Sex therapists seem to be everywhere these days – on chat shows, online, on the radio and even in your high street. You could live next door to a sex therapist and not even know it! So, what is a sex therapist, what do they do, and can they help with erectile dysfunction? Here are some answers to your questions. Only you can decide whether a sex therapist is appropriate in your particular case, and this chapter should help you make that decision.
What is a sex therapist?
A properly qualified sex therapist – and this is the only type you should consider using – is likely to have a background in relationship counselling, psychiatry, psychology or clinical social work. They may even have a medical background, but they will have received specialist training to be recognised as a sex therapist qualified to advise individuals or couples on problems within their relationships that relate to sex in some way.
Simply put, a sex therapist treats sex problems with science and an open mind, in the specialized ways that are often required in such cases. Personal opinions and experiences are usually unlikely to influence the way he works with his patients, and each new case is approached with an open mind, but also with a number of scientifically proven solutions in mind. Although the treatment is tailored to the individual, it is based on years of experience in the field, and scientific back up. Most sex therapists have a more detailed knowledge of human physiology as it is affected by sexuality, and all the processes that take place before, during, and after sexual intercourse. In fact, a really good sex therapist may have more expert knowledge of this particular area of physiology than many medical practitioners.
A sex therapist is not a snake oil salesman or prostitute or escort under a more than modest job description. It's not like in some porn movies, where the sex therapist jumps into bed with one, two or several of his clients, and everyone's sexual problems are solved as if by magic with the cameras rolling. In fact, most sex therapy revolves around talk and advice. In some - very rare - cases, a surrogate partner therapist can be used. We'll take a look at that option later in this chapter, as it's something completely different.
What to Expect from a Sex Therapist
In the initial session, your sex therapist will want you to do most of the talking, so he or she can determine whether the cause of your problem is physical, psychological, or a combination of both. Questions will be asked, and you will need to answer them completely and honestly. Depending on the exact details of your individual case, it may take more than one session to complete this important first step. This detailed assessment will help the sex therapist create a plan of action for you, and decide how often you need to attend therapy sessions. The therapist may suggest that your partner attends some or all of the sessions with you, or you can attend on your own. You will not be expected to do anything against your wishes, and the atmosphere should be relaxed and conducive, so that you can open up to your therapist and work together to solve your problems.
Part of the therapy will involve doing exercises at home between sessions, either alone or with your partner. These will be designed to help you understand your body and your sexuality, and increase your self-confidence and sexual awareness. You should remember – and your therapist should remind you regularly – that sex is supposed to be a pleasurable, enjoyable experience, and the sessions will be geared toward that achievement. Some of the exercises may not seem to make much point, but remember that this is a scientific treatment program, and there is a reason for everything you do. If you don't understand something, ask your therapist to explain, as you need to work on it together if you are to get the maximum benefit from the sessions.
You'll need to provide a detailed history of your sex life. This isn't salacious interest on the therapist's part - it's just a great way to get a sense of when the problems started, and in some cases, why. You'll also need to talk about masturbation, because in a lot of cases of erectile dysfunction - particularly those involving young men - there's no problem getting or keeping an erection, it just occurs when they're with a partner. This could mean that performance anxiety is driving your problem, and your therapy will be tailored to address this, and any other issues that transpire during the initial evaluation.
Everything you tell your therapist is and will always be confidential, so be open and honest, and answer all questions completely. Talking like this helps you understand why you're having problems keeping an erection, as well as teasing out long-buried stuff that you thought you'd forgotten, but which may still be impacting your life even after many years. It's all very cathartic, and it can help your therapist design the most appropriate and effective program for your needs. Don't be shy and come back to anything - it may be a cliché, but your therapist has really heard it all before. He or she won't be shocked by your revelations, so open up, and let it out in the presence of someone who is highly trained to help you work through your problems and move forward with your life and your sex life.
Although the atmosphere is meant to be relaxed and intimate, inviting to confidants, the therapist will not touch you, because much of what goes on in the office is based around talk, not physical contact. It is against the professional code to touch clients, and this will be explained to you at the beginning. It makes sense when you think about it – it would be only too easy for the client to develop an unintended and inappropriate attachment to his therapist, given the nature of the secrets he has shared.
The therapist is also likely to ask about your general life outside of the bedroom, as he needs to build up a picture of you as a complete person in order to offer the best consultation and advice for your particular case. Although sex therapy is a science like medicine, the difference is that it is also not tailored to the individual. For example, there may be only one way to remove the appendix, but there are countless ways to treat erectile dysfunction within the scientific framework.
And it may be that some of the exercises you are asked to do have nothing to do with sex at all. Still, they are prepared to help you achieve a more satisfying sex life. For example, if it emerges that you have a poor body image, you may be advised to join a gym or fit some extra exercise into your routine. "
A very successful way to re-establish lost intimacy is to lie in bed together naked, touching and cuddling, but not attempting foreplay or sex. Often, the simple act of removing the pressure to have sex can be a big help in resolving erectile dysfunction issues, so the therapist may also advise you not to have sex for a certain period of time, and if this is the case, you should respect the advice, as he or she has been dealing with this kind of stuff for a long time. When the therapist feels you are ready to succeed and have fulfilling intercourse, you will be the first to know! Other 'homework' may include non-sexual touching exercises and recommended reading. The whole process is geared towards helping you get to know yourself and your sexuality on a deeper level, so that you can understand what has happened to you and why, and then work through it and take your relationship to the next, happier and more intimate level.
