Sex Therapy FAQs

Q. What is sex therapy and how do I know if I need it?

Sex therapy is a set of behavioral and psychotherapeutic techniques used with men, women and couples to enhance sexual functioning. You might see a sex therapist if you don’t get erections when you want to; get excited but can’t climax; have pain with intercourse; or notice your sexual enjoyment declining and don’t know why.

Couples go to a sex therapist when they argue about frequency (she wants sex twice a week, he wants it twice a year); preferences (he wants oral sex, she doesn’t); or what’s acceptable (he wants to watch porn and she doesn’t, or she wants monogamy and he doesn’t). Your psychologist or physician might refer you to sex therapy if they can’t provide a solution to (or they aren’t comfortable with) your difficulty.

How can I be sure the sex therapist is credible?

Above all, a good sex therapist is a good psychotherapist, someone who can ask questions you haven’t thought of, and see patterns you haven’t seen. Select a professional with a good reputation, or get a recommendation from a physician or friend.

You want someone who’s comfortable with sex, and with whom you feel you can tell the truth without being judged. If the therapist seems more interested in him- or herself than in you, flirts with you or suggests that you’re abnormal or kinky, run for the door.

What can I expect in sex therapy?

The therapist will evaluate a range of questions. Are sexual difficulties caused or exacerbated by anger, fear or sadness? Is alcohol involved? Is there performance anxiety? Unrealistic expectations? Misinformation about how bodies work?

He or she will help you see sexuality in the larger context of your life, both present and past. The therapist will also comment on how you talk about your sexual experiences, and if you have a partner, how you talk with each other.

Once the therapist understands your problem and has a treatment plan, you will get homework, often weekly. This may include reading, writing or a guided touching exercise. Masturbation is often assigned. Sometimes, a therapist will ask you to refrain from intercourse (not sex, intercourse) to reduce performance pressure or encourage other forms of erotic connection.

In all, sex therapy is usually a pretty eye-opening experience. You may learn things about yourself or your partner with which you’re uncomfortable. But you won’t walk away unchanged, and you’ll probably have new respect for the complex ways you express — or repress — your sexual energy.

You may very well enjoy sex more than you ever have. You’ll almost certainly understand it better.

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