Sex Therapy: How It Works

This is the second part of our interview with sex therapist Sarah Young, who works with individuals and couples to help them rediscover--or perhaps discover for the first time--the joys of sex.

Q: At what point does the woman’s partner usually get involved?

A: Usually, I work with a woman for about a month before bringing in her partner. At that point, I try to get a feel for where he’s coming from, whether he wants to meet individually. If he does, we might move ahead where every other session is with the couple--so it’s couple, individual, couple, individual, through the duration of the therapy.

Q: What are some of the therapy techniques you use with couples?

A: We have many techniques, but if we need to talk about the basics, such as specific sexual positions and so on, I have these two little pipe cleaner people. The little blue person with the erection represents the man, and the pink one, with little boobs, is the woman. It’s delightful because some people have a problem even looking at pictures, so it’s a very neutral way to teach people positions.

I’ll also suggest readings, and we use a lot of sensate focus, too, which is kind of the default “go-to” for sex therapy in terms of reintroducing touch to couples. They rediscover the joy of just looking at each other, or sitting together, or holding each other. That also gives the therapist some control to say, okay, I’m going to take over your sex lives for awhile. You don’t have to worry about whether you should be doing this or doing that. You just have to do this one exercise, and it’s not even going to involve your genitals.

Because sex is not just about orgasms; it’s not just about his erect penis and your lubricated vagina. If that’s how it’s framed for couples, they’re doomed for failure. But if they can broaden their definition of the sexual experience, it’s huge for them in terms of being allies in the bedroom, on the same team, saying, this stage of life can be fabulous, how can we really embrace it?

Q: Can you give an example of a successful case involving a husband and wife?

A: There was a woman who came to see me because she wasn’t enjoying sex; for her entire married life it had been, “Okay, let’s just get this over with…” Come to find out, when she was a little girl, she was experimenting with masturbation, as kids often do. Her mother, who was very uptight about sex, discovered her and flipped out, making her filled with shame and guilt over it.

First we had to deal with her wounds, dissolving some of the lies she believed and getting her to see her sexuality from an adult perspective, rather than through the eyes of a seven-year-old.  We talked about how a person’s sexuality is not just limited to the bedroom; it’s part of who you are every day. I gave her some exercises to increase her confidence. For instance, a lot of women will look in the mirror and just see sagging boobs and cellulite. But I had her stand in front of the mirror and take joy in her hands, the hands that had held her children and made food for her family. And instead of keeping her sex drive on a low boil, I told her to go get some red underwear to remind herself that she’s a beautiful, sexual woman who has a right to enjoy and to be enjoyed by her husband. So it was getting her to see things in a new way, as an adult.

Over a period of time, she began to gain confidence, becoming more mentally present with him in the bedroom. And it just kind of took off from there. She’s still working on not feeling uptight, but she’s doing really great.

Q: Your work must be very satisfying. Do you enjoy it?

A: I absolutely love it; to see the hope in a woman’s eyes when she finds out she’s not crazy or abnormal or to see a husband who feels like he’s got his wife back, it’s just the best thing.