What happens during sex therapy for couples? How do you know if you need sex therapy?

In this short article I would like to demystify the topic of sex therapy. I will explain what sex therapy is and what it is not. I will also explain how you can tell whether you need sex therapy as a couple or not.

Here are the most common reasons people seek sex therapy:

– Higher desire in one partner and lower desire in another
– Absence or lack of sexual intimacy in the relationship
– Lack of open communication about sex
– Concerns with sexual performance
– Difficulty reaching an orgasm
– Sexual addiction

I often ask couples at the beginning of sex therapy to do a simple self assessment of their sex life. I ask them to think of a number between 0 and 10 when they think about their lovemaking. I tell them that this is very subjective. I also ask them not to change the number they chose if their partner says it first.

Obviously, you can easily do this at home either by yourself or with your partner. Consider two factors – the frequency of your sexual interactions and also the quality. Zero would be the worst sex you can imagine and 10 is the ideal. If your number is 4 or below, you are probably very dissatisfied with your sex life together. If it is a 5 or a 6 then it is okay, maybe so-so but not enough to be truly dissatisfied. If the answer is a 7 or an 8, you are probably quite content with where you are sexually as a couple. Obviously, a 9 would be quite excellent. I don’t really believe in a consistent 10.

Once you know where you are, it is much easier to focus on whether there is something to improve or not. If you are both an honest 9, for instance, I would not recommend sex therapy. If it’s not broken, don’t fix it.

If you are a 7 or an 8 you could benefit from sex therapy or you can make improvements without consulting a sex therapist. Ask yourselves “What needs to change for us to make it a solid 9?” If you can easily communicate about it and make the necessary changes then you are good.

If at least one of you is a 5 or a 6 I would recommend consulting with a sex therapist. If the number is below 5, I would definitely recommend sex therapy with an experienced specialist. There is a very low chance that it will improve with time by itself.

Let’s say you decided to try a professional consultation. What can you expect from sex therapy?

1. You will openly talk about sex with your therapist.

That is a must. Sex therapy would be meaningless without an open conversation on the topic. In some situations, it is necessary to discuss very intimate details. In other instances, general conversations are enough. Your therapist should ask you if you are comfortable talking about details. They should not simply “jump into it” without checking with you. Sometimes it helps to wait for a couple of sessions before going into intimate details. This will give you a chance to get comfortable with the person.

I usually focus on the couple’s emotional connection first. That way I make sure clients feel comfortable with me before engaging in a more sexual conversation. I also strongly believe that any couple needs a strong bond outside of the bedroom in order to enjoy their sexual intimacy together.

2. You will not have any sexual interactions with your therapist or with each other.

An experienced sex therapist will give you homework (I like to call it home-play) assignments that you can do in the comfort of you home between sessions. However, there should be absolutely no instance of you either being sexually touched or exposed in any physical way during the session. You may feel emotionally exposed, of course, but nothing physical.

It is appropriate for your sex therapist to assign sensual activities at home. It is also okay for the sex therapist to ask you to engage in sexual interactions between sessions. Any sexual interaction at home should feel comfortable and progress at your pace. You can then discuss your experiences during the following session.

3. The therapist is likely to take your sexual history. Your sexual history is an important component of your current sex life.

Therefore, it is one of the central parts of sex therapy. An experienced sex therapist needs to be able to make meaningful connections between your past sexual experiences and your current sex life.

If you are not comfortable discussing the details of your sex history in front of your partner, make sure you ask for an individual session each. This will give you a chance to speak openly to the therapist about some intimate details of your sex life. Be prepared to discuss your previous sexual partners as well. Keep in mind that your sexual history starts with the first time you realized there is sex. It is important to understand what messages you received about sex growing up. It is even more important how you made sense of those messages and how you view sex now.

You can then decide what is appropriate to share with your partner in the joint session. Regardless of what you decide to share, you should not be shamed or laughed at in any way either by your partner or by your therapist.

4. The therapist’s language should not be offensive.

Uncomfortable or awkward, maybe. But you should not feel offended by her or his language about sex. If you are, let them know. An experienced sex therapist should be trained to speak in either plain or scientific language that is easily understood by anyone.

Needless to say, you should not be judged by your therapist about your past or current sexual experiences. They should also not judge you on the language you and your partner use when describing sex and sexuality. The therapist needs to match the language that is comfortable to you as a couple, not try to impose theirs.

5. Sex is much bigger than intercourse.

Your therapist will probably define sex as any sexual interaction between the two of you. Intercourse is only one part of it. Most people consider intercourse as the main dish, so to speak. I agree. At the same time, you can probably remember going out from time to time without ordering an entrée. Sometimes an appetizer is enough or a salad. Sometimes, it’s just the desert. It helps to think of sex that way too. It removes unnecessary pressure from intercourse. As a result, intercourse becomes more spontaneous.

6. Emotional connection with your partner is central.

It is not enough to talk about sex in sex therapy. You will probably talk about your emotional connection with your partner as well. Remember, what happens outside of the bedroom impacts your sex life.

Maybe one of you felt hurt during a particular situation. The feeling of hurt will probably interfere with how you interact sexually. Maybe it wasn’t a single event. It is possible that it has been an accumulation of small things over the years. As a result, there is now some resentment that makes closeness difficult or impossible. Maybe one or both of you had some emotionally traumatic sexual experiences growing up. If you are comfortable talking about it and confiding in each other, it will probably help your sexual connection as a couple.

I usually start sex therapy with couples by discussing the strength of their companionship. How do they communicate when everything is good? How do they talk when things get difficult? Can they stay connected while having a tough conversation? If they ended up disconnecting, can they repair in a timely manner?

All in all, sex therapy should be a comfortable experience for both of you. As a result of professional sex therapy, you should learn to communicate better as a couple both in the bedroom and in general. Any specific sexual concerns you came with should be worked through. There is no mystery to sex therapy. It is down to earth and very effective.