They say one shouldn’t talk about sex, but do it. But not everyone can, wants to, or enjoys doing it. In this case it is worth to talk about it. Our article series reveal the most common sexual problems and present how sex therapy works.
Sex is a very complex activity in which we participate with our whole being, both on physical, mental, emotional and intellectual level. This is why it is difficult to give a clear definition of sexual dysfunction.
Sexuality is very unique, very personal and private where a lot of things can fit into the limits of normality. Therefore sexual failure is considered as an experience resulting in failure for a certain person, too much is considered what a certain person finds too much and dysfunction is considered anything that causes suffering to the person. Mostly, it is not only the problem of one person but rather the couple`s that needs to be addressed. Experts divide sexual dysfunctions into four groups: sexual desire disorder, sexual arousal disorder, orgasmic disorder, and sexual pain disorder.
About sex therapy
Sex therapist (usually a psychologist or psychotherapist) is a person who can help solve these problems using the methods of psychotherapy, couples therapy and sex therapy. The assistance is based on discussions, homework, and sometimes demonstrations with certain aids. The key to success is in the hands (and in the feelings and thoughts) of the clients. The therapist can help you find the way to a happy sexual life. The aim of the first session is to get to know the couple better. They talk in detail about their problems encountered during sex. Of course, first this is not easy at all: in many cases even the right words are missing. In addition, there are some unconscious thoughts that they might not even said to themselves before.
If both the couple and the therapist believe they can really work together, on the second session the therapist outlines how many more meetings will be necessary. It is important that the couple clarifies between each other what they want to achieve and they also say it out loud. The therapy makes sense only if the couple aims to develop together and be happy together. It is worth to put the goal into quite detailed words and even record it in writing. For example in case of premature ejaculation problem, the couple would like to postpone the occurrence of the ejaculation from 2 minutes (which is disturbingly short for both of them) to 10 minutes. It is also useful because later the achievements will be more measurable.
Disorders of the desire phase
We talk about sexual desire disorder if a person doesn’t have desire for sex and if this causes anxiety because the feelings of unmet expectations of their own, of the partner or society (However if the person participates in sexual activity is able to enjoy it). Reduced or low sex drive (also known as hypoactive desire) may be caused by anxiety, depression or even memories of past abuse. It may develop due to fear of joy or failure, losing control, the closeness of the partner, or pregnancy. Some misbeliefs can also cause low sexual desire. For example many women – due to their upbringing- consider having sexual desire as being loose therefore they suppress the urge in themselves too.
Also, many men thinks they ought to `want sex` very often, but the constant pressure to initiate starts negative impulses minimizing their desire for sex. It can also be very frustrating when a couple`s sex life becomes monotonous or boring. No wonder that after a while they do not want to have sex that often as they used to, however there is a lot of opportunity for restoring sexual excitement.
It is also possible that some feel completely disgusted by sex. This is called aversion. The feeling may relate to the partner, the situation or a certain body part. Causes may include anxiety, anger, guilt connected to sex or relationship problems. Some men are unable to reconcile the image of the mother and the sexy woman in their wives.
Because in our culture beauty and sexual attractiveness is linked to youth, aging may also be the cause of asexual behavior. Sexual self-esteem is often reduced in older age causing the loss of sexual interest. Many women in menopause reported decrease in their sexual desire. Often, vaginal dryness associated with menopause can also contribute to making sex less joyful. On the contrary, other women`s sexual appetite increases after menopause, maybe because they can have sex more freely now without the risk of unwanted pregnancy. In this case the changes in the ratio of sex hormones can increase sexual desire which might be disturbing as well for women after menopause.
During the therapy first we have to find and understand those situations, behaviors and thoughts that might be in connection with the complaint, and might cause the so-called problem behaviors. Sometimes it takes more time than finding the actual solution. It is important to interpret negative thoughts and be aware of the good experiences too. The therapist may give you homework about what you should pay attention to the next time when you have sex.
Of course it makes a huge difference how the partners relate to each other. In many cases it turns out to be a relationship problem instead of a sexual one. If one party doesn’t really want to be together with the other the therapy will be either unsuccessful or the result will be obvious for both of them: that they cannot be happy together any more.
Frank Gillespie has a Master's Degree in Counseling from LaSalle University in Philadelphia. He is a nationally Certified Counselor (NCC). He has provided therapy for over 23 years. During his career, he has helped more than 10,000 people move past their obstacles towards reaching their potential and fulfillment in their lives. He practices Cognitive Behavioral Therapy with a warm and nurturing approach. In addition to being a therapist, Frank has been an adjunct college professor teaching social work, a clinical consultant, a clinical director, and a seminar speaker. Frank has recently retired from his full time practice to focus on a part time online practice. He is married. He enjoys listening to music, watching sports, power walking, swimming, reading and writing.