Stage One of Sex Therapy
The individual or couple’s first meeting with their sex therapist will be stage one of the assessment. It is important at this stage to out rule any medical or physical causes for the dysfunction so a visit to your GP maybe advised. If at the end of this session the therapist considers the relationship to be in a “good enough” place the second stage of assessment takes place. This involves individuating the couple out for one to one sessions with the therapist.
Stage Two of Sex Therapy
In the second stage the therapist will be gathering information like the age you are and any medical conditions that exist and have to be managed. In this detailed history the therapist will take into consideration any historical or psychological factors, which may be relevant and which could possibly be out of awareness to the clients. The therapist will study the histories and come back to the clients having put together her hypothesis of the reasons the problems exist. This will include issues both from the past and the “here and now”.We will not be able to change the past but we can influence the “here and now”. This will involve looking at what thoughts, attributes and behaviours, which may block you dealing with your problem.
Part of the history taking is to understand the reality of the relationship and how close or distant you are as a couple. In order to have the best chance of a good outcome from the work the couple’s relationship has to be in a good place with shared goals and good communication. The importance of good communication cannot be minimised. If a couple have lost their way with this a therapist will work with them to establish a respectful way for each to communicate their needs. This may involve some sessions of couple work prior to the start of the sex therapy programme itself.
A Sex Therapy Programme
A sex therapy programme is collaboration between therapist and clients. The history talking represents the “scaffold” for the work to take place. The therapist may have to go back to it should the work get blocked. The work itself is all about a new way to be. At any stage of life it is important to be as healthy as we can be. A holistic approach to diet and exercise may be included.
Clients need to know that in order to have good sex they need to be relaxed. They need to accept that not every sexual experience will be the same. They need to lose the fantasy that that all sex is ”Hollywood sex” and this is the only sex worth having. One of the most accessible and popular theorists on sex, an American called Barry McCarthy, states that the best sex of all can happen between a couple in long term relationship who know each other well. Barry also states that not every sexual encounter needs to end in penetration.
The use of sensuality is crucial. The fact that men and women are different needs to be known and respected. Women can be likened to ‘electric cookers’ take longer to warm up but can be slower to come down. Men are like ‘gas cookers ‘inclined to get hot quickly and come down quickly. So in a heterosexual relationship this has to be managed so both can have good sexual encounters.
For men sexual confidence is more about function i.e. “performance”. While for a woman to have sexual confidence she may need to be in a relationship that includes trust, security and caring.
McCarthy also says that if sex is working well with a couple it represents approximately twenty per cent of that relationship. However if the sexual intimacy becomes problematic it flips and becomes approximately eighty per cent of the relationship. So we know having regular sex is good for adult intimate relationships. Recent neurophysiological findings say orgasm releases as many “feel good hormones” as a heroin hit.
Working with a Sex Therapist
To sum up a sex therapy programme is a multi- faceted approach designed for each individual or couple to help them to achieve agreed realistic goals to address their presenting problems. Therapist and clients work as a collaborative team to achieve this.
You can be assured you are not alone. Those of us in this work regularly come across clients who believe they are the only ones with sexual problems and the rest of the world is having “mad passionate sex”. Of course, this is all media driven.
If you believe sex therapy is an option for you it would be important to check that your therapist is an accredited member of COSRT (College of Sexual and Relationship Therapists). This will ensure that your therapist has specific dedicated training in the field, is qualified and is engaged in continuing professional development.
Written by Anne Mathews, Psychosexual Therapist