Sex therapy - should you consider it?

Sex therapy is a special type of psychotherapy or talking therapy. It addresses both mental health and/or emotional problems that affect sexual function, sexual feelings, and intimacy, either in individuals or couples. Often sex therapy is provided by a licensed sex therapist and can benefit people of all ages and sexual orientations. Nonetheless, psychologists, social workers, and physicians also sometimes provide sex therapy.

Sex therapy usually only takes a short period of time to complete and has a relatively small number of sessions. However, this may change because treatment plans are determined by the problems and goals being addressed.

Sexual dysfuntions

Sex therapy treats problems that prevent you from wanting or enjoying sexual activity. In more scientific terms we call these ‘sexual dysfunctions’. It is important to keep in mind that sexual dysfunctions are not the same as asexuality. Asexuality is a lack of sexual attraction towards others or low to no interest in sexual activity. Some consider asexuality to be a sexual orientation while others describe it as a lack of one. On the other hand, sexual dysfunctions and disorders are clinical and can happen anytime to anyone. People of all ages experience sexual dysfunctions but the chances increase with age. In addition, they are highly prevalent.

According to a 2000 study published in Current Psychiatry Reports, sexual dysfunction affects about 43% of women and 31% of men. More recent research states that these numbers haven’t changed much even though decades have passed. Consequently, While it is not always easy to bring up the subject of sexual problems, they are not uncommon.

Some sexual dysfunctions include:

  • erectile dysfunction
  • low libido or sex drive
  • lack of interest
  • premature ejaculation
  • low confidence
  • lack of response to sexual stimulus
  • inability to reach orgasm
  • excessive libido or sex drive
  • inability to control sexual behavior
  • distressing sexual thoughts
  • unwanted sexual fetishes

Inability to reach orgasm or orgasmic dysfunctions is quite common in women. Premature ejaculation, on the other hand, is the most prevalent sexual problem among males.

In addition to high prevalence, sexual dysfunctions also have a major influence on interpersonal functioning and general quality of life in both men and women. A fulfilling sex life is both healthy and natural. Physical and emotional closeness are important components of your overall well-being. If you are suffering from a sexual dysfunction, it can be difficult to have a meaningful sex life.

History of sex therapy

Until the 1950s Psychoanalysis was used to treat and understand sexual problems. Psychoanalysis has its roots in Sigmund Freud’s work. It proposes the idea that sexual problems are a result of childhood developmental conflicts. In 1958, Masters and Johnson introduced the term sexual therapy for the first time in a research proposal. They later went on to talk more in-depth about sex therapy in their 1970 book “Human Sexual Inadequacy”. Based on their ideas Helen Singer Kaplan combined both sex therapy and psychoanalysis into her 1974 book, “The New Sex Therapy”. Other strategies for treating sexual problems began to advance in the 1970s, including Gestalt, Rational Emotive, and Humanistic Therapies.

In the early days of sex therapy, it was often seen as a technique for helping patients repress sexual behavior that was considered “deviant” at the time. However, so much has changed since then. The technique is now frequently recommended to people who struggle with intimacy and couples who want to increase their sexual experience. Though many couples or individuals still regard sex to be a taboo subject, sex therapy can help people overcome this reluctance and discuss the subject in productive, beneficial ways. In addition, it also helps couples or individuals gain more confidence, communicate effectively and restore or improve their sexual health.

How does sex therapy work?

Sex therapy, like we mentioned earlier is a type of psychotherapy. This means that you will have to talk about your experiences, worries, and feelings to a therapist. You will then work on healthy ways to cope with your therapist to help improve your responses in the future so that you may have a healthy sex life. During initial meetings, your therapist will either speak with you alone or to both you and your partner. The therapist is there to guide and assist you in dealing with your present problems. In addition, they will push you to accept and better manage issues that may be causing sexual dysfunctions.

All talk therapy, including sex therapy, is both helpful and informative. You will most likely leave your therapist’s office with homework and tasks to do before your next session.

That being said, not everything you hear or think about sex therapy may be accurate. Here are two things that you should not expect to happen during sessions:

  • A sex therapist will not help persuade anyone or take a side.
  • Despite some common misconceptions, a sex therapist will not teach you or show you how to have sex. It will be like any other therapy session.

