What Is Sex Therapy And When Should You Seek It?
Similar to traditional therapy, sex therapy is a type of treatment that people seek out when they're having sex-related issues, either alone or if they're in a relationship. Contrary to the name, there's never, ever any type of sex being had in these therapy sessions (you'd be surprised by how many people can be confused by this), but instead, sex therapy is actually talk therapy, but the topic is about sex and dealing with all things sex-related.
"As sexual beings, we all carry complex sex histories [that] include lifelong family and societal messages that affect our sexual functioning, body image, and relationships," AASECT-certified sex therapist and director of The Intimacy Institute for Sex & Relationship Therapy Jenni Skyler, Ph.D., LMFT, CST, tells Mind Body Green. "Sex therapy can help a person explore their past sex history and find solutions to enhance the present and future ... We teach specific behavioral exercises to address sexual concerns so that clients learn how to be students of their own and their partner's sexuality."
No matter what the issue may be, the sex therapist, after an initial assessment will help their patients understand why they respond to certain sexual scenarios the way they do and how to manage those scenarios in a healthier and more productive way. There are so many reasons why someone might consider sex therapy, from lack of sexual communication in a relationship to things like sexual trauma. But no matter the reasons that may have someone seeking out therapy, it's important to know that if your sex life is suffering in any way, there is treatment and a sex therapist can provide that in a safe, judgment-free space.
Here are some of the most common reasons why people look into sex therapy.
You and your partner want to spice things up
Although not every couple, over time, will need to spice things up sexually — some relationships are spicey for the long haul — for those who have reached a point in their sexual relationship with their partner where they're bored, are no longer interested in them with the same enthusiasm, or similar feelings have arisen, then therapists can come up with ways to get that spice back.
"Couples may come to sex therapy for any number of reasons," says Christopher Ryan Jones, Psy.D., tells Pure Wow. "They may feel that they have lost romantic feelings toward one another ... The focus of the therapy would be to open up communication to discuss their wants and desires, and also give the couples homework that would help them to rekindle their romance."
It's natural to get bored with someone, sexually or otherwise, after a long period of time, but just because this happens, it doesn't mean you should throw in the towel and walk away from your relationship. It means you should reach out to a sex therapist to help you get back to where you once were.
Processing sexual trauma
Sexual trauma can not only be devastating but life-altering — even more so if it isn't dealt with and processed in a timely manner. Experiencing any sort of sexual trauma and pushing it down inside us as a means to forget and move on, will only work for so long. At some point, it needs to be addressed. Whether you choose to address it immediately or let so much time pass that it officially reaches the level of debilitating, sex therapists are there to guide patients through this trauma in a productive way.
"Oftentimes therapists will talk about the trauma, but there's no resolution on how we move forward as our sexual selves," psychologist and certified sex therapist Holly Richmond, Ph.D., tells SELF. "[Sex therapists] process the trauma and move forward to help you have sex with your partner. We can help you move from survivor to thriver." As Richmond says, although the trauma can't be erased, having a professional lead you in a direction where you can at least take your power back from the situation through a series of treatments can have an extremely positive impact on your sex life and your life as a whole.
Difficulty in achieving orgasm
When it comes to achieving an orgasm, especially if you're someone with a vulva, it can be real a struggle. Time and time again, research has found that 75% of women can't orgasm without clitoral stimulation, while those with penises orgasm 95% of the time — this is what's called the orgasm gap, or in some cases, the pleasure gap. To add to this disparity, according to findings by MedlinePlus, 10% to 15% of those with vulvas report never having an orgasm at all, like, ever in their life.
Although reasons why those with vulvas struggle to orgasm can vary, sometimes it simply comes down to a partner not understanding the anatomy involved in an orgasm being achieved. For example, just how essential clitoral stimulation is for orgasm. A sex therapist can help a couple, or even someone single who struggles to orgasm, to get to the bottom of the problem. Is it purely physical and about a lack of understanding the power of the clitoris? Or does it run deeper than that, resulting from psychological issues instead?
