How to Seek Psychotherapy for Sexual Problems

Three Parts:Seeking Individual PsychotherapyGetting Couples Sex TherapyDeciding if Therapy is For You

Many people suffer sexual problems at one time or another. We might feel a loss of interest in sex or intimacy, self-consciousness, difficulty achieving or sustaining arousal, or even an inability to have sex. It’s possible that psychotherapy can help, though. Whatever the problem, consider talking a doctor about your options – individual therapy, sex therapy with a partner, or possibly resolving the problem through other means.

Part 1
Seeking Individual Psychotherapy

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    Ask for a referral. To seek psychotherapy for sexual issues, start with your normal doctor and ask for a referral to a therapist. You doctor may already know of a nearby practice or specific doctors to recommend. If not, she may still be able to help you find a suitable therapist.[1]
    • Close family members may also have ideas. You might feel more confident about a therapist if you have a recommendation from a loved one.
    • Feel free to ask close friends for referrals or suggestions, as well. You don’t need to say what the issue is, merely that you’re looking for a therapist. The same goes for recommendations from other trusted figures.
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    Look for a licensed therapist on your own. You can also try personally locating a psychotherapist in your area, either online or by consulting local mental health resources. Some websites like Psychology Today can direct you to therapist finders and search engines. Otherwise, look into nearby hospitals and professional organizations.[2][3][4]
    • Try online databases, as said. These resources will often provide a bit more information than the phone book, like the therapist’s experience, degrees, and specializations.
    • Many states and localities have professional psychological associations, too. Consider calling and asking for a specialist in sexual issues.
    • Try your community mental health center for more suggestions or, if possible, a nearby university or college department of psychology.
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    Ask plenty of questions before settling. Fit is important in finding the right therapist, especially for sensitive sexual issues. You don’t need to settle for the first therapist you meet. Instead, be ready to ask questions to establish that the therapist is qualified to help you, that you are comfortable with her, and that you’re willing to work together.[5]
    • Make sure that the therapist is licensed. It may help to follow up by asking how long he or she has been in practice.
    • Ask about the therapist’s areas of expertise. Say, “I’m feeling anxious/depressed/not myself and am having some sexual problems. What experience do you have working with these kinds of issues?” You should also ask about techniques and treatments.
    • Don’t forget to ask potential therapists about fees, i.e. how much they charge per session, as well as what forms of payment they accept. Will they accept your insurance, for example?
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    Begin to explore your “sexual story.” Once you’ve settled on a therapist, you’ll have to work together to get to the bottom of your sexual issues. Think of this as exploring your own “story.” Everyone has a sexual story – not just your sexual past but all the cultural, gender, familial, and personal baggage you carry related to sex. Chances are your therapist will try to locate the problem in underlying issues. [6][7]
    • Expect the therapist to ask about your home and work life. Are you experiencing stress or worry? Are you having trouble balancing the demands of work and family?
    • Is something from the past behind your intimacy problems? Were you raised to see sex as negative or bad, or did you experience a trauma?
    • Or maybe you are preoccupied with a big event in life – a death, the birth of children, a divorce, or a layoff from work? This might explain lack of desire or interest in sex, among other things.

