What is sexual therapy or sex therapy? Our sexuality is about our relationship and sex therapy can be beneficial in this. In which cases should we go to see a sex therapist? How do I know if my problem is not caused by a physical cause? How does sexual therapy take place? How is sex therapy done?

On average, 70% of patients (women and men) who undergo sexual therapy (sex therapy) succeed in improving their sex and couple lives. A success rate that should help convinces people to consult a specialist.

Relationship and Sex Therapy

In reality, our approach to sexuality has everything to do with understanding life. Eros, our libido, the desire we have – and how we use it – speaks of our relationship to the world. Sexual therapy is a psycho-sexual but above all relational therapy. Our sexuality is about our relationships. Relationship with oneself, with one’s own body, this stranger for many, relation to the other, to the couple…

In our sexuality, more than in many other areas, we carry deeply our inheritance, parental, family, transgenerational, but also collective and cultural. In sex therapy, the question of desire is the central theme. Desire, this unknown, which one does not command.

Desire, like emotions, fits into the “body,” For many, going into these spaces related to the emotional and the unconscious is a difficult challenge.

This is the accompaniment offered by sexual therapy or sex therapy.

In sexual therapy, all issues related to sex are addressed. The first thing is to remove taboos and shame, guilt, ignorance they generated. Trauma, abuse, rape, incest, lack of libido, impotence, anorgasmia, premature ejaculation, orgasm, masturbation, are problems with which many struggles in the private sphere without being able to speak. There is also often an education that has not been done and that we take again, it can go through anatomy pure and simple. Sex therapy is above all a way of the Self, which goes through our innermost depths to be able to fully live this adventure of desire, which is nothing but the adventure of life.

I – Definition of Sex Therapy or Sexual Therapy

Sexology studies the sexuality of men. But concretely what is sexuality? Sexuality is a bio-psycho-social reality, that is, it encompasses biological, psychological and social aspects. It is a dynamic concept. Our sexuality will not be the same in every stage of our life, and it is always unique and different from other people. And of course, it is closely related to sex.

Sex does not mean only intimate parts, penetration, or orgasm, although it encompasses all these aspects, and so much more … We are born sexed and we will be born to death even when we do not know where our genitals are or when we do not practice penetration.

Sexology thus studies this vast concept that is sexuality. Sexologists are not all psychologists, there are also doctors, sociologists, pedagogues … They are also sex therapists and educators.

II – In Which Cases Should One Go to See a Sex Therapist?

It is especially if you need help, sexually speaking. Challenging doubts and misconceptions about sexuality improve the quality of sexual intercourse. But beware, sexologists cannot answer questions like “How to achieve better sexual practices?” or “What does my partner like?” Each person is a world, it is impossible to generalize everyone’s tastes and preferences and the best way to have answers to these questions is to talk about them with your partner.

– If your sex life has changed and you are unable to adapt (for example, changes caused by physical disorders such as hormonal changes during menopause, or radical changes such as a breakup or the arrival of one or several children in the family).

– If your partner and you are not on the same wavelength sex side.

– If you have noticed a significant decrease in your libido during the last 6 months or less and if it affected your relationship with your partner.

– If you have difficulty reaching orgasm alone or two.

– If you are a woman and cannot practice penetration or that it hurts you.

– If you do not take pleasure during your reports.

– If you cannot get an erection or lose it quickly.

– If you control your ejaculation badly.

These are obviously the ones that can challenge you to go to meet a sexologist or sex therapist.

III – How Do I Know If My Problem Is Not Caused by a Physical Cause?

Some sexual problems can be caused by diseases or side effects of drugs. If you take treatment, it is important to read the instructions carefully to avoid any risk. For example, hormonal contraceptives may promote vaginal dryness and may affect libido.

How to determine if your sexual problems are related to physical causes and if you have to go to the doctor? Ask yourself since when do you suffer from it and if the problem always arises (without exception).

– If a man has difficulty maintaining an erection every time he wants to have sex, for all the practices supposed to excite him (oral sex, masturbation …), as well alone as to two, he must go to a doctor because there is a good chance that it is related to a physical problem. But for exceptions, for example, if erectile dysfunction occurs only with the partner and never alone or during penetration only and never during oral sex, then the problem is not essentially physiological.

– As for the problems of premature ejaculation, some diseases such as prostatitis can make it difficult to discriminate sensations and to prevent the control of ejaculation. But in general, this problem is related to psychological causes such as anxiety and over-excitement or a lack of knowledge of one’s own sexual response.

– In case of pain during penetration, it is advisable to consult a gynecologist to rule out any physiological causes. These causes are ruled out if the woman can introduce a sex toy of similar size to the penis of her partner, without any problem but she suffers pain during intercourse. If the specialist finds no pathology, then it is necessary to resort to sexual therapy.

– The problems of lowering desire or lack of desire, except those related to hormones, are always treated by sexual therapy.

IV – How Does Sexual Therapy Take Place?

During the initial consultations, the specialist gathers all the important information to establish the most accurate diagnosis possible and takes into account the patient’s objectives, to work with him and to help him.

Individual work outside the consultations is very important, the sexologist gives “homework” or exercises to do at home alone or as a couple. The person who comes to consult must have a real desire to change the current situation because it is she, with the help and advice of the therapist, who, step by step, will improve things to achieve its goal.

