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Sexual Health Blogs

What To Expect in Sex Therapy

Many people may experience problems with sex at some point in their life, though some issues can be resolved without the need for intervention, others may find they need additional support from a certified sex therapist. Reasons for going to a sex therapist can include lack of desire, difficulty having an orgasm, pain during sex, inability to have penetrative sex, difficulty keeping an erection, and premature ejaculation. This article aims to give a brief outline as to what can be expected during a sex therapy session. Whatever difficulty it is you are facing, be reassured that you are not alone. 

THE PRIMARY SESSION 

Be sure to go into your first sex therapy session knowing you may discuss your sexual health, relationship, and trauma history, states Gretchen Blycker, a sex and couples therapist. Especially in your first session, your therapist will need to get a sense of the context that is surrounding your concerns, this can and may include the discussion on topics you may find uncomfortable. Sex therapy can look similar to traditional therapy forms, but with a direct focus on sexuality in addition to and in conjunction with the uneasiness or worries that brought you to therapy. “Generally, when attending a therapy session with sexuality as your primary concern, you can expect your therapist to gently inquire around what has been bothering you, and what you would like to be different,” says Laura Federico, licensed clinical social worker.

In your first therapy session, you may be asked questions about these topics: 

  • Your sexual history (this may be as individuals, or as partners) 

  • Your mental health history 

  • Your sexual orientation and gender identity 

  • Your family and relationship with them 

  • Any traumatic experiences or history they should be aware of 

  • Any physical or medical concerns that may be affecting the current issue 

  • Your relationship outside of sex 

  • Your typical sexual habits 

  • How you show desire and affection beyond sex 

If it is thought to be a medical problem that is causing further issues, your therapist may be able to refer you to a physician for an examination or medication management. This means any medical causes can be ruled out before addressing any psychological and relational reasons. In other situations, the sex therapist may recommend traditional psychotherapy may be recommended by the sex therapist in order to address mental health concerns. Dr. Raymond Zakhari, certified sex therapist, discloses that “In couples therapy, if one of the members is a trauma survivor, then individual therapy may be necessary.” Based on this intake appointment, the sex therapist will work with you in order to work out your best course of action.

WHAT TO EXPECT TO HAPPEN IN A SESSION

As addressed above, there are many reasons why someone may choose to go to sex therapy, and every reason is valid. Just the same with other types of therapy, sex therapy is customized to each client—what works for one may not work for another. Therapy sessions may involve “‘insight-oriented work’” such as processing the psychological causes of your concerns, as well as “‘hands-on homework’” in between sessions which aim to develop the skills discussed in the face-to-face session. In addition to active work, sex therapy often includes an educational component. This can range from learning the basics of your or your partner’s anatomy to learning about the science of desire and sexual satisfaction. “When working with sexuality, this might mean removing performance-based expectations, embracing individual unique desires, and gently processing painful experiences from the past,” explains Federico. 

WHEN TO REACH OUT 

It is specifically recommended that you seek out a sex therapist when your sex life becomes or feels overwhelming or stressful to the point it affects your everyday life. Dr.Jason Greenburg, psychology and sex therapist, summarises that anything that “related to sexual desire or behavior falls under the sex therapy umbrella.” Even if you are simply looking to try something new in your relationship, you can still go to sex therapy!

WHY HOMEWORK?

Unlike the typical form of homework, sex therapy assignments are based on your personal situation and circumstances. These assignments might include practicing affirmative sexual touch in order to remove critical expectations around performance. You will likely spend time during each session going over the results of the homework and feelings surrounding it. 

SEX CAN BE WEIRD TO TALK ABOUT 

Levels of comfortableness in discussing sex and sexuality can vary from person to person. It is totally normal to feel worried about or uncomfortable with discussing sex with another person, especially in a professional setting. But let your worries stop here! Certified sex therapists have strived hard to provide a non-judgemental and safe space in order for you to feel comfortable to express any feelings you have been carrying. Your therapist may ask you many personal questions, such as your frequency of masturbation or how you feel about your body. These questions are NOT here for your therapist to judge or laugh at you, but to help you as much as they can. Zencare does note that “a good, compatible sex therapist will work at your pace and comfort level,” a therapist that does not respect you or your boundaries should be left immediately. Though part of your sex therapist’s job will be to sometimes guide you gently towards discussing topics you may feel uncomfortable with, you should NEVER feel pressured to reveal more than you feel comfortable with.

WHAT TO LOOK FOR IN A SEX THERAPIST 

  • Specialized training in sex therapy and sexual health 

  • Trust, non-judgment, and feeling comfortable 

  • Assessment of progress throughout treatment 

WHERE TO FIND A SEX THERAPIST 

If you are based in the UK like me, the NHS states that “it’s a good idea to see a GP first as they can check for any physical causes. The GP can then refer you to a sex therapist.” Though sex therapy is not available on the NHS in all areas, so you may have to pay for sessions. You can also check out our sister company Respark, an all-inclusive psychotherapy practice based online. They offer couples therapy, sex therapy, and individual counseling and coaching—whatever you are after, respark can offer a helping hand!

Though sex therapy may be uncomfortable at first, it can be a greatly beneficial way to heal and improve your sex life. No matter what you are dealing with, I can assure you that there is someone out there who is willing to help you, and able to help you.

By Stephanie McCartney