Relationships: Getting Curious About Your Own and Your Partner's Turn-0ns

As a sex therapist, when I'm working with individual clients or couples who want to work on their sex life, I often hear clients say they're bored or they're not turned on by what their partner wants to do sexually or the idea of doing something new makes them uncomfortable (see my article: What is Sex Therapy?).

Getting Curious About Your Own and Your Partner's Turn-Ons

These are a common problems, which is understandable because no two people are exactly alike and each will have their own preferences when it comes to just about anything--whether it's food, sex, types of entertainment they enjoy and so on.

Aside from the fact that many people don't know how to talk about sex with their partner, talking about sex when two people don't want to engage in the same sexual activity can be especially fraught (see my articles: How to Talk to Your Partner About Sex - Part 1 and Part 2).

The partner who is making him/herself vulnerable by asking for a sexual activity that is outside of their usual sexual repertoire often feels rejected when the other partner doesn't want to even considerate it. 

In most cases, the other partner isn't rejecting their partner--they're rejecting the activity.  But in the moment, it can feel like a personal rejection (see my article: Coping With a Sexual Rejection From Your Partner).

This often shuts down any more talk about sex due to fear of rejection. In many cases, this sets up a dynamic where sex becomes routine and boring over time because there's nothing new and each person is reluctant to talk about it.

Sexual shame and guilt often get in the way of partners being able to talk about sex.  If shame and guilt are worked through in therapy, a reluctant partner can get curious about their partner's and their own sexual interests.

How to Get Curious About Your Own and Your Partner's Turn-Ons

As I've said in prior articles, no one should do anything they don't want to do.  

Consent means more than just going along with your partner's wishes when you don't want to do it.  

But when you're in a relationship with someone you trust, your response doesn't have to be either Yes or No.  Instead, you can get curious about what turns your partner on about the particular sexual activity they're interested in and get curious about your own erotic preferences.

Even if you both decide not to engage in any of these activities, your curiosity and the discussion with your partner can open up other possibilities that you're both interested in.

Are There Sexual Brakes Getting in the Way?

Even more important than understanding your own and your partner's turn-ons is understanding each of your turn-offs.  

According to Sex Educator Emily Nagoski, Ph.D., when a couple is experiencing sexual problems where they're out of synch with regard to sexual desire, it's important to pay attention to whether one or both people are dealing with "sexual brakes."  

The sexual brakes need to be addressed first before looking at the sexual accelerators (turn-ons).  To paraphrase Dr. Nagoski: You have to turn off the offs before you turn on the ons.

This is an issue I discussed in detail in the article listed below, so I won't go into it in more detail here:

Getting to Know Your Own and Your Partner's Sexual Accelerators and Brakes

Clinical Vignette

The following clinical vignette illustrates how to use curiosity and an open discussion to bring a couple closer together emotionally and sexually:

Nina and Tim

Nina and Tim, who were both in their early 40s, were married for several years when Tim told Nina that he felt their sex life had become too routine and he would like to spice it up a little.

Prior to dating Tim, Nina was only in one other long term relationship so she didn't have a lot of prior sexual experience.  

She was also bored with their sexual routine, but she didn't feel sexually confident, so when she heard Tim say he wanted to spice things up, she felt embarrassed and apprehensive.  

Sexual Boredom is a Common Problem in Long Term Relationships

In addition, due to her religious and cultural upbringing, talking about sex brought up guilt and shame for her (see my article: Overcoming Feelings of Sexual Shame and Guilt Due to Cultural Issues).

Even though she felt uncomfortable, she wanted to be a good partner to Tim, so she asked him what he had in mind.  

Tim knew talking about sex made Nina feel uncomfortable, especially talking about trying something new, so he reassured her that he wouldn't try to get her to do anything she didn't want to do.  He only wanted to expand their usual sex script (see my article: Changing Your Sex Script).

Tim told Nina he wanted to try doing role plays (see my article: What Are the Benefits of Sexual Role Play?).

He could tell from the look of her face that she was hesitant about this, which made him feel emotionally vulnerable and embarrassed that he even suggested it, so he told her to forget it.  

