Helpful Tips on How to Make the Most Out of Your Couples Therapy

Couples therapy can be a transformative experience (see my article: What is EFT Couples Therapy?).

A skilled couples therapist can help you and your partner to overcome challenges in your relationship.

How to Make the Most Out of Couples Therapy

To get the most out of couples therapy, it's important to understand that it's common to feel a certain amount of anxiety and ambivalence, especially if you don't know what to expect (see my article: It's Not Unusual to Feel Anxious and Ambivalent at the Start of Therapy).

To help reduce your anxiety, it's helpful to know how to approach couples therapy so you can get the most out of it. 

What Do Couples Talk About in Couples Therapy?

Couples can talk about a variety of issues (see my article: What Do Couples Talk About in Couples Therapy?).

Here are just a few of the issues that couples talk about in couples therapy:

• Communication problems

• Fear of intimacy
  

• Moving in together or getting married

• Sharing the mental load

• Infertility issues

• Grief and loss related to miscarriages

• Grief and loss due to the loss of a child

• Parenting issues

• Blended family issues

• Different perspectives about managing money

• Sexual issues

• Opening up your relationship to see other people (see my article: What is Consensual Nonmonogamy?)

• Aging

• Infidelity
  

• Problems with in-laws

• Retirement issues

• Divorce and co-parenting

• Taking care of aging parents

• Other major issues 

What Are the Do's and Don'ts in Couples Therapy

Do's in Couples Therapy:

• Approach Couples Therapy With Curiosity and Openness: It's important to state your feelings openly and honestly to your partner and to the couples therapist in session.

• Talk About What You Want: Being able to tell your couples therapist and your partner what you want to get out of couples therapy will help to define your goals. You might even be surprised that your partner might have different goals and these differences might need to be negotiated.

How to Make the Most Out of Couples Therapy

• Set Realistic Goals: Once you and your partner have agreed to what you want to get out of therapy, set realistic goals for the couples therapy. When you have goals, the couples therapy has direction and you can assess your progress. However, it's also important to know that progress in therapy isn't linear. This means that setbacks (where you take two steps forward and one step back) are a normal part of the process, so don't get discouraged (See my article: Progress in Therapy Isn't Learner).

• Practice Active Listening in Your Sessions: Learning to actively listen to what your partner and your couples therapist say is an important part of couples therapy (see my article: The Importance of Active Listening in Your Relationship).

• Practice the Skills You Learn in Couples Therapy Between Sessions: Use the skills you learn in couples therapy between sessions so you can continue to hone your skills in your daily life with your partner.  If you run into obstacles, talk about it at your next couples therapy session so you can continue to develop these skills.  There might also be some topics that you and your partner will only discuss in couples therapy sessions until you both develop the necessary skills to talk about these issues between sessions.

Don'ts in Couples Therapy:

• Don't Wait Too Long to Start Couples Therapy: Many couples wait until they're ready to end the relationship to get help. Getting into couples therapy becomes their "last ditch effort". By then, it's often too late. The sooner you get help the better.

• Don't Focus on "Fixing" Your Partner: Focus on what you want to change about yourself in the relationship instead of having the attitude that you're there to "fix" your partner.

How to Make the Most Out of Couples Therapy

• Avoid Critical, Contemptuous or Defensive Behavior: You and your partner need to learn to approach your problems as a team rather than pointing fingers or blaming one another (see my article: Improve Communication in Your Relationship By Avoiding the "Four Horsemen of the Apocalypse").

• Avoid Trying to "Fix" Your Partner: You and your partner need to approach your problems like a team, as previously mentioned. Instead, focus on the areas where you can grow.  Couples usually have negative patterns that each partner contributes to in their dynamic. So, part of the work in couples therapy is for you and your partner to learn work together as a team to change the negative patterns.