Part 2
Getting Couples Sex Therapy

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    Look with your partner for a sex therapist. Sex therapy is a kind of psychotherapy designed for couples who want to address issues of desire, sexual function, or intimacy. Anyone can use sex therapists regardless of age, gender, sex, or sexual orientation. Sex therapists can be psychologists but also social workers, physicians, or licensed therapists with a special training in relationships. [8][9][10]
    • Ask for a referral from a physician or, perhaps, from a trusted friend or family member. You can also make use of the resources mentioned above at local psychological associations, online databases, psychology departments, and community mental health centers.
    • Look for a good fit. Ask the potential sex therapist about his education, credentials, and experience – is he licensed by the state, for example, or accredited with the American Association of Sexuality Educators, Counselors and Therapists?
    • Find out whether the therapist has experience working with your specific sexual issue. Sex therapists can specialize in different areas like past sexual abuse, gender issues, and sociocultural factors in sexual values.
    • Keep in mind: certified sex therapists do NOT have sexual contact with patients. Physical contact (sometimes called sex surrogacy) is NOT part of mainstream sex therapy.
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    Consider a Marriage and Family Therapist (MFT). An MFT is not the same as a sex therapist, though the roles can overlap. MFTs are mental health professionals that are trained in both psychotherapy and in family dynamics. They are licensed to treat emotional and mental problems, including sex and intimacy, in the context of a family, marriage, or close partnership. [11]
    • One advantage of an MFT over a regular psychotherapist is that they are trained to treat not just the individual, but the individual within the context of a relationship or family.
    • Usually, MFTs have some level of graduate training. They must be thoroughly credentialed and can come from backgrounds like psychology, psychiatry, nursing, pastoral care, and social work.
    • Look up MFTs near you online, such as through the American Association for Marriage and Family Therapy’s therapist locator.
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    Pursue a program of therapy. In general, therapy for sexual issues is a short process with only a limited number of sessions. It will also seek to address any emotional or mental problems that are contributing to your sexual issues, and to teach you behavior to control physical symptoms. While cases involving things like trauma may take longer, most couples resolve their complaints within two months to a year.[12][13]
    • Therapists may try to identify negative attitudes, if the problem is a lack of desire, and try to help you develop new ways of thinking about sex. One popular technique is called sensate focus, in which couples touch or caress one another without sexual contact. The idea is to learn to feel secure while giving and receiving pleasure together.
    • For erectile dysfunction, therapists may try to address possible performance anxiety and teach the couple to take the focus off from intercourse. Or, for problems with premature ejaculation, couples may learn focusing techniques to allow sex to last longer.
    • Expect these exercises to prompt strong emotions and then to discuss your feelings with the therapist in psychotherapy.

Part 3
Deciding if Therapy is For You

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    Get a physical. Sexual dysfunction comes in several varieties: disorders of desire, arousal, orgasm, and pain. Some of these can be caused by psychological issues, while others may stem from physical causes. If you are experiencing a sexual problem, you should first call your doctor to book a physical and determine what is behind the issue. A physical problem might need to be treated with medication or other means, rather than psychotherapy. [14]
    • Expect to have a full physical with your doctor and to answer questions about your symptoms. Your doctor might also order diagnostic tests to pinpoint the problem.
    • Conditions like diabetes, heart disease, hormone imbalances, drug or alcohol abuse, or chronic disease of the kidneys and liver can all affect sexual health, for example. Some medications may also interfere with sexual function, like certain antidepressants.
    • Your doctor may also ask you questions about your levels of stress, past sexual history, use of alcohol or drugs, and others to help determine the cause.
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    Try medication, if you’re having physical issues. Sometimes sexual issues are the result of underlying physical problems and can be resolved with medication. This is often true for erectile dysfunction, but for other conditions as well. Your doctor should advise you after performing a physical. [15][16]
    • If the problem is hormonal, ask your doctor about shots, pills, or creams that can treat imbalances or deficiencies. For women this might include estrogen or androgen therapy, both of which are important for sexual function.
    • For men, meds that increase blood flow to the penis like Viagra or Cialis can effectively treat erectile dysfunction. The US FDA has also recently approved a drug Flibanserin, a so-called female Viagra that can help to boost the libido.
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    Experiment with mechanical aids, if need be. Psychotherapy might not be necessary for you either if you can treat the problem through mechanical means. There are a number of aids to help resolve physical sexual dysfunctions. Men can use pumps or implants to help with erectile dysfunction, for example, among others.[17]
    • Talk to a doctor about potential aids and whether this is an option. She can then advise you on safe products.
    • You can find many sexual aids like vacuum pumps online. These are available for men as well as women – the Eros is an aid approved especially for women, for example, though it is expensive.
    • Women may also find a vibrator helpful for sexual arousal, while those who have spasmodic contractions (vaginismus) can try dilators.

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Categories: Emotional Conditions