Talking about sex in therapy…?

barefoot

Sponsor
Wondering whether people talk about sex with their therapists.

Like, about things that feel difficult/stressful about sex/physical intimacy. Or frequency of sex. Or feeling conflicted about it (having desire for sex vs feeling stressed about it) Or whatever.

Do you speak to your regular therapist about it? And, if so, how does it help you (if it does)?

Or is this really the realm of sex therapy (ie should see a specialist sex therapist)?
 

internal

MyPTSD Pro
those are things i would speak with my current therepist about. i'm not quite at the place where i can speak of those things often, but yeah-that's normal therapy stuff! if you're worried about it you can ask your therapist what their comfort level is around sex related topics.
 

barefoot

Sponsor
Thanks @grief. I don’t really know why I’m posting about it…because I don’t really know what I’m saying I want to talk about…I’m just feeling a bit preoccupied and bothered about sex at the moment.

Sex has come up before in my sessions and I think my T is ok about it ie she doesn’t seem uncomfortable. She just tends to listen, nod and look compassionate! So, I don’t ever feel that I ever move anything in around the topic. So, I wondered if this is something that requires more expertise.

I don’t know. Don’t know what I’m trying to say here. Something about it feels important and I feel a bit upset/stressed about the whole topic.

It wouldn’t be easy to bring it up with her. Because it’s excruciating. And I know she won’t mind hearing about it. But I don’t know if it’s worth it. Because, I suppose, I don’t know how she could help with this stuff really. I just feel stuck with it.
 

barefoot

Sponsor
@somerandomguy - so talking to your therapist about sex is really a core part of trauma therapy for you?

I suppose when I have brought it up before it has largely been in a here and now context…as a separate topic to any trauma stuff. Though I did mention once that sex since starting therapy had become quite triggering. Maybe not joining those dots (or thinking there was a significant connection between current frustrations/anxieties/difficulties and historical stuff) is what’s made those conversations with T ultimately feel quite ‘so what?’ and not very helpful…

Does talking about it help because doing so helps you process past trauma? Rather than helping improve/resolve any current difficulties? Or…? (No problem if you’d rather not answer that - I know it’s a personal question!)
 
so talking to your therapist about sex is really a core part of trauma therapy for you?
Yes. It's absolutely crucial to my trauma therapy.
Does talking about it help because doing so helps you process past trauma? Rather than helping improve/resolve any current difficulties?
No, it's all of the above. Past trauma comes to roost as present issues. I personally couldn't talk about one without the other. I also have a partner I want to be intimate with.
 

Wendell_R

MyPTSD Pro
I had a CBT therapist before I had a trauma therapist, and we spent a number of months working through a textbook on sexuality. The fact that it was a textbook helped to make it a bit more distant and not as frightening, so it was exposure therapy. That therapist was very calming. It was helpful for me to see how we could talk about sexuality and not have the world cave in.

Sexuality is a core trigger for me, so I talk about it a lot with my trauma therapist. But addressing the sexuality by itself doesn't really solve things. We need to keep going back to the neglect and terror of when I was very young. But we talk about sexuality in the present to help stabilize me. It's a back and forth thing--talk about old stuff, talk about new stuff.
 

Movingforward10

MyPTSD Pro
Yeah I do.
I find it highly embarassing but I do.
Something's I still hyper ventilate if we broach certain topics. But yep: spoken to her about what sex means to me; when I cry after sex; when I have been triggered in sex; exactly what those triggers are in terms of detail about that.
It's very very personal and I often tall about how I feel talking about it because it is so personal. I have a thing that I don't want her to feel I am getting sexual enjoyment out of the conversation. She reassures me that she knows I am not.

I also have wondered if I need a sex therapist.
But my T is all about relational trauma and relational healing. And I suppose sex is relational. So I see her coming to it from that angle.

