Blog 117. Therapy Part G: Sex Therapy.
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Once a relationship therapist qualifies, they will have a sufficient knowledge of the various sexual issues that most couples face. Certain therapists however, can go on to specialise in sex therapy.
A sex therapist is usually recommended for either an individual or a couple with particular sexual issues, especially if it is a couple’s foremost presenting problem. Sexual issues may also however, overlap with other relationship issues. This is why it is therefore important that a sex therapist be initially trained as a relationship therapist.
When clients enter the first sex therapy session, they may feel nervous and embarrassed. It is therefore important for the therapist to make clients feel reassured and comfortable as soon as possible.
A sex therapist will have been trained specifically and there will be very little that they will not have already heard or dealt with.
A sex therapist does NOT and should not have any physical contact with a client.
The therapist is only there to listen and guide, and/or they may also provide the client or couple with exercises to do in their own time.
These sessions differ somewhat from other therapy sessions. Depending on the problem/s presented, clients don’t always have to see a sex therapist on a weekly basis. Instead, fortnightly or monthly sessions may be accepted and indeed, agreed upon. This may change as the therapy continues.
What actually happens in a sex therapy session?
Here is a summary of what sex therapy involves which you can look up on the Internet:
“A sex therapist will listen to you describe your problems and assess whether the cause is likely to be psychological, physical or a combination of the two.
Talking about and exploring your experiences will help you get a better understanding of what is happening and the reasons.
The therapist may also give you exercises and tasks to do with your partner in your own time.
Each therapy session is completely confidential. You can see a sex therapist by yourself, but if your problem affects your partner as well, it may be better for you both to attend.
The therapist may advise you to have weekly sessions or to see them less frequently, such as once a month”.
The main reasons why it may be important to see a sex therapist:
And again, most sex therapy sites on the Internet explains the following:
“The most common understanding is that a sex therapist can help people with various sexual problems, including:
- lack of desire.
- difficulty getting or keeping an erection which is also known as erectile dysfunction).
- premature ejaculation or other ejaculation problems.
- lack of desire.
- difficulty having an orgasm or pain during sex or inability to have penetrative sex”.
Here are some of the other reasons I also know of or came across:
Individual sex therapy:
Sex therapy may also be useful when there is:
– an addiction to sex.
– sexual issues as a result of abuse and so on.
– physical sexual issues that may lead to a lack of confidence, embarrassment and relationship issues as a result.
– a concern about sexual preferences, especially if there is family or religious concerns. Help may be required with regards accepting sexuality and possibly ‘coming out’.
– women who find sex difficult and traumatic as a result of genital mutilation.
– men who find sex difficult and traumatic after circumcision if the operation was unsuccessful for whatever reasons.
– men or women who may be victims of rape. Experiencing sex after this trauma can be very difficult as it may bring back memories of the abuse.
Couple sex therapy:
Seeing a sex therapist is often highly recommended, especially when:
– A couple may be struggling to communicate their sexual desires and it is beginning to impact their relationship.
– a couple may be experiencing particular sexual problems that may need to be addressed as it could be stunting or damaging the relationship.
– some couples find having sex during or indeed, after pregnancy and children difficult.
– a partner may be questioning their sexuality. In this case, it may be that both partners need to address this issue, so that they can find a resolution that will suit them both.
– a couple may have fertility issues and as a result, having sex on demand may prove difficult. This may bring up other issues that may have been sitting dormant or hidden in the relationship dynamic.
– some couples who’ve been told they’re unable to conceive, find having sex after hearing his news difficult. This could lead to blame, anger and resentment – and it could result in the couple splitting or separating.
How each person perceives sex and the messages that they may have received about sex, may have originated from their parents, their family, their religion and their culture:
Some couples may however find communicating their sexual needs extremely difficult.
Sex may be:
– embarrassing and a couple may be shy or ashamed.
– they may not understand what happens during sex.
– they may not actually understand their own anatomy.
– they may not understand that pregnancy may be consequence of sex.
– they may be bored and sex may need to be revitalised.
– they may have suffered a loss: miscarriage or the death of a child and they may need help rekindling their sex life.
Also, here is an extreme example of what a couple may struggle with:
Sometimes one member or partner of a couple may view sex only as a method of conceiving children and if no children are produced, this could create friction, a sense of failure, anger, depression and resentment. The extended families may also try to get involved and this may add to the pressure of trying to conceive. The couple may need help to relax or they may need help accepting the situation. Most importantly, they may need help understanding that sex is just as important, in order to sustain their relationship intimacy.
This example is one of many that points out how important it is for couples to understand what each partner’s expectation of sex really is. However, sometimes the expectation is either unconscious or part of the person’s unquestioned understanding of sex – which may it be part of their culture or their upbringing.
In other words, what is expected sexually from either male or female can also vary from person to person, or from culture to culture. And if couples come from different backgrounds then it is crucially important that each individual finds a way of communicating their sexual expectations so that a better understanding or if necessary a compromise, can be reached between the couple.
Past experiences and traumas can also have a direct influence on sex and any resulting pregnancy:
Sometimes it may become important that during sex therapy, childhood and any past relationships may have to be explored, or indeed past traumas explored, in case there are any patterns that are emerge that are aggravating the present problem.