Overcoming sex-related shame
Sex-related shame is hardly uncommon in our culture. Whether it stems from religion, the taboo surrounding the topic, or the ways society has dictated how people should feel and act when it comes to sex, you can be capable of having sex, but not be capable of fully enjoying it because of that shame. It's important to understand that there's nothing remotely shameful about sex (or masturbation), no matter what the sex acts involve, the desires attached to them, or anything that happens to fall under the umbrella of the term sex.
"Sexual stigma can show up in many places in our lives — like feeling shame about having a period, our body shape or size, being diagnosed with a sexually transmitted infection (STI), or our gender identity or sexual orientation," vice president of education and training at Planned Parenthood Federation of America Dr. Sara C. Flowers tells PsychCentral. "It can also stem from many sources, including our culture or religious beliefs, our upbringing, our past experiences, and even the stories we've heard from others." While overcoming sex-related shame, depending on how deeply it affects your life, might require a bit of work, a sex therapist can really make a difference, ideally putting that shame to bed so sex can become far more enjoyable.
Lack of desire
In the same vein of sex-related shame, there's also a level of shame when someone doesn't have the desire to have sex. It's as if as much as our culture wants us to experience the weight of the sexual taboo that persists, it also wants us to feel like there's something wrong with us when we don't want to have sex.
Sexual desire, for many people, comes and goes in waves throughout their life. Sexual desire is rarely consistent because desire is affected by so much more than our genitals — a common misunderstanding of those who have yet to learn that sex and sexuality are something that is neurological-based. For example, stress, anxiety, depression, and other mental health issues can act as disrupters when it comes to desire, as can certain medications (antidepressants are notorious for wiping out a sexual desire and arousal), and hormonal deficiencies.
What's most important to realize is that if you have zero interest in sex — and some sexualities never have any interest in it — there's nothing wrong with you. However, if the lack of desire is something new and you've never experienced it before, so you're unsure as to how to navigate it, then that's where seeking out help from a sex therapist is a good idea. Not only will they reassure you that it's okay, but they can offer techniques on how to handle it in your relationship or on your own if you happen to not currently have a partner.
Issues with any type of pain
According to ACOG, 75% of women experience pain during intercourse. In some cases, as the ACOG found, the pain is occasional and infrequent, while for others, like those who have endometriosis, the pain can be ongoing. Although this type of sex-related issue is something for medical professionals, notably OB/GYNs, that doesn't mean that those who are experiencing pain during sex — for whatever reason — can't benefit from going to a sex therapist in addition to seeking medical help.
Sex therapy can teach couples how to deal with the pain together through both physical exercises and overcoming the psychological anxiety that often accompanies painful intercourse. By using methods that focus on both partners, the one experiencing the painful sex will feel less alone, and less ashamed (although, remember, painful sex is very common!), and they'll feel more like a team — the couple working on ways against the pain together in a supportive, understanding, and communicative way.
Mismatched libidos and/or kinks
If you're able to find someone whose libido and kinks are perfectly in line with yours, then congratulations! Because that doesn't happen very often. Since sex drives, as well as kinks, reside in the brain, you're not always going to be on the same schedule or the same page as your partner. This can create issues in some relationships.
"The lower sex drive partner may feel guilty, like they're being viewed as a sex object, or feel pressure to go beyond their own desires to please their partner," sexpert Lorrae Bradbury tells Bustle. "The higher sex drive partner may feel unsatisfied, or like their partner is not attracted to them, that they're not satisfying their partner, or that something is wrong with the relationship."
But even if you and your partner can identify this as being a problem, trying to talk about it can prove difficult. However, sex therapists can make couples understand not only how common it is, but develop ways to manage the situation together so both partners feel desired, loved, and appreciated.
Although our society has come a long way in accepting just how beneficial therapy — of all kinds — is to those who seek it, because there is a stigma still attached to sex, it can feel daunting to even think about talking about your sex life with a stranger. But, because sex is such an important component of a happy and healthy relationship, you shouldn't just accept things as they are. You should, if your relationship is worth saving, look into sex therapy.