When should you consider Sex Therapy

Approximately 35-50% of those who live with depression experience sexual dysfunction.

Let that sink in for a moment. Most cases that come into a therapy office seek treatment for depressive symptoms. Nearly half of those are experiencing some form of sexual dysfunction. Not to mention, many psychotropics used for treating anxiety and depression may also include side effects that impact sexual functioning.

According to the DSM-5, sexual dysfunction includes desire (being turned on/libido), arousal (how your genitals are working, ie, erections and lubrication), pain, and orgasm. In my experience, this is too narrow a scope and doesn't cover nearly enough of what goes on in the bedroom. I imagine if the criteria for dysfunction include (to name a few) performance anxiety, porn use, hypersexuality/compulsive sexual behavior, and dissatisfaction with sex life, that statistics may go much higher.

Regardless, this is a surprising statistic to me because prior to becoming a sex therapist, I had no idea just how common sex issues are. I went nearly 4 years without anyone bringing up sex unless it was related to trauma.

Maybe it's because of discomfort, maybe it's because my clients didn't know whether that topic was “allowed.” More likely, it could also be my own discomfort as their therapist, not wanting to seem creepy, inappropriate, and inexperienced. Looking back, I think I was worried that simply talking about sex would mean crossing the therapist-client professional boundary.

Part of understanding my client's experiences is recognizing that many of them have dealt with untrustworthy health providers and authority figures, so why would I add myself to that list? As therapists, we do so much to make sure there is a thick line boundary between client and therapist, that we create sterile versions of ourselves to be seen as safe. I will add that it is very necessary, but it can also make us come off as intimidating.

I've realized in training that this leaves clients with the moral dilemma: Is this too much, or maybe it's not a big enough deal to bring up to my therapist? Leaving them in silence and isolation in what's supposed to be one of the safest and healthiest relationships.

To break the ice, the silence, one of us must be brave, and the other must trust that all that would be spoken would be kept safe within the confines of a healthy therapeutic relationship.

I'll admit the first person to be brave wasn't me. What started this whole journey into sex therapy was one of my clients who trusted me and became brave enough to tell me they were afraid of having sex for the first time sober.

Not only was I moved by their courage and vulnerability, but I also felt helpless because I didn't have the tools to help them, and I just knew this was important. At the time, I had so many clients who had been using substances since childhood, which was also the time of sexual exploration and understanding identity. If this is one person telling me after years of building rapport, then he couldn't be the only one.

I'll admit that I signed up for sex therapy school on a whim, 4 days after that conversation.

When your intuition is telling you something that needs to change in how you connect with intimacy and your body. When you know something is 'off.'

It may seem minor, or it may be all-consuming and distracting you from the things that are most important in your life. Either way, talking to a professional is a great start.

Think about it like this: you have tried to deal with it and learn about it the best you could on your own. And not much has changed. Well, that's because these things are not meant to be dealt with alone.

Cross-culturally, we have rites of passage for puberty in which large communities welcome members with changing bodies into adulthood. But somehow, what is left out is instruction and guidance, which leaves us floundering to figure it out. We encourage community and education in every other facet of our lives, so why not sex and relationships?

We may not be able to change sex education on a large scale immediately, but change can start at an individual level.

Fortunately, in sex therapy, it's the therapist who will be brave enough to ask the right questions and work towards building and maintaining the trust of their clients to be able to talk about their most intimate lives.

If you feel like there's something that has been bothering you regarding your intimate life, feel free to schedule a 15-minute consultation. It not only allows you to see if I am a good fit for you but also provides insight as to whether you may actually benefit from sex therapy.