What Happens in a Sex Therapy Session?

By jimmyhutton on January 8, 2018 in

If only they’d had a sex therapy session, by David Lee Rothel

As a sex therapist I am often asked what actually happens in a sex therapy session. Sex therapy is a counselling experience where the client has identified their problem as a sexual one.
Unlike other types of counselling, sex therapy focuses on human sexuality and intimacy; facets of our lives that are often difficult to discuss. It is based on open conversation in a comfortable non-judgmental atmosphere where single and partnered individuals, no matter what their sexual orientation, can feel safe.
Sex therapy helps men resolve issues such as premature or delayed ejaculation, erectile dysfunction or impotence, performance anxiety, sexual problems after illness, and compulsive sexual behaviours. Issues for women include painful intercourse, difficulties experiencing an orgasm, loss of desire for sex, or problems when reaching menopause. Both men and women may struggle with sexual orientation or gender identity.
Through sex therapy, couples can discuss desire discrepancies, intimacy issues, jealousies, infidelities, lack of sex education, and other related relationship problems.
Sometimes the fear of confronting the issue and perhaps discovering that they are not compatible is so powerful that some couples delay asking for help. They might have easily solved their problems but by waiting too long they suffer for years and by then it’s often too late to save the relationship.
Most of my clients believe they are the only ones having sexual problems. They think their friends and colleagues have great sex lives. The media does not help either; they portray sex as easy, making it look like everyone has lots of it, except them.
When I counsel couples, both have the opportunity to talk about their issues with the other. They often can’t solve them on their own because the hurt, anger, disappointment, accusations, and fighting have led them to stop talking altogether.
As I am extremely aware of how anxious clients may feel talking about such intimate issues with a stranger, making them feel comfortable and relaxed is a priority.
The first session for a couple usually takes about 1.5 hours. We discuss what they believe the issue is, when the problem started, whether their relationship was once a happier one, why they think the problem happened, and whether they’ve tried to resolve it on their own. Also, crucially, what they expect to get out of the session.
There is a sense of safety in a counselling room that allows people to divulge and express themselves rather than staying silent; even anger is allowed. Often couples start telling each other things they usually wouldn’t, simply because I’m there as the mediator.
After seeing them as a couple, I sometimes see each of them separately for a confidential session. This time alone often helps individuals answer the tougher questions more honestly and clearly. Anything discussed in this session is strictly confidential and won’t be brought up in the next couple session if they don’t want it to be.
I have rarely encountered a problem between two people that I didn’t feel was somehow resolvable.