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Sex Therapy: How It Works, Examples, What It Costs & What to Expect

Updated: Jul 26, 2023

Sex therapy is an effective way to achieve satisfaction in your sex life. Seeking consultation with a credentialed and knowledgeable provider can help both couples and individuals address common sexual concerns. Typical rates for a certified sex therapist are on the upper end of private pay therapy rates in your area, and treatment can last anywhere from a few sessions to a few years, depending on the issues being addressed.




PART 1: What Is Sex Therapy and How It Works?


What Is Sex Therapy?

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.


Therapeutic goals are established by the client in areas of their sex life that cause them difficulty or dissatisfaction, whether that be through internal thought patterns or outward expression. These goals are often addressed in tandem with other therapeutic topics typical to counseling, such as a sexless marriage or relationship, conflict in the relationship, stress, sexual trauma, anxiety, or depression.



You Keep Your Clothes On When You Work With a Sex Therapist

Sex therapy will never include sexual contact with your therapist. Sex therapy is NOT sex surrogacy or a euphemism for sex work of any kind.


Is your relationship a source of frustration or disappointment?  Lady Fee specializes in helping individuals and couples repair their relationships. Complete a brief questionnaire to be matched with a therapist.



What Can Sex Therapy Help With?

Sex therapy addresses a wide array of sexual concerns that impact both individuals and relationships. Topics include issues with arousal, frequency, sexual pain, difficulty achieving orgasm, out of control sexual behavior, physiological shifts after childbirth or menopause and changes in the sexual dynamic of a couple over time.


When sexual issues cause distress, a sex therapist can help discern what physiological factors to rule out (or refer to other providers for treatment) and what psychological factors can be examined and addressed. Sex therapists typically work closely with general practitioners, psychiatrists, physical therapists, gynecologists and urologists so that a coordination of care can provide the best treatment.



Stress, Anxiety, & Big Life Changes

Common stressors and phase-of-life shifts tend to precipitate the issues presented in a sex therapist’s office. Knowing what these factors are can be helpful in deciding whether sex therapy is the right choice for you or for your relationship.


Stress-inducing factors to look out for include:


• Anxiety


• Depression


• First sexual experience


• History of sexual trauma or other forms of trauma


• History of sex negativity or shame around sex


• Gender fluidity or transition


• Lack of education/information about healthy sexual practices


• STIs


• Disability/illness/medical issues


• Marriage/cohabitation


• Childbirth/child rearing


• Stressful job requirements


• Divorce


• Change in sexual partner(s)


• Aging/perimenopause/menopause


Sex therapy can help mitigate how much impact these factors have on a satisfying sex life. A sex therapist will help identify what the issue is, what physiological components to address, what structural changes can be made and what psychological processes are contributing to the problem.



Sexual Distress

Topics that clients report experiencing distress about include:


• Not having enough sex, as a couple or individually


• Wanting sex more or less frequently than their partner(s)


• Lack of interest in sex


• Pain or discomfort when having sex


• Inability to get aroused or stay aroused


• Inability to have an orgasm


• Having an orgasm too quickly


• Misalignment between gender identity and biological sex/genitalia


• Having intrusive or disturbing thoughts about sex


• Masturbating or having sex compulsively


• Desire to expand the range of sexual experience, as a couple or individually


• Physical Sexual Problems


In addition to these common problems, clients may have received a medical diagnosis from a doctor or believe a medical diagnosis may be relevant to their situation.


Diagnosable psychological and physiological issues that are relevant to treatment by a sex therapist include:1


• Premature Ejaculation/Early Ejaculation


• Delayed Ejaculation


• Erectile Disorder/Erectile Dysfunction


• Vestibulodynia/Genito-Pelvic Pain Disorder


• Anorgasmia/Female Orgasmic Disorder


• Male Hypoactive Sexual Desire Disorder


• Female Sexual Arousal Disorder


• Gender Dysphoria


• Substance/Medication Induced Sexual Dysfunction


• Unspecified Sexual Dysfunction



Do My Partner and I Need to See a Sex Therapist?

If you’re on the fence about sex therapy, consider how your sex life is now versus how you want it to be. If there are specific issues holding you back, a sex therapist can likely help you address them and make appropriate changes to move forward.


There are a number of issues that a sex therapist can help with, including:

• Dealing with and addressing pain with intercourse, including physical pain vs. psychosomatic pain


• Dealing with trauma from your past including sexual contact or penetration


• Uncovering your true libidos as individuals in a relationship


• Discovering or wanting to explore your gender identity and sexual orientation


• Learning how to navigate open relationships


• Addressing sexual shame issues related to sex and sexuality




What Does a Sex Therapist Do During Sessions?

Sex therapists come from a wide range of backgrounds and employ techniques unique to their own therapeutic style. However, there are a few standard components to sex therapy that are widely regarded for their efficacy and which you are likely to experience in treatment with most sex therapists.



Mindfulness


A sex therapist may help you utilize mindfulness practices, a category of tools which has been studied and proven to be effective when used to address sexual dysfunction. Mindfulness as applied to sex therapy, in the words of Lori Brotto PhD, is “the practice of noticing what is happening inside us and of being kind to ourselves, even when we struggle to do so.” Mindfulness improves nonjudgmental attention, one of the precursors to satisfying sex.


Sensate Focus

One type of mindfulness technique, if you are in sex therapy with a partner or partners, is Sensate Focus. Sensate focus exercises are used to reduce anxiety around sexual interactions by slowing down the process of intimacy.4 Partners are directed to incrementally explore basic touch sensations over a series of weeks, dismantling the habitual ways in which they have engaged in physical touch and sexual interaction in the past. The goal is to cultivate awareness around touch and arousal in order to foster a positive feedback loop that increases desire and connection.


Sex Therapy Exercises & Homework

Homework often starts with communication and being able to be vulnerable with one another. Your sex therapist will work with you and your partner to come up with questions that can open up the lines of communication. The goal of these questions and exercises are to continue to build a foundation of safety and security when it comes to sexuality in the relationship.


Physical Issues Won’t Be Ignored in Sex Therapy

It is important to consider physical and medical issues that may be a barrier to a fulfilling sex life. There are various types of conditions such as endometriosis, fibroids, medications, and sexually transmitted infections (STIs) that can cause pain and difficulty with intercourse. Getting treatment for these or ruling out medical issues is a big step in getting a treatment plan for you and your partner.


Evaluate Intimate Dance

Another approach commonly utilized in partnered sex therapy is assessment of the Intimate Dance that partners engage in around sex. This includes how partners initiate sex, who tends to have a higher desire for sex, and what structural factors in the clients’ lives have contributed to an intimate dance that is no longer satisfying to one or more partners.


Dual Control Model

A sex therapist will often employ the Dual Control Model for sexuality in assessing a relationship’s intimate dance.5 The dual control model posits that the context in which our sexuality exists matters. Not only do we need to take a look at what turns us on and the mechanisms of our sexual excitation system, but also what turns us off, or our sexual inhibition system. Utilizing the lens of the dual control model, a sex therapist will help a couple make crucial changes in their intimate dance in order to reach a connected and contented equilibrium in sexual interactions.


Lady Fee is one of the finest certified Sex Therapist in Malaysia. If you have more question, do not hesitate to reach The Lady Fee via email at glamaddict@gmail.com.


PART 2

PART 3

PART 4

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