Do We Need Sex Therapy?

How do you know if you need sex therapy? The answer is easier than you realize, but can be difficult to follow through on. Having relationship problems because of sex is common (Related Article: Relationship Problems – Sex). However, going to couples therapy for sex problems is difficult. It is hard enough to go to therapy for ‘communication problems’, let alone therapy for sexual issues (Related Article: Marriage Therapy In Utah: How Putting It Off Damages Your Relationship). Right? Let’s talk about sex therapy in Utah, aspects of sexual problems and what to do about them. Just getting into therapy to talk with an expert about this can be helpful. 

What Is Sex Therapy?

Sex therapy, experts in the field would say (Weeks and Gambescia, 2015 in Couple Therapy And Sexual Problems), is not a separate treatment from couples therapy, but rather a subspecialty of it. It can be a part of what you are doing in couples therapy in the first place. However, it does require the therapist to have a special knowledge and competency base. It’s like going to a therapist for couples therapy when one of you is depressed. You will work on your depression thoroughly as you work on your relationship at the same time. Going to couples therapy for sexual issues includes also working on your communication, non-sexual connection, parenting, family roles, trauma, depression and anxiety issues. They are connected and therefore are all a part of the solution. 

Sex therapy for couples addresses both sexual difficulty and sexual dysfunction. Let’s talk about the difference. 

What Is Sexual Difficulty?

Sexual difficulty is less severe than sexual dysfunction. Therefore, it is not necessarily diagnosable in the DSM-V (where therapists get the list of criteria to give specific diagnosis to clients). It could include a lack of sex in general or differences in expectations between you and your partner. It can also include difficulty talking about sex or making your discomfort or desires known to each other. Most (all?) couples experience sexual difficulty. It’s part of being in a relationship and mixing your life with someone else. Sex is a sensitive and vulnerable part of you and it can be difficult at times to address. 

Many couples find it helpful to work with a therapist for sexual difficulty. Especially at the beginning of their marriage.

What Is Sexual Dysfunction?

Sexual dysfunction is more severe and diagnosable through DSM-V criteria. It causes more severe complications and disruption to your life than sexual difficulties might. Diagnosed sexual dysfunctions include:

• Delayed ejaculation (DE)
• Erectile disorder (ED)
• Female orgasmic disorder
• Female sexual interest/arousal disorder
• Genito-pelvic pain/penetration disorder
• Male hypoactive sexual desire disorder
• Premature (early) ejaculation (PE)
• Substance/medication-induced sexual dysfunction
• Other specified sexual dysfunction
• Unspecified sexual dysfunction

If you qualify for one of these diagnoses, you would most likely benefit from expert help.

Am I The Only One With A Sexual Difficulty Or Dysfunction?

No, you are not the only one with these problems. In fact, studies have shown that around 50% of men and women in the US have experienced a sexual dysfunction at some point in their lives (Laumann and colleagues, 1994, The Social Organization Of Sexuality: Sexual Practices In the United States). This is a life-time prevalence of half of your neighbors and people you know having a diagnosable sexual dysfunction disorder. Its more common that you think and you are not the only one. 

In 2014, Hendrickx and colleagues (in the Journal of Sex Research) did a survey where they found interesting prevalence rates. Over a four-week time frame, they found that 23% of men and 39% of women met classification for a sexual difficulty. Also, they found that 11% of men and 20% of women met criteria for a sexual dysfunction during that same time frame.

So, no – you are not the only one. But, this is something people don’t tend to share with others, so it might seem as if you are. Talking about it with your spouse is the first step. 

What Can I Do About My Sexual Relationship Problem?

Anxiety 

Focus on reducing your anxiety around sex (and in general!). Many problems with sex, either sexual difficulty or sexual dysfunction, are rooted in anxiety. Sexual performance has been researched and found to be tied to anxiety (i.e., Dettore, Pucciarelli, & Santarnecchi, 2013 – Anxiety and Female Sexual Functioning: An Empirical Study). So, focus on anxiety reducing techniques to help this problem subside (Related Article: Just Breathe! Reduce Anxiety With This Simple Exercise). Doing so will make it easier to address sexual problems that are difficult to talk about. 

Communication

Work to improve your communication with your spouse. Many couples feel uncomfortable or incompetent to share and talk about their sexual needs, experiences, desires and discomforts. Learn how to share raw data and your emotional experience with it, for example (Related Articles: How To Communicate Effectively: Avoid These Two Communication Problems In Marriage and How To Communicate Better Through Boundaries). And try to avoid being your partner’s boss and the expert on them. Certainly, talk more about you and less about your partner (Related Article: How To Communicate Better: Learn These 3 Principles).

Relationship Satisfaction

Increase your relationship satisfaction in general. Not just around sex and intimacy, but overall. This will put you in a better position to be physically vulnerable with each other. You will have a better attachment and feel safer with each other. Being sexual is a risky and physically/emotionally exposed experience. So, make it safer through more relationship satisfaction. 

Learn how to recognize, feel and cope with your emotions in your relationship (Related Article: Emotions 101: How To Be Healthy), for example. This can help you connect better and deepen your bond as a couple. It gives you a platform to deal with discomfort and points you in a direction of connection. 

Education 

Educate yourselves around your body and sex. Many couples don’t know how their body works and don’t know how to explore it. It’s important to be able to understand the mechanics of your body as well as your experience with these mechanics. Find material that you are both comfortable with and learn. Depending on what you need and what you are comfortable with, you could read, for example, one of David Schnarch’s books. It’s titled Resurrecting Sex: Solving Sexual Problems and Revolutionizing Your Relationship. 

Start sex therapy for couples problems today in Orem, South Jordan, or Spanish Fork. 

Written by Triston Morgan, PhD, Utah Marriage and Family Therapist