“The more we trust, the farther we are able to venture.”
We have specialized training and expertise to help you address your sexual concerns. Many people feel intimidated or shy to begin addressing such personal issues in psychotherapy, but our clients tell us that our directness and easy manner in discussing sexual issues helps them feel more comfortable within the first session or two.
Our relational orientation means that we will be carefully tracking the relationship and each partner’s experience as we go; it’s not just a question of how to change a behavior or a symptom as though no people are attached! Your feelings matter, your perspectives matter, your experience matters, and your relationship matters as we address your sexual concerns. We hold an appreciation for the breadth of human sexual experience and embrace an affirmative, sex-positive, and non-shaming perspective.
Sex therapy is like all other psychotherapy: we talk about what’s happening for you. (There is no touch or nudity involved in sex therapy.) We will ask you many questions to help us develop a better understanding of the problem. It is essential that we consider physical/biological, emotional, psychological, and relational aspects of your experience. Some sexual problems come from a single source, but many are multi-determined. Once we have a clear picture of what is happening, we will make a plan for how to address it, which often involves out-of-session homework. It is important that we pace the therapy to suit each client, so whatever assignments we develop should not be overwhelming, and will respect your boundaries and comfort. While there are some core exercises at the foundation of sex therapy, we always tailor the plan to our clients’ particular needs and context.
When you’re in a relationship, we often prefer to see you and your partner together, even if it seems like the focus is more on one person. However, we do see individuals for sex therapy as well. We can discuss your circumstances and wishes when we set up the first appointment.
Sexual Issues Addressed Include:
- Sexual pain
- Impact on sexual functioning or satisfaction related to medical or health problems
- Couple communication problems around sex
- Desire concerns, including discrepant desire in couples
- Difficulty with arousal, including problems with erections
- Difficulty with orgasms
- Rapid (‘premature’) or delayed ejaculation
- Sexual changes with aging; menopause and sexuality
- Not experiencing pleasure with sex
- Couples with differing erotic templates or sexual styles
- Feeling stuck in a sexual rut
- Fear of gynecological exams, or difficulty tolerating them
- Sexual shame
- Past trauma triggered by sex, including experiences like fear, avoidance, flashbacks, dissociation
- Concerns about fantasies
- Concerns around sexual orientation or gender, coming out
- Concerns around kink or kink discordance
- Tensions between religious upbringing or values and adult sexuality
- Concerns about masturbation or pornography use
What to Expect from Sex Therapy
At our first session, we’ll confirm our understanding of what brings you in – what you want to focus on. Then your therapist will invite you to tell them more – about yourself, your life, your background, your relationship if you’re in one, and the problem you’re having. Some people have quite a bit of ease discussing their sexuality. Others may find this initially difficult because it’s been so private. We can help with this. We are good at asking questions to open up the topic, and we work hard to go at your pace. You always have the right to slow the pace or stop the discussion if you are too uncomfortable. Then we’ll switch gears to understand your discomfort and what would help so we can gradually develop a shared understanding of your concern.
We will ask questions, such as when the problem began, how you’ve managed it, what meaning you make of it. Our questions are led both by the answers you provide and by our training and expertise. We know, for instance, specific questions we will want to ask to understand sexual pain, erection problems, orgasm problems, etc.
For couples, sexual problems are often intertwined with relationship patterns and challenges. With a couple we typically follow the same pattern we do for other couples therapy, where we first meet all together, then each partner has an individual session with the therapist. There we gather information about that person’s history, including relationship and sexual history, and develop more of an understanding about how the sexual problem affects each person (whether they are the “symptomatic” partner or not). Then we come back together, and will reflect our understanding of the problem and its contributing factors, and will suggest a plan to address them. For individuals, we will typically do one or two sessions of information gathering and exploration, and then will reflect our understanding of the problem and suggest a path forward to address it.
Woven into this assessment process, and throughout the therapy, we will provide information on sexuality and your specific sexual concern. We may suggest reading materials or other resources. If there is a suspected or known biological component to the problem, we may work with your medical providers, or refer you for medical assessment and care. We find that sexual problems are rarely “just” physical. They are almost always more complicated than that, often having had impacts on your thoughts, feelings, sense of self, and/or relationship that need be explored and processed in order to move forward.
We may suggest exercises for you to do at home, whether partnered or alone. We always discuss the exercises, explain why we are suggesting them or how they work, and explore your feelings about the suggestion and any barriers or problems you anticipate. Consent is essential, and you always have the right to say no if it’s not right for you. In fact, we encourage it. And if you think an exercise will be fine, but when you go to do it, it turns out to be too challenging, that’s fine! We’ll talk in your next session about what was difficult so we can adjust it in a way that works for you.
Sexual Issues Addressed Include:
• Sexual pain
• Impact on sexual functioning or satisfaction related to medical or health problems
• Couple communication problems around sex
• Desire concerns, including discrepant desire in couples
• Difficulty with arousal, including problems with erections
• Difficulty with orgasms
• Rapid (‘premature’) or delayed ejaculation
• Sexual changes with aging; menopause and sexuality
• Not experiencing pleasure with sex
• Couples with differing erotic templates or sexual styles
• Feeling stuck in a sexual rut
• Fear of gynecological exams, or difficulty tolerating them
• Sexual shame
• Past trauma triggered by sex, including experiences like fear, avoidance, flashbacks, dissociation
• Concerns about fantasies
• Concerns around sexual orientation or gender, coming out
• Concerns around kink or kink discordance
• Tensions between religious upbringing or values and adult sexuality
• Concerns about masturbation or pornography use
We are guided by the certification standards and Code of Conduct of the American Association of Sexuality Educators, Counselors, and Therapists (AASECT), and are aligned with other professional organizations such as The Society for Sex Therapy and Research (SSTAR).