What is Sex Therapy?

Sex therapy is a form of psychotherapy, also known as talk therapy, where the sex therapist focuses on the sexual issues of individuals and people in relationships.  There is no physical exam, nudity, or physical touch involved between the sex therapist and the clients (see my article: The Most Common Misconceptions About Sex Therapy).

What is Sex Therapy?

Sex therapy includes an exploration of the physical, emotional and psychological factors that are getting in the way of an individual or people in a relationship experiencing a pleasurable sex life (see my articles: What is Your Erotic Blueprint - Part 1 and Part 2).

Sex Therapy Has Changed: Modern Sex Therapy Addresses Contemporary Issues

Sex therapy has changed a lot over the years.  

Many sex therapists from the past believed that all people needed to do to improve their sex life was overcome sexual dysfunction, learn how to communicate better and improve the romantic side of the relationship.  

While that strategy might work for many people, it doesn't work for everyone.  In fact, there are many people in relationships who have no sexual dysfunction, who communicate well and love each other very much, but they don't have good sex together (see my article: What is Good Sex?)

In his book, The Erotic Mind, Dr. Jack Morin, sex therapist and researcher, called the sex therapy of the past the "neat and clean" sex therapy.  

Contemporary sex therapists, like Dr. Esther Perel, who wrote, Mating in Captivity - Unlocking Erotic Intelligence, helped to develop many of the important concepts that are used in modern sex therapy today.

These days modern sex therapy still addresses sexual challenges and the importance of good communication both in and out of the bedroom, but it also addresses sex positivity and sexual pleasure as well as contemporary issues for heterosexual, gay, lesbian, bisexual, transgender, queer, polyamorous, people in consensual non-monogamous relationships and other types of non-heteronormative sex (see my articles: Savoring Pleasure, Women's Sexuality: Tips on Sexual Self Discovery and Sexual Pleasure and the Erotic Self - Part 1 and Part 2).

What Type of Sexual Issues Do People Work on in Sex Therapy?

The following list includes some of the most common issues in sex therapy (this list is not exhaustive):

• Low Libido
• See my articles: 
• Heterosexual Women Are Often Labeled as Having Low Sexual Desire When the Real Problem is Their Sexual Needs Aren't Being Met During Partnered Sex
• How Mindfulness Can Help With Low Libido

• Lack of Interest in Sex 
• See my article: 
• The Power of Novelty to Enhance Sexual Desire

• Enhancing Sexual Pleasure and Problems with Arousal 
• See my articles:
• Understanding Your Sexual Accelerators and Brakes
• Discovering Your Peak Erotic Experiences
• What Are Your Core Erotic Themes?

• Arousal Nonconcordance 
• See my article: 
• What is Arousal Nonconcordance?

• Problems with an Orgasm Gap in Your Relationship(s)
• See my articles: 
• Closing the Orgasm Gap - Part 1
• Closing the Orgasm Gap - Part 2
  
• Rethinking Foreplay as More Than Just a Prelude to Intercourse
• 
  
• Sexual Desire Discrepancy Between Individuals in a Relationship 
• See my articles: 
• What is Sexual Desire Discrepancy in a Relationship? 
• Overcoming Sexual Desire Discrepancy

• Lack of Confidence During Sex
• See my article: 
• Is a Negative Body Image Ruining Your Sex Life?

• Overcoming Sex Related Shame
• See my articles: 
• Your Sexual Fantasies Don't Always Match Your Values and Beliefs
• Your Sexual Orientation and Erotic Orientation Don't Always Match and That's Normal
• Understanding the Unconscious Meaning of Your Sexual Fantasies

• Improving Communication About Sexual Issues with Partner(s)
• See my article: 
• How to Talk to Your Partner About Sex 

• Changing a Sex Script That is Not Working in a Relationship 
• See my articles: 
• What is a Sex Script?
• Changing Your Sex Script

• Painful Sex (vaginismus, dyspareunia)
• See my article:
• Getting Help in Sex Therapy For Painful Sex
  

• Performance Anxiety

• See my article: 
• What is Performative Sex?

• Delayed Ejaculation

• Unpredictable Ejaculation

• Impulsive/Compulsive Use of Pornography 

• Infidelity
• See my article: 
• Learning to Trust Again: Coping With Betrayal in a Relationship

• Opening Up a Relationship/Consensual Non-monogamy
• See my article: 
• What is Ethical Non-Monogamy? 
• What is Solo Polyamory?
• 
  
• Exploring and Integrating Kink/BDSM/Eroticized Power Play and Other Consensual Pleasurable Activities 
• See my articles: 
• What is Kinky Sex?
  
