Talking to Your Therapist About Sex

Sex Is a Relational Experience

Sex. Talking about sex with a therapist can be anxiety provoking for some until they have crossed that threshold. Sex is part of the relational human experience and therefore often comes up in therapy. Clients or Therapists can shy away from talking about this topic.

As a therapist, I proactively ask clients about their sex drive, as along with sleep and appetite can provide insight into potential mood changes as well as stress levels. Sex is often part of measuring one’s relationship satisfaction.

I consider myself to be a sex positive therapist and support my clients across a spectrum of relationship types, sexual practices, and concerns with sexual dysfunction impacting their relationships negatively.

Individuals or couples can have struggles with sex at any point in a relationship or marriage. Common struggles are desire mismatch, sexual dysfunction in one or other partners, differing viewpoints on the value of sex, pursuit of novelty, sexual exploration, self esteem issues, and sexless marriages to name a few.

Approach Goals and Avoidance Goals 

The truth is, there are a myriad reasons we want to have sex with someone: to feel emotional intimacy, to express love, achieve pregnancy, because of lustful attraction, or to simply experience some physical pleasure ourselves. A person who has sex for these reasons, is motivated by positive outcomes and has what is known as “approach goals” for wanting to have sex.

In contrast, a person who has sex for “avoidance goals” is focused on avoiding negative outcomes, such as disappointing a partner or preventing a fight. The goals for sex matter as research has shown they influence both the sexual experience and relationship satisfaction for partners.

What is Sexual Dysfunction?

Sexual dysfunction can present itself in different ways. Some people find they have no libido, or no desire to have sex. Other people may have the initial desire, but cannot physically get aroused for the actual sex act. Still, others have difficulty achieving orgasm.

Sexual dysfunction occurs because of a variety of reasons. There may be physical pain involved with sexual intercourse or a chronic condition such as diabetes or hormonal imbalances that affect how the body reacts to sexual stimulation.

There are also psychological causes such as stress, depression and anxiety, history of sexual abuse, feelings of shame and low self-worth that may cause a person to have no sexual desire.

Talk Sex with your Providers

Talk without reservation to your medical provider about any sexual health issues. Talk to your therapist about any sexual relational issues you may be having as these issues may be a component of the connection and/or disconnection in your relationship or marriage. A therapist will refer you to a sex therapist if more expertise is required.