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What happens in a sex therapy session?

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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, by portraying sex as easy and hot and 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 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, was their relationship once a happier one, why do they think the problem happened, and have they tried to resolve it on their own? Also crucially, what do 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 am in the room 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 workable and resolvable. I am a solution-focused therapist and often two to five sessions are enough to get excellent results.

About half of my clients are young males with some sort of sexual dysfunction that has affected their sexual confidence. These days there are so many unrealistic expectations of what normal sexual behaviour should be that they are very confused. Unlike many women, men can't seem to talk about their problems to their mates.

Men have to perform. If, for example, they have premature ejaculation, they can also acquire erectile problems which can result in performance anxiety. In a session I would take their sexual history and try to find out if the problem had been life-long or started later in life. Do they have the same problem when they masturbate?

If a list of possible causes is ruled out, it's often a performance anxiety issue, which can be successfully treated with counselling, practical sexual advice and reassurance. Sometimes one session is enough.

The same happens for women who believe they have lost their desire, experience painful sex or have difficulties achieving an orgasm. By taking a detailed history I can identify and clarify the issue, help to get a better understanding of them and together we can develop the right strategies.

Relationship counselling embraces the concept that sex will get better as the relationship problems are solved. But I don't believe that; it's my experience that unresolved sexual problems are harmful. Sex therapy focuses on improving a couple's relationship and sex life by addressing the problems in both areas at the same time.

If more people went to sex therapy as soon as a problem arose, there might be less heartache and divorces down the road.

18 comments

  • Expect requests for your contact details by those with low libido partners.
    Anyhow, my take on it is whatever the problem/challenge, acknowledging it is the first step towards resolution, all too often people bury their head in the sand in the delusional belief that there is no problem/challenge and that it's all normal.

    Commenter
    Victorious Painter
    Date and time
    March 04, 2014, 8:41AM
    • Great ad.
      Are you free sometime tomorrow afternoon?

      Commenter
      We Have a Problem
      Date and time
      March 04, 2014, 9:08AM
      • Great article! I wished I would have known sex therapy could be so effective, maybe I still would be married!

        Commenter
        Claudia
        Date and time
        March 04, 2014, 9:15AM
        • Yeah i thought the same.

          Commenter
          Matt
          Date and time
          March 04, 2014, 3:57PM
      • A wonderful service and it's great to let people know more about it so they don't feel intimidated thinking about booking a session or two - well done Matty

        Commenter
        Norma Jean
        Date and time
        March 04, 2014, 11:39AM
        • "Relationship counselling embraces the concept that sex will get better as the relationship problems are solved."

          I agree that this is not necessarily true. There are relationship problems, and then there are sexual problems. It's all about communication, and sex is a language in and of itself, different from the words that are uttered from the heart and out of the mouth. Sex is a language conveyed primarily through actions that may or may not be interpreted the same way between partners. It's pretty complex which makes it that much more special when it really works between two people.

          Commenter
          All Heart
          Date and time
          March 04, 2014, 11:40AM
          • I guarantee the very first thing that happens is...

            Your contact and banking details...

            Commenter
            Sexed
            Location
            Sydney
            Date and time
            March 04, 2014, 11:52AM
            • Of course you should expect to pay for this or any service. Nothing is for free.

              Commenter
              I know, I've been there
              Location
              Sydney, NSW
              Date and time
              March 04, 2014, 12:59PM
            • LOL...no more to say...LOL.

              Commenter
              Sexed
              Location
              Sydney
              Date and time
              March 04, 2014, 1:09PM
          • I truly wish more people would acknowledge the gentle guidance and positive help solutions a Sexual Health Therapists can provide. It is a service well worth the money IF you're WILLING and WANT to help your relationship or yourself.

            Commenter
            I know, I've been there
            Location
            Sydney, NSW
            Date and time
            March 04, 2014, 12:58PM

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