When she saw the look of embarrassment on his face, Nina wanted to say something comforting, but she didn't know what to say, so she turned on the TV to cover the awkward silence between them.

After that awkward conversation, they didn't talk about sex again for another year.  They continued their usual sexual routine, even though they were both bored with it.  Over time, they had less and less sex because neither of them looked forward to it.

So, a year after his first attempt, Tim tried talking to her about their sex life again, but he could see how uncomfortable she was, so he suggested they see a sex therapist to work on this, which Nina agreed to do.

Their sex therapist normalized their difficulty with talking about sex.  She also told them that it was common for sex to become routine for couples in long term relationships and they were no different from many other couples (see my article: What is Sexual Boredom in Long Term Relationships?).

Gradually, Nina and Tim began a dialog about their sex life in their sessions.  They also worked on their emotional connection, which they both wanted to strengthen.

Strengthening their emotional connection helped Nina to feel more comfortable talking the possibility of trying new sexual activities, including role playing.  She was also able to listen to Tim tell her what turned him on about role playing.

Nina also worked on the shame and guilt related to her religious and cultural background, so she was able to open up to her own sexual curiosity. 

In addition, Nina explored her own core erotic themes to understand herself as an erotic being. This enabled Nina to get curious about her erotic needs as well as Tim's (see my article: Sexual Self Discovery with Pleasure Mapping).

Getting Curious About Your Own and Your Partner's Turn-Ons

Nina and Tim's curiosity motivated them to try sexual role plays, which added spice to their sex life together.  They also began exploring other sexual activities they were both curious about, which was pleasurable for both of them.

Conclusion

Aside from guilt and shame, there can be many other reasons why you might hesitate to explore your own and your partner's sexual turn-ons.  

If your initial reaction is to criticize or show contempt for your partner's turn-ons, try to get curious instead.

When you get curious, you allow yourself to be open to new possibilities that could expand your sexual repertoire. This can lead to a more pleasurable sex life for you and your partner.

Getting Help in Sex Therapy

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

Individual adults and couples seek help in sex therapy for many different issues (see my article: What Are Common Issues Discussed in Sex Therapy?)

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

Rather than struggling on your own, seek help from a licensed mental health professional who is a sex therapist.

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.

What Are the Most Common Misconceptions About Sex Therapy?

This is the first article in a series of articles about sex therapy where I'll begin addressing the most common fears and misconceptions that people have about sex therapy and some of the most common issues addressed by sex therapists (see my article: What is Sex Therapy?)

Sex Therapy For People in Relationships

There are many misconceptions about sex therapy which, as a sex therapist, I would like to address in this article.  These misconceptions and their related fears often keep people from seeking much-needed help in sex therapy.

Common Problems and Misconceptions That Keep People From Seeking Help in Sex Therapy

Some of the most common problems and misconceptions include (but are not limited to):

• Shame: Shame is a big reason why people, who could benefit from sex therapy, don't go.  Many individuals and couples who are having sexual problems don't know that their sexual problems are common, so they feel too ashamed to see a sex therapist. However, whether the problem is lack of sexual experience, low libido, problems with sexual desire discrepancy in a relationship, premature ejaculation, erectile unpredictability, painful intercourse, a desire to explore consensual non-monogamy or BDSM or kink, or a variety of other issues, these issues and other sexually related issues are common in sex therapy.  

Sex Therapy For Individual Adults

• Fear of Being Asked to Do Things They Don't Want to Do: Many people who have misconceptions about sex therapy fear that the sex therapist will ask them to engage in sexual acts they would be uncomfortable doing (group sex, threesomes, and so on).  But sex therapists focus on what the clients want.  They don't have their own agendas.  

• Fear of Being Judged or Criticized: Many people fear the sex therapist will judge them for their problems or their desire to explore certain areas of sexuality, like kink or BDSM (Bondage, Discipline, Dominance, Submission and Sadism and Masochism) as one example.  The reality is that most sex therapists are trained to discuss these issues in a sex positive and nonjudgmental way. 

