For most people, it takes a lot of courage to call a therapist. For people to call a sex therapist, it usually takes even longer. Most people get an idea of what happens in psychotherapy from watching TV shows or movies where a character enters therapy. But there isn’t much about what actually goes on in a sex therapist’s office. Given all the shame and guilt about sex, it’s not surprising that people have a hard time imagining what’s going on without feeling upset or even disturbed.
A sex therapy session is much like any other psychotherapy session. The client (or patient) discusses her history and experience with a problem, and the therapist helps by putting things into perspective or providing concrete suggestions for change. No touching (except for an occasional hug, if the customer asks) and definitely no nudity or sex.
The course of sex therapy also resembles other psychotherapy. Most sex therapists ask clients to complete an initial intake form. The forms differ, but the sex therapist usually wants to know specific information about you, including why you are seeking help and what you may have done to resolve the problem in the past. The therapist also wants to know about you in a more general way. For example, the therapist needs to learn about your relationships, your job, and something about the family you grew up in.
In sex therapy, the therapist often wants to know what you were taught about sex and by whom. If your family never talked about sex and your parents slept in different rooms, they still taught you something about sex, albeit indirectly. Or your parents might have been open about sex, but you married a partner who knew very little about it. It could also be that you learned about sex in a negative way; maybe your first sexual experience was scary or sad, which is a terrible way to start learning about sex.
The therapist will also want to know about your current sexual experience in your relationship. Are you enjoying sex? Do you hate it or do you think it’s “disgusting”? Do you function as you are supposed to, that is, do your sexual organs function? Do you find sex painful? Do you watch a lot of porn or have sex with strangers? Do you have an unusual interest in sex, for example, fetishistic behavior? Do you and your partner have different ideas about sex? Do you even fight about it?
If you are in a relationship, the sex therapist will observe what is happening in your relationship outside of the bedroom. If there is a lot of conflict or stress, the therapist will want to help you learn better ways to deal with it so that your relationship is more pleasant, making it easier to work on the sexual problem. Sometimes there is no conflict at all, which is actually not a good sign; it usually means that one or both of you are upset, but are unwilling to “rock the boat” for fear of the relationship breaking down. In this case, the sex therapist should encourage the couple to talk about their issues so that they have a more real connection and understanding with each other.
Sex therapy usually includes recommendations for activities, from going on a date together, to discussing what turns you on with your partner, to taking turns touching each other sensually. Sex therapists often recommend reading up on topics so you have the most up-to-date knowledge and can dispel any myths that are hurting you.
One more thing that is important to know is that sex therapists must be licensed in the state in which they practice. A sex therapist can be a psychiatrist with a medical degree; a psychologist with a doctorate; a licensed clinical social worker with a master’s degree; or a licensed marriage and family therapist or professional counselor, also with a master’s degree. Only one state, Florida, requires a psychotherapist to have additional training to use the title “sex therapist.” However, all psychotherapists are ethically required to have education, training, and consultation if they are to treat a new or specialized population.
There are several organizations that can help you find a sex therapist. The largest is the American Association of Sexuality Educators, Counselors, and Therapists, or AASECT. You can also ask for referrals to a sex therapist in your area from your doctor or the psychology department at your local university.
