Sex therapy is a specialty of psychotherapy that focuses on specific concerns related to human sexuality. Couples usually come in with issues around sexual desire (libido), difficulty with arousal, difficulty with orgasm, sexual pain or discomfort, or feelings of out of control sexual behavior.
This is one of the most common complaints of clients. It is not uncommon for there to be a lower desire and a higher desire partner in a relationship, but when the discrepancy becomes great or when there is a sudden and drastic shift, therapeutic intervention may be necessary. Sadly, the lower desire partner is often labeled as “the one with the problem.” While there may be specific factors that inhibit one’s desire for sex, we take a closer look also examine dysfunctional relationship patterns that may also be contributing. We have specifically designed assessments that help us accurately the root cause or causes. We then design a treatment strategy that may include individual or couples counseling to tackle the issue.
Sexual arousal refers to the cognitive, affective, and physical response to sexual stimuli. Erectile difficulty makes up a very large percentage of our cases. It can feel extremely frustrating when the cognitive or emotional arousal is present but the body doesn’t respond. Some men have issues with maintaining an erection while others have difficulty attaining one at all, despite the desire for sex. We work very closely with some of the best urologists in town to rule out any physiological cause. Often times though, a psychological issue (like anxiety) is to blame, in which case, therapy is indicated. Luckily, erectile dysfunction is one of the more “simple” issues we treat. Women may struggle with similar issues with sexual arousal. For women the issue is usually described as difficulty with vaginal lubrication. Just like we do with men, we help women determine what may be creating disconnect between the mind and body.
Usually women come in with concerns of their ability to have an orgasm while men tend have issues around rapid ejaculation or delayed or inability to ejaculate. Sometimes the solution is as simple as working with you to strengthen your mind-body connection. This may be achieved using mindfulness strategies or coaching you on how to better understand the needs of your body and communicating those needs to your partner. Other times, deeper issues may be to blame. We often take a look at factors like self-consciousness, vulnerability, and trust in the relationship to see how this may be playing a role.
Sexual pain, or dyspareunia, is an umbrella term that refers to any pain one experiences during sexual activity. Both women and men may suffer from pain during sex. With women, the pain is usually due to vaginismus (an involuntary spasm of the pelvic floor muscles) or vestibulodynia (inflammation of the vestibule, the tissue that surrounds the vaginal and urethral openings). There are many other causes of sexual pain, but these are the most common. Vaginismus usually has a psychological component and is best treated using a combination of psychological and physiological treatments. Regardless of the type of pain you are having, therapy will help deal with any underlying anxiety, depression, or relationship issues that cause or come as a result of the pain.
Sexual pain is less common among men, but it does happen. It is most often physiologic in origin, but may have a psychological component as well. Your therapist will help you differentiate the causes and outline the best course of treatment for your pain.