What's Sex Therapy Like?
Photo by Willian Justen de Vasconcellos on Unsplash
The conversations about sex are very different today than they were 50 years ago. Popular culture instills in us that we should all have fantastic sex and be sexually liberated. But culturally, it's still difficult for people to talk about their sexuality, especially if they encounter issues and dysfunctions.
That's also why so many people turn to medicines such as viagra to treat erectile dysfunction, or other drugs like Addyi to treat low desire in premenopausal women. Sex therapists believe that there should be more focus on psychotherapy interventions which use various approaches to treat a sexual concern without the side effects of drugs.
What is sex therapy?
Sex therapy in a few words
Sex therapy is a type of talking therapy to help individuals and couples alike regarding their sex lives. The therapist can address medical, psychological, personal issues that impact sexual satisfaction.
The goal of sex therapy is to reach a fulfilling sex life and relationships, and move past challenges. How to recognize if you have a healthy sexual relationship? Honesty, respect, trust, equality, good communication, reliable support, mental and physical wellbeing, and the feeling of being completely yourself are some positive signs.
What is the difference between a sex coach, sex therapist, sexologist?
A sex therapist requires a professional state license and a Master's Degree in a related field, as s.he works with patients in a clinical setting. Sex therapy is often based on the underlying reasons of the concern: where does the issue come from? Since when? It's mostly done on a talk therapy basis, but some therapists also use somatic (body-based) tools.
A sex coach is more about exploring the present and the future. What does the client want to create? How to reach that goal? While coaches can come from many different backgrounds, there are specific certifications required to be one. Some are even trained for teaching intimate touch in their sessions.
A sexologist is a specialist in human sexuality. Many sexologists choose to pursue a career as sex therapists. Many others choose to work as researchers, sex educators, public policy activists, and more.
A couple therapist works with issues such as betrayal, infidelity, premarital counseling, and receives comprehensive training in family counseling and individual psychotherapy. A sex therapist would cover all the above, but also the sexual aspect.
An intimacy coach helps people feel safer and connected to their partner, physically and emotionally, increasing emotional awareness and healing attachment wounds.
To make the most informed decision possible, you can read more on the difference between sexuality educators, counselors, and therapists and sexology credentials.
A brief history of sexology
Discussions and treatments of sexual dysfunctions are not only modern concerns. They have existed in various forms - manuals, spells, remedies, spiritual practices - across civilizations.
We all have heard about the ancient book of Kama Sutra that dates back from Ancient India
Natural remedies called aphrodisiacs were used by Ancient Romans, Greeks, Arabs, or in traditional Chinese medicine 4,000 years ago to enhance sexual vitality and fix sexual issues
Tantric yoga, a Hindu and Buddhist philosophy that recognizes divine feminine power in all aspects of the material world
Literature in ancient China is a great source of information concerning ways to control erections. The techniques used back then are still the ones advised by sexologists today!
And more.
In the West, sexology was limited to scientific conversations until very recently. It wasn't until the 19th century that scientists referred to themselves as sexologists. Before that, most essays on the topic were rather… questionable. In 1760, Samuel Auguste Tissot published a book stating that masturbation was the cause of illnesses, including tuberculosis.
In the 1940s, sexology based on scientific methods was finally born, leading to the deconstruction of prejudices inherited from ancient and patriarchal times.
Alfred Kinsey established himself as a pioneer of sexology while studying the sexual habits of thousands of Americans. In 1947, he revealed that practices judged "abnormal" were, in fact, very common, including oral sex, homosexuality, masturbation, and adultery. For example, 1 in 10 men surveyed already had gay sex. The publication of these numbers revolutionized people's perspectives of sexuality!
Kinsey also introduced the sexuality spectrum when discussing sexual orientation, rejecting the idea that we are either heterosexual either gay, but that anyone can be floating in between.
Masters and Johnson, whose work is featured in the recent series Masters of Sex, stated that sex isn't only for men's pleasure (no, really?) but also for women. Through their studies, they discovered the four phases of sexual intercourse, and that women could orgasm too!
In 1972, Pierre Simon published a report about the sexual behavior of French people. Even after May 1968, numbers show that the population was not that liberated. In fact:
75% of people surveyed said they spoke very rarely about their sexual problems
8% of women only were taking the pill
80% of people were having sex in the dark
To learn about pleasure, it was necessary to desacralize sex, and to speak about it objectively. Thus sex education needed to happen through a more profound knowledge of the human body.
Why is sex therapy still relevant today?
Sexual dysfunctions: some numbers
Sexual dysfunctions have existed for millennia, and they haven't disappeared along the way. As a reminder, sexual dysfunctions refer to the inability to achieve "normal" sexual intercourse. But how widespread are they?
In 2000, sexual dysfunctions affected 43% of women and 31% of men
A 2020 research revealed that 50% of women surveyed feel sexual distress in their lives, and one in five women experience one more sexual dysfunctions
A 2021 survey says that 35% of French women are not satisfied with their sex life
Why consult a sex therapist?
