Just the words sex therapist sound like an erotic, controversial word sandwich. Delicious as this might sound, what does sex therapy even mean? What does a sex therapist do precisely, what is a sex therapy session like, and how is sex therapy different than other types of therapy? I also asked myself the same question two years ago when I embarked on this journey.
I’m not like other associate therapists; I’m working alongside a group of sex therapists! Yes, as ostentatious as that sounds, it has taken years of practice and expanding my knowledge to gain a deeper understanding of what that actually means past the title. Although I am near the end of my associate therapy hours at Modern Intimacy, my journey to understanding this profession has just begun. Let me tell you why everything I knew about sex therapy was wrong.
History Of Sex Therapy
Before discussing my naivety of what I thought sex therapy was and what I have come to find, let’s discuss the beginnings of this profession and why such an area of study was created.
Judeo-Christian beliefs colonized many cultures, thus changing the climate of their culture’s attitudes about sex and sexuality. Many cultures celebrated human sexuality and saw sexual pleasure as a part of life. This is in direct contrast to medieval Europe, which largely held Christian beliefs, which perpetuated celibacy, shame, and guilt around sexual behaviors and attitudes that didn’t reflect Christian teachings. To veer away from these wildly held beliefs would cast you out as a sinner and an interloper, which often led to an untimely death. Frequently, these views were used as excuses for the brutality of women, queer individuals, and people of color.
Fast forward to the early 20th century, the controversial psychoanalyst Sigmund Freud began to conceptualize the treatment of sexual dysfunction by linking sexual dysfunction to unresolved conflict in childhood. It was Freud who coined the terms “Madonna whore complex,” “Oedipus complex,” and “penis envy.” Other clinicians, such as Richard von Kraft, during the 20th century, explored topics of sexual deviation, which at the time deviation meant anything that veered from heterosexuality.
His teachings on homosexuality further stigmatized the LGBTQ+ community, deeming non-hetero-attracted individuals as suffering from mental illness. While both Sigmund Freud and Richard von Kraft further pathologized sexual behaviors, they carved a path for clinicians in the future to reevaluate their findings using more unbiased scientific approaches.
It wasn’t until the 1960s that more sex-positive research and treatment of sexual health began. Doctors Masters and Johnson’s groundbreaking research on the human sexual response cycle, which aimed at understanding the orgasm, established the foundation for understanding sexual dysfunction around arousal, erectile dysfunction, and orgasm difficulties.
Masters and Johnson also began finding evidence-based treatment for sexual dysfunction, developing sensate-focused exercises to help individuals and couples overcome sexual difficulties. Dr. Helen Singer Kaplan, who was inspired by the work of Masters and Johnson, combined psychoanalysis and behavioral methods for the treatment of sexual issues.
Dr. Helen Singer Kaplan later went on to establish the first clinic in the United States for sexual disorders. It was through the work of these scholars that the narrative around sex began to shift from shame-based ideologies to a more sex-positive narrative focusing on people’s sexual satisfaction and sex life.
Modern-day sex therapy practice includes a more biopsychosocial approach incorporating a person’s biological, psychological, and social factors in the treatment of sexual dysfunction and mental health concerns. Sex therapy also aims to be more inclusive around sexual orientations, gender identities, and relationship structures.
Trauma-informed approaches that focus on sexual trauma and its impacts on intimacy have been a focus of sex therapy and how clinicians conceptualize treatment.
The development of Institutions such as the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) provides ongoing, most recent, and effective evidence-based continuing education for sex educators and sex therapists alike.
Goals Of Sex Therapy
Sex therapy is a relatively new form of treatment, especially in the mental health field. It has been and continues to be an ongoing battle to fight for sex-positivity in a sex-negative culture. As AASECT quotes, “Sexuality is an inherent, essential, & beneficial dimension of being human.”
Sex therapists aim to educate, reduce harmful stigmas, and build a thoughtful community where people feel comfortable, supported, and seen from both physical and emotional fronts. However, from what I have learned through my experience as a sex educator and associate clinical counselor, there is a caveat to this.
Sex Therapy Is Not Just About Sex
When I first started in sex therapy, I was hyper-focused on the “sex” aspect of sex therapy. While yes, this is why many people seek out a sex therapy practice, sex is the vehicle to the center of individual personhood. Often, we compartmentalize sex in its own category and focus solely on how it impacts one’s sex life.
What I have learned is that sex affects all areas of the self far past just sexuality and intimacy. For example, suppose a client comes to me with non-medical-induced erectile dysfunction. In that case, a sex therapist might want to look at their level of anxiety around intimacy and how that anxiety might show up elsewhere in their lives.
A sex therapist might also look at a client’s communication with their partner if they have one, as well as their narrative about their body, previous traumas, whether they were sexual in nature or harmful beliefs taught about masculinity. This is just one example of many where we are focusing on sex but conceptualizing the individual by looking at environmental, social, and other mental health issues so as to provide the best possible treatment not just for the short term, but the long term as well.
How long will this take? I often get asked this question regarding the duration of treatment. There is no correct answer. Some people find relief just through traditional talk therapy and homework centered around their areas of concern. Others might find it more helpful to have a professional guide them into the unexplored regions of their psyche, thus leading to a more long-term therapeutic relationship. My point is that sex therapists are not just sex-focused therapists. They are therapists equipped to work with a myriad of mental health concerns. I have come to learn that you might want to work with a sex therapist even if you don’t experience any sexual dysfunction.
Navigating Our Sex-Negative Culture
Working at Modern Intimacy, I have had to do a lot of my own deconstruction around what it means to be a woman in a patriarchal system. As a team at Modern Intimacy, we are continuing to learn and educate ourselves about the impact of hostile and benevolent sexism on both men and women.
I have had to take a hard look at how these harmful beliefs impacted me personally, and I won’t lie; I have had to go through my personal grieving process to make the necessary changes I needed to end generations of harmful perpetual stereotypes against women. Thus, this process has helped me take a healthier, more conscious approach to my own relationships.
Working as an associate clinical counselor at Modern Intimacy, I have had the privilege to guide many women, men, and nonbinary individuals on how the patriarchy negatively impacts their lives. I have also had the wonderful opportunity to challenge people on their preconceived notions about gender, race, sexuality, and privilege.
Sex therapy is a great space to process these less-discussed topics with someone who has a more intersectional-based therapeutic approach—many couples who come to therapy unconsciously or consciously suffer from this same rigid belief system. Sex therapy looks like untangling these harmful narratives to help the couple find a healthy balance that works for their relationship dynamic.
Final Thoughts
I have experienced ample growth both in my knowledge as well as personally in my expansion of what sex therapy means in practice. I hope that this article provides some insight into what sex therapy is and can be, as well as an insight into my personal approach to therapy. To me, sex therapy is far more than a tool to address sexual dysfunction — it’s an evolving field that examines the connections between sexuality, mental health, and societal norms.
From its early days, which was researched and measured through sex-negative lenses, sex therapy has grown into a comprehensive, inclusive practice rooted in evidence-based approaches. Whether addressing issues of trauma, relationship dynamics, or broader questions of identity and societal expectations, sex therapy offers a path toward healing and understanding in ways that extend far beyond the bedroom.
0 Comments