sex therapy

Sex Therapy

“We have been in a relationship for the last 3 years. Things are going fine I guess, but something seems to be amiss. We haven’t really been having sex since the last few months. A few times that we did have sex in these months, we both had difficulty reaching an orgasm. And we haven’t really talked about it either. I don’t really know what the problem is. We talk about other things- our busy work schedules, our everyday chores, going out with friends- just not this. I have noticed it has been affecting our relationship, we fight more, physical intimacy is less, hugs, kisses have also become less. I feel distant from her and guilty about initiating sex. I am losing my confidence in myself and in the relationship. We need to figure this out but we both don’t know how.”

We hear of several cases like these. People in these situations, feel alone and confused. The fact though is that you are not alone. For example, people who start having sex can go through performance anxiety, newly-wed couples can have adjustment issues, couples can find a lowered sex drive as they get older; sexual difficulties are not unusual and are quite common:

As much as 57% of men and 64% of women in the Asia Pacific region are not very satisfied with their sex lives, reveals an Asia Pacific survey conducted in India and 12 other countries. 

Then, where does this sense of loneliness and unacceptance come from? The problems arise because in a country of over a billion people, the topic of sex remains behind closed doors. The survey also revealed that in India; discussion about sexual experience is still a major concern. Due to social inhibitions and the great deal of secrecy about sex, you do not freely discuss, find out or take help when you face these issues. Stereotypes about sex pushed through the media and societal norms further makes you feel inadequate and insecure about sex. Not only with others, you often don’t discuss these issues even with those close to you and sometimes even with your own partners.

The more you avoid confronting them, the more these issues fester, spilling into other areas of your life and affecting your general sense of well-being. This is where Sex Therapy comes into play. Even though it can be intimidating for most people to talk about their sexual issues, sex therapy provides an open, non-judgemental space that lets you express freely and comfortably.

The Psychological Basis of Sex

Sexuality is part of what makes us human. Even though its fundamental function is to help procreate and guarantee survival of the species, sex goes far beyond this. Like physical needs, people also have some core psychological needs- such as security, self-esteem, autonomy, and connection. To be satisfied, happy beings, you strive to fulfil these needs consistently through various ways. Sex is one of these ways. Through evolution, as humans, you have actually evolved to relate sex more to your psychological needs than physical needs.

We have learnt to relate it to emotional connection, attachment in relationships and our sense of self-esteem. It produces joy, comfort, love, affection and ecstasy. Our physiological sex drive has now been intimately linked to our emotions, thoughts and behaviour. When you suppress these needs, they come rushing back as sexual difficulties that represent underlying emotional issues.

Thus, for many people sex is not a satisfying and fulfilling experience- but one that comes laced with feelings of inadequacy, insecurity, guilt, sorrow, resentment.  These emotional barriers could be due to traumatic experiences, influence by the media, your family or even religion. Sexual problems can also surface as a product of another mental health issues, such as depression or anxiety, or they may be derived from physical conditions, such as bowel problems, chemical imbalances or changing hormonal levels. It becomes imperative then to explore and understand these difficulties and work with them in a compassionate, effective setting.

What is Sex Therapy?

Sex therapy is a form of therapy which helps the individual work with a range of physical and psychological sexual issues. This therapy is generally sought when there is no clear medical/physiological cause for these issues. Through sex therapy, you can address concerns about sexual function, sexual feelings and intimacy — either in individual therapy or in joint therapy with your partner. It helps individuals and couples identify the source of their distress and work with emotional barriers in order to enhance sexual experiences. Sex therapy can be effective for adults of any age, sex or sexual orientation.

Sex Therapy is generally required in three major areas:

1) Individual problems about sex: This could include doubts about sex, sexual dysfunction, sexual preferences and questions about your own sexuality.

2) Sexual problems entangled in relationships: This could be due to lack of intimacy, different levels of sexual desire, power struggles, etc. It is usually in combination with marital/relationship therapy.

3) Trauma: This involves childhood abuse or neglect, previous abusive experiences in relationships, difficulty feeling connected or trusting anyone.

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What does Sex Therapy involve?

In these sessions, we will be focusing on certain areas:

  • What are the core issues?Are they physical or psychological?
  • For how long have these issues been persisting?
  • What are the possible direct or indirect reasons for these issues?
  • Is it an individual concern or do both the partners feel that there is something sexual lacking in the partnership?
  • Gaining insight into your own and your partner’s differences, needs and expectations.
  • Learning the art of talking about sex with each other.
  • Talking about openness to new experiences.
  • Working with certain unhealthy beliefs and attitudes towards sex.
  • To understand the joys of sex and to give it some priority in your relationship.

Sex therapy looks into both individual and joint responsibilities in the relationship. This is to bring in focus both individual and the partner’s needs, providing a more holistic framework for therapy.

Sex Therapist 2

What are the benefits of Sex Therapy?

“The obvious thing is that you’re dealing with the human body so you can’t just talk about how you feel; you’ve got to work on the physical level as well,” says sex therapist, Myles.

Sex therapy generally addresses the emotional issues underlying sexual problems and employs behavioural techniques to deal with the physical symptoms:

On an individual level:

  • Helps you become aware of your sexual preferences and sexuality.
  • Working with and addressing doubts or questions you might have.
  • Helps to get you in tune with your body.
  • Learn to work with stress and anxiety about sex.
  • Identifying underlying emotional issues and feelings of guilt, sadness or anger that might be present.
  • Coping with sexual dysfunctions such as difficulty achieving orgasms or pain during intercourse.
  • Working with sexual addictions or fetishes.
  • Becoming comfortable with sex and developing a healthy attitude towards it.
  • Equiping you with techniques or resources to work on these issues.
  • Cultivating a beginner’s mindset and enjoying physical intimacy.

As a couple:

  • Honest and open communication between partners.
  • Achieving a balance between sexual and emotional intimacy.
  • Working through issues in infidelity.
  • Learning to value the physical relationship.
  • Working with adjustment problems pre-marriage or for newly-weds.
  • Rediscovering your sex life after child-birth.

What is the Role of the Sex Therapist?

A sex therapist can be a psychologist, a marriage and family therapist, or a clinical social worker. Most sex therapists have a particular awareness of sexuality that rises above personal opinion or personal experiences. Different therapists use different approaches to work with the problem. Largely though, a sex therapist follows this process:

  • identifies your areas of concern: a detailed personal history focusing on your childhood, family, relationship history, current relationship, your understanding of sex, etc.
  • will often provide education about pertinent sexual issues, including anatomy, physical response, and healthy sexual behavior.
  • will guide you and help you work through issues by talk therapy, behavioural exercises, relaxation and mindfulness and will give you homework that might involve behavioural or sensation exercises.
  • does not engage in sexual relations or carry out sexual activities with the individual or couple under any circumstances.

We know that sexual energy is powerful- it can affect your mood, thoughts and behaviour. Discussing your issues with family, friends or sometimes even partners can be uncomfortable and evoke feelings of guilt, anxiety and frustration. Approaching a sex therapist means providing yourself with a liberating space and an avid listener who is there to talk about any difficulties, fantasies, fears, memories, or desires regarding sexuality.

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Do write in to us with your questions and feedback. We would be glad to help you out.

Image Credit:

Tela Chhe

Danumurthi Mahendra