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What to Expect at Sex Therapy


USA, New Jersey, Jersey City, Couple discussing issues during therapy
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Having sex is fun. Talking about sex, especially if there's a problem, is the opposite of fun. It's like having your tooth drilled at the dentist's office. Even though you love your spouse and perhaps you can easily communicate about everything else in your life, you are unable to talk to one another about the intimate things that go on (or don't go on) in your bedroom.

Don't be alarmed. Help is on the way. You can always go to sex therapy. If you're thinking this is some sort of weird hippie dippie type of counseling for couples, where you are going to have to try out strange sexual positions or discuss your G-spot ad nauseam, then you're wrong. Mostly, you'll just be trying to get at the root of your problem with a third party, who is objective and trained at helping people with similar issues.

"I talk to people about sex just like I would anything else," says Lonnie Barbach, a clinical psychologist in the San Francisco area and author of For Each Other: Sharing Sexual Intimacy (Anchor, 1983). She promises that clients usually get more comfortable and are more willing to open up as the session continues. Here is how she approaches therapy:

Determine the problem.

Usually, the therapist wants to first know why you have come to therapy, what problem you want to address. Now, you don't have to sign on for therapy just because you are having issues. You can go just to make sure you are on the same page about sex and to discover ways to make your sex life remain healthy and exciting. More often than not, however, couples are heading to therapy to resolve some sort of problem. And Barbach encourages her clients to be specific by sharing when the problem started, if it ever stopped, and any other details that might be helpful. A typical conversation might revolve around lack of orgasm or erectile dysfunction. Really, problems are as unique as the couples who have them. There's no need to by shy about sharing with the therapist.

Try to get at the root of the problem.

There is always a reason for the problem. Sometimes, you can figure out the cause quickly. For instance, an older couple who visited Barbach had to use a penile prosthesis due to a medical condition of the husband. He was unable to penetrate and he and his wife had already seen their physician about the problem. Barbach made them realize that they were not using the proper angle, and their problem was resolved and they didn't have to return for a second session.

Sometimes, the problem is harder to either identify or fix. Newlyweds, says Barbach, often have relationship problems. One young couple didn't understand each other. The wife was emotional, and he was a problem solver. When she would get upset, he would try to fix her problem. But she really just wanted him to listen and comfort her. Because they couldn't meet each other's emotional needs, sex became difficult.

Learning to communicate can go a long way to building intimacy. When you feel comfortable with one another, can talk to one another, and understand one another, everything is easier, including sex. Part of what makes sex therapy effective for newlyweds is that many of them still don't know each other sexually. "It's all new," says Barbach. That can be true even if you and your spouse have been having sex for years.

Get past your hang ups.

Getting couples to open up about their sex lives and offering them constructive advice is what you can expect at therapy. Going through this process might help you get over your hang ups about sex and could also help you get past certain issues that have been plaguing your marriage. Sex therapy is effective if you find a therapist whose specialty is relationships and sexuality. It's not just about sex, says Barbach. It's about your feelings and thoughts and the relationship as a whole.

Pay for your sessions.

Of course, sex therapy is not free. You're going to have to pay for it. Many therapists don't take insurance, so you'll have to pay out of pocket. The price varies, depending on the therapist's qualifications, location, and experience. Barbach suggests calling your insurance company to find out what is covered beforehand.

Even if you can't afford therapy, don't ignore your problems. "If you have a problem and sex is part of it, handle it sooner rather than later," says Barbach. "The longer you wait, the more the problem evolves, creates negativity, becomes a pattern, and creates bad feelings."

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