Sex: How Willing Should A Therapist Be To Talk About It?

[Lomoco]

Well no I've never discussed sex with my therapist. sex is one part of my life that I don't wish to talk about or analyse - feels very private to me.
Is it sexual dysfunction you're needing to talk about or just sex in general?
I think if it's a specific problem maybe you could ask to be referred to a sex therapist. I wouldn't expect any and all therapists to be adept at talking about sex.
It's a pretty specialised field and I would think those therapists do s lot more training with boundaries etc as sex is fraught that way. Just talking about it can kind of bring it into the room and into the relationship - something therapists have to avoid doing.
I'd go and see a specialist if you really want to sort this out

 

[Ohudo]

My NHS therapist has never dodged the subject. I found it an uncomfortable subject, but he helped me discuss it as was required for my healing.

I would suggest you make no judgements. Some therapists will be comfortable and others not.

 

[Emov]

Is it sexual dysfunction you're needing to talk about or just sex in general?

Both. Personally, I don't know how you would keep sex segregated from other topics that come up in therapy. It just weaves itself into so many areas of life. You should talk about what comes up, period. I don't like the idea of fencing myself in.

 

[Peku]

While the question seems pretty general, I think that it is really more complicated to persons and situations. Often, sex is not about sex. Sex is no big deal, unless there is a problem or lack of in a relationship, then it can be a huge issue.

If therapist is specialized in trauma, they may be more adept in sexual issues related to trauma. I can think of many instances where both partners presence would be beneficial, and that does not happen in individual therapy generally.

I agree that you should be able to discuss anything. Sometimes therapists redirect for therapeutic reasons as well--they see more pressing issues to address, such as safety, addictions, self harm.

 

[Wotes]

That's sort of like... Why bother having a trauma therapist? What therapist doesn't deal with trauma?

Sex Therapy, Trauma Therapy, Family Therapy, Grief Therapy, DV Therapy, and scores of other places that certain practitioners specialize in. In all of those areas? There's also no single approach or school of thought. They can approach their specialty through a CBT lens, a Psychodynamic lens, Multimodal lens, Physiological lens, etc. ((There are roughly a dozen major schools of thought in Psych, and each school has it's own approach to every sub specialty.)) And that's just in Psychology. Clinical Practicing MSWs, Sociologists, Psychiatrists, Prescribing Nurses, & Psychologists are all highly educated / trained therapists. But not only will none of them be expert in all schools of thought, much less all areas... But in many states the only thing a person must do to be a licensed counselor is pay a $30 fee to the state licensing board, and voila. Or pass a 6 week to 6 month course (thinking of CDPs, but there are quite a lot of other quickie-certifications out there). Lastly, add in religious & peer counselors? Forget about any kind of universal standard of what any therapist's training and education is, much less specialty. Psychologists and Similar have at least spent 8-12 years in school. But that doesn't guarantee that they'll be studied in the areas or approaches that you need/want. Nor, if they have, that they'll either be any good, or a good fit for you.

 

[Aba]

I'm compulsively hypersexual, kinky, and queer. I've had numerous therapists not want to talk to me about sex. I've been told, "I won't be able to give you the right kind of advice" because I'm not interested in changing. I'm not in therapy to become heterosexual, monogamous, nor vanilla. So many therapists are like... "Uhhh... well.... uhhhh... I'm glad you aren't upset by those parts of yourself."

I don't think therapists get the training they need when it comes to sex.

 

[Ebi]

I've seen a sex therapist. And I've discussed psychosexual issues with general therapists. The general therapists have been happy to listen but clear they didn't have expertise. The sex therapist was at ease with it all.

 

[Bewic]

Often, sex is not about sex. Sex is no big deal, unless there is a problem or lack of in a relationship, then it can be a huge issue.
.

That's so true! That made me think a lot....thank you

 

[Atelu]

I'm compulsively hypersexual, kinky, and queer. I've had numerous therapists not want to talk to me about sex. I've been told, "I won't be able to give you the right kind of advice" because I'm not interested in changing.

But I dont understand why you'd want to talk about sex with your therapist if there's nothing you want to change.
If you're happy the way things are, what is there to discuss?

 

[Ecaj]

If you're happy the way things are, what is there to discuss?

I'm not Aba, but I'm also someone who has generally been happy with their sex life, and have been completely uninterested in fundamentally altering it.

That doesn't mean that it isn't a part of my life, or never associated with problems that need sorting.

More like, if my husband is cheating on me, I'm not interested in becoming homosexual (fundamentally altering my sex life), but I'm very much going to be going through the ringer in regards to sexual topics. AKA I'm generally happy, but may be gutted by something occurring in the present.

Same token, while I can generally be happy with my sexual identity, proclivities, relationships, etc.? That doesn't mean that there won't be tie ins to old trauma that need sorting. AKA something from the past is causing me problems. But not to the degree of throwing the baby out with the bathwater.

 

[Eba]

But husband cheating on you isn't so much a sexual problem as betrayal of trust - which of course can make trusting a man again feel very fraught and totally impact upon sex. But still it's not sex or Technique or what you do or don't do that needs addressing, is it? More the difficulties in trusting again.
In my own experience there has to be trust for a sexual experience to be all it can be, but if the sex wasn't working id be looking elsewhere for the answer.
Like within my emotional relationship with that person.
So that doesn't really mean that much talk about sex except for it isn't working.
Maybe I'm not getting something here....

 

[Losiz]

That's assuming I wasn't still having sex with my husband while he was cheating on me. Or that it wasn't the one thing that did still work in our relationship. Or if it didn't work, that it was a black and white result instead of a very complicated one. Or that I wasn't still attracted to him, or didn't still enjoy having sex with him, or couldn't separate out the physical from the emotional, or wanted to be able to split emotions and actions and couldn't (or vice versa), or chose to divorce him after I found out, or if I stopped having sex with him didn't still have a sex drive of my own & unmet needs, wants, desires that I would somehow have to piece into what my morality is on the subject (meaning a revenge affair, or affairs, or sex with friends, or open relationship, or one sided open relationship, or BOB, or celibacy), or what the sudden removal of a coping mechanism -in addition to the stressor of betrayal- might do to my PTSD symptoms in the long term if I did choose to stop having sex with my husband, or how the sex between us might change if we continued having sex and how that might affect me, my symptoms, or both, or what past traumas might be suddenly drug out of the shadows into the spotlight and be manifesting in my sex life -or lack thereof- was looking like...

...and that all of that ^^^^ wasn't just the tip of the iceberg.

Yep. Used a real example in my husbands infidelity creating myriad sexual problems in my life. Some directly related to PTSD, many more not but still serious enough to warrant needing to come to terms with. Those ones are something most MFT therapists are well used to dealing with (average recovery time 2-5 years, so yeah, a lot of issues). The PTSD & trauma related sexual problems that are brought out? Not so used to dealing with. The conjoining of the 2 sets of problems interacting with each other? Even less familiar with dealing with.

Which is only one reason why even a vanilla hetero married couple may well be sent to sex therapy, where the facilitators entire focus is on sex & relationships. Because even if the primary therapist is used to, and totally capable of working with the sexual issues they're familiar with? Whether it's trauma sex issues or marriage sex issues... Add in something they're unfamiliar with, and it may suddenly be beyond their skill set to help effectively.