therapists around the country and internationally. I often ask how many of those have any type of sex therapy training. In a roomful of 50 or 60 therapists, I usually get no more than four hands! If I give a talk on problematic sexual behaviors, marital therapy, or sexual trauma and abuse, I fill a room. But a talk on helping individuals and couples with sexual pleasure has less than half as many people show up.
Too often, the untrained therapist makes unsound judgments about what constitutes a healthy sex life—perhaps based on their unexamined sexual history of abuse, trauma, or infidelity. They can project this onto the clients and then lead the individual or couple accordingly, often taking sides with the person who feels aggrieved in the relationship. This is not helpful.
Before you book an appointment, here are some questions you may want to ask a potential sex therapist:
What do you consider “normal” sexually? You don’t want a therapist who has their very rigid and fixed idea of how often and how a couple should be having sex.
What areas do you focus on in your practice? If they say "everyone,” take heed, they may not be for you. Good sex therapists and couples counselors usually just focus on that, and maybe a couple of other areas.
What is your accreditation? The largest accrediting body for sex therapy is AASECT. This is not to suggest that there are no excellent therapists without AASECT accreditation, but many therapists are uncomfortable talking to their clients about sexual confessions. So, a therapist with AASECT accreditation can’t hurt.
What are some of your approaches to sex therapy? If your therapist says, “I only use one method,” be wary. Sex therapy is not a "one size fits all" approach.
Ask the therapist, "are you trained in what I’m calling for specifically?" (i.e., kink fetishes, BDSM, and have you had sexual health education training?) There are many certifications therapists can be trained in, including Modern Sex Therapy Institutes.
It’s also important to know what the sex therapist should NOT be doing. Here are some red flags to look out for…
Sex therapy should never include nudity, sex, or any type of sexual touching in the presence of a therapist.
An ethical therapist will never try to “rid” you of your sexual identity or erotic interests. This is misinformed therapy and offensive.
The therapist should never judge the client and should never pathologize their sexual behavior. i.e., saying to you, “That’s bad!”
If a couple comes to therapy and the therapist doesn’t ask about the couple’s sex life, that’s a huge red flag. They should be bringing up your sex life! It’s a huge part of your relationship.
If they say that you’re a sex addict, it often means they are not trained well as that is not a diagnosis and more of a cultural terminology and can be a sign that the therapist doesn’t have a sexual health understanding.
Beware of therapists that identify themselves as ‘sex addiction therapists.’ This is because, with most sex addiction therapy training, there’s not a mandatory sexual health component.
- A specialization in therapy for sex offenders should be left to trained therapists who work with and are educated on non-consensual and illegal sexual behaviors. Sex therapists are not necessarily trained in this unless they get this training outside of sex therapy.
Finding the right therapist can feel a bit like dating. Despite their qualifications, therapists are humans, too. You might run into a therapist with their own sexual hang-ups or old-fashioned views, or just someone with which you don’t gel. But when you find “the one,” there’s no feeling like it.
Finally, you want to make sure that you work with someone who shares your values around sexuality. Once you meet with a therapist in person, check-in with how they made you feel, uncomfortable emotions and challenges are part of therapy, but you should feel safe and supported by your therapist. After your first session, ask yourself if you felt a connection with your therapist and whether you would get value out of going back? If the answer to either of those questions is no, move on and look for someone else.
Connect. Transform. Thrive.
Joe is a leading expert on sex and relationships. He specializes in Out-of-Control Sexual Behaviors (OCSB)/“sex addiction”, Relationship Problems and Marital Conflict, Sex Therapy, and Sexual Identity Concerns, Depression, Anxiety and Post Traumatic Stress Disorder (PTSD). His practice is located in Royal Oak, Michigan but he welcomes clients from all over the Metro Detroit area. Joe is also available for long-distance coaching and consultation. His practice is mixed with straight, gay, lesbian, bisexual, and transgender individuals and couples.
Joe graduated from Michigan State University with dual majors in Psychology and Social Work. At Wayne State University, he earned his Master's in Social Work (MSW), then a Master’s (MA) in Psychology, and has received his Doctorate (Ph.D.) in Clinical Sexology from the American Academy of Clinical Sexologists (AACS). He is in the process of becoming a certified transgender therapist through the World Professional Association for Transgender Health (WPATH.org). WPATH is the standard of care for transgender medical and mental healthcare. In addition to that, Joe is also the founder and director of The Center for Relationship and Sexual Health (his associate's biographies can be found here), teaching faculty at the University of Michigan Sexual Health Certificate Program, a Board Certified Sexologist, member of the Academy of Certified Social Workers, member of the National Association of Certified Social Workers, member of EMDRIA Eye Movement Desensitization and Reprocessing (EMDR) Basic Training, and a licensed clinical social worker in the state of Michigan.