Diagnosis and Treatment of Sexual Issues in Psychotherapy and Counseling

Clinical Update

By Zur Institute

View a complete list of Clinical Updates.

“I would discuss sex with my patients, but they’re just too resistant.”

“I would discuss sex with my therapist, but he/she would just die of embarrassment.”

These two assumptions lead to a common outcome: Sex doesn’t get discussed in sessions nearly enough.

Sexual Issues

When sex is discussed, therapists and patients alike tend to rely on gender stereotypes. Therapists tend to believe that monogamy is the healthiest arrangement, while sexually healthy patients struggle with that belief. Patients tend to feel guilty about their fantasies or desires, while therapists wonder how to tell if dark fantasies of coercion are dangerous, or if erotic power play can possibly be healthy.

And how about pornography? Vibrators? Swing clubs? Most therapists get absolutely no training in subjects like these. We’re left to educate ourselves through the media (sensationalized and inaccurate), personal experience (hit and miss), and the Internet (good luck).

Did you know…

  • Conflict over the balance of household duties can have a major effect on a couple’s sex life
  • Focusing on the penis is not the best way to help a couple deal with erectile dysfunction
  • Male and female sexuality are more similar than different
  • Anti-depressants can decrease people’s ability to achieve orgasm
  • While most clients say they want pleasure and closeness from sex, they often focus on very different things before and during sex
  • Couples who refuse to make dates to be available for sex often have little or no sex
  • Having an orgasm is no guarantee of sexual satisfaction

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