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Sex therapy treats sexual problems, but the different types of sex therapy target where the clinician or practitioner believes the problem originates. Some types of sex therapy target the individual either medically, mindfully, or psychologically. Other types of therapy target the forces outside the individual and couple. And the type, that myself and my clinic practices, targets the space between the couple. We believe that there can be a push-pull dynamic that is most toxic to the couples’ sexual relationship.
Many of us struggle against these toxic forces but for some of us we need psychosexual therapy to really analyze how they stop us in bed:
I practice sex therapy from an attachment theory lens. This is a different type of sex therapy than many sex therapists practice. Often sex therapists are cognitive-behaviorists who prescribe interventions like sensate focus to quickly get couples reacquainted with each other’s bodies. This can work if the couple is not terribly distressed over their sexual differences. But by the time a couple seeks therapy, sexual attachment if usually markedly disrupted by a pursue-withdraw negative cycle between couples. One person wants sex more (or more variety, intensity, etc.) and the other seems to back away from sexual encounters. The more the first initiates, pesters, complains; the more the other person feels defensive, defeated and like they are not good enough.
Attachment theorists don’t see libido as a discreet quantity that one person has too much of and the other person has too little of – it’s actually a shared quality in-between the two people.
Sex is imperative to a romantic relationship for most people. We fall in love in the beginning usually with someone we find sexually attractive. We also want someone who gets us – who understands who we are. Both emotional and sexual connection make for a secure bond. Without sexual excitement we are tempted by other partners. We may find our relationships empty and our attachment eroding. We question whether we are even in love. Both areas of connection have push-pull cycles that influence each other. For more on this type of sex therapy listen to this episode on my podcast Foreplay – Couples and Sex Therapy. For instance, often one person needs to feel safe emotionally before they feel sexual desire. And their partner often needs sex to want to open up emotionally. Deal with sexual problems simultaneously with your emotional problems. This is essential to your relationship and to good couples therapy and to good sex therapy.