Embarking on a journey in sex therapy is a step towards improving one of the most intimate and rewarding (yet often confusing and difficult!) aspects of the human experience. As a psychotherapist specializing in relationships and sex, I have had the privilege of guiding many individuals, couples and individuals through this transformative process. Here is some information you may want to know before starting treatment with a sex/intimacy counselor.
Recognizing the Need
Realizing that you may need help from a trained sex therapist is important and deserves serious credit. Courage is probably the word to use when you recognize what it takes to own that there are aspects of your sex life that you cannot resolve on your own or even with a loving and cooperative partner. Many of us first turn to books, podcasts, or best friends as a way to fix what we probably perceive as broken in our intimate lives. And while there are great resources out there, having a skilled provider who can tailor their treatment to exactly what you need is sometimes what’s required.
Sex therapy is more than just sex
While the primary focus of “sex therapy” is on sexual issues, therapy often involves much more than focusing solely on what happens in the bedroom. It is not uncommon for sex therapy sessions to delve into broader relationship dynamics, communication patterns, self-concept challenges, family of origin, and numerous psychological factors that affect your sexual health. Sexuality is intertwined with many aspects of our existence, as well as a number of moving parts of our relationship that we may never have expected to be related to the sexual struggles that led us to therapy.
I was reminded of this recently at a meeting with a physical therapist for leg pain. While I was about to discuss this area of my body, she started by saying something like, “Does your leg hurt? Great, so let’s let you take off your shoes, stand on the floor over here and do some moves. You know, it might not actually be your leg… it might be your hip, or your neck, or how you hold your posture. Can I see how you sit when you’ve been in a chair all day?’
When you look at the whole person and the whole relationship, you see what else is going on that needs to be addressed. So as therapists, especially those trained in sex/intimacy, we don’t just focus on the problem it presents. Instead, we step back and explore how the whole system might contribute to sexual anxiety.
Openness, honesty and vulnerability are required
Most of us know that for therapy to be effective, openness and honesty on the part of the client is vital, although this can be an especially big ask when the focus of therapy is sex. While your provider will do everything within their training to make it easy for you, the process will still require you to share intimate details about your sexual experiences, feelings and concerns. When I first start working with someone and I ask in the intake session how they feel about starting this process with me, the word I hear most often is “terrified”! And how easy it is to empathize with that experience. But while starting to open up to a stranger about this part of your life can feel scary at first, a skilled therapist knows how to create a space that is soon recognized as safe.
Time for a change
It is important to manage expectations about the timing of treatment, and perhaps especially when working on our personal lives. Change, especially when it involves deeper issues or patterns, will simply take time. Progress in sex therapy is often gradual, requiring patience and persistence, although a consistent therapist will help you celebrate the victories along the way. I like to start sessions by asking my clients, “Before we talk about what’s been difficult since I last saw you, what can you brag about? What are you proud of as a couple recently? Where was there movement, even a little?’ This helps us recognize and believe that the process is working. Allowing change to take time also gives us grace when setbacks inevitably occur as part of the healing journey.
Individual Effort Within Collaboration
Research shows that the biggest determinant of client success in psychotherapy is not the therapist’s credentials, theoretical approaches, or even experience level. Instead, it is the client who has the biggest impact (by far) on the amount of change one sees from time spent in therapy. This means being proactive in sessions, doing any homework, and communicating openly about what is and isn’t working for you. Therefore, one consideration for starting sex therapy is simply asking yourself, “How ready am I to really engage in this process? If I’m not there yet, what would need to change in me to be ready to fully take that step?” Hopefully this post can help you get to that point of readiness.