– Here is an extreme example of how past abandonment, or how the fear of abandonment can influence the sex life of a couple if indeed the wife were to become pregnant:
A possessive husband may want his partner all to himself and the idea of her attending to a child can seem threatening. This may even result in violence as the jealous husband tries to kick or punch the pregnant woman’s stomach. I have written about this previously and how worrying and stressful this kind of circumstance can be for the pregnant mother. Sadly, this may create further problems as parenting and all that it involves, may become an issue resulting in a couple even separating or if she stays the violence could continue.
– If someone has been raped or sexually abused this can have an impact on any further sexual relationships. Sex may trigger past memories and this may become an issue for a couple.
– If someone has had an abortion or if they’ve miscarried then this could create an anxiety and even guilt, if the mother goes on to conceive another child. Sex could then become an issue in various ways.
Often all these issues can lead to a lack of desire and this may become difficult in a relationship.
And it may therefore be important to explore past relationships to see if there is also a pattern of sexual issues that may help solve the current problem.
It is often worth while checking if a sexual issue isn’t one that occurred in a previous relationship or whether it is a pattern that needs addressing. In this instance relationship therapy may be necessary before the sexual issues are dealt with.
Sexual Issues may lie not with the individual but within the couple dynamic:
Sexual issues or problems don’t always only lie with the individual. It could also lie within the couple dynamic: how a couple relates, how they communicate or why they were attracted to one another, may become part of the therapy. Most importantly, what a couple expects from one another and /or what they expect from one another sexually, may be crucial to understanding the issues presented.
Not every couple has a raging sex life:
Some may think that all couples have regular and consistent sex lives. For some couples this may be true. However, for many other couples, sex may not be all it’s made out to be.
Often couples struggle to articulate what suits them best, some may be too embarrassed or indeed ashamed. Some may even fake the experience so as not to rock the boat. Some have orgasms whilst others struggle to. And some may never even have experienced an orgasm. Some may find sex too painful, others have little or no desire and this may become an issue for a couple, especially if they want children.
Sex and Men – which is often never discussed:
Women don’t always realise just how stressful sex can be for men, especially as they get older. During any sexual experience, once a man gets hard, sustaining this in order to please a woman can either lead to premature ejaculation or losing the urge too soon. This can be frustrating for a couple and if it keeps on occurring them it certainly needs addressing. And also pleasing a woman and helping her reach orgasm can be just as stressful. This is why most men worry whether they are able to perform adequately in bed.
Women don’t always understand that men have sexual needs that relate to their physical anatomy. Often they physically require sex so that they can release the build up of semen. Not having sex can therefore uncomfortable over time. Sure, men and women can just masturbate – but within certain relationships or certain religions this may not be acceptable and sometimes it can even be experienced as a rejection.
This is why communication is important and it is also imperative that both partners learn to understand how the different sexes operate, so that they may achieve a closer or deeper intimacy.
Also, men are often saddled with a reputation that they’re either rapists or sexual predators attempting to get their sexual desires met. But even if this might be true for some men, this results in many others feeling entirely misunderstood.
It is therefore evident that sex, like any other area, requires communication between two people and when this does not happen, misunderstandings can occur, especially as most people are too embarrassed to discuss this important area.
The Couple and Sex:
Once children are born, parents are often far too tired to have sex. Resuming sex is often difficult because both partners will have changed. They will have become parents and the roles and expectations will have changed too. As a result, even if sex is resumed, it can hard to have sex with children around.
Some couples eventually have sex once, maybe twice a week. Others start having sex once a fortnight or once a month. Others may find even this hard.
Years later, trying to re-kindle a sex life can then become really difficult and often this is when sex therapy can come in useful.
Watching pornography and social media:
In Blog 47 and 79 I explain just how young children can be, when they start watching pornography. We are now beginning to see the results and how it can affect a couples sex life – and indeed, how young men struggle to relate to women in real life. When they find out that women’s vaginas are all different and how women respond whilst having sex, many find the process of dating and having sex daunting. More worrying is that many think violence is acceptable and that women are prepared to do things that they’ve seen, rather than what is reality. Sadly too, pornography will not have taught the art of romance or what shared communion and love really involves.
As a result, many now have no clue how to sustain sex within a relationship and many are now refusing to enter relationships as they think it’s too difficult to manage.
This can be worrying as many might want to have children and although IVF (in-vitro fertilisation which is a treatment where the eggs are removed from the ovaries and fertilised by sperm (donated by various men), in a glass dish in a laboratory, is available – this may lead to some men feeling angry as this procedure may result in them feeling like they’re surplus to requirements. This in itself may have other negative consequences for relationships in the long run.
Either way, sex therapy may be useful for couples wanting to develop long-term relationships.
Requiring the help of a sex therapist should not be embarrassing. Many couples have problems in this area but sadly, many don’t ask for help. Consequently, a problem that can be fixed is left – and it eventually can turn into a bigger problem.
I therefore urge you to get help if any of the above issues or any other issues are getting in the way of you having a good sex life.
However, please do know too that some reasons are not purely physical. Many issues are also emotional or psychological and can easily be treated if understood.
© 2019 Deidré Wallace All rights reserved.
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