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 partnered, we may involve your partner 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 understand where they are with certain subjects, but others are looking for a specific plan around improving physical and/or emotional intimacy. I do both, and our plan will depend on makes most sense for you.
I am not sure what AASECT Certified Sex Therapists do. They:
1. Help people understand if specific sexual difficulties have mostly a psychological or physical cause. Certified sex therapists put a plan together to address both components.
2. Help people manage desire discrepancies, when one partner has a higher drive than the other.
3. Teach specific behavioral interventions for different sexual difficulties (for example, with erectile dysfunction, painful sex, delayed orgasm, etc).
4. Provide sex education to minimize misconceptions about sex, allowing people to have realistic expectations and less arguments when they engage intimately.
5. When people haven’t engaged in some time, offer specific suggestions to help patients add in intimacy in a way that allows them to be successful. Many people approach this in ways that actually 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.
6. Help people learn to think of themselves as sexual people and learn to think of their partners as sexual. This can be more difficult for some due to illness. Other times couples relate more as friends, or people have ingrained thoughts around sexuality from religion, society or family.
7. Help people work on body image and self image along with other areas that relate to feeling desirable. Many people go outside their relationships to feel that someone other than their partner desires them. This seems like more powerful when it is someone from the outside, demonstrating that they have worth.
8. Help those who have Out of Control Sexual Behaviors. People often do this for many reasons, but sometimes to feel and know they are desirable and to feel they have worth and value.
9. Provide more effective marital therapy. Relationships include both emotional and physical intimacy, and sex is a part of every relationship whether people are sexually active or not.
10. Help facilitate effective communication around intimacy to minimize arguments between partners.
11. Process feelings of shame and anxiety associated with sex and sexuality.
12. Help people understand and navigate fetishes or erotic interests that cause distress.
13. Help patients work through grief and loss due to the change in sexual functioning. While I help patients accept and adjust to their new sexual normal and help them shift their mindset, we also address what things might allow them to engage in an intimate way.
14. Help navigate open, poly, consensual non-monogamous relationships.
15. Explore orientation and gender with those who are trying to better understand where they fit with their identity and/or behaviors. This may or may not involve letters with recommendations for those that are interested in obtaining hormones or surgeries.
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 28 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 obsessive 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 someone is not open to or able to work on his/her part, I work with family members on how to manage their piece and navigate forward. 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 an issue arises. They don’t need an additional therapist to see them for basic mental health issues. If you have a good general therapist that you are comfortable with, you can just see me around the sexual related difficulty.