Sex Therapy For All Genders and Sexual Orientations

• Fear of What Will Happen in the Sex Therapist's Office: There are people who fear they will have to take off their clothes or engage in sex in front of the sex therapist. However, there are no physical exams in sex therapy, no nudity and no touching.  In fact, a sex therapist's office is just like any other therapist's office.  Sex therapy is a form of psychotherapy which is also known as talk therapy.

Sex Therapy Online

• Fear of Sexual Boundary Violations: As mentioned above, there is no nudity or sexual acts in a sex therapist's office.  You and the sex therapist talk about your problems and there might be assignments for you and your partner(s) to try at home and come back to discuss the following week, depending upon the issue and how the sex therapist works.  Sex therapists don't have sex with their clients.  That would be a serious ethical and legal breach.  Also, a sex therapist doesn't talk about her own sexual experiences.  In other words, sex therapists are licensed therapists who must maintain legal and ethical boundaries with their clients.  

What Are Some of the Most Common Issues Addressed in Sex Therapy?

Most sex therapy begins with the clients discussing what they want to work on in sex therapy.  As previously mentioned, these issues include but are not limited to:

• Lack of Sexual Experience (for all genders/sexual orientations)

• Sexual Anxiety

• Sexual Shame

• Lack of Sexual Confidence or Sexual Self Esteem

• Problems Talking About Sex With Partner(s)

• Low Sexual Desire or Problems With Sexual Arousal

• Sexual Desire Discrepancy or Sexual Frequency Disagreements in a Relationship

• Problems With Body Image That Interferes With Sex

• Problems with Having an Orgasm For Both Men and Women

• Painful Sex

• Erectile Dysfunction

• Premature Ejaculation

• Sexual Compulsivity Including Compulsive Use of Pornography

• Sexual Boredom or Lack of Sexual Pleasure

• Understanding the Conscious and Unconscious Meaning of Sexual Fantasies

• Understanding the Difference Between Sexual Fantasies and Sexual Acts

• Understanding Your Erotic Blueprint

• A Desire to Explore Kink, BDSM (Bondage Discipline, Dominance, Submission and Sadism) or Fetishes

• A History of Sexual Abuse That Negatively Impacts Current Sexual Pleasure

• A Wish to Explore Polyamory or Opening Up a Relationship to Include Other Partners (also known as Consensual Non-Monogamy)

• Problems With Sexual Intimacy After an Affair

• Problems With Sexual Intimacy After Having Children

• Problems Understanding Sexual Orientation or Erotic Orientation or Sexual Fluidity

• Other Emotional or Mental Issues Interfering With Sex

What Happens in Sex Therapy?

Now that I've addressed some of the most common fears and misconceptions people have about sex therapy and some of the most common issues addressed, let's begin a discussion about what actually happens in sex therapy.  I'll go into further detail about this in my next article.

What Happens in Sex Therapy?

Both individual adults and people in relationships, including monogamous and non-monogamous relationships, attend sex therapy.  

As previously mentioned, sex therapy is a form of psychotherapy, which is also known as talk therapy.

Sessions can be in person or online.

The initial session is for clients to discuss why they are seeking help in sex therapy.  

For a variety of reasons, many people feel ashamed to talk about sex, so part of the sex therapist's role is to help clients get more comfortable talking about sex without experiencing shame.  

Sex Therapy Online

It's also common for clients to want to get comfortable with a sex therapist before they really open up to talk about their sexual problems in detail, and skilled sex therapists know how to facilitate this.

Other clients might feel more open and comfortable talking about sex right away.  So, the sex therapist can begin getting a sexual history from the client(s).

Getting a comprehensive sexual history taking is an important part of the initial stage of sex therapy.

When Should You See a Sex Therapist?

If you have tried on your own to resolve sexually related problems without success, you're not alone.  

Many people seek help in sex therapy, and you could also benefit from seeing a sex therapist.

A sex therapist can help you with practical steps to resolve the underlying issues related to your sexual problems.

Rather than struggling on your own, if you're having sexual problems, seek help with a licensed psychotherapist who is a sex therapist.

You deserve to have a fulfilling sexual life.

About Me

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

I am a sex positive therapist who works with individual adults and couples.

I provide in-person and online therapy.

To find out more about me, visit my website where I have many articles about sex therapy as well as other topics: Josephine Ferraro, LCSW - NYC Psychotherapist.

