What sex therapists are really thinking

Reconciled couple smiling at each other in the therapist office (iStock)

Have you ever wondered what happens in a sex therapist’s office?

Sari Cooper is an American Association of Sexuality Educators, Counselors and Therapists-certified sex therapist, a licensed clinical social worker and family therapist, with a private practice in New York City for more than 20 years. She serves as a clinical supervisor for sex therapists-in-training and for general therapists who want help with the topic of sexuality.

Ms. Cooper uses a combination of techniques in her practice, including behavioral sex-therapy exercises, cognitive behavioral therapy, family systems therapy, psychodynamic therapy and mindfulness training.

Here are edited excerpts from her interview:

Why do couples come to you?

Individuals and couples come to me for help with low sexual desire, erectile disorders, inability to have orgasms, painful sex, discrepant desire, infidelity, out-of-control sexual behavior, interest in an erotic fantasy or activity which may not have been discussed with a partner and desire to open up a relationship to include non-monogamy.

I see clients in their 20s up through their 60s and 70s, although I once saw a client who was in his 90s. I don’t always see partners together, although I try to encourage that.

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How does sex therapy work?

I will spend five to six sessions doing a thorough assessment, which includes getting details of the history of the problem and finding out about each partner’s familial and sexual history, including sexual trauma.

A sexual history helps me understand the verbal and nonverbal messages a client received as a child about what sex might be like. If a child remembered her parents enjoyably flirting with one another and expressing love through kisses and date nights, they received a message that it is OK to have these feelings and that long-term couples can have enduring sex lives. If a child grew up with messages of shame, anger, and isolation around the topic of sexuality, they feel shame about their own desires and try to suppress them.