Starting sex therapy is a step towards improving one of the most intimate and rewarding (yet often confusing and tricky!) parts of human experience. As a psychotherapist specializing in relationships and sex, I’ve had the honor of guiding many individuals, couples, and polycules through this life-changing process. Here are some insights that you may want to be aware of before beginning therapy with a sex/intimacy counselor.
Recognizing the Need
Realizing that you might need help from a trained sex therapist is important and deserves serious recognition. Courage is probably the word to use when acknowledging what it takes to admit that there are aspects of your sexual life that you can't deal with alone, or even with a loving and cooperative partner. Many of us first turn to books, podcasts, or close friends in an attempt to fix what we probably see as issues within our intimate lives. And while there are great resources out there, having a skilled provider who can customize their treatment to exactly what you need is sometimes what’s necessary.
Sex Therapy Is About More Than Just Sex
While the main focus of “sex therapy” is on sexual issues, treatment often involves much more than just focusing solely on what happens in the bedroom. It’s not uncommon for sex therapy sessions to explore wider relationship dynamics, communication patterns, self-perception challenges, family background, and the various psychological factors affecting your sexual health. Sexuality is connected to many aspects of our being, as well as a number of elements within our relationship(s) that we may not have realized were related to the sexual struggles that brought us into treatment.
I was reminded of this recently in a meeting with a physical therapist for leg pain. While I was ready to jump into discussion of that area of my body, she instead began by saying something like, “Your leg hurts? Great, so let’s have you take off your shoes, stand on the floor over here, and do some movements. You know, it may not actually be your leg…it may be your hip, or your neck, or how you carry your posture. Can I see how you sit when you’re in a chair all day?”
When you look at the whole person and the entire relationship, you see what else is going on that needs to be addressed. So as therapists, especially those trained in sex/intimacy, we don’t just focus on the presenting problem. Instead we back way out and explore how the whole system may be contributing to the sexual concern.
Openness, Honesty, and Vulnerability Required
Most of us know that for therapy to be effective, openness and honesty on the part of the client are crucial, though this can be a particularly large request when the focus on treatment is sex. While your provider will do everything within their training to set you at ease, the process will still require you sharing intimate details about your sexual experiences, feelings, and concerns. When I first begin working with someone and ask in our intake session how they’re feeling about starting this process with me, the word I hear most often is “terrified”! And how easy it is to empathize with this experience. But while starting to open up to a stranger about this part of one’s life can initially feel daunting, a skilled therapist knows how to create a space that is soon recognized as safe.
Time for Change
It’s important to manage expectations about how long therapy will take, especially when dealing with personal issues. Making progress in sex therapy usually happens slowly and requires patience and persistence. A good therapist will help you celebrate small victories along the way. I like to start sessions by asking my clients what they're proud of as a couple recently, which helps us see that the process is working and build trust. Allowing change to take time also helps us be kind to ourselves when setbacks happen during therapy.
Individual Effort Within Collaboration
Studies show that the client’s effort is the main factor in the success of psychotherapy, more than the therapist's qualifications, methods, or experience. Being active in sessions, completing any assigned tasks, and openly discussing what is or isn’t working for you are crucial. Before starting sex therapy, it's important to ask yourself, “Am I ready to fully engage in this process? If not, what do I need to change in myself to be ready?” I hope this post can help you get ready for that.
