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

[Emov]

Sex is pretty simply what it is - sex.

That's a matter of opinion, and I think the majority of folks would strongly disagree with you.

Picture this: You're talking to your therapist about "the betrayal." You've been going on for about 35 minutes about the lying, the sneaking around, the heartache. You start to say that you never imagined he was dissatisfied with your intimate life....."Oh, but there was that one time we were in bed, and he wanted to try something a little unconventional. He wanted to take my --" Suddenly your therapist says, "Stop right there. We're veering into sex now, and I'm going to have to write you a referral, so you can talk to a sex therapist about that. You can talk to them about your sex life, but you can only talk to me about the nonsexual parts of your relationship."

That's what I mean by the near impossibility of segregating sex out of "general therapy," and that's what this post is about.

 

[Ecu]

That's a matter of opinion, and I think the majority of folks would strongly disagree with you.

Picture this: You're ta...

well, we don't agree! I don't think betrayal comes about through lack of sexual satisfaction, so my focus was not there. It was more like how did we become such strangers?
But anyway, one thing is for sure - we are all different. It's not for me how it is for you and vice versa.
And this thread is about wanting to talk about sex with a therapist - so mayve the truth is sex means different things for all of us. For me, sex is a reflection of a relationship, not the focus

 

[Pevot]

No Emov, it does not work that way. Same scenerio, therapist lets you go on and asks some questions so YOU might find INSIGHT., but you dont. You keep revisiting the sex part rather than the betrayal. Finally you say, well I guess I never did like to do anything but missionary position and no other acts. I never had an orgasm and fake it often. etc etc I really did not enjoy sex. etc. This dialogue goes on. Since your therapist is not the best value for your buck as she/he does not feel like the best person to address this with you. After several sessions that this seems to keep coming up, T says, "It seems to be that this is really bothering you" and you say, that you want to figure this out before entering another relationship. Your therapist offers you a referral to someone they know that is more experienced. That person may be able to help you in 3 visits with focus on sex and you continue working with this therapist for the issues you originally came for. The problem is-Too many therapists do not make those referrals and are wasting your time and money when they are not

 

[Kupu]

Sometimes fine with therapist, sometimes not and sex therapist better. Just MHO.

 

[Emon]

I think the disagreements in this thread highlight very well how even people with the same disorder come at & weight subTopics -like sex & betrayal- very differently. Which folds into some of their therapists might not need to even say word one about sex over the course of their treatment, while others are going to be discussing sex deeply over a long period of time.

 

[Emov]

No Emov, it does not work that way.

It sure shouldn't work that way, but apparently with some therapists it does. My last therapist shut me down the minute the topic of sex came up -- and nothing too raunchy either, I mean stuff you could hear on MTV these days. How the hell are they going to know if you need a sex therapist if they change the subject the second the topic comes up?

 

[Okasi]

Because my trauma was mainly serial, both my T's encouraged talk around the subject of sex. My current T I have never discussed it because I'm too anxious to even mention the trauma. But she knows I dissociate as certain reminders during sex are triggering of course. Sex is definitely not simply 'just sex'! It's super complicated for many of us, good or bad, I would think.

 

[Jowu]

*sexual not serial lol

 

[Owo]

I wish I could weigh in on whether my T would be comfortable talking about sex or not but the reality is that I am not. The majority of my traumas are sexual in nature, CSA, multiple rapes, and the inability to have a non-abusive sexual relationship as an adult. I have not reached a point where I feel safe enough to speak about my abuse in anything but high level terms no real details to know how comfortable T is with the topic and that is after nearly two years of therapy together.

 

[Zalol]

Keep in mind that trauma type therapy is relatively new, picked up in last 15 yrs or so. For a long time, PTSD was primarily diagnosed for military. PTSD diagnosis was created for vets. So in earlier times, sexual problems were not so related to current issues now known. Some raised in strong religious homes brought great guilt, etc.

I have a friend who has shared her experiences with her husband and a sex club. It is out of my realm of experience and I feel uncomfortable. My discomfort is because I find their behavior dangerous. She quit telling me and I am sure that it is because I can not show some sort of approval or interest. I also know she has history of eating disorder, comestic surgery like Barbie Doll, history of being exploited. As a friend, I see it destructive. If she came as a client and said these things, I would be seeing this as a symptom rather than problem and not too useful to discuss at early point.

 

[Ginub]

As with anything, it's about finding a therapist that is a good fit.

I think it's a bit much to expect every therapist to be knowledgeable about sex simply because you believe that all therapists should be able to help with sexual issues.

Many therapists deal with issues that are very much outside the sexual realm. This is their right. It's also a boundary issue, too. There is no professional requirement for therapists to be willing and able to address sexual issues.

Not all roads lead to sex. I've never discussed sexual issues in therapy and I know many others never would either. Sex isn't a universal topic that is an issue for everyone.

Perhaps a better route would be to find a professional who can help you as we cannot change the world to suit our needs. Nor is this an issue that I think even should change in therapy. It would be a bit ridiculous to expect every therapist to set aside personal boundaries and say they must step outside of their comfort zone to help clients with sexual issues. In addition it would be an overreach of professional organizations to require therapists to all be trained in sexual issues (not to mention a major waste of time, money, and resources.)

I think this boils down to a personal beef that you have had with one or two therapists. Instead of being proactive and looking for someone who suits your needs, it's a bit easier to make a post like this.

Everyone here is always advising others to find trauma therapists, and this is very much the same. If you need sexual guidance, find a therapist who has expertise in that area.

 

[Namam]

Ginub-best spoken post. You have politely asserted the most reasonable response I have read. It is not one size fits all!