Can A Sex Therapist Help Our Sex Life?

Updated October 21, 2024by Regain Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.
”Sex is not only an activity but also an important form of communication in a relationship. If you find yourself struggling with the issue of sex in your relationship, seeking the help of a professional sex therapist may help in reconnecting you back with your partner.” - Aaron Dutil, LPC

Sex therapy is a therapeutic approach designed to improve sexual dysfunction in both men and women. Sex is a complex, multifaceted experience, and modern, sex therapy considers the biological, psychological, and social factors associated with human sexuality. There is a stigma associated with sex therapy; it has often been viewed as a "fringe" psychotherapy with little real-world effectiveness.

However, researchers have studied the effectiveness of sex therapy thoroughly since its genesis in the 1960s. Decades of research have demonstrated that sex therapy is an effective treatment for many sexual dysfunctions, and today it is considered a mainstream, evidence-based approach.  

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A brief history of sex therapy

Moden sex therapy first came to light thanks to the work of two pioneers in the field of human sexuality: William Masters and Virginia Johnson, who began their research in the late 1950s. Before Masters and Johnson, clinicians attempted to address problems with sex and intimacy psychoanalytically. Psychoanalysis is a mostly debunked form of psychotherapy pioneered by Sigmund Freud, a neurologist and early pioneer in psychotherapy.

The psychoanalytic approach to treating sexual disorders was used in the early-to-mid 20th century and was limited in effectiveness. Psychoanalytic theory ties psychological problems to unresolved childhood conflict or poor parental attachment. In contrast, the approach taken by Masters and Johnson focused on the behaviors surrounding sex and on increasing sensuality in the sexual experience.

Masters and Johnson also focused on sex education. At the time of their research, they noted that many of their research subjects had a missing or inaccurate perception of "normal" human sex. Their approach educated couples on relevant human anatomy and physiology and encouraged the couple to disregard preconceived notions about sex. Traditional approaches to sex therapy concentrated on intercourse and orgasm, a method that reinforces the harmful idea of sex as a goal-oriented activity.

Masters and Johnson instead focused on desire, pleasure, sensuality, and satisfaction, rather than achieving orgasm. Their approach achieved incredibly high success rates, largely due to the need for psychosexual education in the population. As those with more complex sexual dysfunctions came forward, researchers like Helen Karr and Jack Annon expanded on Masters' and Johnson's approach.

The original principles of the work done by Masters and Johnson form the foundation of modern sex therapy. Today's therapists focus heavily on education, anxiety reduction, and sensual exercises. For many, addressing only those factors provides relief from their sexual dysfunctions. For those with more complex problems, sex therapists expand on the approach of Masters and Johnson through modern empirically-supported techniques, like rational emotive therapy, systematic desensitization, and communication skills training.

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What does sex therapy treat?

Sex therapy is used to treat all manner of sexual dysfunctions. Sexual dysfunction (SD) is the inability of a person to achieve sexual arousal or sexual satisfaction. Common sexual dysfunctions that are treatable through sex therapy include:

  • Hyposexuality. This SD is characterized by inhibited sexual excitement, or the ability to achieve sexual arousal only with great difficulty. 
  • Anorgasmia. Specific to women, this SD describes someone who has a recurrent inability to achieve orgasm despite normal sexual stimulation. 
  • Vaginismus. This SD occurs when the vaginal muscles contract strongly during intercourse, preventing sex entirely or making it painful. 
  • Dyspareunia. This SD is present when a woman experiences significant pain during sex, usually due to a lack of lubrication. Dyspareunia can also be induced through medical causes, as opposed to psychological ones. 
  • Erectile Dysfunction. This SD refers to the inability of a man to achieve or maintain a suitable erection for sex. 
  • Ejaculatory Impotence. Also known as inhibited male orgasm, this SD occurs when a man cannot ejaculate inside a woman's vagina, even if he can maintain an erection or ejaculate through other means. 
  • Premature Ejaculation. This SD occurs when a man ejaculates very early in the sex process, either before or nearly immediately after entering the vagina. 

