Real Sex Therapy

Sex Therapy can be confusing!

Sex therapy is quite a broad term and it’s a field that treats a lot of different problems and issues. As a sex therapist, I’ve found this particular field is very confusing to clients. As someone who did his dissertation on men’s sexual dysfunctions, there are several reasons why it’s confusing. Trust me, it’s not just you. Over the years, I have worked to educate clients and other professionals about how sex therapy helps. But I also have worked to gain an understanding about what can cause confusion for clients who come into sex therapy. 

Number #1 reason for confusion. Sex therapy is facilitated by many different professionals and professions.

I believe that one of the primary reasons that sex therapy confuses people is that if you do a Google search for sex therapists in your area, you’re going to see that many different professionals offer sex therapy. Some are psychotherapists, some are psychiatrists, some are medical doctors, and others are nurses. There are sex surrogates as well. There are even physical therapists who sometimes offer sex therapy! 

The most common therapeutic sex therapy recommendation is sensate focus. It can be beneficial, but it has its limitations.

A bit of a history lesson about sex therapy. The origins of treating sexual problems are usually linked to the medical field. The early idea of treating sexual problems was to treat a problem with a solution. Sounds pretty basic right. And for the most part, the early treatment of erectile disorder, premature ejaculation, and problems with orgasm. Here is the bad news… The success wasn’t ever able to be replicated again. However, these old interventions still have their place. The research at that time (because it was before medications like viagra) included many directed activities such as sensate focus. Sensate focus can have many benefits. It can help you get in touch with what is most enjoyable, connective, and pleasurable as it relates to touch.

However, some people are not very in touch with what is going on in their bodies. This can make exercises like sensate focus can be very difficult for people who don’t know a lot about their internal body experience. One way to tell if you’re one of these people is by answering a basic couple of questions. The first question is, “what emotion are you feeling right now?” The second is “what is happening in your body that is telling you that this is the emotion you’re feeling?” If you answer, “I don’t know” (don’t worry there are a lot of people who struggle with this), exercises like sensate focus are going to be very limited in how much they’ll benefit you. 

Sometimes, in order to have sex therapy strategies, you have to engage in other work to build a foundation that might just not be there. A lot of research shows that this foundation may be mindfulness-based therapy where you learn more about what is happening in your body in different experiences. 

The relevance of medicine.

There are effective medical treatments for erectile dysfunction. The only medications that have shown consistent effectiveness in sexual dysfunction treatment are for erectile dysfunction. These include drugs like Viagra, Levitra, and Cialis. You’ll read a lot about other medications such as hormone treatments and off label medications and these are inconsistent and mixed in their treatment results. That means that there are no effective medical treatments specifically for early ejaculation, low sexual desire, pain with sex, struggles with orgasm, etc. Sadly, some of these medications can be specific for treatment of problems, but the success rates are mixed.  A great example of this is the controversy surrounding Addyi, a drug reportedly meant to treat low sexual desire in women. 

This isn’t to say that medications are always ineffective. However, medications may be used to treat other underlying issues. Those medications for erectile disorder are quite effective, but sometimes even they fail. There are injections and gels such as Trimix that are almost completely effective for erectile disorder. Some want to utilize more natural treatments. If you’re wanting more natural treatments or you’re dealing with an issue other than erectile issues, you’ll likely need to put more work into the problem than just getting a prescription. 

It’s still a good idea to talk with your primary care physician about what you’re dealing with. They might be able to prescribe you something that can help. For example, many of the men who are dealing with premature ejaculation and erectile disorder are also dealing with some struggle with anxiety. A physician can help with this. Medical doctors can also help with ruling out other underlying medical conditions, which can lead to sexual dysfunctions. 

Medical doctors may also be able to refer you to physical therapists who specialize in pelvic floor therapy. This is a type of treatment that is done by physical therapists that can help with issues with pain during sex, primarily for women. 

Finally, psychiatry can also be helpful for people who are experiencing problems with sex due to mental health issues such as depression, anxiety, and trauma. 

The more holistic the better.

Sex therapy often has to focus on being more holistic because sexual dysfunctions are almost secondary issues to other things that are going on in your life. Relationship issues, underlying emotional and mental issues, other physical problems, and your own personal history can all lead to sexual dysfunctions. Therefore, your treatment should include a focus on the physical, but also a focus on your relationships, history, emotions, and thought processes. This means, you may require a team that can help you with medical issues and also mental health issues. 

Some people just don’t realize that they’re coming in for mental health therapy when they see a sex therapist. There is stigma around sex, and then there is stigma around seeing therapists for help with mental health issues as well. So, it makes sense that taking this step can be so intimidating. What people often want are some quick solutions. Unfortunately, sex therapy doesn’t work like a prescription for a medication might. Obviously, there are medications for some sexual dysfunctions, but sex therapy involves improving the other areas of your life that are preventing you from having the type of sexual relationships that you want to have. 

The overall goal should be to gain insight into the problem. What’s underneath it? Then you can work on the elements that are underneath the issue to see what helps improve your symptoms. 

A similar comparison is improving other health markers on your lab. You sometimes have to take several steps and do a lot of trial and error to get them to improve. You might even have to work on improving how you handle stress. 

Sex is a complex thing and when there are problems with sex, the solutions can be complex too. If you’re needing help with dealing with sexual issues, please don’t hesitate to contact us