People are always curious and perhaps a little unsettled when I tell them that I am a sex therapist. I can see a multitude of thoughts and questions going through their mind as they try to work out exactly what the job of a sex therapist might entail. I tend to reassure people quickly that this is a talking therapy not a touch therapy, more for their comfort than mine. Culturally, we are still poorly educated in sexual issues so I can understand both the salacious interest and concerned confusion in people’s eyes when they first hear what I do for a living.
So, what exactly does a sex therapist do? Sexual health and well-being is a combination of biological, psychological and social factors and sex therapists work with the psychological piece of this bio-psycho-social pie. Many sexual function problems are caused by biological factors, such as heart disease, diabetes and thyroid issues. Sex therapists are trained to ensure that the biological aspects of a client’s difficulties are picked up and it is our colleagues in primary medicine who then diagnose and treat these problems. We also consider the social and cultural aspects of a client’s life that can affect their sexual health, such as their religious beliefs, family structure, access to privacy and their housing situation. Primarily though, we work with clients’ thoughts, feelings, behaviours, past and current life experiences and relationships – the psychological contributors to sexual well-being.
Sexual health and well-being is a combination of biological, psychological and social factors and sex therapists work with the psychological piece of this bio-psycho-social pie.
In day to day clinical practice terms, sex therapists help clients to overcome sexual function problems, such as erectile disorder, premature ejaculation, low sexual desire and genital pain conditions. In addition, we are trained to work with sexual and gender orientation themes, relationship problems, couple therapy, sexual abuse, out of control sexual behaviours and infertility, to name but a few. We work with clients to address, for example, their sexual beliefs, their body image, self-confidence and anxiety levels, all features of thinking that can affect sexual pleasure and comfort. We put a lot of effort into improving our client’s sexual education, including explaining basic anatomy. (It is genuinely shocking how little people know about either the function or part names of their genitals!) We often support clients to reduce their anxiety about sex, as anxiety is generally part of the problem with many sexual function problems. We help couples to stop fighting, to re-establish their sex lives and to recover from affairs. We even help them to separate and divorce – couple therapy is not always about re-establishing a relationship. It can just as easily be about ending it well.
Sex therapy can be a little like CBT (cognitive behavioural therapy) as the sex therapist works with the client’s thoughts about sex (cognitions) and their sexual behaviours (we give homework!). Some of our work can also be much longer term and feel more transpersonal or psychodynamic, particularly if we are working with sexual trauma. I think the term ‘pluralistic’ applies well to sex therapists as we draw on a range of therapeutic approaches to support recovery for our clients.
So, in a typical day I might work with a female client who has never been able to manage penetrative sex and now wants to have a baby with her much loved husband. I might then see a male client who has lost interest in having sex with his partner but is masturbating to porn twice a day. My third client might be a young man who is struggling with premature ejaculation or equally it could be a young man who cannot ejaculate during penetrative sex. My fourth session could be with a couple who have not had sexual contact for several years and need help to get their intimacy back on track. My final session of the day might be with a client who is sexually attracted to men and women but whose culture demands they marry someone of the opposite sex.
As you can see, I have fascinating and varied job which I consider myself very privileged to have.
If want to join me in this profession take a look at our Diploma in Clinical Sexology course .
If you would like help with a sex or relationship issue contact Local Counselling Centre or email our Practice Manager Kathy Freeman on our confidential email hello@localcounsellingcentre.co.uk
