QUESTION: "Dear Ian:

Doesn’t being a sex therapist take some of the awe and joy out of sex for you? After all, sex is more than just mechanics and positions (Insert A into B and twist until secure) -- it’s an expression of love. And isn’t love ultimately mysterious and unknowable?"

ANSWER: What a great question to help me frame my preliminary thoughts on male sexuality. The more I learn about the nature of love, and its expression through sexual intimacy, the more I am in awe of it. But sometimes I think we use the concept “love is a mystery” to keep ourselves mystified and avoid responsibility for the hard work true intimacy entails. The fact is we live in a culture in dire need of sexual education. Despite, or perhaps in accord, with our country's prurient, almost pubescent fascination with "the look" and "fashion" of sex, we remain sadly sophomoric in flesh-bound pleasure-training.

The number two reason for divorce in this country, after financial conflicts, is sexual dissatisfaction, and a crucial part of the problem is lack of communication and poor information. The truth is that when it comes to talking about sex with a partner, breaking the ice is like breaking an iceberg, and we all know what happened in Titanic.

Let me briefly explain how I, as a clinical sex therapist, approach a new patient or couple. Sex therapy generally follows a model called P-LI-SS-IT, which stands for Permission, Limited Information, Specific Suggestions and Intensive Therapy. First, a patient needs permission to confront an issue openly and safely with a therapist. Second, they need accurate information, ranging from physiological facts to psychological reactions, to tackle their problems. Next, they need specific suggestions to get them back on the road to sexual health. In some circumstances, they may also need intensive therapy, although most of the time the first three steps will do the trick.

I’ve adapted the P-LI-SS-IT model to accommodate my own working version, which I call the “See Me, Feel Me, Touch Me, Heal Me” approach to sex therapy. (And, yes, I listened to The Who a lot growing up). For therapy to succeed, a patient must, first and foremost, be seen. This is so important when you consider how many people are leading quiet lives of secret desperation when it comes to their relationships. Next that individual must be felt. Their emotional turmoil must be communicated effectively and experienced by their partner. Next comes the touch part, which takes the form of sex-assignments that are done at home and then discussed in subsequent sessions. All that needs to occur before a person can even begin the process of healing. So, to answer my reader's question, love is indeed mysterious. Sexual ignorance, however, is not. It’s a function of laziness, prejudice, and fear. The more we learn about sex, the more there is to appreciate, understand and savor.