I have to gear myself up for this aspect of discussion though. Have to feel very safe and connected with T to do it. And at the moment I have deliberately decided not to bring up topic for a few weeks, but think I might again.
 

barefoot

Sponsor
Do you remember the name of the book @Wendell_R ?

But addressing the sexuality by itself doesn't really solve things. We need to keep going back to the neglect and terror of when I was very young. But we talk about sexuality in the present to help stabilize me. It's a back and forth thing--talk about old stuff, talk about new stuff.

Yeah....I suppose when I've brought sex up in the past with her, I've brought it up as a sort of standalone here and now challenge. In that, I don't bring it up in the context of any historical/trauma stuff. I don't join any dots. But then, neither does she either... I guess I should approach it differently...start making connections...


when I cry after sex

I mentioned this once and my T just sort of normalised it – shrugged it off almost, as if everyone cries after sex and it doesn't mean anything bad/that anything's wrong... I don't think she was being invalidating...I think she was trying to say it was ok. But I didn't bring it up again!

She also once suggested that I drink some wine before sex to relax, because I'd been talking about feeling anxious/fearful at the prospect of having sex with my partner.

And she also said that I should probably talk to my partner about sex (in terms of frequency/my anxiety around it/wanting to have sex but feeling afraid etc). And I said, 'Well, I'm talking to you about it?' And she said that was fine, I could talk to her about it to explore how I'm feeling...but that only talking to my partner about it was going to change anything. Something like that anyway. So, it didn't really feel...useful.

To be fair, those things ^^^ were quite early on (6+ years ago) and it was only about a year or so ago that I explicitly said that, back then, sex triggered some flashbacks. And that sex has just become very triggery since I started stirring shit up in therapy.

I don't get the feeling that she is embarrassed/uncomfortable talking about sex or listening to me talk about sex. I just don't feel we get very far when we do talk about it. It feels like we're both waiting for the other one to come up with a major insight about it all! And it makes me wonder if this just isn't really her area of expertise. So, perhaps it's that I need a sex therapist. Not that I have any intention of getting a sex therapist! But from what you guys are saying here, sex should be an area of expertise (or at least competence) with T's who are working with people with sexual trauma?


I don't want her to feel I am getting sexual enjoyment out of the conversation

Yeah, I get this. I've said to my T a few times that, when I get triggered, I (my body) gets....well, she calls it 'erotically charged.' It's something that really bothers me. She has been great about validating that and making it ok/normalising it etc. But we've said a few times about getting into that more. But then we don't. Part of my challenge is that, if we were to talk about some of my current difficulties with sex, I probably would end up feeling 'erotically charged' afterwards (and possibly during) But it's not actually that I'm getting sexual enjoyment out of talking about it. It's hard to explain... I just hate it :( Perhaps this makes me more hesitant to bring this stuff up now...because she now knows about this. Ugh!
 

Movingforward10

MyPTSD Pro
I mentioned this once and my T just sort of normalised it – shrugged it off almost, as if everyone cries after sex and it doesn't mean anything bad/that anything's wrong... I don't think she was being invalidating...I think she was trying to say it was ok. But I didn't bring it up again!
Yeah, my T does the same thing: as if it isn't a big deal. (But it is!). I think it is them normalising it and making it ok and taking the shame out of it. But I experience her saying that as "she doesn't understand!". When I don't think it is that. It's the intensity I feel it at seems minimised with her validation.

She also once suggested that I drink some wine before sex to relax, because I'd been talking about feeling anxious/fearful at the prospect of having sex with my partner.
That would be problematic for me, with my history of using drink and drugs in sex. But maybe that isn't a problematic suggestion for you? Idk.

