A day in the life of … a sex therapist

By Tamara Hoyton – MA, PGDip PST

Being a sex therapist…

Obviously no day in the life of a sex therapist can go by without tremendous variety and a large dollop of non-judgemental curiosity. How could you not be?

Referrals

Clients are referred into our service by GPs, nurses, health workers, from in-house relationship therapists; and many self-refer so please do get in touch (shameless plug intended).

A referral shows very brief details of the issue affecting clients which can be indicative of the awkwardness often experienced in discussing sex. A level of narcissism is necessary for good self-esteem; but when we convince ourselves that we’re the only one ever to have suffered from erectile difficulty, painful sex, or loss of desire it can often inhibit us from seeking help.

(In terms of sexual myths, that last one, ‘loss of desire’, is the biggest one out there by a country mile. “Everyone is having sex more often, AND better, than me!” Please. Don’t worry. We’re all making it up as we go along…..)

Initial Meetings

Client’s initial meetings are our first opportunity to invite them to relax. Most of the presenting issues we encounter are based in anxiety and so addressing this is pivotal. Clients describe what troubles them in different ways. For example using innuendo, speaking graphically, hoping you’ll guess (!). Often by being explicit, using metaphor, or humour.

All of these give direction to the therapist about what language to use with clients to make it easier for them, so that the therapist can get as much information as possible. Clients are invited in so that we can go through a history taking with them and explore why it is that they may have been psychologically pre-disposed to a sexual difficulty, what might have set it off for them, and, in some cases why it has been maintained for so long. With a couple, the enigmatic nature of their dynamics and interactions are fascinating and impossible to ignore.

In the sessions

Many of our clients have been living with a sexual dysfunction that causes them real distress as they meditate or catastrophise on possibly losing their partner, or never being able to have children, or missing out on pleasure. These are enormous issues in anybody’s life.

Much of the work we undertake originates in the view that sex is about getting to the ‘main event’ which most people see as orgasm or ejaculation. When an uncertainty or anxiety arises around that not happening (through either stress, tiredness, illness, life-stages – things that none of us are immune from), self-doubt and stress often take over and the cycle becomes a self-fulfilling prophecy.

Sex therapy puts the brakes on all of this as it seeks to reframe sex as a fuller and more relaxing experience, and fundamentally a more thoughtful one. Asking clients to really put thought and time into what drives their desire is often something they have never done before, and can be life changing purely for the pleasure derived. But if it results in a much wanted pregnancy so much the better.

In terms of how we interpret life, we have, as a point of survival, a tendency towards a negativity bias and what we do when thinking about sex can be no different. We suspect our inadequacies and avoid them becoming exposed! In sex therapy we explore the joys of exploration, fumbling, and curiosity. That sex is a recreational past-time to be given time to and not goal oriented but rather more thoughtful, unpredictable, and creative.

And funny… Definitely funny.

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Future blogs to keep an eye out for:-

  • Desire; it’s complicated
  • Fantasy; why it’s a very good thing
  • Dysfunctions; how do you know if you’ve got one?
  • Is it in the relationship……or is it ‘me’?