The Psychology Of Sex: Therapy Gets Even More Personal

You may feel like you tell your therapist everything, but there’s a topic many of us tend to avoid: sex. While unpacking your thoughts and emotions, how often do you talk to your therapist about your sex life? Many people have to think back to the last time they mentioned it even in passing. 

There is a psychology of sex and a growing body of literature that therapists use to help individuals and couples experiencing challenges related to sex or intimacy. Sex involves a physiological drive that helps meet the psychological need for connection. If you avoid this topic with your therapist, you may be leaving out a significant topic that affects your psychological well-being. Your mental health, as well as your sex life, can greatly benefit when you decide to discuss this topic with a therapist and potentially engage in sex therapy.

What do I talk about?

For some people, the most significant hurdle they have once they decide to speak with their therapist about sex is figuring out how to jump into this conversation after many sessions of artfully avoiding it. First, you might identify whether you have a problem in your sex life or if everything is going well.

Here are a few questions to ask yourself:

• Am I sexually satisfied?
• Am I happy with the frequency of sex in my life?
• Are my partner and I sexually compatible?
• Do I feel respected in my sex life?
• Do I want to or need to process a past sexual trauma?
• Do I have difficulty climaxing?
• Do I experience pain during intercourse?
• Has my libido increased or decreased recently?

If you answered "no" to any of the first four questions or "yes" to any of the last four, you may have plenty to discuss with your therapist. However, even if your answers are reversed, you can still have a conversation about sex. Your therapist might be able to help you more if they know where in your life you are functioning well and in what areas you might improve.

Your own therapist, a couples therapist, or a sex therapist?

Are you open to speaking more with a therapist about your sex life but unsure about whom to talk to? This is a common question that people have about matters related to sex and intimacy.

Mismatched sexual desire or communication problems can be referred to a couples therapist or a sex therapist, depending on the situation. Sexual health concerns necessitating medical care can often be addressed by a medical doctor. 

However, in general, to discuss sex with a therapist, you don’t necessarily have to talk to a sex therapist. You can talk to a psychologist, a marriage and family therapist, or a psychiatrist. Just speaking with your regular therapist may help as many therapists are used to talk to their clients about these topics. If your therapist thinks you may benefit from talking to someone else, they may recommend you see a sex therapist.

A sex therapist is trained in therapy methods beyond those practiced by professionals who don’t specialize in the psychology of sex.

In most cases, sex therapy is a form of talk therapy. Its goal is to address factors impacting sexual satisfaction, whether psychological, interpersonal, or medical. Talk therapy is the traditional approach in most therapy, and sex therapy does not involve physical activities in the presence of a therapist. However, the therapist will likely recommend homework to address sexual problems, and will want an update on how the strategy impacted sexual issues.

These can include topics that affect almost everyone at some point, such as low libido, erectile dysfunction, lack of arousal, and premature ejaculation. However, some people need to work through concerns that can seem more complex. Low libido, for example, may actually be a sexual desire disorder, which can be useful to know so that a partner doesn’t feel unwanted. 

A sex therapist can also address partner infidelity and distrust, unwanted sexual fetishes or mismatched sexual interests, sex addiction, or sexual thoughts and shame. If you believe there is a sexual problem affecting you or your relationship, a sex therapist can likely help.

If you haven’t started therapy yet, but you’re considering it, the licensed mental health professionals at Regain can help you work through any concerns and successes in your sex life (and other aspects of your life). With Regain, you can connect with a therapist alone or with your partner to discuss topics related to sex, intimacy, communication, and your relationship in general. You’ll have the opportunity to participate in therapy from the comfort of home or wherever you have an internet connection. 

What isn’t considered a sexual concern?

Perhaps when considering whom to consult, you aren’t sure whether you actually have a concern that relates to sex. The psychology of sex isn’t dissimilar to other psychological themes. If it causes you anxiety or stress, you might consider discussing it with a therapist. Talking to a therapist is likely to help, but some sexual dysfunction requires medical care to treat. It may also be worthwhile to reach out to your primary care physician or another medical provider.

While sexual health concerns can often be addressed with the assistance of a medical doctor, the emotions that can accompany them are often treated in therapy.

Talking to a therapist about sex doesn’t have to be taboo. The world is changing and evolving—what was maybe once considered a topic to avoid is likely now welcomed openly in the mental health community. If you find a sex therapist, you can feel free to discuss consensual sexual desires, fetishes, and other topics that you might initially feel nervous revealing. 

Also, a sex therapist will likely understand how past sexual traumas, phobias, and toxic relationships can play a role in who you are and what you need today. People with past sexual trauma can enjoy healthy, fulfilling sex lives. Any information you relate about this topic may help your therapist understand what tools you may need and what support to provide.