• Avoid Contacting the Therapist Privately Without Your Partner's Knowledge: Most couples therapists do individual sessions to get family and relationship history. However, other than those individual sessions, avoid speaking, texting or emailing the therapist without your partner's knowledge because this can undermine the therapy.  The couple is the client in couples therapy--not the individuals in relationship. Contacting the therapist privately without the other partner's knowledge often occurs when one person is trying to get the couples therapist to align with them against the partner, which a skilled couples therapist will not do.

• Avoid Keeping Secrets From Your partner and Your Therapist: Most couples therapists will not keep an individual's secrets in couples therapy. Keeping secrets from the therapist or your partner will become an obstacle to progress in therapy. For instance, if you're having a secret affair, most couples therapist will not work with you and your partner because the affair would be undermining your relationship.

Conclusion

Couples therapy can be beneficial for couples who are experiencing problems in their relationship.

You and your partner can learn to come together as a team in couples therapy to overcome the obstacles in your relationship.

If you and your partner decide that it would be best to end the relationship, a couples therapist can help you both to end the relationship as amicably as possible and come to an agreement about how to talk to your children about the end of the relationship and how to co-parent if these issues are applicable.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist (see my article: What is Sex Therapy?).

I have over 20 years of experience working 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.

What Are Ravishment Fantasies?

According to social psychologist and sex researcher Justin Lehmiller, ravishment fantasies are common (see my articles: The 7 Core Sexual Fantasies and It's Normal and Common to Have Sexual Fantasies).

Ravishment Fantasies

Based on Dr. Lehmiller's sex research:

• 61% of women fantasize about being ravished (24% of these women fantasize about it often)

• 54% of men fantasize about being ravished (11.5% of these men fantasize about it often)

• 68% of people who identify as nonbinary fantasize about ravishment (31% fantasize about it often)

What Are Ravishment Fantasies?

Since these fantasies are so common, I think it's worthwhile to explore them in the current article.

Ravishment Fantasies

According to Dr. Lehmiller and other sex experts, ravishment fantasies are thoughts about being "forced" to have sex.

It's important to note there's a big difference between wanting to be forced to have sex in reality and fantasizing about it.  These fantasies are not wishes to be sexually assaulted (see my article: Are You Afraid to Share Your Sexual Fantasies With Your Partner?).

Who Tends to Have Fantasies About Being Ravished?

According to Dr. Lehmiller's research, people who have ravishment fantasies tend to:

• Have a very active imagination

• Have an unrestricted sociosexual orientation. They have the ability to see sex and emotion as separate. They can distinguish sexual acts from emotions.

Ravishment Fantasies

• Be sensation-seeking individuals who have a greater need for sexual excitement and thrill seeking

• Have an anxious attachment style and lower self esteem 

• Have more BDSM (bondage, discipline/domination, sadism and masochism) fantasies (see my article: BDSM and Kink: What Are Sub-Dom Relationships?)

Sexual Roleplay

Many people who enjoy ravishment fantasies like to engage in forced sexual roleplay with their partner(s) (see my article: What Are the Benefits of Sexual Roleplay?).

Sexual roleplay that involves ravishment has the illusion of nonconsent as part of the fantasy, but consent is a crucial part of these roleplays. 

This is often described as consensual nonconsent where individuals act out a pre-agreed upon nonconsensual situation. In other words, even though they are roleplaying a forced sex scene, everything has been agreed to beforehand.

Ravishment and Sexual Roleplay

To engage in roleplay that involves ravishment, it's important to have:

• Communication beforehand about what is and is not acceptable to the individuals involved

• Enthusiastic consent for whatever is agreed to by all participants

• A safeword

• Aftercare
  

Romance Novels and Ravishment Fantasies

Many women (and some men), who might never participate in a sexual roleplay or a ravishment fantasy, enjoy reading romance novels or erotica that include ravishment.

Romance Novels and Ravishment Fantasies

These romance novels allow people to experience the sexual excitement and thrill of ravishment vicariously without actively participating themselves.

Getting Help in Sex Therapy

It's common for individuals in a relationship to have different likes and dislikes when it comes to sex (see my article: What is Sex Therapy?).

