A few months ago we talked about couples therapy, which caused some discussion about a closely related field: sex therapy. The idea of going to a sex therapist may be so scary that you wouldn’t even consider it! You’re probably not alone. That’s why we decided to talk with Sarah Young, MA, who is a sexual therapy specialist whose practice is Christian-based.
Sarah was educated at the Institute for Sexual Wholeness in Atlanta; her philosophy is that sex is not just sacred, it’s meant to be enjoyed. “It’s still such a taboo issue,” she says. Her goal is to help people find a “voice” for their sex lives, to talk about it and explore it freely without shame or guilt. She had so many interesting things to say, we’ve divided the information up into two parts; here, she talks about getting started:
Q: What’s the biggest “fear factor” or misconception women have about sex therapy?
A: Sex is such a personal, intimate thing. They’re afraid they’re going to have to get naked and perform: Oh, my gosh, am I going to have to take my clothes off and show her what we do? That’s not how it works at all.
Q: Let’s talk about how it does work: How do you get started?
A: A lot of my referrals come from doctors working with women, so I’ll usually start with the woman. We’ll just have a conversation at first. Patients often ask how I got into sex therapy, and that gives me the opportunity to establish my professionalism, my ethics, and how I feel about the sacredness of sex, which always makes them feel more comfortable.
Then we’ll begin by talking about the bigger picture, her world as a whole: What are her other life stressors? I need to get an idea of everything that’s going on in her life, the larger dynamic, because it’s all entwined in the bigger circle. It’s not, Okay, give me all the details and let’s go.
Facing failure goes against what Hollywood says your sex life should be; it’s very threatening for people. So I try to validate her in that first session — here’s where you are and this is fine — and to offer her hope.
Then in the second session, I’ll usually engage in a pretty in-depth sexual history just to find out where she’s coming from. What are her automatic thoughts, how has her body image been formed, and what other experiences are in her reality? Some of the questions are very difficult for people, like whether she is masturbating, and if so, how often.
Once we uncover all the issues, we’ll talk about a game plan. At that point, I usually give it three weeks to a month between sessions, so they can just go through a cycle of life. Because you need to give this time; one week you might have a hormone issue, the next week, everything is okay. You need that whole cycle to give it a framework.
Q: What kinds of issues do you typically deal with in older women?
A: One big thing, of course, is menopause and all the changes that come with it. Women sometimes feel defective when they’re going through it, which is understandable. Often it’s a matter of shifting their perspective to just normalizing it; it is what it is, you need to take it one chunk at a time.
Other issues might be aging in general, or a partner’s infidelity, or the reality of cancer and mastectomies: How am I still supposed to feel sexy when my breasts are gone? And the empty nesters: The kids have gone off and mom and dad haven’t paid attention to each other for years. Now all of a sudden, she’s thinking, I don’t even know how to be his friend, let alone his lover. So a lot of it is empowering people to reignite the passion and the friendship they once had; they’re in a place when they can engage in a more mature perspective.
Q: Once a person starts therapy, how long might it last?
A: It really depends… I have couples I’ll see every few weeks for three months and they’ll check in after that every few months to update, or if they’ve hit a glitch or want to talk through it. Every case is different, really.
Watch for part two of Sarah’s interview, in which we discuss partners’ roles and therapy techniques used; you can see it next week!
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.