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

Sexual Compatibility Can Develop and Evolve Over Time

One of the most common problems that brings people into sex therapy is what they perceive as sexual incompatibility, including sexual desire discrepancy. Sexual desire discrepancy means that you and your partner aren't in synch with regard to what you each want to do sexually and/or how often you want to have sex.

Sexual Compatibility Can Develop and Evolve Over Time

As I mentioned in an earlier article, sexual desire discrepancy can occur at any time for many reasons, including but not limited to:

• Not knowing each other sexually during the early stage of a relationship
• Stress
• Hormonal issues
• Medication side effects
• Negative body image
  
• Unresolved resentment between partners
  
• Trust issues
  
• Lack of sexual experience as an individual and/or as a couple                                
• Lack of emotional intimacy and vulnerability
• Sexual boredom
  

Sexual Compatibility Doesn't Always Happen Naturally

Most people assume that sexual compatibility just happens naturally during the early stage of a relationship.  They think it's either there or it's not.  

But the reality is that sexual compatibility often doesn't always happen naturally.

I'll unpack these ideas in this article.  For now, the idea to grasp is that since sexual compatibility isn't automatic, the most important thing is a willingness to put the time and effort into communicating and working on your sex life.  

More about this later in this article (see my articles: Is a Willingness to Have Sex Enough to Get Started - Part 1 and Part 2).

The Early Stage of a Relationship: Getting to Know Each Other

When you first start seeing someone new, you're getting to know all kinds of things about them, including what they want and don't want in a relationship, their beliefs and values, what kinds of activities they enjoy and so on.  

The Early Stage of a Relationship: Getting to Know Each Other

Over time, if you enjoy each other's company and you spend time together, you'll probably  discover you both like certain things and not other things. 

For instance, you might both share a passion for hiking, but you also love going to the gym a few times a week and they don't.  Or, you both love sushi, but they also like hamburgers and you don't.  

If you both really like each other and you want to see how the relationship develops, you wouldn't automatically rule each other out because of these differences.  You would probably try to find ways to make your similarities and differences work.  

Similarly, when it comes to sexual compatibility, you might not have swinging off the chandelier sex at the beginning of a relationship because you're getting to know each other and what each of you like (see my article: What is Your Erotic Blueprint - Part 1 and Part 2).

Obviously, if one of you believes that sex is the life blood of your existence and the other finds everything about sex repugnant, things might not work out between you.  But if your views about sex are similar enough, you can work out the differences because sexual compatibility can develop and evolve over time.

For instance, a common problem that couples talk about in sex therapy relates to sexual frequency.  A lot of people assume that if you and your partner have differences in how often you want sex, this means you're sexually incompatible and the relationship is doomed.  

But it's normal and common for two people in a relationship to have differences in how often they want sex.  

You wouldn't think it was unusual if you love to go dancing two or three times a week but your partner only likes to go once a week.  If everything else about the relationship is good, you would probably find a way to compromise.  

Similarly, a shift in your attitude can make a big difference when it comes to sexual frequency.  Instead of focusing on quantity, focus on quality.  

If you like having sex 2-3 times per week, but your partner prefers once a week, you could take care of your sexual needs by pleasuring yourself because, ultimately, you're responsible for your own sexual needs (see my article: Sexual Pleasure and the Erotic Self - Part 1 and Part 2).

Spontaneous Sexual Arousal and Responsive Sexual Arousal

Another common difference between people is how easily they become sexually aroused.  Some people, including many men and some women, experience spontaneous sexual arousal. 

Other people, including many women and some men, experience responsive sexual arousal (see my article: (see my article: Spontaneous and Responsive Sexual Arousal Are Both Normal).

Spontaneous arousal is what is frequently portrayed in movies and in mainstream pornography: Two people look at each other with desire and they immediately tear each other's clothes off because they can't wait to have sex.

Even though spontaneous arousal is portrayed as being better, in real life sexual arousal isn't always spontaneous at all.  

In addition, neither spontaneous nor responsive sexual arousal is better or worse.  It's just different.  And both types of arousal are common and normal.

