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QUESTION: What exactly is a sex therapist, how do I know if I need one, and where can I find a sex therapist that's qualified to work with me?
ANSWER: Unlike many other mental health professions, sex therapy is a largely unregulated field that does not require licensure in most states. As a result, there are lots of people who call themselves sex therapists that are largely unqualified to practice. A sex therapist is very often someone who was originally trained in a related field such as psychology, social work or counseling and has chosen to go on to specialize in the treatment of sexual issues. A sex therapist might also be a person who did not previously come from a related clinical field, but has received both a proper education, as well as clinical supervision, from a university that offers a qualified graduate program in Human Sexuality.
When dealing with sex and relationships, it's often difficult to separate the sex part from the relationship part. But that's exactly what a sex therapist tries to do; not that sex therapists don't care about your bigger relationship concerns, or don't want to talk about them, but very often it's important to isolate the actual sexual issues from the underlying relationship factors. Experience has shown that fixing your relationship won't necessarily fix your sex life, so sex therapists like to focus on specific behavioral therapies that are known to successfully address a broad range of sexual problems.
Sex therapy usually requires in-office visits, but sometimes can be conducted via telephone or email depending upon the nature of the problem. Some of the more common problems that sex therapists deal with include: premature ejaculation, erectile disorder, female orgastic dysfunction (inability to reach orgasm), female sexual unresponsiveness, low libido and lack of desire, interpersonal psychodynamics around sexual issues and lack of communication between couples about their sex lives. Many sex therapists also handle gender identity disorders and sex-change counseling, as well as fetish and paraphilia-related issues (deviant sexual behaviors such as pedophilia) and sexual trauma to name a few. In general, sex therapy takes its cues and definitions of sexual dysfunctions from the Diagnostic and Statistical Manual of Mental Disorders, also known as DSM-IV, which is published by the American Psyhicatric Association and is essentially a compilation of symptom and behavior checklists that help clinicians make reliable diagnoses of mental disorders.
The original therapeutic models for sex therapy go back some thirty years to the work of pioneering sexologists, Masters and Johnson, and were later developed and refined by brilliant clinicians such as Helen Singer Kaplan and media personalities such as Dr. Ruth Westheimer. Sex therapists have devoted considerable time and effort to researching and understanding human sexuality and are much more apt to put a patient on an appropriate clinical program than a typical psychologist.
To dispel a myth: if you go to a sex therapist, you will not be asked to get undressed or engage in sexual activity. What you see on HBO's Real Sex has nothing to do with what happens in the office of a real sex therapist. Sex therapists use their time with patients to foster communication and understanding, as well as to pinpoint the precise nature of a given sexual problem.
Sex therapists will often give their patients "homework" that includes intimacy-building activities of a sexual nature and then discuss the results of those assignments later during an in-office session.
Sexual dissatisfaction is the #2 reason for divorce in this country and, unfortunately, lawyers far outnumber sex therapists. But if you're having a sexual problem and would like help, you can locate a qualified sex therapist by contacting organizations such as AASECT (the American Association of Sex Educators Counselors and Therapists) and the American Board of Sexology or asking your medical doctor for a referral. If that doesn't work, feel free to email me and I'll try to connect you with a qualified sex therapist in your community.
Also, here's a link to a recent article in the Washington Post, entitled Is there a Sexologist in the House, that addresses this very topic —how to know if you need a sex therapist and where to find one that's qualified—and features an interview with Dr. William Granzig, Ph.D., the Dean of the American Academy of Clinical Sexologists, with whom I had the good fortune to study.
In his play, Cat on a Hot Tin Roof, the playwright Tennessee Williams wrote of the marriage-bed, "When a marriage goes on the rocks, the rocks are there, right there!"
I like to believe that sex therapists use their skills and experience to help couples clear the rocks from their bed and ultimately smooth out the sheets. |
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