What is “Sex Therapy?”

Sex therapy addresses the needs of both individuals and couples who have concerns about their sexual desires, relationships, pleasures or performance.  Often, couples who have great relationships but want to “spice up” and otherwise improve the sexual side of intimacy will work with a sex therapist as a “sex mentor” to help them gain inspiration, ideas and skills.  Other times, sex therapy is one aspect of psychotherapy and couples counseling.

If any aspect of your sex life or sexual relationship is concerning you, or if your sexual connection with your partner isn’t quite where you’d like it to be, then talking to a trained, credentialed sex therapist is probably the best choice you can make.  Here’s why:

Sex is never separate from other aspects of who we are, or from the context of our lives and relationships as a whole. Still, if one of your concerns is sexual, then working with someone who has special training, experience, and knowledge about sexual matters is essential.

Most credentialed sex therapists are trained as full-fledged psychotherapists with a Masters or Ph.D. degree, usually in psychology, counseling, or social work.  However, they also have additional advanced training in sexology and wide-ranging sex therapy methods. It’s this additional training—as well as ongoing continuing education in the field—that really distinguishes a Certified Sex Therapist from other types of therapists.

Some people, and even some mental health professionals, hold the mistaken notion that sex therapists address merely the functional part of sex—i.e., getting or keeping an erection, having an orgasm, desire and arousal (or lack thereof), sexless relationships, pain with sex, or sexual preferences and identity.  While it’s true that sex therapy does deal with these issues, that’s often just the starting point. Our sexuality is connected to every aspect of our selves, and we can’t really split-off body from psyche.

Our sexual self is informed by the culture we grew up in and the community we live in now; it’s affected by the way we learned about sex and our early relationship experiences. Our sexuality influences how we feel about our bodies, our physical health, our moods, and, of course, the satisfaction we find in our intimate relationships.  A sex therapist has to be expert at working with all of the puzzle pieces of her clients’ lives—emotional, mental and physiological; past, present, and future—in order to help them fit together.

Some practitioners use terms like “sex educator” or “sex coach” to describe themselves. What, exactly, is the difference between a sex educator, sex coach and sex therapist?

The greatest difference between these titles is the amount and depth of training each professional has undergone, and the degree of emotional and personal history she is trained to explore with an individual or couple. Level of education can be a factor, too: sex educators and coaches do not necessarily have advanced degrees—although some do. Typically, educators and coaches are able to offer explicit sex information, teach love-making and communication skills, and provide suggestions for positive change. However, they are not experienced therapists. They aren’t meant to delve too deeply into your emotional or relationship concerns. By contrast, a sex therapist can work with you as intensely as needed, plus, do the same kinds of skills-building and educating as coaches. Some sex therapists identify their expertise using both titles. In addition, because a sex therapist is usually an experienced individual and couples’ psychotherapist first, clients needn’t split time and funds between a sex therapist and a “regular” therapist who is probably ill-equipped to cope with complex sexual issues. Most have little or no training in that area at all.

What Issues Does Sex Therapy Usually Address:

The list is long, but here are most of the basics:

  • Reduced desire for sex
  • Difficulty becoming become aroused
  • Erectile problems
  • Orgasm problems
  • Communicating about sex with partners
  • Improving boring or routine sex lives
  • Sexless marriages
  • Partners with different degrees or types of sexual desire
  • Concerns about what turns you on, or who turns you on
  • Being sexual with a partner if you or your partner has a history of trauma or sexual abuse
  • Pain during sex
  • Out of control or compulsive sexual behavior
  • Problems with body image
  • Trouble experiencing pleasure
  • Sexual pleasure or functioning in the face of physical challenges or chronic illness
  • Concerns about your sexual orientation or preference
  • Helping parents communicate with kids about sex
  • Gender transitions
  • Alternative relationship styles
  • Concerns about sexual practices
  • Fetishes

What’s The Best Advice for Someone Thinking About Starting Sex Therapy?

Whether you choose to see me or someone else, be sure your therapist is certified by AASECT* or can demonstrate an equivalent level of training.

Your therapist should be someone you feel very comfortable with. You’ll be speaking in great detail about your most intimate experiences, so you want to feel accepted no matter how unusual you think your concerns may be. You’ll want to feel that your therapist really gets you. Whether your relationship and sex life is a traditional one, or what some people call alternative (or kinky), or somewhere in-between, you’ll want to be sure to work with a person who is accepting of and knowledgeable about your lifestyle.

Because any form of therapy creates a very unique relationship between therapist and client, impeccable skills are just a starting place. Sometimes, no matter how good a therapist looks on paper, the chemistry between you is just wrong. That’s why it’s so important that you trust your gut. There’s no substitute for feeling safe enough to reveal your deepest truths.