Sexual Health and Sex Therapy
The World Health Organization, defines Sexual Health as:
.....a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
The only caveats that I would add to this definition of ‘sexual health’ are that in my view: 1) it requires that an individual assess, confront and evolve their own subjective definition of sexual health across development; and, 2) that the individuals within an identified couple must do the same.
Sex Therapy then is a specialized form of psychotherapy through which a client can address concerns and feelings about sexual intimacy, confidence, and sexual functioning via individual therapy or in therapy with a partner/lover/spouse. When I hang my shingle out there and it reads, Certified Sex Therapist, clients know that they have a ‘green light’ to bring the sexual issue of importance directly into the dialogue of the therapy. Many do so in the initial phone consultation as a way to find out if I actually can be of help with a specific topic(s) that they are challenged with at the time. It should also be understood and clear of any confusion, that there is no physical or sexual contact involved in the conduct of sex therapy that I do.
The work of sex therapy is usually quite focused but it does have considerable overlap and is contained within the more general realm of psychotherapy. Typical issues that individuals and couples seek treatment for from me include:
low sexual desire
discrepancies in desire
rapid ejaculation
painful sex
fetishes
compulsive sexual behavior which some describe as ‘sexual addiction’
polyamory
impact and repair of affairs
erectile dysfunction
asexuality
issues related to sexuality in the aging process
broad area of sexuality complicated by physical health concerns (autoimmune issues, diabetes, heart disease, cancers, menopause, and man-o-pause)
Many couples; straight and gay, monogamous, monogamish, polyamorous, and those in other non-conventional arrangements come to see me. For some there is a belief that ‘relationship issues’ are the cause of sexual issues between a partner or spouse and once we address relationship problems, sexual issues will naturally be resolved. While this can and does happen, unfortunately, this is not always the case. Therefore through sex therapy, sexual issues are addressed directly. For others, there is a belief that ‘sexual problems’ are the cause of relationship problems between a partner or spouse. Unfortunately, direct work on sexual problems might not yield the change desired in the relationship. Usually, the sexual problems and relationship issues are interwoven. I compassionately, playfully, honestly, and directly help individuals and couples/partners work through these issues and more.
Click here to read more about my training:
Specialized Training: I am a Certified Sex Therapist and have met the rigorous training and vetting demands of the American Association of Sexuality Educators, Counselors, and Therapists (AASECT.ORG). I continue to receive training and supervision in sexual therapy and health on a regular basis. Further still, I am required to do so by AASECT to maintain my certification and keep abreast of developments in sexual health and therapy.
I chose to focus on ‘sex therapy’ as a specialty area about 10 years ago for several reasons. First and foremost, I believe that helping people overcome fears, injuries & abuses, insecurities, and inhibitions in the area of sexual functioning is truly rewarding. This can and often includes aspects of sound sexual education. Second, helping another to become conscious of their own unique sexuality and energy is equally enlivening and it promotes a ‘ripple effect’ in the culture of what is possible when the gift of sexuality is flowing in a mature, responsible, and non-judgemental manner. Third, with the prohibitions of the societal and religious past still pervasive but colliding with the wild, wild, west of the ‘anything goes internet-era’, I myself and many of my clients struggled to make sense of the conflicting meanings presented. So....I study, seek training, supervision, and I invite individuals and couples to see me in this arena of therapeutic work
Click here to read Case Presentations
Case # 1: A 42-year-old white male, highly educated, Ph.D. in Political Policy working as a high-end consultant to businesses seeking knowledge of his expertise. Sought consult one year ago with multiple personal issues including: a) difficulty getting pregnant with his wife of 3 years; b) brother committed suicide two years ago; and, c) dad is retired and in early dementia. He and his wife chose to enter into treatment with a local fertility clinic where I interfaced with his treatment team and helped he and his wife negotiate the fears, disappointments, frustrations, and costs of the procedures. There was low sperm volume and subsequent to examination he had a palpable varicocele. A varicocele procedure was conducted and the clients sperm count and motility improved at 6 months post op, but not enough to conceive naturally. They had been considering timing, cost, and existential issues of entering IUI and IVF procedures. This is a weekly individual client with added couples therapy where he sought help with this male factor fertility difficulty, a frustrated wife, and a host of extended family issues. We worked on education, self- confidence, maintaining sexual interest, and managing stress from the confluence of life factors.
Case # 2: A 26-year old female CPA in a Big Four firm and her 36-year old boyfriend/fiancee, a lawyer in a large firm. The client described painful sexual intercourse. Over the ensuing 3 years, she and I worked on historic Christian beliefs, parental attitudes towards sex, educating her and her lover about fit, foreplay, and physiological issues. I also referred her to a local pelvic floor specialist who worked intra-vaginally to relieve tight muscles and tissues. The pelvic floor physical therapist introduced a progressive practice of vaginal dilators to be used daily to increase flexibility and muscle tone. The client was diligent in working with self- pleasuring using a this series of vaginal dilators. She worked to educate her reluctant partner about her need to to a series of self-stimulating (or partnered) warm up exercises prior to penis-in-vagina intercourse. She was able to gradually increase her own vaginal capacity and had pain free intercourse upon termination.
Case # 3: 44-year-old Asian American professional married for two years to a 41-year-old lawyer. She is on an international, high stress work assignment for the past year in Europe. They have not had sex for the two years of their marriage. He is upset with his erectile functioning as he cannot sometimes get or maintain an erection when desired. I referred him to his primary care physician for a complete physical, including Testosterone and Free Testosterone analysis. All was fine. He masturbates to orgasm to mild porn 1-2 time per week when they are apart with a good quality erection (8 of 10). There is significant trauma in her background and emotional withdrawal in his. In my estimation (and his consulting Urologist agrees) this is not a physiological issue and I have attempted to educate him about his own needs for connection, her travel and high stress job, and his reluctance to advocate for what he needs in the relationship. After 10-12 sessions I prescribed couples therapy if they can arrange time.