• What is the Difference Between a Kink and a Fetish?
  
• Destigmatizing Sexual Fantasies of Power and Submission, 
• What is Power Play?
• What You Can Learn From Kink About Consent 
• What Are the Benefits of Sexual Role Play?
• 
  
• Recovering From Sexual Abuse/Trauma
• See my article: 
• Overcoming the Trauma of Childhood Sexual Abuse

• Overcoming Sexual Boredom in Long Term Relationships 
• See my articles: 
• Sexual Boredom in Long Term Relationships 
• The Paradox of Love and Sexual Desire in a Committed Relationship

• Coping With Issues of Sexual Fluidity: 
• See my articles: 
• Women and Sexual Fluidity - Part 1
• Women and Sexual Fluidity - Part 2

• Sex and Aging

• LGBTQ Issues

What Happens During Sex Therapy?

Most sex therapists know that, even though people have sought help in sex therapy, they are often uncomfortable talking about sex.  

What is Sex Therapy?

Often this is based on family history, cultural history, religion and other factors.  

So, a sex therapist will normalize this and she will help each person to develop a comfort level talking about sex.

Most sex therapists get a comprehensive sex history of the couple as well as each individual (see sex therapist Dr. Suzanne Iasenza's book, Transforming Sexual Narratives, for more details about sexual history taking).

Here are some of the most common questions: 

• What is the presenting problem (as each person sees it)?
• When did the problem start?
• What efforts, if any, have the client(s) made to overcome the problem?
• What is your earliest memory about sexuality?
• Are there health concerns?
• What is your definition of sex?
• What first attracted you to your partner?
• Are there any particular emotional blocks to your experiencing sexual pleasure?
• What is your sex script?

And so on

What Kind of Feedback Does the Sex Therapist Provide to Clients?

Once again, each sex therapist will be different.

For instance, if the sex therapist is trained in Emotionally Focused Therapy For Couples (EFT), the therapist will help the clients to understand the strengths and positive aspects of their relationship as well as the negative cycle in the relationship and help them to change that cycle (see my article: Overcoming the Negative Cycle in Your Relationship That Keeps You Both Stuck).

Setting Goals Together

After the assessment, history taking and feedback, which could take several sessions, a skilled sex therapist helps the clients to work on setting goals together.  

Rather than just coming to therapy sessions and talking about whatever is on their minds, clients in sex therapy establish goals so that the work will have meaning and direction, and they can assess along the way if they are moving in the direction towards accomplishing their goals.

Just like any other goals, goals in sex therapy can be changed, but it's important that both people be able to collaborate with their therapist to identify meaningful goals.

Sex Therapy Assignments Between Sessions

Sex therapists give assignments between therapy sessions.  These assignments are relevant to the particular issues being addressed in sex therapy.

Many of the assignments can be fun and enjoyable (see sex therapist, Dr. Ian Kerner's book, So Tell Me About the Last Time You Had Sex to see some of the assignments that might be part of your sex therapy).

The idea is that if you and your partner(s) are trying to change some aspect of your sexual relationship, you need to practice at home if the partners are willing.  

Sex Therapy Assignments Between Sessions

If an assignment is challenging, you and your partner(s) will discuss it with your therapist at the next session.  You would talk about where you got stuck and what you can do to deal with it.  

Since most sex therapists are patient, empathetic and know that there will be certain blocks or challenges along the way, you don't need to worry that you will be scolded as you were in high school when you didn't do your assignment.  But, generally, there is an expectation that you will make an effort to do the assignments or come in to talk about what happened between sessions.

Everything is grist for the mill.  In the long run, your progress as well as the underlying issues involved with your blocks can help you to overcome your problems.

When Should You Seek Help in Sex Therapy?

If you and your partner(s) have tried on your own and you have been unable to overcome your problems, you could benefit from seeking help with a sex therapist.

When Should You Seek Help in Sex Therapy?

If your partner(s) is unwilling to join you in sex therapy, you can come for individual sessions to work on the problems and, at some point, your partner(s) might join you.

You and your partner(s) deserve to have a pleasurable, fulfilling sex life.  

By freeing yourself of the obstacles that get in the way of pleasurable sex, you can have a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex positive therapist who works with individual adults and people in relationships 

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.