If you're in a relationship where you and your partner are having problems with intimacy, you could benefit from working with a skilled sex therapist (see my article: What Are Common Misconceptions About Sex Therapy?).

Rather than struggling on your own, seek help from a certified sex therapist so you can have a more meaningful and pleasurable sex life (see my article: What Are Common Issues Discussed in Sex Therapy?).

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Certified Sex Therapist.

I work with individual adults and couples in person and online.

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.

It's Common and Normal to Have Fantasies

In prior articles, I've discussed many different aspects of romantic and sexual fantasies (see my articles: The 7 Core Sexual Fantasies and Exploring and Normalizing Sexual Fantasies Without Guilt or Shame).

Fantasies Are Common and Normal

The current article focuses on how and why sexual fantasies are normal and common.  

What Are Fantasies?

There are many definitions for fantasies.  

Basically, fantasies are imaginary scenarios that people play out in their mind.  Sometimes these fantasies are new or recurring scenarios and/or they might be based on memories.

Many fantasies are never acted upon, but they can still be enjoyed in your mind.

In general, fantasies can be about anything, including but not limited to:

• Imagining winning the lottery
• Thinking about what it would be like to be famous
• Imagining what it would be like to travel around the world
• Imagining being someone else--either someone you know in real life or a character in a TV program, movie or book
• Imagining having certain super powers
• Having thoughts about having an affair you have no intention of doing real life
• Imagining being in a more interesting job
• Entertaining yourself while you're bored
• Playing with "what if...." scenarios in your mind: "What if he likes me the way I like him?" or "What if I accept that new job offer?" or "What if I take a risk?"
• Imagining what you would do in a worst case scenario as a form of mental rehearsal
• Imagining what you might have said or might say to someone in a conversation
• Imagining how you'll feel if you accomplish a goal that's important to you
• Having thoughts about what your life might be like under different circumstances

And so on.

What Are the Benefits of Fantasizing?

In general, there can be many benefits to having fantasies whether they are enacted or not.

Fantasies Are Common and Normal

Here are just a few:

• Helping you to get to know yourself better by seeing yourself in new and unfamiliar situations
• Helping you to see alternatives to the way you are now
• Coming up with creative solutions to problems
• Using a fantasy as a mental rehearsal before acting on it in real life
• Acting as a compensatory wish you derive satisfaction from--even though you won't do it in real life
• Boosting your mood
• Getting yourself out of a rut
• Becoming open to new experiences
• Providing you with a temporary escape from your current situation
• Energizing you mentally, emotionally and physically

Why Are Some People Afraid of Their Fantasies?

From an early age, many people are taught (implicitly or explicitly) that fantasizing, in general, is wrong.

For instance, young students are often scolded for not paying attention in class if they're daydreaming.  And, although it's important that students learn their lessons in class, it's also important for young minds to explore and create in their fantasies.  After all, play--whether it's children's play or adult play--is about being creative.

Many people are taught at a young age that having daydreams and fantasies are a waste of time.  They're taught that actively doing is more important than imagining. 

While it's true that if you only daydream about your hopes and dreams and never do anything to bring them to fruition you won't get very far, the seeds of creative ideas often begin with a daydream or fantasy that can be the start of fulfilling your dreams.

Why Are Some People Afraid Specifically of Their Sexual Fantasies?

Having sexual fantasies is common and normal as I have been reiterating.  In fact, research on sexual fantasies has revealed that 3 out of 4 people have sexual fantasies.

So, if sexual fantasies are common, why are some people uncomfortable with the idea of them?

Discomfort and fear of sexual fantasies are often based on certain religious, cultural or familial prohibitions that indicate that sex in general shouldn't even be thought about--much less engaged in--before marriage.  

However, these prohibitions can have a lasting effect.  For many people it's not like flipping a switch after they get married to suddenly feel comfortable with sex and sexual fantasies.  They might still have a vague feeling that it's wrong.

