Who needs sex therapy?
Men and women come to sex therapy for all kinds of reasons and they can be of any age. Some people come to therapy on their own and others come as a couple. Whether a client’s sex life has changed because of surgery, the side effects of medication or other physical causes, or they are experiencing mental or relational challenges, seeking help is a very positive step and will open up new possibilities for healthy sexual functioning and increased couple intimacy.
How does sex therapy with me work?
When assisting a client with a sexual problem, I look carefully at the whole picture. I offer two initial assessment sessions of 50 minutes each, in which I collect basic details, medical history medication, lifestyle, and information about family, upbringing, schooling, and religious or spiritual beliefs. I ask about how the client learned about sex, and what their first sexual experiences were like – right up to their current sexual relationship if they are in one.
As I work with a client I formulate a ‘diagnosis’ which considers focuses on:
I explore the reasons why a person may be more likely to have sexual problem. Perhaps they have not had adequate sex education, or they have had negative past sexual experiences including sexual abuse or trauma.
Precipitating factors (triggers)
Did anything happen directly before the problems began? For example, a couple’s sex life might have been good until a life event impacted it eg. the birth of child, bereavement, an affair or redundancy.
Sexual problems are very common and so it is important to understand what is keeping this person or couple ‘stuck’ in this dynamic while others might have been able to get over the problem.
When considering sexual problems is also important to understand certain things:
Is the problem absolute or situational?
For example, if a man can get an erection during masturbation but not with his partner, this would be considered situational and it would be less likely that a physical condition is the source of the problem. If the problem does not change in either scenario then this would be considered absolute and more likely to indicate an underlying physical cause.
Is the problem the problem is primary or secondary?
Primary is where the person has always experienced the problem. Secondary is where there is a clear development of the problem. A woman may have had sex comfortably for many years and then it becomes painful. This would be considered secondary dyspareunia.
Once I have gathered all of this information in the assessment sessions I then formulate a treatment plan with the client, which may include ‘homework’ in the form of exercises or education, to be done between sessions.
I give follow up sessions on an ad hoc basis depending on the needs of the client(s) and their treatment plan. I tend to not see a client more than once every fortnight and sometimes not until one to three months after the initial assessment depending on whether the problem is being treated with medication or with more of a behavioural focus.