Sex therapy is a conversational form of psychotherapy and psychiatry used to treat sexual disorders. The treatment spectrum of sex therapy covers from sexual dysfunction, psychological trauma to pathological manifestations of mild to severe sexual disorders.
What is sex therapy?
Sex therapy is a conversational form of psychotherapy and psychiatry used to treat sexual disorders. Sex therapy refers to the psychological and psychiatric treatment of sexual problems and mental-sexual disorders. The simplest forms of sex therapy begin with the psychotherapist or alternative practitioner and deal with sexual problems and disorders that do not yet have a disease value or even endanger the patient and others. For example, sex therapists deal with sexual problems in the couple relationship, with the sexual sensation of their patient, the expression of sexuality or with sexual traumas and negative experiences. In part, the disorders that sex therapy deals with are also of a physical nature with effects on sex life. In addition, there is the treatment of sexual disorders with pathological value; in this area, sex therapy in part crosses over into psychiatry. Sex therapy relies heavily on talk therapy, while medications are used very rarely and are often prescribed by other medical specialties. Behavioral therapy and depth psychology, systemic procedures, drug treatment of physical disorders, and of course practical application of what is learned in sex therapy are common treatment procedures. The goal is to make the patient’s sexuality as physically and socially comfortable as possible for the patient and to reduce suffering.
Treatments and therapies
Sex therapy can initially help people who find their own sexuality unsatisfying. Whether it is due to a lack of partnership, listlessness, orgasmic disturbances or impotence, together with the patient the therapist finds out during sex therapy what the dissatisfaction is due to. The decisive factor for sex therapy is whether the patient feels any pressure to suffer – if he can come to terms with his situation, he does not need sex therapy. An unfulfilled desire to have a child can also become a case for sex therapy, starting from the phase of accepting medical support to coping with the case of not being able to have a child together. Patients who are unable to have a normal sex life due to physical reasons such as illness or dysfunction are also managed through sex therapy and ways are found to live out sexuality in a satisfying way. While sex therapy focuses on finding out reasons for the disorder and managing them through discussion, it can simultaneously get support from other medical specialties, such as medication or surgery to treat the cause of the disorder. While these forms of sexual dysfunction only become cases for sex therapy when there is suffering, since they do not endanger the patient or others, sex therapists also deal with paraphilias, some of which are more dangerous. Harmless are disorders of gender identity or coping with homosexuality, which also do not always require treatment. Therapy, on the other hand, can be more difficult in the case of fetishism, such as exhibitionism or sadomasochism. While not all sufferers need treatment even for these paraphilias, sex therapy in its most challenging areas borders on diseases such as sex addiction or pedophilia. Since in these cases of extreme sexual dysfunction, other mental illnesses are sometimes present or sufferers would hurt or kill third parties to satisfy their sexual need, sex therapy sometimes crosses into the realm of psychiatry in this regard.
Diagnosis and examination methods
Most of the time, sex therapy comes to a solution of the problem with a profound anamnesis procedure as well as with talk therapy, behavioral therapy, systemic therapy and depth psychology. As part of the anamnesis, sex therapy takes a very thorough approach, asking about the sexual history from the discovery of sexuality, parental approach to it and previous sexual experiences.The patient then describes his problem and his level of suffering and, together with the sex therapist, develops possible solutions and situations that he can live with. With this thorough anamnesis, the sex therapist finds out whether the problem is purely psychological or physical and can find the appropriate therapy and decide whether medication or surgical intervention is advised. A psychological trauma, for example, which today leads to orgasmic disturbance or sexual listlessness and which, in the worst case, has even been completely repressed by the patient, must be dealt with in a completely different way than a lack of desire for sex due to relationship problems with the current partner. In addition, sex therapy also asks about the medical history, since many sexual disorders are also due to hormonal imbalance and hormone therapy is then the way to improvement. In the case of lasting sexual disorders that could endanger third parties, a similar anamnesis is used in sex therapy, but also the exact determination of the factors that arouse sexual desire in this case. This allows the therapist to work with the patient to try to find ways to either deal with this sexual desire differently or to steer it in a different direction altogether. Especially in the case of severely pronounced paraphilias, whose sufferers tend to endanger others, admission to a closed psychiatric ward is recommended, since in some cases it can never be ruled out, or only after successful sex therapy, that they will have their paraphilias under control to such an extent that they can live safely for themselves and others in the midst of society.