For many people sexual fantasies can cause fear, confusion, anxiety, guilt, shame and ambivalence.  On a certain level, some people might enjoy a sexual fantasy--even one they have no intention of carrying out--but on another level they feel bad about it.

On the other hand, other people find it exciting to engage in sexual fantasies that are taboo, so it depends on the individual (see my article: A Cornertone of Eroticism: Violating Prohibitions By Breaking the Rules).

What Are the Benefits of Sexual Fantasies?

As mentioned earlier, fantasies are normal and common.

The mind is creative and exploratory, so having fantasies, sexual or otherwise, is one way that people can satisfy their needs and wants.

Fantasies Are Common and Normal

People have sexual fantasies regardless of gender, sex, sexual orientation, age, race, marital status, ability/disability or other factors.

Sexual fantasies often help to promote sexual arousal.  

For instance, if you and your partner have scheduled time to have sex in a few days, having fantasies about it can help to build sexual anticipation and excitement (see my article: Creating Sexual Desire Using the Sex Drive Simmer Technique and Anticipation and Longing as an Erotic Aphrodisiac).

Sexual fantasies can also help to boost sexual confidence in many ways, including having a fantasy of being able to initiate and enjoy sex.

Should You Share Your Sexual Fantasies With Your Partner?

Sharing a sexual fantasies with a partner can be empowering and fun if your partner is open to talking about fantasies.

Typically, sharing sexual fantasies can strengthen the bond between partners.  

However, if your partner tends to be judgmental or unsure, it could have the opposite effect.

Sometimes the problem is with the word "fantasy" so, instead, you can ask what your partner might be curious about sexually (see my article: Substituting the Words "What's Your Fantasy?" With "What Are You Sexually Curious About?").

What Can You Do and Your Partner Aren't on the Same Wavelength About Sexual Fantasies?

Some people like sharing their fantasies with their partner and others like to keep it private.  

If you do want to share your sexual fantasies, be aware that it's not unusual for individuals in a relationship to have differences when it comes to sexual fantasies.

Just like anything else, including the kinds of food you each like, sexual fantasies can be unique for each person.  

What one person enjoys, the other person might not.  Or one of you might have a rich sexual fantasy life and the other might not be comfortable with sexual fantasies at all.

Others might want to talk about their fantasies, but they don't know how (see my article: How to Talk to Your Partner About Sex - Part 1) and Part 2).

If you feel the differences between you and your partner are getting in the way of having a pleasurable sex life, these differences can often be negotiated and worked out in sex therapy.  

Getting Help in Sex Therapy

Sex therapy is a form of talk therapy for individuals and couples (see my article: What is Sex Therapy?).

People seek help in sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

There is no physical exam, nudity or sex during a sex therapy session (see my article: What Are Common Misconceptions About Sex Therapy?).

If you're struggling with sexual issues, you could benefit from seeking help in sex therapy to have 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 work 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.

What is a Consensual Voyeurism?

In prior articles I've discussed different types of sexual behavior between consenting adults such as threesomes, group sex and cuckolding, which all involve consensual voyeurism (see my articles: How to Have a Fun and Passionate Threesome and Kinky Sex: What is Cuckolding?).

Consensual Voyeurism

What is Consensual Voyeurism?

Let's start by comparing consensual voyeurism to nonconsensual voyeurism to understand the difference.

Nonconsensual voyeurism usually involves one or more people watching unsuspecting adults engaged in sexual behavior.  It could also involve watching an unsuspecting person in a state of undress (e.g., a person who is trying on clothes in a dressing room).

Aside from watching, nonconsensual voyeurism could involve a "Peeping Tom" photographing or videotaping an individual or a couple in their home or in another place where privacy is assumed. In other words, it's without the individual or couple's consent.  This form of voyeurism is illegal in most places.

Consensual or Nonconsensual Voyeurism?

Consensual voyeurism, which is a fetish, is very different from nonconsensual voyeurism because all people involved have consented with consensual voyeurism (see my articles: Are You Curious About Exploring Fetishes With Your Partner? and What Are the Rules of Sexual Consent?).