There are various reasons that can drive a person to consult, which can be psychological, physical, emotional, related to past experiences or present ones. Our sexuality is not fixed but changes over time, whether linked to age, a change of partner, loss of confidence, or a traumatic event. That's why we may need support at some point in our lives.
Some sexual dysfunctions might include:
Erectile dysfunction
Low libido
Lack of interest and/or response to sexual stimulus
Premature ejaculation
Low confidence
Inability to reach orgasm
Excessive libido, hypersexuality, inability to control sexual behavior
Unwanted sexual fetishes
Past unwanted sexual experiences
Trauma due to sexual abuse
Intimacy issues related to a disability
Concerns about sexual orientation
Gender dysphoria, transgender
Painful sex, vaginismus
Troubles with aging
And the list isn't even exhaustive.
If sexual concerns make you unsatisfied with your sex life, and that it deeply affects you and/or your relationship, it's perhaps time to think about it.
Why is a fulfilling sex life important?
Sure, we can live without sex if that's a choice. But sexuality is still an important aspect of human life. Interestingly, in the ancient religious texts of Hinduism, desire - as in, art, sensuality, beauty, love, intimacy - is one of the four inherent values of the Universe. Pleasure is believed to be necessary for human fulfillment, a balanced lifestyle, a deep and meaningful life.
A 2015 study shows that frequent sex increases general wellbeing. To be more precise, it was proved that relationship satisfaction improved from no sex to having sex once a week.
Needless to say, there are emotional and physical benefits of sex.
Increasing happiness by the release of endorphins, which decrease feelings of depression, and oxytocin, a happy hormone
Lowering levels of stress
Boosting self-esteem
Building and maintaining intimacy in a relationship
Lowering divorce rates
Pain reduction due to the release of endorphins that reduce back pain and migraine
Immune function
Enhanced brain function: sex is associated with better cognitive functions
Better heart health: sex is associated with lower systolic blood pressure
Better physical fitness: according to the American Heart Association, sexual activity corresponds to moderate physical activities
On the contrary, unsatisfied sex life can lead to anxiety, loss of confidence, relationship complications, and more.
What does a sex therapist do?
What happens during sex therapy?
Sex therapy happens like any other therapy, alone or with your partner. The therapist usually needs to understand the reasons for the consultation. Then, the patients talk about their life, experiences, feelings, concerns, and challenges. Even though it might feel awkward at first, communication is one of the best ways to overcome issues.
What is covered in sex therapy? A sex therapist is here to guide you in the process of your current challenges, understand your coping mechanisms, reframe sexual challenges, increase sexual satisfaction. And for that, more than one session is generally necessary.
During each consultation, the therapist pushes you towards better acceptance of the concerns leading to sexual dysfunction. By offering you a safe, supportive and educational space, there may be a progressive shift in your way of coping and interacting - sexually or not.
Sometimes, patients leave the office with assignments, communication exercises with a partner, mindfulness techniques, some reading or watching content about sexual health.
They might include the following:
Experimentation: trying different sexual activities, role-playing, sex toys, positions, etc.
Sensate focus: it's a technique for couples to build trust and intimacy. There are three stages: nonsexual touch, genital touch, penetration. Couples touch each other as they tune in physical sensations.
Education: anatomy, body functions, the science behind sexual activity.
If the therapist notices that the cause of your issue may be physical, you might be referred to a doctor.
Does sex therapy involve sex?
That's one of the common myths related to sex therapy! Do sex therapists perform sex, or watch you having sex? Well, no. A sex therapist never has any sexual contact with a client. Sexual coaching with sexual contact is not part of mainstream sex therapy. Actually, it's against the ethics of mental health professionals...
But. If you are looking for a professional who uses touch, breathwork, mindfulness, and relation exercises to meet specific goals… You can research sex surrogates. Surrogate partner therapy is for those who want to become more comfortable with intimacy, sensuality, sex, and body.
This type of therapy happens between a licensed therapist, a client and a partner surrogate. However, the therapist never ever has to do with what's happening between the client and the partner surrogate. For the record, intercourse only occurs 15 to 20% of the time in that context.
How do I find a sex therapist?
When searching for a sex therapist, make sure that they have a sex therapy certification. They are either licensed psychiatrists, psychologists, marriage and family therapists, or clinical social workers. You can start with the list provided by the World Association for Sexual Health.
If you don't get along with one, try another. Each therapist comes with their style and personality, but compatibility is essential to feel comfortable.
Can single people go to sex therapy?
Hell yes! You don't have to bring a partner. Actually, solo therapy can be even more adequate depending on the issue you wish to consult for. It really depends on you.
Is it covered by health insurance?
Not all health insurances cover psychotherapy. It's better to check with your health provider first if that's a requirement for you.
To finish, we should note that sex therapy isn't still very inclusive. Historically, it's more focused on cisgender people and heterosexual relationships. Sex therapy is also a financial weight that isn't available to low-income people because health insurance doesn't often cover therapy. Let's be grateful for all the incredible progress sexology has made since the past decades, but let's hope for more to come... Everyone comes with their own specific issues and deserves to be supported ♥
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