NYC Sex Therapist Talks – “Sex Therapist- doesn’t that mean you sleep with your clients?”
I have been interested in sexuality for as long as I can remember, which, incidentally, is about as long as I knew I was gay. I had wanted to go into the mental health field, and as soon as I took my first sexuality course my sophomore year at college, I knew that this was the direction I wanted to pursue. I took as many courses I could find, which surprisingly for the University of Missouri in Kansas City, was more than you might think.
When I trained at the masters level in Psychology, I chose to do an emphasis in marriage and family therapy, which seemed to make the most sense for pursuing a career as a sex therapist. It was shocking for me that during graduate school, we were only offered one course in human sexuality, and it didn’t really focus on how to work with clients on issues related to sexuality. (It’s even more shocking to know that one course in sexuality is more than many medical and mental health professionals have, including medical doctors!) Like most graduate students in the mental health field, I had a clinical internship where I worked under supervision with clients. I felt woefully unprepared to work on sexual issues, and often avoided bringing up anything unsavory in session. This is often the case with therapists who call themselves sex therapists, sex coaches, life coaches, etc- the title may or may not match the credentials.
Luckily, I came across a unique doctoral opportunity in clinical sexology, from a small program in Florida. (Florida, by the way, is one of the only states that certifies sex therapy, and requires a minimum of 120 hours of education as well as supervised experience in order for therapists to call themselves “sex therapists”. ) This extensive (and relatively intensive) training as a sex therapist really prepared me for what clients actually came to therapy with- issues ranging from high intimacy but low libido in couples, to a critical analysis of the “sex addiction” meme. There were eye-opening discussions on working with people with gender identity issues as well as sexual identity (who knew that being gay does not make you an expert in sexual identity?!). I was trained in working with folks who struggled with desire and arousal issues as well as issues like premature ejaculation, erectile dysfunction and other sexual difficulties people might deal with, whether in individual counseling or couples therapy.
In my practice now, I supervise graduate students and post-graduates to be well-versed in the various issues that present in therapy that are related to sexuality. Often, clients remark that they have never felt comfortable talking to previous therapists about sex, which never ceases to amaze me. How odd that you can talk to your therapist about all sorts of issues, but not sex! How odd to leave out your interest in kink or fetishes when working on your relationship in couples counseling! How odd to go take pills like Viagra for erection problems when most of the time problems with erection are related to psychological state, not physiological problems (mind, not body)! Sex therapists might refer you to other clinicians to rule out medical issues, but work in tandem with these other clinicians to set up an effective treatment plan.
Talking about sex with your therapist or talking to a sex therapist doesn’t have to be creepy or awkward. The discussion often involves some reading at home (“Sex Without Guilt in the 21st Century” by Albert Ellis is a good place to start), as well as some introductory sex education. The sex therapist isn't there to be judgmental, moralizing, etc. It’s also not going to end up with sex therapist and client forming any sort of sexual or intimate relationship. (People often confuse sex therapists or clinical sexologists with sex surrogates which are quite rare, and have mostly been outlawed in this country). The work between sex therapist and client involves frank and open discussions about sex and sexuality, a basic human drive, and how struggling with this drive can sometimes cause you to become anxious, depressed, repressed, angry, guilty, or any of the other unhealthy negative emotions we get bogged down with from time to time. These discussions are based on sexology, the scientific study of human sexuality, not on religious myths, 12-step, or other memes. Sex therapists are already licensed in other areas as mental health practitioners, so they work on issues like anxiety, depression and other life conflicts- sex therapists just have extra training in sexuality. When you have issues with your sink, you call a plumber. Hopefully when you have issues in your life, you will find the a sex therapist with the right training to help you out, whether related to sex or something else.
from the AASECT (American Association of Sex Educators, Counselors and Therapists):
Specialized Graduate Programs. Although many graduate programs offer a course or two in human sexuality - usually as part of a general program in a field such as clinical psychology, counseling, social work, or primary care medicine - there are currently only three programs in the United States that offer graduate degrees focused in a concentrated and specialized manner on clinical and educational services in the field of human sexuality. Each program has its own distinctive characteristics, and each program has “pros” and “cons” depending on your individual needs and interests. Although AASECT does not officially endorse training programs, the following listing may be helpful to you in seeking further information:
Institute for Advanced Study of Human Sexuality: Located in San Francisco, this independent “free-standing” graduate institute offers a range of training programs as well as a wealth of resource materials in human sexuality and erotology. Maimonides University: Located in southern Florida, this graduate program trains professionals who have already achieved at least a masters degree, and who are licensed in their home state, to specialize and achieve doctoral training in sex therapy. Widener University: Located in Philadelphia, this program offers masters and doctoral degrees in two tracks - one that is specifically focused on training sexuality educators, and one that is specifically focused on training sexuality counselors and sex therapists. (Read full article)