No two couples that seek help from a sex therapist are exactly the same. Still, the issues that these experts help their clients address tend to be of a similar variety. If left unaddressed, each issue can create major problems for couples in the long run.
Below, sex therapists and sexologists share with The Huffington Post some of the most common issues they help couples work through.
“Many women seek help because their husbands have gone missing erotically and no longer initiate sex,” said Stephen Snyder, a sex therapist in New York City. “Often it’s a vicious cycle where she feels sexually and emotionally abandoned by him, she gets upset, he avoids her because he can’t stand to see her upset and so on.”
The advice: “Usually she needs to be a little less critical of him and he needs to learn how important it is for her to feel desired,” Snyder said. “And sometimes, he needs to become more vocal about his own needs.”
“Men who come to a sex therapist have courage because I can assure you, it’s the last place they want to be,” said Megan Fleming, a psychologist and sex therapist in New York City. “Many come in because of erectile dysfunction. I can also tell you, almost all leave the initial consultation feeling so much lighter. They feel a sense of exhalation and hope that ‘there is gold in them hills,’ as a client of mine said this week.”
The advice: “I reassure men that there are things to try and actions to take that bring back confidence, arousal and erections,” Fleming said. “Almost all men ― even if there are organic, physical reasons for difficulties maintaining erection (vascular, neurological, endocrine problems, symptoms of a disease or a medication side effect) ― have an additional psychological overlay. Said plainly, they have unspoken anxiety of over sexual performance. Anxiety and performance demands inhibit arousal like nobody’s business. Fortunately, sex therapy teaches skills and offers exercises to focus on pleasure and address the underlying anxiety.”
“Many women experience pain during intercourse, sometimes because of physical and hormonal fluctuations,” said Lisa Paz, a sex therapist and marriage and family therapist in Miami, Florida. “It has a negative effect on desire for sex because the act becomes overall unpleasant.”
The advice: “First, it’s important to determine the cause of the pain. If the reason is best treated in my office, then treatment includes relaxation techniques, which is essentially helping a woman re-learn how to ease into sex instead of tensing and bracing for pain,” Paz said. “Suggesting that the partner become part of the solution is key, too. Couples are usually so discouraged and frustrated by the time they come to me that sex has an overall negative connotation. Rewriting that sexual script is crucial.”
“Sometimes, one member of a heterosexual couple wants to explore same-sex attractions but doesn’t want to lose their partner, who is uncomfortable with the idea of an open marriage,” said Gracie Landes, a sex therapist and marriage and family therapist in New York City. “The reluctant partner is usually afraid of being abandoned for another person.”
The advice: “When this happens, it’s important for each person to feel free to air their concerns, while listening to and understanding what the other person is really saying,” Landes explained. “For some people, bisexuality is an identity. For others, they want to explore it. What really helps people thrive in long-term relationships is being accepted for who they are.”
“This is a common complaint,” Los Angeles-based sex therapist Gila Shapiro revealed. “When you think about it, we spend more time talking about what restaurant to eat at or our new favorite app than about what does or doesn’t feel good for us during sex. We don’t say tell our partners things like, ‘Move your finger to the right’ or ‘I really like it when you do this’ or ask ‘Does this feel good for you?’”
The advice: “I point this problem out to clients and we talk about their challenges in sharing. Some clients judge themselves or worry about being judged for their sexual preferences,” Shapiro said. “I encourage them to communicate their sexual turn-ons; it’s not your partner’s responsibility to know what does or doesn’t feel good for you unless you share. Because we are unique individuals, we each have a unique sense of what feels good for us. When you do talk, be sure to make eye contact, listen without judgement and acknowledge what your partner is saying. And if you’re not sure of something, ask.”
“The number one issue that drives couples into my office is their suffering from the pain of being in a sexless, touch-less relationship,” said Patti Britton, a sexologist and author of The Art of Sex Coaching: Expanding Your Practice. “These are couples who are usually married, long-term partners. For years they haven’t kissed, fondled, held hands or engaged in anything reminiscent of what you might think of as S-E-X. The true tragedy is that they’ve usually stopped touching each other in fear that even a slight graze of a hand on a potentially evocative body part might make their S.O. feel pressured to have sex.”
The advice: “We talk and I teach them how to be great lovers again. Getting back to touch is essential,” Britton said. “I often tell couples like this to reevaluate their priorities: I insist they commit to spending time together as a couple, regardless of other demands. I help them to reorganize their endless to-do lists to save time for physical touch, when they’re not depleted from exhaustion. I usually suggest an e-fast: Shut off the smartphone or computer after dinner for human conversation in the flesh.”