As part of the fetish, some people prefer to be the ones who are watched while they are undressed or engaged in sexual behavior, other people prefer to watch others, and some people like to "switch" between watching and being watched.

How to Practice Consensual Voyeurism in an Ethical and Responsible Way

If you and your partner want to engage in consensual voyeurism, you can do it in a responsible and ethical way so that everyone involved is consenting beforehand to what will take place:

• Watching Your Partner Masturbate:  This can be a good way to start if you're new to consensual voyeurism. Assuming your partner shares your interest in this voyeuristic fetish, talk to them beforehand about what feels comfortable and what the boundaries will be.  Many couples incorporate watching each other masturbate as part of their sex script and might not even think of it as voyeuristic.  You can either be with your partner or you can "hide" somewhere, like in a closet or behind a door where you watch through the peephole to add sexual excitement.  In addition, you can spice things up with "dirty talk" and encourage your partner to do certain things that would turn both of you on.

• Role-Playing: This is another sexual activity where it's only you and your partner watching each other. If you both agree to certain sexual fantasies in advance, you can each become sexual characters in whatever type of scenario you would both enjoy.  You're only limited by your imagination. Maybe you pretend to be a stranger who is watching a sexual scene with your partner and someone else and then you enter into the scene (see my article: What Are the Benefits of Sexual Role Play?).

Sexual Role-Play

• Cuckolding, Threesomes and Group Sex: If you and your partner have agreed in advance to include other people in your sexual scenarios, you can include people who have consented to be part of a specific sex scene.  Be aware that your sexual fantasies about cuckolding, threesomes and group sex might be better than what you experience in reality. This is due, in part, to the fact that at least one person can feel left out if they feel they're not getting enough sexual attention. In a sexual fantasy, an individual often imagines they're the focus of attention, but an actual scene might not turn out this way (see my article: Are You Curious About Exploring Cuckolding With Your Partner?).

Play Party or Sex Club

• Attending Play Parties or Sex Clubs: When you attend a sexual play party or a sex club, there is an expectation that there will be sexual scenes that are open to the viewing of others at the party who are not directly involved in the scene. If the play party is organized well, the organizer will usually tell the attendees what to expect so that if they're not interested in a particular fetish or kink, they can avoid observing that scene.  For instance, if a scene will involve BDSM (bondage, discipline or domination, sadism or submission, and masochism) and an attendee would have a problem observing this, they would know this in advance from the organizer. 

Don't Expect Everything to Go Perfectly the First Time

If you and your partner are new to consensual voyeurism, you might want to start with watching each other without a third party (as mentioned above). Even then, don't expect everything to necessarily go as planned (see my article: How to Talk to Your Partner About Sex?).

Before you start, you might think you both have covered everything in terms of boundaries and what you do and don't want to do. But there can be unforeseen circumstances.  For instance, you might think you would enjoy having your partner watch you masturbate, but once you start, you might feel unexpectedly uncomfortable so that you want to stop (see my article: Tips on How to Talk to Your Partner About Your Sexual Desires).

Always make an agreement beforehand that if one or both of you get uncomfortable, you can stop, take a break or do whatever you need to do to make each other comfortable.  

You and your partner can talk about it afterwards to improve your experience for next time--if there is to be a next time.

And don't forget to engage in sexual aftercare where you and your partner hug and hold each other and engage in other soothing care you give to each other.

Conclusion

Consensual voyeurism is very different from nonconsensual voyeurism, as described earlier in this article.

If you and your partner enjoy this type of fetish, consensual voyeurism can be fun and exciting.

Part of the sexual fun and excitement is the feeling that you're violating sexual prohibitions or engaging in something "naughty"--even though both you and your partner have consented to your voyeuristic activity beforehand (see my article: A Cornerstone of Eroticism: Violating Prohibitions By Breaking the Rules).

