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Saturday, April 13, 2013

The Importance of Talking About Sexual Problems in Your Psychotherapy Sessions

Many psychotherapy clients feel uncomfortable talking about sexual problems in their therapy, whether they're in individual therapy or they're participating in couples counseling.  Even though their problems might be having a significant impact in their lives, clients often avoid talking about sexual problems with their therapist.  To make matters worse, therapists often avoid asking about it.
A Couple Having Sexual Problems: The Importance of Talking About Sexual Problems in Your Therapy Sessions

Why Is It So Hard to Talk About Sexual Problems With Your Therapist?
There can be many reasons why you might feel uncomfortable talking to your therapist about sex, including:
  • You don't know how to bring up the topic of sex in your therapy session.
  • You don't know how to describe the sexual problem that you're having.
  • You fear being judged by your therapist.
  • You feel ashamed of your sexual problem.
  • You feel guilty about your sexual problem.
  • You feel uncomfortable talking to your therapist about sexual problems because of your therapist's age or gender.
  • You're afraid to talk about your sexual problem because it would be violating a family secret to talk about it.
  • You feel you'll be defying cultural or religious conventions by bringing up problems about sex in your therapy.
  • You think you'll make your therapist feel uncomfortable if you talk about your sexual problem.
  • You're in denial about how significant the sexual problem is in your life.
  • You've resigned yourself to living with the sexual problem because you don't think there's anything that can be done about it.
  • You tried discussing the problem before, either with family members or in a prior therapy, and you had a bad experience.

There can be many other reasons why you, as an individual client in therapy or as part of a couple in couples counseling, might feel uncomfortable talking to your therapist about sexual issues.

A Couple Having Sexual Problems: It's Important to Be Able to Talk About Sexual Problems in Therapy

Why Is It Important to Address Sexual Problems in Your Therapy Sessions?
Sex is a natural part of life, and yet most people feel uncomfortable talking to their therapist about sex.  The degree of discomfort is different for everyone.

Just like any other problem, unless you address it in therapy, you're not giving yourself an opportunity to overcome this problem with your therapist's help.


It might be hard to imagine at this point in your life, but working through a sexual problem in therapy can help you feel so much better about yourself.

Often, once you begin talking to your therapist about a problem, whether it's about sex or anything else, what might have seemed impossible for you to talk about suddenly seems not as bad as you expected.

Over the years, I've had many clients, who, once they began to address an uncomfortable issue, came away feeling, "That wasn't as bad as I thought it would be.  In fact, I feel relieved that I'm starting to talk about it."  They feel less burdened by the problem now that it's not a secret in therapy any more.

Some Helpful Tips to Help You Talk to Your Therapist About a Sexual Problem
  • Recognize that, if you're seeing an experienced therapist, she has probably heard just about anything that you can imagine.  
  • Take comfort in knowing that sexual problems aren't unusual among individuals and couples, so you're not alone.
  • Be aware that you can take your time and you don't have to reveal every aspect of the sexual problem all at once.  You might start out by just telling your therapist that you have a sexual problem that you're not feeling comfortable talking about.  You and your therapist can begin by addressing what might help you to feel more comfortable so that you can open up about this issue.
  • Recognize that if you start to feel overwhelmed with anxiety as you begin discussing the sexual problem, you can pause so your therapist can help you to calm yourself.  After you've calmed down and you feel emotionally safe again, you can resume talking about it.

Sexual Problems and Trauma
When sexual problems involve trauma, it's important to work with a therapist who has expertise with both problems.

A skilled therapist will know how to work with the sexual trauma in a way that feels safe and comfortable for the client.  This doesn't mean that the work won't be uncomfortable at times, but a trauma therapist, who is a licensed mental health  clinician, usually has the skills and experience to work in a way where the therapy is not retraumatizing for the client.

How I Work With Emotional Trauma
Whether the client's trauma involves sexual abuse or it's some other form of trauma, I often like to use Somatic Experiencing (also known as SE) because it's a gentle and effective form of therapy that was developed specifically for trauma.

By using Somatic Experiencing, the client and I can work on the problems in manageable segments rather than trying to do too much too quickly where client is likely to feel overwhelmed.

When I'm working with a client who has emotional trauma, whether it's sexual trauma or any other form of emotional trauma, I like to provide clients with psychoeducation first so they understand how I work.

Then, the client and I collaborate on how we will work together.  I have many different ways that I work with trauma.  Aside from Somatic Experiencing, I also use EMDR and clinical hypnosis, which are also effective treatment modalities for trauma.

Every psychotherapy client is unique, so it's important that each treatment is tailored to the needs of each client.  This is why the first session is a consultation where I meet with the client so that the client sees if he or she is comfortable with me, and I can determine if what the client is looking for is within the scope of my expertise.

Getting Help in Therapy
Whether you're an individual or a couple, if you're having sexual problems, you're not alone.  

Taking the first step to get help is often the hardest.  But once you've taken that first step, it can be such a relief.  


Sexual Problems in Your Relationship Can Get Worked Out With Help in Therapy

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

I work with individuals and couples.

To find out more about it, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (212) 726-1006 or send me an email: josephineolivia@aol.com

Also see my articles:  

Have You and Your Spouse Stopped Having Sex?

Are You Too Shy to Talk to Your Spouse About Sex?

Overcoming Sexual Incompatibility

































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