And she also said that I should probably talk to my partner about sex (in terms of frequency/my anxiety around it/wanting to have sex but feeling afraid etc). And I said, 'Well, I'm talking to you about it?' And she said that was fine, I could talk to her about it to explore how I'm feeling...but that only talking to my partner about it was going to change anything. Something like that anyway. So, it didn't really feel...useful.
I get what she is saying here. Learning to communicate with your partner. Sometimes I think I
am, but then realise I'm not. So I think she has something in this? Communicating with your partner and your T?
It feels like we're both waiting for the other one to come up with a major insight about it all! And it makes me wonder if this just isn't really her area of expertise. So, perhaps it's that I need a sex therapist. Not that I have any intention of getting a sex therapist! But from what you guys are saying here, sex should be an area of expertise (or at least competence) with T's who are working with people with sexual trauma
I think that perhaps your T is only going at the pace of which you bring this up? It might be that she has made the dots on day one. But she is waiting for the right time? My T has said a few times that she is being careful with what she says in this area as she knows how emotional it is. So maybe we're waiting for them to come with answers and they are working on not pushing us so that we are re-traumatised?

Yeah, I get this. I've said to my T a few times that, when I get triggered, I (my body) gets....well, she calls it 'erotically charged.' It's something that really bothers me. She has been great about validating that and making it ok/normalising it etc. But we've said a few times about getting into that more. But then we don't. Part of my challenge is that, if we were to talk about some of my current difficulties with sex, I probably would end up feeling 'erotically charged' afterwards (and possibly during) But it's not actually that I'm getting sexual enjoyment out of talking about it. It's hard to explain... I just hate it :( Perhaps this makes me more hesitant to bring this stuff up now...because she now knows about this. Ugh!
My T once mentioned the erotic element with me too. Freaked me out. Totally. But I understand what you are saying. It feels very uncomfortable. Just thinking about it freaks me out. But I think I link that, in my mind, to replaying abuse through consensual sex, and that freaks me out too.

Essentially: it's a confusing mindfield. And sorry I have no answers, but hearing you and along this journey too.
 

barefoot

Sponsor
my T does the same thing: as if it isn't a big deal. (But it is!)

Yeah....I get the normalising...and I get that they aren't going to sit there and be like, 'OMG, I can't believe you cry after sex, how terrible!' 😉 But, as you say, it is a big deal...and sometimes being really neutral and normalising these kinds of experiences doesn't recognise that.


But maybe that isn't a problematic suggestion for you?

It's not problematic in terms of alcohol/drug use. But it did feel like a glib suggestion. I was sharing something embarrassing and difficult and something that felt like a really big deal...I didn't realise at the time that sex was sometimes triggering flashbacks and so I hadn't expressed this to her...but I knew it felt distressing and had expressed that....and so the idea of having a glass of wine first to relax and 'get in the mood' just felt way off beam and I felt really misunderstood. Plus, someone saying they have a problem with sex and a therapist saying 'get a bit tipsy first, that'll help' (obviously, she didn't literally say that!) didn't feel...well...therapeutic!

get what she is saying here. Learning to communicate with your partner.

Yeah, sure...communication with partner is key in all aspects of a relationship. The way she said it (and, again, bearing in mind that it had taken a lot for me to bring it up with her and it was very difficult to say) just felt very 'talk to her, not to me.' And like talking to her (my T) wasn't going to be useful.


I think that perhaps your T is only going at the pace of which you bring this up?

It doesn't really come up with T anymore as I'm not really having a distressing time with sex anymore...as I've just become completely avoidant of sex! Maybe she thinks that, as I'm not bringing it up, it must be fine now...

My T is all for going slow, going gently, not cracking a nut open with a sledgehammer...and I understand that and appreciate it... Sometimes though it just feels sooooooo slow and then it's hard to see any progress because often it feels like we are standing still.

Thanks for hearing me. And sorry this stuff is hard for you too.

I know I'm not the only one on this site who has challenges with sex (not by a long way!) Hence interested in whether/how people bring this to therapy.
 

Movingforward10

MyPTSD Pro
Maybe you could bring it up and say how you experienced her interventions before and it's making you wary of bringing it up again? So sort of setting boundaries with her and working on an agreement of how to open up more dialogue around sex?
Before you tackle your feelings now of sex?
 
Top