The Psychology Of Sex: Therapy Gets Even More Personal

Updated May 25, 2021

You may feel like you tell your therapist everything, but there’s a topic we avoid for most of us. While unpacking your thoughts and emotions, how often do you talk to your therapist about your sex life? Most likely, your response is the sound of silence as you try to think back to the last time you mentioned it even in passing, and your therapist may have also chosen to ignore the theme.

Your mental health, as well as your sex life though, will greatly benefit when you decide to discuss this in a session. Studies show that up to two-thirds of people are unsatisfied with their sex lives, and that number is likely higher in many populations who seek therapy. Why? Because many antidepressants are well-known to suppress sexual desire and orgasm, it might not surprise you to learn that depressed people and others with mental health diagnoses can find relationships and communication challenges.

There is a psychology of sex – it is a physiological drive that meets the psychological need for connection. Therefore, it stands to reason that if you avoid this topic with your therapist, wherever your sex life falls on the spectrum from lackluster to outstanding, you are leaving out a broad topic in your psychological well-being and sexual health.

But What Do I Talk About?


Most likely, the most significant hurdle you’ll have once you decide to speak with your therapist about sex is how to jump into this conversation after many sessions, artfully avoiding it. First, identify if you have a problem in your sex life or if everything is going well.

Here 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 have plenty to discuss with your therapist! But if your answers are reversed, you still have a full conversation due. Your therapist should know where in your life you are functioning well and the areas in which you struggle. In fact, it is so fundamental to your well-being that the psychology of sex means that fulfilling sex life can help a person stabilize emotions and process hard times. At the same time, a dissatisfying one can be a symptom of a greater problem.

Sexual Desire and Sex Differences as Social Constructs


If you find yourself in a relationship with a mismatched desire for sex, it may surprise you to find this might be purely a product of social grooming. Throughout history, women have been conditioned to feel shame if they desire sex, while men conversely are conditioned to use their desire to symbolize power. As a result, women use sex for connection, and men use sex for self-esteem.

This sexual psychology disconnect means that partners often find themselves not meeting one another’s needs, and their sex lives fall short, even if the sex is frequent and sexual desire is on overdrive. The fact is that human sexuality is complex, and it isn’t always biological; sometimes, it’s a construct. If you feel too distant, or you feel like your partner isn’t enjoying you, and communication between the two of you isn’t bridging the gap, your therapist or a certified sex therapist can help bridge these sex differences. Your sex life, your mental health, and your therapy will be significantly improved.

Sexual Arousal As a Science

Throughout history, most sex studies have focused on men. But today, psychology is becoming more equanimous, and we are beginning to understand more about female arousal. Male arousal for apparent reasons is more observable than that of women, and if we add to this that women experience conditioned taboo surrounding sexual desire, it’s a complicated issue.

Studies from psychology today suggest that men are more aware of physiological signals of sexual arousals – such as increased heart rate and respiration, increased skin temperature, and conductivity; this again may point to a very simple fact in the psychology of sex (and the biology!). Men may need to look for indications because women can’t physically provide significant visual indicators.

These differences may cause sexual performance problems in a relationship or in a person who struggles with effective communication. It may be possible that women verbalize their desires while men act on theirs after intuiting sexual desire, which may or may not be correct. It stands to reason this can create tension in a relationship, and sex therapy can help.

What Happens In Sex Therapy?


Any sex therapist can tell you that they get many raised eyebrows when saying what they do. A sex therapist can be a psychologist, a marriage and family therapist, a social worker, or a psychiatrist. In fact, just speaking with your regular therapist can help, and you may not necessarily need to look for a specialist – psychology today as it becomes a more common standard of care means that therapists are well-versed in universal themes even if taboo, such as human sexuality.

However, a sex therapist is trained in therapy methods beyond those 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.

This can include topics that affect almost everyone at some point, such as erectile dysfunction, low libido, premature ejaculation, and sexual disorders that are somewhat common. But some people and couples need to work through something that can seem deeper; low libido may actually be a sexual desire disorder, which is useful to know so that a partner doesn’t feel unwanted. They can also address partner infidelity and distrust, unwanted sexual fetishes or mismatched sexual interests, sex addiction, or concerning sexual thoughts and shame. If a client believes there is a sexual problem in a relationship or within themselves, a therapist is beneficial.

Your Own Therapist, A Couples Therapist, or A Sex Therapist?

Are you open to speaking more with a therapist about your sex life, but you aren’t sure who to talk to? If you’re already seeing a therapist, it would be best to start there. If they feel that your issue is something more serious than they may be qualified for, such as sex addiction, sexual desire disorder, or any variety of sexual disorders, they may suggest you see a sex therapist. Mismatched sexual desire or communication problems may be referred to as a couples therapist or a sex therapist depending on the situation, or sexual health problems necessitating medical care will be referred to as a medical doctor. As psychology today becomes a more utilized medical service, you have more options for specifically what you need.


If you haven’t started therapy yet, but you’re considering it, the licensed mental health therapists at ReGain can help you work through any concerns and successes in your sex life and all other aspects.

What Isn’t Considered a Sexual Problem?

Perhaps when considering who you should speak with, you aren’t sure if you actually have a problem or with whom you should consult. The psychology of sex isn’t dissimilar to other psychological themes. If it causes you anxiety or stress, you should discuss it with a therapist who can help you resolve your negative thought patterns.

If you are concerned that you may have a sex addiction or affect your life or relationship somehow, a sex therapist can help. Sexual health concerns can be referred to as a medical doctor, but anxiety or shame are often treated in therapy.

The field of psychology is changing, and many things previously considered taboo no longer are. Sex therapists do not consider sexual orientation to be mental health deviance; other therapists have historically practiced conversion therapy in rare instances, but that is no longer an accepted practice, and sex therapists have never embraced it. Consensual sexual fetishes and sexual desires are not unusual either, and therapists accept that people with past sexual traumas or negative relationships may need help to process what has happened to them.

However, psychology today tell us that people with past sexual trauma do not necessarily have to process those experiences to lead healthy sex lives or to be mentally well, and this is all the more reason to share thoughts, positive or negative, about your present sex life with your therapist, as well as to share any past traumas. This information can help your therapist understand what tools you may need and what to provide for you.

The fact is, you most likely tell your therapist almost everything about you. They know things about you that you might hesitate to share with others, but therapists and their clients alike report this is one subject that tends to be avoided, even in today’s psychology. And if you don’t feel dissatisfied with your sex life? The psychology of sex isn’t so different than the rest, and it’s helpful for your therapist to hear about the areas of your life that are functioning well, too, not just the stressors.

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