Educational work is essential, a large part of sexual problems are due to inadequate or incorrect sex education. It is important to get rid of all received ideas and to have a broader view of sexuality.

When she has completed the therapy, the person will have acquired certain reflexes and mechanisms that will enable him to be able to work on his own sexuality and to adapt to any changes in the life cycle.

V – How Is Sexual Therapy Done?

Regarding the course of sexual therapy, it is very important to note that it takes place in 3 modes: individual, couple, and group. And each mode has peculiarities.

*** Individual sexual therapy

Here, it takes place in four (4) phases namely:

– First Phase: Assessment of the Problem or Difficulty

The first phase consists of an evaluation of the problem presented. It is at this stage that the therapeutic alliance is created between the client and the sex therapist. The latter determines if there are no contraindications for sexual therapy. During the meetings, you may be asked to discuss the reasons for consultation, the hypotheses that could explain the disorder, a summary of your personal, relational, sexual and family history, your therapeutic past, etc. In summary, the therapist makes an assessment of the problematic situation by leading you to state what seems relevant to the progression of the therapy. He may request a medical check-up; this phase usually requires two sessions.

– Second Phase: Clarification of the Problematic Situation

The second phase consists of a clarification of the problematic situation. Once confidence is established, the sex therapist will gather more detailed information about the disorder that motivates the person to consult. The goal is to deepen our understanding of the conflict before attempting to solve it. At this stage, you and the sex therapist will formulate hypotheses that can explain the causes, the triggering, and the maintenance of the sexual, relational, or emotional difficulty. From these assumptions, sex therapeutic goals are formulated and means to achieve them are set. The therapist informs you of the tools that seem most relevant to him.

– Third Phase: Implementation of the Treatment

The third step is to implement a treatment plan. For example, the therapist can offer you work in Gestalt or fantasy or fantasy or sometimes a more behavioral approach with exercises to acquire skills or even provide you with enlightened advice. The goal remains the same: to reduce anxieties, suffering, change erroneous beliefs, irrational thoughts, or undesirable behavior.

– Fourth Phase: Prior Learning Assessment

The last phase consists of the assessment of achievements. Before ending the therapy (by goal achievement or otherwise), you will draw up a report highlighting the results of the treatment plan and the significant elements of the change. The sex therapist ensures that you can apply, in your daily life, some gains to promote the management of your sexuality. Finally, one year after the end of the treatment, a follow-up will be done by contacting you.

*** Couple sexual therapy

The process will be more or less the same. The therapist will work first with both partners individually. It is a delicate work where he will be particularly attentive to confidentiality and will take part in neither one nor the other. Then gradually and as soon as possible will be sessions at 2 or the “couple” entity will be the client. The couple will learn to communicate better, to dream, even to fantasize together, to engage in behavioral changes, to develop sexual skills, there will sometimes be changes in the objectives.

*** Group sexual therapy

– Individualized work in a group, in a couple in a group, in a group of couples.

– Work in unisex groups Men/Women, permanent or casual.

– Intensive residential placements of two to five days when the person or couple has already done an individual job allowing for development and sufficient communication capacity to take advantage of the awareness and benefits that the residential group can bring.

In Conclusion: Is Sexual Therapy Really Effective?

As with any treatment, it is essential that the sexual therapy patient really follows the therapist’s instructions, does the prescribed exercises at home on a regular basis, and is motivated to follow through.

The key to good treatment follow-up is the therapeutic alliance: the patient-therapist relationship must be built progressively and in the best possible way, in order to create the confidence necessary for the smooth running of the treatment. The skills and empathy of the therapist and the fact that he clearly and explicitly sets goals to achieve are also a guarantee of success.

Note that sex therapies may also have undesirable or desirable side effects. Given the significant awareness of the person about herself and her relationship, sexual therapy can indeed lead in some cases to separation, to divorce. Conversely, some separated couples manage to find themselves through sexual therapy.

*** The role of the partner

If the therapy does not bear its first fruits after the first three sessions, the specialist should be able to recognize that it is necessary to change treatment or even therapist or to better adapt the method to the personality and temperament of the patient.

Involvement and participation of the partner (already in the initial consultations) are also essential. The couple should, therefore, agree on the treatment to be followed, and the partner should ideally participate, or at least support his spouse in his approach. Otherwise, it will jeopardize the very success of the therapy, and sometimes of its couple. Moreover, if both partners are satisfied with their relationship outside of sexuality, this contributes to successful treatment.

*** Prevent recurrences

In any case, one must remain vigilant to preserve one’s sexual health and to prevent new sexual troubles and problems of the couple. It is, therefore, useful to consult if and when they are felt to reappear, which may be the case when changes in the life situation of the couple (unemployment, birth, bereavement, etc.), or during a change. of partner.

*** Duration of therapy

It is difficult to predict the duration of sexual therapy. Depending on the situation, the disorder can be overcome in just a few sessions. Conversely, some patients will need several months to achieve this.

*** The main factors of failure

A number of factors can alter treatment monitoring, including:

– The lack of motivation from one of the partners.

– A conflictual relationship of the couple outside of sexuality.

– Very limited progress after several sessions.

– The refusal of the partner to participate and to question himself.