Top 3 Reasons to See a Sex Therapist

As a clinical sexologist, I work in a clinical setting, which means I perform sex therapy, assisting clients with a range of sexual concerns. Using a combination of talk therapy techniques, somatic methods, and psychoeducation about sex and anatomy, I work with individuals and couples to increase pleasure and become their ideal sexual selves. My clients present with a wide range of sexual and mental health concerns including erection and ejaculation difficulties, painful sex, inability to orgasm, out of control sexual behaviors, lack of desire, and more, but what are the most common reasons that people seek out a sex therapist like myself?

1. Sexual anxiety

One of the top three reasons why people come to see me is to recover from sexual shame and anxiety. This can manifest in a multitude of ways, and affects folx across age and gender expression, regardless of how much sexual experience they have. For some, sexual anxiety may present as a fear of not being "good enough" at sex, not being "experienced enough." For others, it can stem from negative pre-existing beliefs regarding their bodies or sex in general, most of which was learned in their upbringings (from family, cultural expectations, religious teachings, poor sex-ed, etc.) For male-bodied individuals, sexual performance anxiety can manifest as erectile dysfunction. About 90% of my clients who experience erectile dysfunction find that the root cause is tied to their feelings of sexual anxiety.

When it comes to sexual anxiety, I work with clients to address the root causes by exploring their history and how the sexual anxiety developed. From there, we work together to overcome anxious thoughts through self-examination, increasing freedom in talking about sex, challenging and redirecting negative thoughts, and incorporating the body through practices such as mindfulness, meditation, and yoga. Over time, many clients find that through the development and maintenance of these tools, sexual anxiety is diminished or eliminated.

2. Sexual Desire Discrepancy a.k.a. Mismatched Desire

Another reason folx come to see me, and the top reason that couples come to see me is for sexual desire discrepancy, also known as mismatched libido. By that I mean one member of the partnership reports having a very high libido (or level of sexual desire), while the other party reports having a lower level of desire. In fact, research shows that up to 80% of couples regularly experience situations where one partner wants to have sex and the other doesn't (Day, Muise, Joel, & Impett, 2015). Generally, these couples seek me out because they want to find a way to make the person with the lower libido increase their level of desire, or to somehow bring down the member with a higher libido to match the lower level-identified individual.

In either case, I help couples work together to find ways to make their sex life more complementary, as opposed to trying to create an equal level of desire. Some of the ways I do this are through psychoeducation of things that impact desire, identifying what the couple's ideal sex life would be for both of them, creating the best contexts for pleasurable sex, increasing sensual as opposed to sexual experiences, and focusing on high-quality vs. high-quantity sex. In this way, couples work together to create a sexual relationship that supports both partners.

3. Sexual Trauma Recovery

Lastly, one of the top reasons why people come to me for treatment is for sexual trauma recovery and to rebuild pleasurable sex lives after experiencing sexual violence. Unfortunately, sexual abuse is an epidemic that impacts 1 in 4 individuals. Thus, whether they initially disclose it or not, many people seeking sex and relationship therapy probably have histories of sexual violence, which is why specific treatment methods for sexual trauma recovery in sex therapy are used. In my work, sexual trauma recovery is a multifaceted process that includes general trauma recovery techniques, education, development of coping skills, relationship counseling, and special sex therapy exercises for sexual healing. It also includes receiving education about the effects of trauma, relaxation techniques, and mindfulness to manage hypervigilance and other symptoms, and identifying and coping with one's sexual triggers.

Sexual healing is an empowering process that enables survivors to address and overcome sexual problems caused by past sexual violence. It involves using particular strategies and techniques such as developing a positive sexual self-concept, stopping negative sexual behaviors, coping with unpleasant reactions to touch, and learning new skills for experiencing touch in safe, affirming ways to actively change sexual attitudes and behaviors that may have resulted from the sexual abuse.

Sexual healing frequently combines "relearning touch techniques" (Maltz, 2001) with relationship counseling and trauma recovery work. Also, time is spent addressing specific problems frequently experienced by survivors, such as unwanted sexual fantasies, sexual orientation confusion, sexual aversion, and sexual compulsivity. Furthermore, if the client is in a safe, committed relationship, I often include their partner in the process and what I refer to as a "partner in healing." Through these practices, I work to enable clients to practice feeling relaxed, present, communicative, and in control of their own experience, honoring the past and the pace of each survivor.

Finding a Sexologist or Sex Therapist

Are you struggling with any of these concerns or another sex-related matter? If you are in search of someone who is certified, you can check the listing at the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) online directory. Lastly, if you are interested in working with a sexologist, I encourage you to ask about their area of focus and their background or credentials. That way, you can make the most informed decision about who to trust with your sexual health.

Who am I? A message from Holly…

Dr. Holly is a leading expert in sexual health based in Orange County, certified as both a clinical sexologist and AASECT sex therapist. With extensive experience in sex therapy, sexual wellness, and relationship counseling, Holly provides evidence-based insights to clients in Orange County, the state of California and beyond. Recognized for expertise in sexual trauma recovery, sexual dysfunction, and intimacy, Holly is dedicated to empowering individuals with practical advice and research-backed strategies. For more, follow Holly for expert advice on sexual health and relationships.

Visit www.thehollywoodsexologist.com to learn more and request a consultation.