Sex therapy affirms the fundamental value of sexuality as an inherent, essential, and beneficial dimension of being human. Sex therapists use a non-pathologizing approach, emphasizing sexual freedom of thoughts, feelings, fantasies and healthy modes of sexual activity. Sex therapy allows clients to consider (often for the first time) what their sexual experience has been like over their lifespan, what their sexual experience is currently like and what priorities they have for sexual expression in the future.
PART 2: Sex Therapy Examples
Sex Therapy Examples
There are many reasons why an individual or a couple would seek out sex therapy. This section elaborates on some of the more common examples for why clients come to see a sex therapist and what the trajectory of their therapy might look like.
Infrequent Sex & Trouble Maintaining Erections
Angela and Tony have been married for 36 years. They have a loving partnership, but their sex life has dwindled to an infrequent pattern of sex once every 2 months. Their interactions tend to be brief and awkward. Tony has also begun to have difficulty maintaining an erection. If penetrative sex is unsuccessful, they usually stop their interaction. Both Tony and Angela would like to have more frequent and more satisfying sex.
Their sex therapist refers Tony to a urologist specializing in sexual medicine to assess for any underlying medical issues for his erectile dysfunction. She then assesses the habits the couple has in initiating sex and asks them to dismantle their preconceived notions of what sex should look like. She has them create more space in their lives for sensual touch and quality time. She asks them to follow the Sensate Focus model to build a new kind of intimacy. After 8 months Angela and Tony report a higher frequency of sexual interactions and a higher satisfaction in their sex life. Tony is more able to maintain an erection and the couple also has an expanded sexual repertoire for when his erection dissipates.
Pain During Sex
Paul and Jessica have been in a relationship for 3 years. Their sex is not able to be penetrative or involve direct touch to Jessica’s vulva due to pain she experiences when touched. Jessica has never had a physically pleasurable experience or orgasm involving penetrative sex. Their sex therapist assesses Jessica for a history of sexual trauma. She then refers Jessica to a gynecologist and physical therapist specializing in pelvic pain.
Jessica is diagnosed with vestibulodynia and is given dilators in conjunction with regular physical therapy. Their sex therapist addresses the anxiety cycle in the couple that has evolved as a repercussion of Jessica’s pain symptoms. She assigns mindfulness work for the couple to explore in order to reduce the anxiety and increase pleasure. After 14 months Jessica has made significant progress in being able to receive touch pleasurably from Paul and they are working toward penetrative sex.
Compulsive Masturbation
Sam is 27 years old and has never had a sexual relationship. He watches porn and masturbates 1-3 times a day and sometimes is late to work or misses social activities as a result. The frequency that Sam masturbates has escalated over the last year and he worries that his masturbation behavior has become compulsive and that he doesn’t have control over his life. Sam would like to limit the amount of focus he is giving to masturbation and would also like to explore more meaningful relationships.
His sex therapist works with Sam to understand why his behavior has increased in frequency and feels outside his control. She explores how his childhood and family background may have made it difficult to form satisfying relationships. She helps Sam establish therapeutic goals for modified behavior and cultivate mindfulness practices to achieve those goals. After 11 months Sam has reduced the frequency of his masturbation. He feels less anxious, more confident and more in control of his own life. He is beginning to date someone he has developed feelings for and has experienced partnered sex for the first time.
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PART 3
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