Sex therapists also help individuals and couples overcome other concerns that may be impacting their sex life, such as the ability to communicate wants and needs to their partner. Sex therapists also work with those who have experienced sexual trauma that impacts their ability to have desired sexual encounters.

For whom does sex therapy work?

Early in its existence, modern sex therapy was chiefly employed with married, straight, white couples. The first recipients of sex therapy were young couples, often newlyweds, whose principal concerns involved a lack of knowledge about sex. Interventions were focused on couples and were designed to be used in the context of a marriage. Exercises were designed with the assumption that the couple would be living together, have ample time for practice, and possess the typical anatomy of a straight male-female couple.

Today, sex therapy has been expanded to work with a variety of populations. There are now sex therapists specializing in treating sexual dysfunction within the queer community, with experience and knowledge about the unique sexual dynamics of members of that population. Cultural and racial identities are also taken into account, as new intersectional approaches to sex therapy provide treatment options that respect cultural differences in a person's approach to sex.

Sex therapy is no longer restricted to couples, either. Individual treatments have been developed that allow one person to make substantial gains in their sexual health and address their sexual dysfunction without the help of a partner. There is no one who sex therapy cannot potentially help; if you have concerns regarding your sexual health, a sex therapist is likely to be beneficial.  

What happens in sex therapy?

The specific course of sex therapy will differ for each couple or individual. It is important to note that sexual contact does not take place during therapy; actual physical contact is assigned as homework and completed outside of the therapy session. Sexual surrogacy is also extremely uncommon. Surrogate partner therapy is a little-researched subset of sex therapy wherein a willing third party is brought in to engage in a consensual therapeutic sexual relationship with the client. Sexual surrogacy exists in an ethical and legal grey area and is not typically practiced.

In a typical couples sex therapy session (also known as conjoint sex therapy), the therapist begins by taking a thorough history of both partners' physical and sexual health. The therapist will discuss the most pressing concerns with both parties and determine a course of treatment. The therapist often begins by filling in gaps in sex education, recommending basic strategies (such as using personal lubricant), and assigning homework for the couple.

typical homework assignment is often non-sexual. Many therapists begin by having a couple focus on communication. Communication is necessary for a healthy sexual relationship, and many couples experience anxiety because they do not feel comfortable communicating their wants and needs to their partner. Therapists may also assign reading or other educational resources to help couples and individuals understand specifics about their concerns.

Physical contact typically begins with the introduction of sensate focus, a technique used to improve intimacy and communication between partners. Sensate focus is the first-line treatment for sexual dysfunction and was a key part of the original methods employed by Masters and Johnson. Sensate focus begins by introducing non-genital touching before moving to genital touching and, eventually, sensual intercourse.

"Sensual intercourse" is distinct from "sexual intercourse." The therapist will provide detailed instructions for you and your partner to try at home. These instructions will focus on sensuality, pushing you away from the mechanical, orgasm-driven nature of sexual intercourse. At the start of each session, the therapist will likely discuss your experiences while completing homework before moving on to strategies to address specific concerns.

Those who see a sex therapist individually will likely receive the same education and resources as couples, but the homework will differ. If you see a sex therapist individually but have a willing sex partner who does not attend, your process will likely be similar to that of a couple. Those without access to a sex partner will receive specific guidance based on their individual needs.

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How can online therapy help?

Whether you attend alone or with your partner, sex therapy can be completed remotely. Visiting with a therapist online removes many of the barriers to accessing therapy, including traveling to an office and being restricted to nearby therapists. You may also find it more relaxing to attend sex therapy from the comfort of your own home. Online therapists use the same evidence-based methods as therapists who practice in an office setting. These methods have been researched both online and offline and have been found to be just as effective when administered remotely.

Takeaway

Sex therapy is an empirically supported, effective way to address sexual dysfunctions and concerns related to sexual performance. The roots of modern sex therapy extend back over half a century, and modern techniques incorporate decades of research. Sex therapists help clients shift their view of sex from a mechanical, goal-oriented approach to one driven by sensuality, anxiety reduction, and mutual enjoyment. Sex therapy can be attended either as a couple or individually and therapists frequently address non-sexual concerns like communication. Sex therapy is also effective for those who have experienced past sexual trauma.

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