Sexual Therapy

Sex Therapy is the treatment of individuals who face the trauma of dealing with a sexual dysfunction or unhealthy sexual expression. Using the most sophisticated techniques possible therapy accesses drugs, psychiatry and other areas of medical sciences to deal with a complicated series of sexual problems.

The Rise of Sexual Therapy

Since sexuality has become more and more important in our society the value of sexual therapy has become more and more important. Along with increased attention from the scientific community, the treatment of sexual dysfunction has soared in recent years. Now that we know more about physiology and psychology we are able to treat sexual problems more effectively than even before.

Sexual identity is usually like air, you never notice it until it’s gone or polluted. Most only have a deep connection with their sexuality when it is something to struggle with. For these people struggling with their sexual functions they may experience a devaluation of self.

The institution of marriage is changing and shifting and bringing with it all sorts of different organizing structures for relationships. Alternatives to marriage are now being more openly tried and are becoming more widely accepted than at any other time in our history. Regardless of the structure of the intimate relationship shared, sexuality serves a valuable function for most couples. It becomes an expression of caring, not only for the partner, but also for oneself. It can become a powerful bonding element in a relationship, which, in today's society, must withstand considerable demands on time, energy and commitment. Dissatisfaction with the sexual relationship and the loss of that shared intimacy, in many instances, may lead to negative feelings and attitudes that are destructive to the relationship. Many marriages end therefore, because of unresolved sexual differences and difficulties.

The Problems

The sex therapist works with a wide variety of problems related to sexuality. People seek help with such problems as arousal (impotence and frigidity), as well as problems with orgasm (either inability to climax or the inability to control ejaculation). In addition to seeking medical evaluation and treatment, many people who experience painful intercourse also seek the assistance of a sex therapist. Couples often seek help when it becomes apparent that differences exist in their sexual desires, or when they sense that their sexual relationship is not developing as they would wish. The need for additional information, more effective verbal/physical communication and sexual enrichment leads many couples to the sex therapist's office in their quest to enhance their intimate relationship.

The qualified sex therapist is also available to those wishing to resolve troublesome sexual inhibitions or change undesirable sexual habits. People with questions about their sexual identity or sexual preferences seek out the trained sex therapist for consultation. Parents consult the therapist about the sexual curiosity and experimentation of their children and seek insight into ways to foster the healthy development of their youngsters through effective sex education in the home. Sex therapists also assist those experiencing sexual difficulties as a result of physical disabilities - or as the consequence of illness, surgery, aging or alcohol abuse.

Sex Therapy’s Uniqueness

Sex therapy employs many of the same basic principles as the other therapeutic modalities, but is unique in that it is an approach developed specifically for the treatment of sexual problems. That is, sex therapy is a specialized form of treatment used with one aspect of the wide range of human problems. Herein lies its value and also its limitation! Sex therapy techniques, when applied by an unskilled counselor or therapist, might focus too readily on mechanical sexual behavior, to the exclusion of the total individual and the total relationship.

What Can’t Sex Therapy Do

As with any therapy for personal or behavioral difficulties, sex therapy has its limitations. Although treatment is usually brief and effective with most sexual concerns, sex therapy does not offer a miracle cure for all interpersonal problems.

Success of treatment depends upon many factors, not the least of which are the nature of the problem, the motivation of the patient, the therapeutic goals and the therapist's skills. The motivated prospective patient and/or couple should choose a therapist carefully and establish realistic goals early in the counseling.

If you are not comfortable with your therapist or feel that the therapist has set unrealistic performance goals for you, discuss these concerns with him/her. All therapy depends upon trust and mutual respect, but this is particularly true when working with intimate issues of sexuality.

Discerning a Quack From a Doctor

One must realize that with any new field, a variety of definitions and expectations will exist for a time, and that a wide variety of people will claim expertise in accordance with their own definition of the field. The expectations presented here might be criticized as too rigid, but it is purposefully intended to present a fairly strict set of guidelines for selecting a sex therapist. Very few states license sex therapists, so the client must exercise caution and must choose wisely!

Five criteria need to be met in choosing a sex therapist.

1. Firstly, the therapist must have a sound knowledge of the anatomical and physiological bases of the sexual response. The sex therapist may, therefore, have a basic medical background or may come out of another non-medical profession but with post-graduate education in the biological aspects of human sexuality. A qualified non-medical sex therapist will usually work closely with physicians or may function as a non-physician in a medical clinic or university school of medicine.