Aside from this if your therapist thinks that your sexual problem has a physical or biological reason behind it, they will most likely refer you to a medical doctor. Subsequently, your therapist and doctor will discuss your signs and symptoms and work together to identify any physical issues that may be contributing to the sexual troubles.

Types of sex therapy

The most basic type of sex therapy is talking therapy. Like we mentioned above, this has to do with talking to your therapist and opening up about your sexual problems. You have to be open and willing to discuss these issues even if you find them uncomfortable for the sessions to truly work out.

In one study, a group of sex-therapists stated that desire discrepancies were the most prevalent problem between couples. This means that one partner desires sex more or less frequently than the other. It often stems from emotional issues and excessive stress levels. All of this can be addressed during talk therapy.

Senate focus is a behavioral form of sex therapy that focuses on the specifics of a couple’s relationship before having them undergo behavioral exercises. It’s about touching and being touched. In addition, it includes homework that encourages couples to focus on physical interactions they like without the pressure of penetrative sex. To maximize the potential of sensate focus, a therapist will teach their clients to start with no expectations of what they will experience, how it will feel, or how much pleasure it will bring.

Senate focus also often requires couples to take a step back from engaging in any sexual activities that may be creating anxiety for an extended length of time. The objective is to improve the couple’s intimate experience and to help them build on it by working through any preexisting concerns.

Senate focus exercises

Senate focus exercises are often the center of sex therapy. Their goal is to assist couples to become more comfortable with physical intimacy and become familiar with each other’s, and their own bodies.

Senate focus exercises in couple sex therapy

Here is an example of a senate focus exercise:

Sit together with your partner for five or ten minutes and do a touch exercise by touching each other’s hands and arms. This may sound insensible, but in reality, it’s a talent that you can improve with practice. You are supposed to experiment with texture, pressure, and temperature to acquire a variety of sensations to train your body to notice them and find what you enjoy and don’t.

This exercise focuses on texture awareness. When touching your partner, the therapist will ask you to pay attention to the texture of the partner’s skin in various places of their body. When you touch their neck, calves, hands, or cheeks, how does the texture change? By doing so, you learn to focus on the sensual and not the sexual. The goal here is not to do a good job in touching your partner, rather it is to simply observe what you feel on your fingers.
The receiver, on the other hand, should try and notice how the sense of touch changes as their partner explores different parts of their bodies.

Another couple exercise involves mutual touching. Ideally, before you get to this phase, you must first get in tune with the sensory reactions to the touch of your partner. The goal of this exercise is not to use your hands to sexually satisfy your partner; instead, you will both touch non-sexual parts of each other’s bodies. Furthermore, therapists will also advise couples to try and change the environment of sensual activity. For example, instead of the bedroom, they can move to the shower or a couch in the living room. This will allow them to understand their sensual feelings in a new way.

Senate focus skills

There are several types of senate focus skills that you can learn. These include being aware of texture, temperature, and pressure when engaging in senate focus exercises with your partner.

The first skill is to start noticing texture. We talked about this in the previous section as well. When you concentrate on texture, you begin to think about whether the place you’re touching is smooth or rough. As well as how your hand feels on the body. Your partner, on the other hand, would concentrate on how it feels like to be touched.

The second skill to develop is the ability to detect temperature. When you touch your partner, you will begin to notice the cold and warm spots on their body along with changes caused by friction, breath, or breeze. Similarly, your partner will also note the temperature of your hand when it touches their body.

Finally, there is pressure. When practicing this skill, you will notice the amount of pressure you apply to your touch (firm or soft). When they are touched, your partner will also notice this.

By practicing these techniques, the sensate focus therapy experience shifts from sexual arousal, expectation, or worry to sensations and awareness. Allowing for the flow of pleasure. Even if sexual desire may be handled later, the goal is to prioritize these building blocks first.

In many cases, a therapist will use sensate focus as the final stage in sex therapy; if you have any larger concerns, you will address them first before beginning sensate focus. However, going directly to sensate is alright as long as there is no trauma that has to be addressed.

Senate focus and mindfulness

Sensate focus uses the basics of mindfulness to help you feel connected to the present, to yourself, and to your partner. There are moments when we are out of touch, and other times when we are fully aware. Mindfulness is one strategy for getting both individuals coordinated or to make a coordinated effort to be connected intimately. This means you can both completely enjoy intimacy with less anxiety, making room for enjoyment.

