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Here's What To Expect When You Visit A Sex Therapist


So, I'm familiar with therapy, as I've been seeing therapists on and off for the past 15 years. And I'm familiar with sex. (*Waggles eyebrows suggestively.*) But sex therapy has always been a mystery to me, despite knowing a sex therapist personally. When I first met sex therapist and social worker Danica Mitchell and she told me what she did for work, I don't remember my exact reaction, but I'm sure it involved nervous laugher and an impersonation of Quagmire from Family Guy. ("Heh heh. Giggity.") So what actually happens when you visit a sex therapist? As I'd later learn, the experience is far different (and way less taboo) than what I originally imagined.

I spoke to Danica Mitchell, as well as licensed professional counselor and sex therapist Sarah Watson, to find out what sex therapy actually entails. As Mitchell explains, "Anyone who is struggling with sexual issues is a good candidate for sex therapy." And it doesn't matter whether those sexual issues are emotional or physical. If you associate sex with pain, embarrassment, guilt, or anything that prevents you from enjoying the experience, sex therapy may be a great option for you. Here's everything you should know before making an appointment.

Why should you see a sex therapist?

First things first: Who should consider sex therapy? Just like therapy itself, sex therapy is not just for people suffering from psychological disorders or diagnosable issues. Therapy is simply a place to talk, to explore, and to better understand your behavior and motivations. When it comes to sex therapy, anyone who wants to derive more pleasure from intercourse could consider making a visit.

So what are some potential sexual issues? "This can range from a physical dysfunction (such as painful sex or premature ejaculation) to emotional or relational issues (such as decreased desire with a partner or tension around sex in the relationship)," Mitchell says. "Sex therapy can also be a great place for those looking to explore and ask questions around sex, or for couples to check in and just improve their sexual and emotional relationship." No matter the root of your discomfort, a sex therapist may be able to help you find it.

What can you expect to happen during your first appointment?

A fear of the unknown is what holds a lot of people back from trying something new. Those experiencing frustration in their sex lives may hesitate to contact a sex therapist simply because they have no idea what might happen. But that first visit shouldn't be feared. Like any other initial therapy appointment, the time will be spent getting to know you, not reviewing your whole sexual history in one day.

"Before I set up an appointment with any clients, we have a phone discussion on what is going on and what they hope to get out of therapy," Watson explains. "The initial session is all about gathering information: personal, family, and some sexual history, if appropriate."

Mitchell's process is similar, though she usually likes to discuss a patient's sexual habits upfront as well. "The main difference with sex therapy is that the therapist will also be asking more specific questions related to sexual history," she says. "This likely will include how a person grew up and learned about sex, initial and subsequent sexual experiences, and masturbatory habits." This is sex therapy, after all. It's inevitable that — sooner rather than later — you'll acknowledge the elephant in the room (or, in Watson's case, the tubes of lube and anatomically-correct clitoris sitting on her shelf).

What might you expect from subsequent appointments?

While the structure of the appointments that follow the initial visit all depend on the patient and their needs, the main focus is on goal setting. After your first visit, you and your therapist will decide what you want to achieve and how you can overcome your challenges. The number of sessions and the treatments used will always vary from case to case.

"We try to figure out the emotional barriers that impact your sexual health or relationship," Watson clarifies. "I also have a group of pelvic floor PTs, OB/GYNs, PCPs, and urologists that I refer to. It is vital to have the whole self treated, not just the symptom." As far as the length of treatment goes, Watson believes that there is no limit. "Some clients I see for five sessions, others I have been seeing for years," she says.

Mitchell points out that sexual issues are oftentimes behavioral, so she may assign an individual or couple tasks to do outside of the office. "This may be masturbatory exercises or a sensate date for couples," she explains. "Sessions will often review the assigned 'homework' and adjust as obstacles or progress occurs." The best part about sex therapy: It offers a lot of room for flexibility and creativity. "Sex is not one size fits all," Mitchell says. "Therefore, treatment has to be just as adaptive. Some of it may even be fun, like going to a sex museum or a couples' trip to a sex shop."

Both therapists point out that the process will probably involve some sexual education. "I find that 99% of my clients are lacking medically accurate sexual health knowledge," says Watson, "and that is very important for resolving issues." Mitchell agrees, noting that misunderstandings often involve the individual themselves and their own sexual history. "[Therapy] often involves some psycho-education around sex, as there is a lot of incorrect information people learn about sex," she explains. "It may involve processing past sexual experiences and cultural narratives learned about sex." After all, you can't understand your relationship with sex until you totally understand sex itself, right?

Should you visit alone or with a partner?

Your decision to see a sex therapist on your own or with a partner totally depends on the nature of your issue. Sex therapy can be utilized by both individuals and couples, but if you are in a relationship and your sexual issue involves your partner, then having that person present may be helpful. If you choose to go alone, you might want to at least consider letting your SO know you are attending. After all, sex therapy has a lot to do with improving communication.

"Due to the frequent use of homework assignments, having the partner be open and onboard is really beneficial," Mitchell points out. Of course, there are cases where it's better for a person to visit a therapist on their own. "Sometimes an individual in a relationship may need the privacy to address issues around sex," she continues, "and while a little more challenging, sex therapy can still be effective. For individuals, sexual dysfunctions may be part of why someone is struggling to maintain relationships or date, and individual work can be very helpful there."

When you visit a sex therapist with a partner as opposed to on your own, the first session will probably still involve individual intakes. As Mitchell explains, "This allows for the therapist to have the time to get full individual and sexual histories, as well as provide privacy, as it can be uncomfortable talking about past and present sexual experiences in front of a partner." Couples' therapy focuses more on communication than individual behavior, and a sex therapist can help partners build a healthier and more satisfying sexual relationship.

Sex therapy isn't taboo, and visiting a sex therapist shouldn't feel shameful — rather, the experience should help alleviate the shame you might associate with sex. As Watson emphasizes, "It's a huge step to take, and reaching out can be very overwhelming." But when the payoff is a more pleasurable relationship with sex, with your partner, and with yourself, that first step is worth it.