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Before I discuss how Sensate Focus is used in sex therapy, I want to define what sex therapy is because there are many misconceptions about sex therapy in the general public and even among psychotherapists who don't practice sex therapy.
What is Sex Therapy?
Sex therapy is a specific type of psychotherapy for individuals and couples to address sexual problems (see my article: What is Sex Therapy?).
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| Sensate Focus is a Component of Sex Therapy |
There is no physical touch, physical exam, sex or nudity during sex therapy sessions. Everyone in the room remains fully clothed just like they would in any other type of talk therapy session (see my article: What Are Common Misconceptions About Sex Therapy?
Sex therapy addresses physical, emotional and psychological factors that might be getting in the way of sexual fulfillment.
As a sex therapist, I help clients with a variety of sexual problems, including:
- Mismatched Sexual Desire Between Individuals in a Relationship
- Erectile Problems
- The Sex Script of a Couple
- Age-Related Sexual Problems
- Transgender Issues
- Compulsive Use of Pornography or Out of Control Sexual Behavior
As well as other sex-related issues (see my article: What Kinds of Problems Are Addressed in Sex Therapy?).
A sex therapist might refer a client to various other health care practitioners to either rule out or overcome related medical or physical issues that could be part of the problem.
For instance, if a man is experiencing erectile problems, a sex therapist often refers the client to a medical doctor who specializes in erectile problems to determine if the problem is medical. Once a medical problem has been ruled out or addressed, a sex therapist can help the client with the emotional or psychological issues involved.
Another example of a possible referral is if a woman is experiencing pain during intercourse. A sex therapist often refers the client to a gynecologist who specializes in painful sex problems to either rule out or address the problem. Subsequently, a sex therapist can also refer the client to a physical therapist who is a pelvic floor specialist while the sex therapist simultaneously helps the client with the emotional or psychological issues involved.
What is Sensate Focus?
Sensate Focus is one component of sex therapy among many.
Sensate Focus is a behavioral technique that was originally developed by Masters and Johnson.
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| Sensate Focus is a Component of Sex Therapy |
Sensate Focus involves a series of behavioral exercises that a couple does together to help them to enhance their emotional and sexual connection.
The behavioral exercises are done as part of sex therapy homework in the privacy of their home. They are not done in front of the sex therapist.
When I work with couples who want to improve their emotional and sexual connection, I provide them with psychoeducation about Sensate Focus and how it can be helpful. Then, I tailor the homework to the needs of the particular clients.
For instance, if they are in a long term relationship where there has been either infrequent or no sex for a while and they are apprehensive about Sensate Focus, I collaborate with the clients to see where they each feel relatively comfortable to begin.
I stress to couples that Sensate Focus is a behavioral mindfulness technique and, as such, it's a non-demand exercise.
The non-demand aspect of Sensate Focus means there is no expectation of sex.
In fact, the exercise won't go beyond what has been agreed upon in advance by each member of the couple.
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| Sensate Focus is a Component of Sex Therapy |
For example, with couples who haven't touched each other in a while, I might ask them to start by setting aside two times between weekly sex therapy sessions where they each take turns touching the other partner's hands for 2-5 minutes without any talking (this is to avoid the possibility of criticism which could make one or both people want to stop).
During initial Sensate Focus exercises, I usually recommend that the couple is fully clothed when they do their homework assignment and that they do the exercise with lights on. There is no music or anything else that would indicate the expectation of sex.
By starting at a point where both people feel comfortable, Sensate Focus helps to remove stressful aspects of sexual and emotional connection that the couple might be struggling with. In fact, most people find Sensate Focus relaxing.
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| Sensate Focus is a Component of Sex Therapy |
If one of the partners is uncomfortable with how the other partner is touching them, they can show them by lifting the partner's hand and demonstrating how they would like to be touched.
When the couple returns to their next sex therapy session, assuming they did the exercise, they each talk about their individual experience with the exercise.
If they didn't do the exercise, I facilitate a discussion as to what got in the way of doing it. Beyond giving reasons that they were busy or tired, this helps the couple to explore and understand unconscious issues involved with why they might have avoided doing the Sensate Focus exercise and how they can overcome these issues.
Overcoming obstacles to Sensate Focus also reinforces the idea that there is mutual responsibility for sexual and emotional connection.
In other words, it's not the job of any particular person to be "in charge" of the exercises, so I usually recommend that each individual take turns reminding the other partner about the exercise and initiating.
So, if Person A is the reminder and initiator on Day 1, Person B is the reminder and initiator on Day 2.
From there, I continue to collaborate with the couple on how to proceed to the next step in Sensate Focus.
Based on the clients' mutual agreement, Sensate Focus progresses to include different types of touch as the exercises progress. Once again, the exercises are highly individualized for the particular couple.
What is the Foundation of Sensate Focus?
There are several elements that serve as the foundation of Sensate Focus, including:
- Providing sexual information and education to both partners about sexual function and activities
- Establishing mutual responsibility between partners for addressing sexual communication, sexual needs and concerns of each partner
- Helping couples to communicate effectively about sex without guilt or shame
- Being willing to change sexual attitudes that are getting in the way of sexual fulfillment
- Overcoming sexual performance anxiety, including guilt and shame
- Overcoming issues related to sexual roles in the relationship
- Giving behavioral homework assignments for couples to improve their sexual and emotional relationship
When is Sensate Focus Used?
Sensate Focus is used for a variety of sex-related problems, including but not limited to:
- Sexual Arousal Problems
- Sexual Desire Problems
- Erectile Problems, including premature ejaculation, delayed ejaculation, erectile unpredictability
- Painful Sex
- Sexual Anxiety
- Other Sex-Related Problems
Conclusion
Sensate Focus is a well-researched, effective component of sex therapy.
Sensate Focus helps to enhance emotional and sexual intimacy with behavioral exercises for couples to do privately as part of their homework.
Sensate Focus is beneficial for couples of any age, race, gender or sexual orientation, including heterosexual couples or LGBTQ+ couples.
Getting Help in Sex Therapy
Sex therapy is a form of talk therapy for individual adults and couples.
If you're struggling with sexual issues, you could benefit from working with a skilled sex therapist.
Rather than struggling on your own, seek help from a sex therapist so you can lead a more fulfilling sex 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 couples.
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.
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