When I was training to be a psychosexual therapist or sex addiction therapist, as a cohort one of the things we began to learn was to share with ourselves the impact the training was having on us and on our relationship(s) and regarding sex and pleasure; to be open to listening, hearing and exploring. Those experientials, as any therapist may tell you, are a place of growth, resistance, discomfort, harmony relief, tears, joy. In fact, the whole caboodle.
On the course we met each weekend and come Saturday night we’d meet in the local pub, discuss the course, learning etc, over some very good pub grub and a few beers. We’d laugh at ourselves as we really got to know each other (not everyone wants to become a sex addiction therapist). The topic was quite naturally about sex. That’s what we were studying. But it dawned on us, that as the evenings went on the tables around us emptied, just a little. To the extent we had a moat around us. Not surprising really because although we’d found freedom of expression with the subject we were studying , it wasn’t as matter of fact for those around us. Or they didn’t want to hear us or for a host of many other reasons.
But it dawned on me that for all we went through on the training, in personal development as well as qualifications gained, I knew that day to never expect anyone to walk through the door into the therapy room and feel free to just explain what brings them to see a sex addiction therapist.
So what does bring someone to see a sex addiction therapist?
Everyone has a different beginning. From perhaps the search on line to find a sex therapist , or is it psycho-sexual therapist – we’re all the same 🙂 , to driving to the location, alone or with a partner. Perhaps wondering if it will work? will I be understood? Why have I got to come? …….
To walking through the door and taking a seat and where to begin.
That’s why with everyone, it’s a new beginning. There’s the basics of contracting or a client agreement to know the framework of therapy but there is also an appraisal, or an assessment.
Sometimes I will end up working with a client’s Doctor. There may be physical aspects that are more important to recognise and support before the psychosexual aspect. As for psychosexual, I explain to everyone that psycho is roughly a translation from Greek for soul i.e sex therapy is holistic. About the whole of the individual(s) experience(s), both psyical, social, cultural, biological, environmental, relational and emotional.
The first session is also a time to explain what may be the work ahead, certainly the structure of self focus exercises and sensate focus exercises. Never prescriptive, always collaborative.
Thereafter a history taking which for each individual lasts on average two sessions.
Diagnostic and Statistical Manual of Mental Disorders (DSM–5) from the American Psychiatric Association (APA) https://www.psychiatry.org/psychiatrists/practice/dsm is the backbone re. guideance, determination and diagnosis.
These diagnoses are
- Delayed Ejaculation
- Erectile Disorder
- Female Orgasmic Disorder
- Female Sexual Interest/Arousal Disorder
- Genito-Pelvic Pain/Penetration Disorder
- Male Hypoactive Sexual Desire Disorder
- Premature (Early) Ejaculation
- Substance/Medication-Induced Sexual Dysfunction
- Other Specified Sexual Dysfunction
- Unspecified Sexual Dysfunction
From my first training, through to the specialism that is sex therapy and sex addiction therapy, what I continue to learn is how much therapy (and teaching) can be based in a heteronormative narrative. This means the words used are so, so important. Not to meet with an understanding, but be open and explore.
Back to the beginnings and first session and will someone understand me? Well that could be a problem if everything is encased in a male female intercourse narrative. Or a therapist’s values block off being listened to. Heard, met…. accepted.
Being open may be seen through the diagram below:
Sometimes a diagnosis isn’t going to be readily clear cut. Not does it have to be. Thus, nothing is ever prescriptive.
Those evenings in the pub where great fun as we all dived into this diagram and went exploring. I am sorry for those around us, but we all learnt so much and continue to do so. Thus, when an individual or partners walk through the door, there are no expectations on where you should start, or to be clear and concise in what may be troubling you.
My role as a sex addiction therapist, is to help make meaning of the problem, the sexual problem. To help explore and discover answers, that reach your goals. Your outcome. To listen to what you need, what is unique for you, the relationship etc.