Sex Therapy

Sex therapy is talk therapy, just like other types of psychotherapy. It DOESN'T involve sexual touch between therapist and client, and the therapist doesn't observe sexual contact between clients. To repeat: in sex therapy there ISN'T any sexual contact between therapist or clients.

As part of therapy, I often will instruct clients in "home play" exercises they can try at home, either individually or with a partner. Any exercises I assign to clients are done on the clients' own time, in the comfort of their home.  

What will your course of sex therapy look like? The first thing we’ll do is to talk about your goals, and what led you to seek out help with your experience of sex or sexuality.

Next comes a sexual history interview. When I am working with partners or couples, I will interview each person individually about their sexual story, past and present. This interview typically takes three to four hours, total. My strong preference is to do this interview in one day as a therapy intensive, since the process of gathering this information takes so long and otherwise typically spans several sessions.

The sexual history interview is not only informational for me, it’s also therapeutic for you! During this process, many clients make important connections between their current issues and past events that help shed light on the roots of their problems.  

From there, therapy proceeds just as any other type of “talk therapy” would – with weekly sessions exploring elements that may be related to the issues at hand, such as emotions and interpersonal dynamics; hopes and expectations; core beliefs and unspoken assumptions; hurts and resentments; and traumatic experiences that may have led to anxiety, shame, and other issues.

I may invite clients to read specific books, which we will discuss together in session. I may assign exercises for individuals or couples to try at home, where I feel it will help my clients’ growth towards their goals. These exercises may aim to soften entrenched patterns, to develop new ways of interacting, or to explore pleasure and connection. 

Tantra is a spiritual path that sits at the intersection of Hinduism and Buddhism. Its roots are in the Kashimir valley of India, and as a spiritual tradition it is most closely aligned to today’s Tibetan Buddhist tradition of Shaivism.  

My interest in tantra relates to a few practical aspects:  

• being aware of our internal experience, somatically, emotionally, mentally 

• Living in the present, rather than dwelling on the past or anxious about the future 

• Being honest about and authentic to our desires and emotions 

• Cultivating our awareness of others, and our curiosity about their experiences 

• Understanding how our attitudes, words, and actions impact ourselves and those around us 

• Developing awareness of and facility with subtle energy (e.g., prana or qi, the same force that’s manipulated in reiki and acupuncture). 

Tantra itself is not about sex, but the label “tantric” has been co-opted to describe sexual practices that center these aspects. In the context of sex, the tantric focuses I named above combine to enhance our sexual experience and deepen our connection with our partner. They help transform sex from performance-oriented to pleasure-oriented.  

Yes! If you have a special interest in learning about tantra and how to incorporate tantric practices into your sex life, you’ve come to the right place. My training as a tantra educator and practitioner, combined with my sex therapy expertise, make me uniquely qualified for helping clients who are curious about tantra. 

Most of my therapy clients will naturally end up learning elements of tantra as part of our work together. The tantric principles of mindfulness, presence, and authenticity are intertwined with my approach to therapy. I often incorporate somatic practices to help clients cultivate awareness of their present emotional, physical, and energetic experience. This kind of purposeful awareness is a fundamental part of the tantric approach to life.  

My perspective on healthy sexuality is also heavily tantra-informed. This is because a person who is earnestly searching for more embodiment, intimacy, and pleasure in their sex life naturally arrives at a tantric approach to sex! Many of the exercises I assign for home-play focus on tantric principles and provide the building blocks for tantric techniques.  

Sex therapists are trained to help people experiencing dysfunctions of sexual desire, arousal, and performance, such as:

• Low (or lack of) libido or desire for sex 
• Low (or lack of) arousal leading up to and during sex 
• Erectile dysfunction (ED) 
• Premature ejaculation 
• Delayed ejaculation, also called retarded ejaculation 
• Vaginismus, or spasming of the muscles of the vagina 
• Vulvodynia, which is pain in the vulva 
• Vestibulodynia, or pain at the entrance to the vagina
• Dyspareunia, or pain inside the vagina during intercourse 
• Anorgasmia, the inability to climax during sex 

Sex therapy is also helpful for people experiencing anxiety and other discomfort about sex, including: 

• Performance anxiety 
• Worry about pregnancy or STIs 
• Worry about negative effects of birth control
• Anxiety about overstepping a partner’s limits 
• Anxiety related to lack of experience 
• Fear of sex itself 
• Body image anxiety, including worry about being seen by a partner 
• Anxiety about being heard or seen by others
• Anxiety about not being what a partner wants or needs, sexually
• Dissatisfaction with or lack of attraction to a long-term partner
• Worry about sexual interests not being accepted
• Worry about being turned down when initiating sex
• Disgust at how sex looks, feels, smells, sounds, or tastes
• Disgust about certain sexual acts, or sex overall
• Overactive feelings of modesty with partners
• Worry that saying no to sex (or a specific sexual activity) will lead to rejection or abandonment
• Anxiety about our boundaries being disregarded
• Worry about others (like parents) knowing about our sexual activity 
• Worry about family not accepting a sexual partner
• Worry about being judged or rejected for our sexual history

Sex therapy is the perfect place to explore and transform these thoughts and feelings, and step into comfort and self-confidence.  

Sex therapy is an excellent way to successfully treat sexual trauma. Over a third of women in the U.S. have experienced sexual molestation, assault, rape, or intimate partner sexual violence at some point in their lives. Many men have had experiences of molestation and sexual assault, as well. Sexual trauma can have profound impacts on a person’s ability to enjoy sex with ease, joy, and pleasure.

If you are finding yourself over-sensitive to sexual overtures due to past sexual trauma or having your boundaries crossed, sex therapy can help you find your voice and assert your desires and boundaries. Sex therapy can also help you overcome dissociation and avoidance of sex due to past sexual traumatization.  

This is an excellent question! I am not a doctor, and medical treatment is outside of my scope. However, if you are experiencing any mental health issue that might have a physical element, I will recommend you see a competent medical practitioner. In the therapy I do that's not sex therapy, I enjoy partnering with medical professionals and others to treat other mental health issues that have physical and/or neurochemical elements, including depression, anxiety-related disorders, ADHD, and insomnia.

Sexual issues are no different! Sexual concerns are very often embodied concerns, most especially sexual dysfunction. Many sexual problems have physical causes, and it’s important to rule these out first. 

If you are experiencing sexual dysfunction, I will ask you to visit a medical provider who specializes in sexual health for an evaluation. I am happy to provide a referral to a competent doctor or nurse practitioner, pelvic floor physical therapist, or other specialist who is best suited to help you with your specific concern.

It is important to me to open a line of communication with your relevant medical providers, so that we can collaborate to give you the best care possible. I work alongside medical doctors and specialists, naturopaths, bodywork practitioners, physical therapists, dieticians and other types of specialized healthcare practitioners who may be able to illuminate and address the physical side of whatever sexual concerns you bring to me. 

If a potential physiological cause is identified, ideally you will begin any recommended medical treatment of your issue as soon as possible after starting sex therapy. Even if the medical treatment works wonders for your sexual issue, you may discover there are emotional or relational aftereffects that psychotherapy can help you to manage.