Dear Dr. Jane,
We’ve been married for a long time — it’s 30 years this summer. Our relationship has been rocky at times, but it’s pretty good right now, with one exception. When the kids were little, we saw a couples’ counselor. We learned to communicate better and that was important. Now, even though we communicate well, our sex life is bad. I’m wondering if we should see a sex therapist. If we decide to see a sex therapist, what can we expect? Is it like another type of counselor?
– From, Sex therapy 4 Us?
Dear Sex Therapy,
It’s great that you got therapy as a couple when your kids were young. You learned how to communicate with each other, which is wonderful. Communication is key to having a great sex life. Unfortunately, there are often other barriers to intimacy that are really hard to talk about. Just learning to use “I messages” isn’t near enough to break the logjam that’s been happening in your bedroom.
When should I get sex therapy?
How do you know when it’s time to make an appointment with a therapist or sex coach? Or, as a potential client once asked me, “How bad does it have to be before we need help?”
There’s no one right answer to this question. Some people ask me if it has to do with how many times they had sex last year. Others ask if it’s about how often either partner climaxes. Some wonder if it’s all about erections or “performance.” Or about different sexual positions or sex toys. Lots of people ask about libido. Many people have questions about sexual trauma.
Some of these things (or all of these things) could warrant a trip to the sex therapist or sex coach’s office. Only you can decide if these things are a big enough problem to get help. For some people, problems with sexual intimacy are definitional. For these people, when sexual intimacy isn’t working in their lives, the world is impossible to navigate. For others, sexual concerns are a minor irritation. What about you?
Is sex therapy covered by my insurance?
Once you’ve decided that you’re going to get help for your intimate life, you’ll probably have a few other questions. You might wonder sex therapy is covered by your insurance.
Unfortunately, for many people, insurance often excludes coverage for sex problems. However, your therapist might be able to take your insurance as an individual and then add your partner into your individual work. Some people use their Health Savings Account monies to pay for sex therapy or coaching.
Are all sex therapists the same?
You might wonder if sex therapists are generalists or if they specialize. It’s a good question. Some sex therapists specialize in things like sex or porn addiction, consensual non-monogamy, specific kinks or LGBTQIA+ concerns. Most are generally oriented in their practices helping individuals and couples with the full range of sexual concerns.
What’s sex therapy like?
Sex therapy or coaching looks and feels very similar to other types of therapy with one significant difference. Sex therapy is specifically focused on your life’s experiences, history, environment, communication style, physical concerns, medical issues and erotic expression – not your family of origin concerns. While your therapist or coach may ask you to look into the past to uncover limiting beliefs and/or stuck emotions and fears, you’ll focus on your current experiences, sensations, expectations and communication style. You’ll get exercises from your therapist or coach to do when you get home. It’s the best kind of homework!
Can I fix my sex life without sex therapy?
Sex therapy or coaching can be impactful for your relationship, but you can make big changes without it. Learning how to communicate about your desires is crucial to your sex life and to your life in general. When you work on these concerns, you’re creating the conditions for a better sex life.
In a nutshell: here are my three takeaways:
- Decide how important physical intimacy is in your life.
- If it’s time to get help, find a positive provider to support you.
- Make an effort to make a change — even if it’s something you do yourself.
You got this.
– Dr. Jane
Dr. Jane Guyn is a nationally recognized relationship coach based in Oregon. Her new monthly “Understanding Intimacy” commentary is made possible through the generous support of Guilty Pleasures, 2992 Ashley Phosphate Road, North Charleston.
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