Depending upon the couple, to overcome a difference in how each person experiences sexual arousal, it's often a matter of the person who experiences spontaneous arousal slowing down until their partner, whose arousal is responsive, gets caught up.  

Rather than this being a chore for the person with spontaneous arousal, slowing down allows them to savor pleasure so this can be a sexual turn on if they're able to enjoy the sexual anticipation (see my article: A Cornerstone of Eroticism: Longing and Anticipation).

Getting to Know Each Other's Sexual Accelerators and Brakes

Everyone is wired differently when it comes to sex and that's normal.

Sex educator and author, Dr. Emily Nagoski, discusses the idea of sexual accelerators and brakes in her book, Come As You Are, when she writes about the Dual Control Model of human sexual response.

Getting to Know Each Other's Sexual Accelerators and Brakes

The Dual Control Model, which is a theoretical model, was originally developed by Dr. John Bancroft and Dr. Erick Janssen of the Kinsey Institute in the late 1990s.  Briefly: This model says that sexual response in individuals is a balance between sexual excitement and sexual inhibition.

To simplify the concept of the Dual Control Model and make it understandable to the general public, Dr. Nagoski refers to sexual excitement (turn-ons) as sexual accelerators and sexual inhibitors (turn-offs) as brakes, similar to an accelerator and brake in a car (see my article: Understanding Your Sexual Accelerators and Brakes).

Just like you're getting to know each other in other ways, you're also getting to know each other sexually.  And part of getting to know each other sexually is getting to know each of your turn-ons (accelerators) and your turn-offs (brakes) over time (see my article: Getting to Know Your Own and Your Partner's Sexual Accelerators and Brakes).

Some people's sexual accelerators are more sensitive than their brakes.  For those people, getting turned on is relatively easy, and their turn-offs don't usually get in the way much.  

Other people have sexual brakes (inhibitions) that are more sensitive.  In order for them to get turned on, they need to deactivate (lower) their inhibitions before they can get turned on.  

If you're someone whose sexual accelerators are more sensitive than your brakes but you're in a relationship with someone whose brakes are more sensitive, there's nothing wrong with this.  In fact, it's common and normal.  It just means that the two of you will need to find a way to make it work for both of you (I'll give an example of this below).

As you get to know each other, you'll also discover sexual differences in terms of turn-ons and turn-offs. For instance, you might enjoy sex when you're really stressed out.  Maybe stress helps you to feel energized to have sex.  Not only does it make you feel closer to your partner, but sex is what you need to relieve stress.  So, stress is a sexual accelerator for you.  

But for your partner, stress is a brake.  They can't relax enough to have sex if they're under a lot of stress.  Stress really gets in the way for them.

So, you can find a compromise.  Maybe when you feel energized by stress and you're eager to have sex, you slow down a bit to help your stressed out partner by giving them a massage to help them relax.  The physical touch can be sexually invigorating for you and calming for your partner.  Then, when your partner is relaxed enough to have sex, you can both enjoy it.

According to Dr. Nagoski, for most people to become sexually aroused, it's a matter of deactivating the brake and activating the accelerator.  

A Willingness to Have Sex and Work on the Differences is Often Enough to Improve Sexual Compatibility

As I mentioned earlier, a willingness to have sex is often enough to get people started.  

This often means that one or both people aren't necessarily turned on when they start having sex, but they know they will become turned on once they get into it.

A willingness to have sex and to be open to novelty can go a long way to improving sexual compatibility.

Clinical Vignettes: Sexual Compatibility in a Relationship Can Develop and Evolve Over Time

The following vignettes are composites of many different cases with all identifying information removed to protect confidentiality:

Tom and Gina: When Tom and Gina first met, they clicked right away.  Their first conversation started at a mutual friend's party and continued over drinks later that night.  They had a mutual attraction, and they discovered they had a lot in common in terms of their interests, family background and values.  

Two weeks later, Gina asked Tom to come over one night for drinks.  As they kissed and cuddled on the couch, she invited him to spend the night.  They had both been anticipating and looking forward to this night.  But things didn't go as smoothly as they had anticipated. 

