Embarking on a journey into sexual therapy is a step towards improving one of the most intimate and rewarding (but often confusing and challenging!) aspects of human experience. As a psychotherapist specializing in relationships and sex, I have had the privilege of guiding many individuals, couples, and groups through this transformation process. Here are some insights you might want to know before starting therapy with a sexual/intimacy counselor.
Recognizing the Need
Acknowledging that you may need the help of a trained sexual therapist is significant and deserves serious recognition. Courage is likely the right word to acknowledge that there are aspects of your sex life that you cannot solve on your own or even with a loving and cooperative partner. Many of us initially turn to books, podcasts, or best friends to fix what we likely perceive as broken in our intimate lives. And while there are wonderful resources available, sometimes it is necessary to have a competent provider who can tailor their treatment specifically to your needs.
Sexual Therapy is More Than Just Sex
While the main focus of „sexual therapy“ is on sexual issues, the treatment often encompasses much more than just focusing on what happens in the bedroom. It is not uncommon for sexual therapy sessions to delve into broader relationship dynamics, communication patterns, challenges in self-perception, family of origin issues, and the numerous psychological factors that influence your sexual health. Sexuality is intertwined with many aspects of our being as well as with a myriad of moving parts within our relationship(s) that we may have never thought were related to the sexual struggles that brought us into treatment.
Recently, I was reminded of this during a meeting with a physical therapist for leg pain. While I was prepared to talk about that area of my body, she instead said something like, „Your leg hurts? Great, so take off your shoes, stand over here on the floor, and make some movements. You know, maybe it’s not really your leg, but your hip, your neck, or your posture. Can I see how you sit when you’re sitting on a chair all day?“ When you consider the whole person and the entire relationship, you see what else is going on and needs to be addressed. So, as therapists, especially those trained in sex/intimacy, we don’t just focus on the presenting problem. Instead, we step back and examine how the entire system may be contributing to the sexual concerns.
Openness, Honesty, and Vulnerability Required
Most of us know that for effective therapy, openness and honesty on the part of the client are crucial, although this can be a particularly large challenge when the focus of treatment is on sex. While your provider does everything in their training to reassure you, the process still requires you to disclose confidential details about your sexual experiences, feelings, and concerns. When I work with someone for the first time and ask them how they feel about starting this process with me in our intake session, I most often hear „fear“! And how easy it is to empathize with that experience. Even though it may be daunting at first to open up to a stranger about this part of life, an experienced therapist knows how to create a space that is quickly recognized as safe.
Time for Change
It is important to keep expectations about the therapy schedule in mind, perhaps especially when working on our intimate lives. Changes, especially when they involve deeper underlying issues or patterns, simply take time. Progress in sexual therapy often occurs incrementally and requires patience and perseverance. However, a good therapist will help you celebrate victories along the way. I love starting sessions by asking my clients, „Before we talk about what a challenge has been since I last saw you, what can you brag about? What have you and your partner been proud of lately? Where has there been movement, even if just a little?“ This helps us recognize and trust that the process is working. Allowing changes to take time also gives us grace when setbacks inevitably occur in therapy.
Individual Agency Within Collaboration
Research shows that the biggest factor for a client’s success in psychotherapy is not the qualifications, theoretical approaches, or even the experience of the therapist. Instead, it is the client who (by far) has the greatest influence on the extent of the changes seen during the course of treatment. This means being proactive in sessions, completing all homework, and openly communicating about what works for you and what doesn’t. So, a consideration in starting sexual therapy is simply asking yourself, „How ready am I to truly engage in this process? If I’m not quite there yet, what do I need to change within myself to be ready to take this step fully?“ Hopefully, this post can help you approach this place of readiness.