Sex therapy is caring for the sexual health and erotic well being of another
by a qualified provider, through the use of talk and communication.
Sex therapy often includes sexual homework assignments for the client to do later in the privacy of their own home.
Photo: Otis Charles - 2006
About
I am certified by AASECT (American Association of Sex Educators, Counselors & Therapists) as a Sex Therapist, a Sex Educator and as a Supervisor for sex therapy interns. There is no state licensing in California of sex therapists. Anyone can claim that they are a sex therapist, but only AASECT certifies appropriate candidates who have undertaken proper training. Consumer beware. There are well-meaning therapists who just don’t know jack. If they can’t tell you what the PLISSIT model is, a SAR, or sensate focus, then I would recommend moving on. There are some licensed psychotherapists who are not AASECT certified, but still do a first rate job of sex therapy. Sexology, like sexuality, is complex and multidimensional. Sexological research indicates there are many differing ways in which Americans approach sex, talk about sex, behave sexually, and conceive of sexuality. African Americans often reach menarche (first menstruation) and experience coital debut (first partnered sex) at earlier ages than Asian Americans. Most wives think looking at porn is cheating, and most husbands don’t think it’s cheating. The citizens of Utah consume more porn per capita than any other state. The work of sex therapy is complex, and must be inclusive in its awareness of the interplay between medicine, biology and physiology, psychology, culture, environment, and individual interpersonal relationship dynamics.
Sex therapy is sometimes performed as an adjunct to psychotherapy. In these cases, it will be to your advantage for me to consult with your primary psychotherapist.
It might be therapeutically advantageous for you to bring into session a significant sex partner to be a part of the treatment. Depending on your situation, I may suggest that you be treated by (and/or I consult with your existing) psychiatrist, physician, urologist, gynecologist, surrogate partner or sacred intimate, or persons of faith.
Sex Therapy
Cognitive Behavioral methods of psychotherapy sometimes work for some sexuality issues, such as rapid ejaculation and vaginismus. These body function concerns usually take only a few months of treatment, and have a high success rate.
There is no guarantee that sex therapy will solve your problems. Sometimes fantasies are better left fantasies, and sometimes sex problems are better left unresolved. Or maybe thought of in a more positive frame. Sometimes there simply is no cure, no treatment known that works. I will let you know all that I know.
Body function problems:
- erectile disorder
- rapid ejaculation
- delayed orgasm
- genital pain (dyspareunia)
- genital spasm (vaginismus)
- incontinence
Desire Issues:
- loss of desire
- unwanted desires
- too much desire
Behavioral struggles:
- impulse control
- masturbation habits
- performance anxiety
- attraction to danger
- unwanted attraction(s)
- fear of incompetence
- distraction during sex
- compulsive sexual behavior
- illegal attractions
- dangerous attractions
Relational concerns:
- infidelity
- negotiating non-monogamy
- managing jealousy
- love/lust split
- troublesome turn-on’s
- attachment style conflicts
- protocol concerns
Temple carvings: Khajuraho, India: 2009
Clients
In sex therapy I’ve worked with clients of every gender, religion and ethnicity mentioned in the Psychotherapy section. Some sex therapy patients are in relationships, some single. I’ve worked with all ages from kids to geriatrics. My very very first patient as an intern was a seven year old boy, and within a few minutes he said to me, “Dr. Wilde, I have sex problems.” And he certainly did. I’ve worked with blind people and persons with cerebral palsy, hearing impairments, and Tourette’s.
Presenting Concerns
Some clients have genital pain during sexual activity, some have a loss of sex drive or sexual desire. Others may have trouble with erections or lubrication, ability to orgasm when wanted, or may be hooked on one particular thing in order to reach orgasm. Maybe you’ve never had an orgasm. Some folks worry they’re a sex addict. Or a love addict. Sometimes people see me because their spouse says, There’s something wrong with you. Others may worry that they’re not normal: in their fantasies, behaviors, or genitalia. Clients may have a special concern—a secret for years—which they feel compelled to finally address.
I welcome all inquiries: nothing is too out-there for me. I’m the out-there guy.
Style
We discuss your presenting problem and co-factors that may be playing a role in the sexuality concern. In the style of Masters and Johnson, I may take a brief sex history of the client. I give an assessment of the situation, possibly a diagnosis, and a preliminary treatment plan suggestion.
Sometimes one session is enough. A couple came to me upset that sex had been wonderful and fulfilling until about half a year earlier when the wife seemed to have lost interest in sex completely. Turns out she was also put on an SSRI (anti-depressant) six months earlier. I recommended that she ask her prescribing doctor to switch her to Wellbutrin, a non-SSRI anti-depressant with little-to-no sexual side effects. Most prescribing physicians do not discuss sexual side effects with their patients, especially female patients. In this case, one session of consultation was enough.