Mindfulness is all about being present in the moment without letting your mind drift away into the past or present. It is not meditation; the two are distinct and frequently misunderstood. The influence of mindfulness on intimacy has been scientifically studied. For instance, two studies in the Journal of Marital and Family Therapy on ‘the role of mindfulness in romantic relationship satisfaction’ found that higher mindfulness traits go hand in hand with higher relationship satisfaction, better relationships stress responses, lower emotional stress, better communication, and relationship well-being.

Other benefits of Senate focus

Studies show that Seneta focus exercises and techniques are useful for addressing specific sexual problems and also increase sexual satisfaction.

Senate focus is also useful in the treatment of individuals who are experiencing sexual difficulties as a result of medical diseases such as breast cancer. It is popular with sex therapists and doctors who treat sexual dysfunction. In addition, the technique is very safe and most people find it very easy to follow. This is due, in large part, to the fact that sensate focus was deliberately developed as a slow and gentle method of lowering performance anxiety and tension associated with sexual intimacy.

Sensate focus, according to many sex therapists, is a simple and effective approach to building intimacy and connection between couples. This includes same-sex and opposite-sex couples.

Other therapeutic techniques of sex therapy

A sex therapist will often set three main goals when moving into couple therapy sessions:

  1. Identifying what each person of the couple wants to acomplish out of the therapy sessions.
  2. Getting to know both people and what they have to say, along with their sex lives, feelings and emotions.
  3. Identifying what each person in the relationship finds satisfying and how each partner can keep these things in mind during intimacy.

Sometimes in couples therapy sessions, the therapist will request to speak to both people together and separately. This way each partner can open up about certain things that they may not be comfortable with talking about when both people are in the room. In addition, this also allows the therapist to get an insight into how the couple interacts with one another, and how or if they change when they’re on their own.

Do I need sex therapy?

There are various reasons why a person would go for sex therapy It is often advised for anybody whose quality of life is impacted by their sexual function or desire, and/or for anyone experiencing intimacy issues in a relationship, regardless of age, gender, or background. In certain cases, adolescents who are confused or anxious about sexual issues or sexuality can also choose to see a sex therapist.

One way to find out if you need a sex therapist rather than another form of talk therapy is to consider which aspects of your life are most influenced by how you are now feeling. For instance, if a sex-related issue is causing you any distress or affecting your emotional well-being, it is a good idea to see a sex therapist. Similarly, if you have problems communicating with your partner or any intimacy issues that may be causing problems in the relationship or decreasing your relationship satisfaction, sex therapy is a good place to start.

What you can expect

At the beginning of your sex therapy sessions, you will most likely have to talk about your sexual concerns. Sexual issues are complicated. Consequently, a therapist will try to get a clear understanding of everything that is behind the problem. This usually involves an in-depth review of your background along with any sexual or relationship difficulties. After the therapist has assessed the problems, you and your therapist will explore how to address your worries and enhance communication and intimacy.

Talking about sex and intimacy may seem awkward or create anxiety at first. However, sex therapists are trained to put you at ease and are excellent at diagnosing and addressing sexual difficulties.

If you’re in a relationship, it’s best to include your partner in sex therapy sessions. This way, the therapist will most likely give you and the partner homework. You can do these after the sessions to maximize the benefits of therapy. These could include:

  • Communication exercises
  • Senate focus exercises
  • Slowing down and focusing on what you’re sensing during intimate encounters
  • Reading about and watching vedios on sexual health
  • Making changes to the way you sexually or non sexually interact with you partner

What you need to keep in mind

Problems with sex and intimacy are often linked to underlying mental health issues such as stress, anxiety, and depression. On the other hand, it is also affected by chronic illness, side effects of medication, age, and surgery.

Depending on your problems and physical health, visiting merely a sex therapist may be sufficient; alternatively, your sex therapist may be part of a team that includes your primary care physician and other health care professionals. Medication may be beneficial for some sexual issues. A thorough medical examination can help determine the nature of your condition and the treatment choices that may be available for you.

How to find a sex therapist

A sex therapist can be a licensed psychiatrist, psychologist, marriage and family therapist, or clinical social worker. All these mental health experts have extensive knowledge of human sexuality and the problems associated with it.