Consensual voyeurism can also expand your sexual repertoire in a positive way as long as it's done ethically and responsibly by everyone involved.

Also see my article: What is Consensual Exhibitionism?.

Getting Help in Sex Therapy

Sex therapy is a form of talk therapy (see my article: What is Sex Therapy?).

There is no nudity, physical exams or sex during a sex therapy session (see my article: What Are Common Misconceptions About Sex Therapy?).

Individuals and couples attend sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Rather than struggling on your own, seek help from a skilled sex therapist so you can have 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 work 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.

What Are the 4C's of Safe and Enjoyable Sex?

Enjoyable sex is also safe sex (see my article: What is Good Sex?).

Usually, when people think about safe sex, they only think about protecting themselves and their partners from pregnancy and sexually transmitted infections/diseases (STIs/STDs). But safe and enjoyable sex is about much more than just protection as I explain below (see my article: Sexual Wellness: Savoring Pleasure).

The 4C's of Safe and Enjoyable Sex

What Are the 4C's of Safe and Enjoyable Sex?

• Communication: Of the 4c's, communication is one of the most important if not the most important. It doesn't matter if your sexual encounter involves a one-night stand, Friends With Benefits (FWB) or a long term partner (see my articles: Creating Your Yes, No, Maybe Sexual Menu):

• Before: Talk to your partner about consent, condoms, contraception and safe sex.  Also, set boundaries and talk about what you each expect with regard to what you both want to do and what is off limits for each of you (see my article: How to Talk to Your Partner About Sex).

The 4C's of Safe and Enjoyable Sex

• During: Check in with your partner to make sure sex they feel comfortable and sex is enjoyable for them. Be prepared to stop if one of you isn't comfortable anymore.

• After: Talk to your partner about the experience--what worked, what didn't work and what could be changed next time.

• Consent: Consent means that both you and your partner are enthusiastic about the sex you're able to have. Even though you are both consenting, be aware that either of you can withdraw consent at any time if one of you feels uncomfortable (see my article: What Are the Rules of Consent?).

The 4C's of Safe and Enjoyable Sex

• Condoms: The only way to be at least 97-98% safe is using condoms.  You can include putting on the condom as part of foreplay.  This also means knowing how to use a condom properly by:

• Opening up the wrapper carefully
• Placing the condom on the head of an erect penis
• Pinching the air out of the tip of the condom
• Unrolling the condom all the way down the penis 
• Holding the condom at the base after sex and before pulling the penis out of your partner
• Removing the condom carefully and throwing it away in the trash

• Contraception: Aside from condoms, many people use an additional form of contraception, like the pill, an IUD or an injection. You and your partner should consult with your medical doctor to determine what type of contraception is best for each of you.

Getting Help in Sex Therapy

Most psychotherapists aren't trained in sex therapy. This is why you need to see a sex therapist if you're having sexual problems.

Getting Help in Sex Therapy

Sex therapy is a form of talk therapy (see my article:  What is Sex Therapy?).

Individual adults and couples attend sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

There is no nudity, physical exams or sex during a sex therapy session (see my article: What Are Common Misconceptions About Sex Therapy?).

Rather than struggling on your own, get help from a skilled sex therapist so you can have 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 work 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.

How is Sensate Focus Used in Sex Therapy?

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?).

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:

• Low Libido/Sexual Arousal/Sexual Desire
  

• Mismatched Sexual Desire Between Individuals in a Relationship

• Sexual Communication

• Sexual Boredom

• Erectile Problems

• Sexual Performance Anxiety
  

• Painful Sex

• Orgasm Problems
  

• Sexual Guilt and Shame
  

• Sexual Self Esteem

• The Sex Script of a Couple

• Sexual Abuse/Trauma

• Age-Related Sexual Problems

• Body Image

• The Unconscious Meaning of Sexual Fantasies

• Kink, BDSM , Eroticized Power Play 

• Transgender Issues

• Consensual Nonmonogamy
  

• 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. 

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.

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.

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.