While relationship and sex therapy are individualized and I start where you are, I have found that sex therapy with couples or individuals often includes common themes. I can explain these more in detail but understand that in sex therapy, there is no touching in the office. I use an educational and talk therapy approach to teach clients to improve physical and emotional intimacy with their partners. We work on a variety of subjects so that you can learn how to feel comfortable and safe as both a giver and receiver while being intimate with your partner. Together we work towards your goals and we do this with current research from the field of Sexual Health. These techniques will vary and depend on you and what you bring forward. If you are a member of a couple, heterosexual, gay, bisexual or transgender, we may utilize couples therapy to address aspects of your relationship that contribute to and maintain sexual difficulties. Or, we may work individually depending on the issue. Together we will decide what makes the most sense. Some people come in to process and talk through to understand where they are with certain subjects, but others are looking for a specific plan around improving intimacy. I do both, and our plan will depend on makes most sense for you.
I am not sure what certified sex therapists do. They:
1. Provide sex education to correct misconceptions about sex, allowing people to have realistic expectations when they engage intimately.
2. Offer specific suggestions to help patients add in intimacy in a way that they can be successful. Many people approach this in ways that make it worse or create other problems, for example, people pull back and stop engaging all together, or they “white-knuckle” through pain or situations that are not positive.
3. Help people learn to think of themselves as sexual people and learn to think of their partners as sexual people, if these things are more difficult (due to illness, couples being more friends, or from ingrained thoughts around sexuality from religion, society, family).
4. Help partners negotiate desire discrepancies (when one partner has a higher drive than the other), and other times it is helping couples negotiate differing erotic interests or fetishes.
5. Help people work on body image and self image along with other areas that relate to the feeling desired and desirable. Many people go outside monogamous relationships to feel that someone other than their partner desires them proving their worth.
6. Work with those who have out of control sexual behaviors.
7. Provide more effective marital therapy. Relationships include both emotional and physical intimacy, and sex is a part of every relationship whether people are active or not.
8. Help facilitate effective communication around intimacy to minimize arguments between partners.
9. Process feelings of shame and anxiety associated with sex and sexuality.
10. Help couples with desire discrepancies or where one or both partner has a fetish that is causing distress.
11. Help patients work through grief and loss if there is a change in their sexual functioning due to illness or age. The focus becomes helping patients accept and adjust to their new sexual normal and helping them shift their mindset to continuing to engage, one way or another.
NON-SEXUAL HEALTH ISSUES AND MENTAL HEALTH: While I have additional training in sexual health, many individuals and couples work with me on issues that have nothing to do with sexual health. With 25 years of post-masters clinical experience as a psychotherapist, in in-patient psychiatry and out-patient private practice, I have see people with non-sexual health issues presenting with anxiety or worry, depression, loss, divorce, trauma, cancer and other illness, grief, self-esteem, trust related issues, infidelity recovery, and issues around parenting or employment. Others come in around struggles with mood or bipolar disorders or difficulties related to major mental health. I work with couples in marital therapy or divorce therapy (couples working to separate out in a healthy way, for the individuals involved including their kids). When a person is not open to or able to work on his/her part, I work with family members on how to manage their piece. I also see people for non-sexual health issues, but they know that it is possible to talk about sex in their individualized therapy if it comes up.