Many sex therapists say that their The saddest thing about the profession is that couples and individuals treat sex therapy as a ‘last chance salon,’ when many of the problems presented to them can be resolved very quickly and simply, even if they initially appear insurmountable to their clients. Most sexual problems have a solution, but often, anger and resentment have built up and it may be too late to save the relationship.
Relationship counseling is a natural part of sex therapy – your therapist needs to determine if something in the relationship is causing or contributing to your erectile dysfunction. In fact, you can expect to cover all aspects of your life and feelings with your sex therapist. Very often, talking about things that have been bottled up for too long – especially things related to sex and intimacy – is a liberating experience for the client, and a revealing one, and you can often discover ways to improve your situation, simply by talking about them with someone who is giving you their undivided attention. If other methods have failed, perhaps sex therapy is worth some of your time and effort in your quest to conquer erectile dysfunction.
Surrogate Partner Therapy (SPT)
Surrogate partner therapy was the brainchild of American sex experts Masters and Johnson, and it has been around for over 60 years, although it has only recently become more mainstream, thanks to media attention and films such as The Sessions, which some know have been seen as a bit short of legal prostitution, an affair with a linare of respectability. However, used in the right way and for the right people, it can help men overcome erectile dysfunction.
A sex therapist does not offer sex as part of a client's therapy. In fact professional ethics and common sense decree that there should be no body contact between client and therapist during counselling. However, another aspect of sex therapy, which is usually used in conjunction with traditional therapy sessions, involves using a surrogate partner who will perform sexual and intimate acts with you as part of the therapy. Not every client is a suitable candidate for this, and not every case is suitable for surrogate partner therapy.
This is no regular relationship, and it is nothing like an encounter with a prostitute – it is a professional arrangement in which a highly trained surrogate will work with a client to address and treat his sexual problems with traditional sex therapy. At the same time, the surrogate and client form a genuine relationship and develop the level of intimacy and sharing that is necessary for the surrogate to help the client achieve his sexual objectives and enjoy happy, healthy and fulfilling relationships in the future.
The surrogate may or may not interact sexually with the client, but when it does happen, it is not about pleasure in the moment – it is about dealing with the sexual problem, and helping the client through it by educating him about his body, his sexual and emotional responses, and by teaching him about structured and unstructured exercises and techniques to overcome the issue of erectile dysfunction.
However, SPT is not all about sex - it deals with the whole spectrum of relationships - how you feel about your body, and how you can have better, happier and longer-lasting relationships with your life partner or partners, with sex, but most importantly, and most crucially, with yourself. Talking can be good, but sometimes talking is not enough, and people need practical experience in overcoming sex-related issues -if you want to put it in a particular way, they need to be shown, rather than advised, how to overcome their sexual difficulties.
Working with a trained partner who is deeply aware of their own sexuality as well as having a special knowledge about giving and receiving pleasure can be very beneficial for some people. In the case of erectile dysfunction, this approach can work where others have failed, because there is no pressure to be happy, even if the pressure is self-imposed. It is a learning experience, and the client will be shown techniques and talked through why certain things work and others don't.
SPT is a combination of scientifically developed sexual exercises, aimed at rethinking attitude and developing couples' communication, so that everything in the bedroom moves toward mutual pleasure and enjoyment, rather than seeing orgasm as the ultimate aim, and new age and eastern thinking on confidence and relaxation techniques. You learn to connect mind and body through meditation, relaxation and breathing exercises, combined with practical techniques designed to enhance pleasure for both partners. This brings a new confidence that is not limited to the bedroom, but radiates into all areas of the client's life.
The successful surrogate partner will work to build the same level of intimacy and commitment that exists in regular relationships. This may include various exercises in touching sexually, sensually and even non-sexually, as well as encouragement and training in social skills, and learning to please a partner and accept intimacy and to do it themselves happily. Some SPTs claim an 85% success rate in cases of erectile dysfunction, and claim to succeed where traditional medicine and medical interventions have previously failed. Make sure your potential surrogate is trained to International Professional Surrogate Association standards and ask lots of questions before committing to an expensive program of treatment. You'll also work with a regular sex therapist, and between the three of you, you'll decide on boundaries, goals, and the length of your relationship with your surrogate. Yes, it's expensive, but you may consider it money well spent if it solves your problems.
Not every man is a suitable candidate for surrogate partner therapy, however, so it may be better to talk to a traditional sex therapist before pursuing that treatment option. While sex therapy isn't for everyone, it is a viable option for treating erectile dysfunction, as it focuses on the sexual aspect of your life, while also incorporating your relationships and lifestyle. It may initially be embarrassing to discuss such intimate matters, but you may find the experience both empowering and effective. Cost may be a determining factor, as sex therapy, and especially surrogate partner therapy, can be expensive, and is not usually covered by national health services or regular health insurance policies. However, if other options have failed, you may want to try some form of sex therapy to address your erectile dysfunction issues.
