When therapy works it’s mostly because of the therapeutic relationship. Unlike most other health care providers, psychotherapists do not “fix” problems. We do not cure illnesses or prescribe medications to treat them. For many conditions, medication is an important adjunct to therapy. Clinical depression, severe anxiety, bi-polar mania and psychosis, to name a few. Sometimes, sex therapists recommend an evaluation by a medical provider who may prescribe medication which can alleviate certain problems that interfere with sexual functioning, such as erectile dysfunction. Usually, by this time there has been some psychological or emotional distress which the medication does not address. That is when a combination of therapy and medication is recommended. .Sex therapists are first and foremost therapists. We help our clients get to the root of their problems, find what the underlying issue is, then help them find ways to overcome obstacles that block their progress. There is a whole lot more to therapy and the therapeutic relationship, but what I’m trying to convey here is a way to look at sex therapy as more of a holistic approach. I would also like to address sex therapy from the client’s perspective. One of the most common questions I hear, after “How much is this going to cost me? is “How does this work?” They want to know what will happen in the session and what is expected of them. Who can blame them? For most clients, the idea of discussing their most sensitive issues and deeply held secrets with a virtual stranger is at best, worrisome.
In the past few decades, psychotherapy has become rather commonplace. In the 1960’s and 70’s, when society became more accustomed to open discussion about personal issues, seeing a therapist was almost as common as going to the dentist. Of course, there remained a significant amount of stigma attached to mental illness, which continues to this day. But for many citizens within certain segments of society, especially those who had the benefit of a higher level of education, seeking ways to reduce stress or improve one’s feeling of well-being became much more acceptable. If they could afford it, and when health insurance was less restrictive, people flocked to therapists and psychoanalysts. People even sought help from self-proclaimed experts, such as newspaper columnists who doled out advice by the armful. Dear Abby and her sister, Ann Landers were both able to carve lucrative careers from their typewriters. That’s right, typewriters! If you’ve never heard of or seen one try Wikipedia or visit your local fleamarket. To the point, the phenomenon did not end there. Self-help books poured into bookstores (another archaic concept) which had to free up space on their shelves for hundreds of thousands of these “psycho-instructional manuals.” Neither were sexual issues ignored by the authors of these books. Nor were the advice columns bereft of the formerly taboo topic. A friend and best selling author, Xaviera Hollander, wrote a very popular column for Penthouse magazine titled Call Me Madam. She, at least, had real hands-on experience. Still an accomplished author, in addition to her successful Bed and Breakfast enterprises in two beautiful locations, Xie writes heartfelt stories about her troubled early childhood and close, loving relationships with both her parents. But it was her Penthouse column which helped so many men, and I believe most of them were men, find answers to their burning questions about their sexualities. The major benefit of this venue was, of course, anonymity.
As all things became more complex, so did psychotherapy. Specialization took hold and general practitioners were no longer comfortable treating issues that required more education, training and experience. Many of my clients are referred by other therapists who say that they just aren’t equipped to handle some of their client’s sexual issues. Much continues to be written, most of it by qualified sex therapists and Sexologists, many of whom I have the privilege of having studied with. Many of whom I know by reputation but haven’t been fortunate enough to meet in person. These, however are not advice or self-help authors. Their writings are research-based, educational and informative. If anything, they shed some much-needed light on the field of sex therapy. For anyone who is struggling with sexual issues or experiencing problems related to sexual functioning, knowing that sex therapy is available, and is another specialization within the broad range of psychotherapies, can be helpful and encouraging. Moreover, there are areas of specialization within the specialty. Relationship and couples counseling, gender identity issues, alternative sexualities, sex and aging, sex and disabilities, sexual abuse issues, and a myriad of others are available. There is nothing sex-related that a qualified sex therapist or Sexologist cannot offer his or her client in the way of knowledgeable assistance.
So when someone is contemplating therapy for any issue, sexual or otherwise, it is important to remember that help is available. Finding a therapist who is caring and compassionate, as well as fully qualified, is imperative. Trusting one’s instincts when contacting prospective therapists is essential. Ask questions. Do some research? Get recommendations from other health care providers. Don’t be afraid to ask your physician. There are referral guides on the Internet. Most will offer a free initial telephone consultation. I spend as much time as I can listening and answering questions when potential clients call me. This is not free therapy by any means. That would be unproductive as well as unethical. But if you feel rushed when making that first call, maybe that particular therapist isn’t the one for you. It’s usually true that first impressions are lasting. Although my time is valuable, so is everyone else’s. And I always keep in mind how difficult that first call can be. Therefore, I am as open and honest as possible when I take that call. There should be no surprises when the client walks through the door. As therapists, our profession dictates that we are caring, compassionate, supportive and non-judgmental. Remember my good people, you deserve nothing less.