What’s the deal with sex therapy and should you be going?
We know what sex is and we’re all about therapy, but we spoke to Psychosexual & Relationship Therapist Kate Moyle about the result of combining the two and why it’s something more of us should probably be considering.
SO, WHAT IS SEX THERAPY?
It’s talking therapy for those who specifically need help with a sexual difficulty and the impact it is having on them. Described as integrative, it involves some medical understanding that helps to identify whether the problem is psychological, physical or a combination of both. It also looks to understand the history of that person, any contributing factors, and what is maintaining the issue in their current situation. It can involve a combination of talking therapy, to challenge negative thoughts or behaviours and increase awareness, psycho-education and some exercises for individuals and or couples to do at home.
WHAT SHOULD YOU EXPECT FROM A SESSION?
Psychosexual therapy will start with an assessment process or appointment to determine the best course of action for the individual or couple. The key point is that, like all therapy, this is a confidential process. Talking about sex can bring up feelings of shame or embarrassment, but psychosexual therapists have specific training in order to work with these types of problems and will help you to feel more comfortable talking about them. An assessment will help to put a clearer picture in place and, if the therapist suspects there may be a physical cause for symptoms, will refer you to ensure the best treatment process. This could be to a GP, gynaecologist, urologist, men or women’s health physiotherapist or sexual health clinic, to understand further what is going on fully. It is also important to note that some medications can impact sexual functioning, so telling your therapist any medications you are on is important.
Post-assessment the therapist will discuss a treatment plan, the approach to the therapy process and what your goals are. The main question that most psychosexual therapists get
asked is ‘how long will it take?’, but it’s all about the individual. Like all therapy processes, the more that someone puts into it, the more they will get out of it; hopefully successfully achieving the change they are looking for. Appointments are typically 50 minutes weekly and there may be some exercises to be done at home in-between sessions.
Some people may initially find it uncomfortable discussing the more intimate details of their sex lives with a stranger, but that’s why therapy can be useful. It’s worth keeping in mind your therapist is completely removed from the rest of your life and relationships.
IS IT SOMETHING THAT SHOULD BE DONE ON ONE’S OWN OR AS A COUPLE?
Either. Many individuals feel like they can’t talk openly in front of their partner about the feelings or symptoms they are experiencing. Although it may sound ironic, it’s often the case that the trickiest person to talk about sex with is the person we’re having it with. Most sexual dysfunctions come with a lot of feelings of confusion and shame that can prevent people from accessing help or trying to work through the problem.
If a sexual problem is occurring in a relationship, it is helpful for couples to attend together as the dynamics may be playing a role in why it’s happening. It also offers the couple a
neutral space with someone else there to express how they are both feeling, and listen to and understand each other better. Many people also attend after the break-up of a relationship or because they have met someone they would like to be in a relationship with.
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WHEN’S THE RIGHT TIME TO SEE A SEX THERAPIST?
Ideally we’d see someone before the problem becomes too engrained, but this is rarely the case. Most people look into psychosexual or relationships/couples therapy when there has been a trigger event, so they attend as a response. If a sexual difficulty is causing you distress, it is better to get it sorted in order to alleviate it and get yourself back to a place of sexual health and happiness — meaning a state of wellbeing and attitude, rather than just being infection free!
The Diagnostic And Statistical Manual Of Mental Disorders characterises that to be diagnosed with a sexual dysfunction, the symptoms must be present for at least six months, but if a difficulty or dysfunction is repeatedly occurring then dealing with it sooner is preferable. It can become a vicious cycle; the more it occurs, the greater the anxiety around it develops. The more stressed a person becomes about a problem, the more in their head and less in their body they are able to be which can interrupt the processes of
sexual arousal and desire, often leading to a higher likelihood of dysfunction. This, in turn, can confirm stresses and anxieties, making them stronger, so the effect can be re-enforcing.
WHAT ARE THE MOST COMMON ISSUES?
When working with couples, it is about understanding how their relationship and sex life is, or is not, working together. Often it comes down to tackling sexual anxiety in different forms, which seems to be at the root of most psychological sexual dysfunctions.
Common presentations are erectile dysfunction, rapid ejaculation, vaginismus, Dyspareunia, sexual anxieties, lack of sexual desire, delayed ejaculation, questions around sexuality or sexual desires, lack of sexual experience, sexual trauma or assault, inability to orgasm, difficulties with pornography use or genito-pelvic pain.
There are often presentations at different life stages, for example trying to get pregnant, or having just had a baby or menopause, or as a result of an illness, injury or medication.
IS THERE A WRONG TIME TO SEE A SEX THERAPIST?
There is never a wrong time to see a therapist and it is likely that even voicing your feelings can be helpful in some way, even if it’s making you more aware of your own process and what is going on. However it’s not a magic wand, so sadly can not fix everything. It’s more of a catalyst for helping the person attending to help themselves. An important part of therapy is setting goals for change, so they may be need to be adjusted, but that isn’t always a negative thing.
ARE THERE DIFFERENT TYPES OF SEX THERAPY AND HOW DO YOU KNOW WHICH IS RIGHT FOR YOU?
Like all therapy, the thing that is central to a good experience is the relationship between the client and the therapist. It is important to do your research and understand the approach of the person you want to work with. There are some more specialist organisations, such as Pink Therapy, who work with gender and sexual diversity clients,
and The College of Sexual & Relationship Therapists (COSRT) offers a listing of all therapists who are General and Accredited members which ensures a level of qualification for the work.
Kate Moyle is a COSRT Accredited Psychosexual & Relationship Therapist and one of the founders of The Thought House Partnership in London. Follow her on Instagram @katemoyletherapy or Twitter @katemoylepsyc