Spontaneous vs Responsive Sexual Arousal

Whereas Tom got so turned on immediately (spontaneous arousal) that he wanted to have penetrative sex immediately, Gina wasn't ready to have intercourse right away. She told him that she needed kiss more and be caressed to get sexually turned on (responsive arousal).  

So, Tom slowed down and kissed and caressed Gina in ways that were pleasurable to both of them.  He also learned from her that she didn't enjoy penetrative sex as much if she didn't have oral sex first (see my articles: Closing the Orgasm Gap - Part 1 and Part 2). 

So, he learned. how to please Gina so they could both enjoy sex (see my article: Rethinking Foreplay as More Than Just a Prelude to Sexual Intercourse).

Alice and Jane: Jane and Alice had strong sexual chemistry from the start.  They both enjoyed sex together, but whereas Jane especially loved to have sex when she was stressed out, Alice needed to feel relaxed before she could enjoy sex.  In other words, stress was a sexual accelerator for Jane, but it was a brake for Alice.  

Getting to Know Each Other's Sexual Accelerators and Brakes

So, over time, Jane learned to slow down to help Alice to relax before they had sex.  

Over time, Jane and Alice learned how to create an environment to enhance sexual pleasure for both of them.  Jane knew that Alice liked to listen to smooth jazz to help her relax and get into the mood for sex, so she made an effort to set up the music before they went to bed.  

Alice knew that Jane liked to watch feminist pornography (also known as ethical porn) to get her turned on, so Alice had certain videos on hand that turned them both on.  They also both liked to give and get massages.  For Jane, it was sexually stimulating and for Alice, it was relaxing.  

Bruce and Ed: When Bruce and Ed first met, they were both very passionate about having sex.  They had sex frequently, including long weekends in bed.  But several months into their relationship, they weren't as passionate with one another.  Some of that new relationship energy had decreased over time and they were having less sex--although Ed usually wanted to have sex more often than Bruce (sexual desire discrepancy).  

Sexual Compatibility Can Evolve Over Time

Sometimes Bruce was willing to start having sex with Ed because he knew he would eventually get turned on (responsive arousal and a willingness to have sex).  But there were times when Bruce wanted to have sex once a week when Ed wanted to have sex 3-4 times a week.  

At first, they argued about it because Ed felt rejected whenever Bruce didn't want to have sex as frequently.  Eventually they worked out an agreement where Ed would masturbate to pornography during those times when Bruce didn't want to have sex. 

This worked out for both of them for a while, but two years into the relationship, Ed wasn't satisfied with this.  As a result, they agreed to have a consensual nonmonogamous relationship (also known as an ethical nonmonogamy).  

They worked out a detailed written agreement until they were both comfortable with it.  Essentially, their agreement indicated that they were primary partners to each other, but they could have sexual affairs with other people as long as they each knew about who they were sleeping with.  The agreement also indicated that these affairs would be strictly sexual and not emotional, and they would be short affairs.  Over time, they revised their agreement to meet each other's needs.

Conclusion

Sexual compatibility can develop and evolve over time.  

Contrary to popular opinion, sexual compatibility doesn't just happen automatically.  Sometimes the newness of the relationship brings sexual passion and excitement. 

But sometimes it takes a couple a while to get in synch with each other at the beginning of a new relationship because each person needs to get to know the other in terms of sexual arousal (spontaneous or responsive arousal) and turn-ons and turn-offs (accelerators and brakes) and find a way to compromise.

A willingness to have sex is often enough for both people to get aroused and enjoy sex.  

Sexual compatibility also changes over time.  Once the new relationship energy subsides, a couple might need to find other ways to enhance their sex life.

The most important takeaway is that a couple who experiences sexual desire discrepancy--whether it's at the beginning of their relationship or later on--can learn to work out these issues.

Getting Help in Sex Therapy

Many couples experience sexual desire discrepancy as an overwhelming problem, especially if this problem is longstanding and resentment has built up over time.

Getting Help in Sex Therapy

Working with a skilled sex therapist can help a couple to find new ways to overcome desire discrepancy so that they both enjoy a fulfilling sex life together (see my article: What is Sex Therapy?).

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 regardless of gender or sexual orientation.

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 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.