Your first step to finding a sex therapist could be to ask people who are close to you for any recommendations. If you do come across any good recommendations make sure that the clinician is licensed by the health authorities of your country, certified and experienced. However, if you are not comfortable talking to anyone around you or asking for recommendations, you can always try googling for clinicians in your area. Alternatively, you could try reaching out to any hospitals in your area or community health services. These organizations will be happy to provide you with information about any sex therapists that work with them.

Your insurance company may also be able to provide you with a list of licensed sex therapists in the area of the country. You can go through the list to find a clinician that would suit you. Often clinicians have websites that you can read up on to get to know them before actually making a call.

If you would like a more personal recommendation, talk with a health care provider that you know. This could be your general practitioner, family doctor, gynecologist, or urologist. Many doctors meet and recommend sex therapists to their patients every day. They might be able to direct you to a provider whose style closely aligns with your own.

Things to keep in mind before your appointment

After gathering information about therapists in your area, it would be in your best interest to read up on each of them. Next, make a shortlist of the ones that are most suitable for you. Here are some things you need to know when deciding who you should choose.


Therapists are unique. A successful therapeutic process is mainly the result of how well you interact with and trust your therapist and their advice to help you get through problems. If you don’t feel comfortable with a sex therapist at any stage, choose another.

Individual vs couple therapy

When choosing a sex therapist, there is a bit of thinking and planning that you need to do. For instance, think of how long it will take for you to get to the office and how easy it will be. If the office is around an hour far it would take you a long time to drive there or get there using any other means of transport. This would take a lot of time off your schedule that you could otherwise have used for something else. In addition, you should also plan when you will be meeting your therapist. For instance: you may be attending appointments during your lunch hour, after work, or on random days when you have a free hour. Some therapists also provide telehealth sessions. This means you may be able to meet with them online from the convenience of your own home.

Treatment plan

Your therapist will most likely go over an initial treatment plan with you at your first meeting. Several sessions are often necessary for most people and couples. However, if therapy is making a substantial improvement and your therapist is confident in your ability to face future obstacles, they will have a conversation with you about bringing the sessions to an end.


If you are someone who has health insurance, keep in mind that not every type of insurance covers psychotherapy. Ones that do cover it could have special requirements or an individual deductible. Talk to your insurance company before you go through with your appointments so that you can be prepared for the financial commitment that comes with the therapeutic process.

How can you prepare

To prepare for your appointment you can make a list of:

  • The details of your problem: for instance, when it began, if it’s frequent or occasional, other professionals you have seen, other treatments you have taken in the past, and their consequences.
  • Important personal information: including medical condition, any stressors that you have and any major life changes.
  • Medication you are taking: these incluse any drugs, vitamins or even food supplements along with their doses.
  • Questions to ask: make a list or note of the questions you want to ask your therapist about your sexual concerns.


Through sex therapy, you can learn to talk about your concerns clearly, better understand your own sexual needs, and better understand your partner’s sexual needs.

Keep in mind that you need to be comfortable with your sex therapist and trust them for the therapeutic process to be effective. If you have any concerns regarding how comfortable you are or how much you trust your therapist, you can always voice these concerns during appointments. Alternatively, you can also choose to see another therapist with whom you feel more comfortable.

The bottom line

Having good sex is a very important component of a healthy and fulfilling life. Physical and emotional elements of a healthy sex life have a range of profound benefits including lower blood pressure, increased cardiovascular health, better immunity, increased self-esteem, lower levels of depression, anxiety, better sleep, and stress reduction. Sex is also just a natural, fun part of life. Nonetheless, for some people sex may be a cause of immense anxiety and stress. Sexual dysfunction can cause interpersonal problems, loss of confidence, and a variety of other unpleasant consequences. Sex therapy is an effective treatment for these problems and their physical and emotional consequences. In addition, sex therapy can also help couples and individuals develop open, honest communication so that they can work through any concerns or challenges toward a healthy, happy sex life.

Here at Epsychiatry, we have a team of experienced and certified mental health experts including psychiatrists and psychologists who are more than qualified to provide you with sex therapy. If you are suffering from any sexual dysfunctions or mental health problems that are disrupting your sex life, please feel free to reach out to us using the contact information provided on our website.