2. Secondly, the qualified sex therapist must be skilled in providing counseling and psychotherapy, and most sex therapists will be found to have a sound background in psychology, psychiatry, psychiatric social work or psychiatric nursing. This background in the behavior sciences is essential to the understanding of the total individual and to the planning of an individualized treatment program. There are, however, some notable exceptions to the rule that sex therapists should have a traditional mental health training background, in that there are also highly respected and well trained sex therapists who began as clergy. These clergy, however, need to demonstrate specific post-graduate training in pastoral counseling or in equivalent psychiatric mental health areas.

3. The third criterion is that the sex therapist, having both biological and psychological sophistication, must be able to demonstrate extensive post-graduate training specifically within the areas of sexual function and dysfunction, sex counseling and sex therapy. A weekend workshop or possession of a few sex therapy films does not meet this criterion, and the prospective client should feel free to ask for a list of specific training experiences in these specialized areas.

4. The fourth requirement to be met is that of having expertise in relationship counseling. That is, the sex therapist should also be a skilled marital, family and/or group therapist. In order to work effectively with sexual problems, the sex therapist must be able to work effectively with non-sexual relationships as well. Sexual behavior does not occur in a vacuum - it occurs within a relationship! The total relationship must, therefore, be accurately evaluated and treated.

5. The fifth requirement is the therapist's adherence to a strict code of ethics! Prospective clients have the right to request a copy of the therapist's ethical code before agreeing to any treatment.

Get a Referral

If you need a sex therapist, you might begin by consulting your family physician, gynecologist or urologist. Ask for a referral to someone your doctor has used confidently in the past.

When calling a professional, be sure to ask questions about qualifications, experience and fees! It is recommended that you call and ask, "Do you have a specialty?" rather than stating, "I have a sex problem - can you help?"

Perhaps the most useful referrals will come from other knowledgeable professionals within your community. However, it is also helpful to be able to discover which therapists belong to recognized national professional associations having high membership requirements and enforcing rigid codes of ethics. Specifically, The American Association for Marriage and Family Therapy (AAMFT) is a national professional association that certifies marriage and family therapists and who would provide a list of its clinical members in your geographical area. More specifically, The American Association of Sex Educators, Counselors and Therapists (AASECT) is the largest national group that certifies sex educators, sex counselors and sex therapists. You can find the names and addresses of the certified professionals in your area by writing to this association. AASECT will also provide you with a copy of their Code of Ethics for Sex Therapists upon request. Addresses for AAMFT and AASECT are provided at the end of this page.

Dealing with the Issues

Even qualified sex therapists may differ widely in their basic approaches to the treatment of sexual problems, but some generalizations can be made.

First of all, you can expect to be talking explicitly and in detail about sex. One cannot solve sexual problems by talking around them! Neither can one gain new sexual information unless clear, direct instruction is given!

Second, you might expect to be offered the opportunity to add to your knowledge by reading selected books and/or viewing clinical films designed specifically for use in sex therapy. You should not, however, do anything which you do not understand, and you must reserve for yourself the right to question the purpose of an assignment. It is your right to decline or postpone acting on the suggestions of your therapist, rather than allowing yourself to be pushed into behavior which might actually increase your discomfort. Every assignment, task or experience presented by the therapist should fit into an understandable and acceptable treatment plan - and you have the right to question the procedures.

Third, you should expect sex therapists to be non-judgmental and to portray their own comfort in giving and receiving sexual information. While you might expect to be challenged and confronted on important issues, you should also expect to experience a respectful attitude toward those values which you do not wish to change.

Fourth, unless your therapist is a licensed physician wishing to conduct a physical examination, you should not expect to be asked to disrobe in the presence of your therapist. Sexual contact between client and therapist is considered unethical and is destructive to the therapeutic relationship. Neither should you expect to be required to perform sexually with your partner in the presence of your therapist. Overt sexual activities just should not occur in your therapist's presence, even though the talk, material and the assignments must, by the nature of the problem, be specifically sexual and at times bluntly explicit.

Finally, you should feel that you are heard and adequately represented in your sexual therapy. That is, you should not have been stereotyped as "female”, "gay", "too old", or in any other way that interferes with your sense of unique identity within the therapeutic setting. You should feel that you are being treated as an individual, not as a category!

Sex therapy is a new, dynamic approach to very real human problems. It is based on the assumptions that sex is good, that relationships should be meaningful, and that interpersonal intimacy is a desirable goal. Sex therapy is by its nature a very sensitive treatment and by necessity must include respect for the client's values. It must be nonjudgmental and non-sexist, with recognition of the equal rights of men and women to full expression and enjoyment of healthy sexual relationships.