When asked what I do for a living I often smile and prepare to answer many questions on how I spend my day. Sex therapy sounds mysterious and risqué, but it is some of the most rewarding work I have ever done. It has led me to examine the authenticity that we embody in our everyday lives and how we relate to ourselves and to others. It continues to surprise me and bring joy as I help others navigate the sacred relationship they have with pleasure and love.

So, what is sex therapy? Like other mental health disciplines such as narrative therapy or cognitive behavioral therapy, sex therapy is built on the foundation of helping people understand their inner and outer worlds. This type of therapy is unique in that it works to understand our relationship to our body, sexuality, pleasure, and to others. 

Individuals

Individual clients come to me to explore their relationship to their sexuality, and therapy begins with an in depth assessment of how this dynamic has evolved over their lifespan. This includes what messages they have learned as children about their bodies, sex, dating, pleasure, and play. Clients may be hoping to work through aspects of themselves that carry sexual shame related to spirituality, trauma, culture, or other societal narratives around sex, gender, and our physical appearance. Individuals may show up to explore curiosities around their sexual and romantic orientation or gender identity throughout their lifespan and how this presents in their current body and relationships. Lastly, sex therapy may look at sexual functioning and the many emotional and physical challenges that come with living in a human body including congenital or acquired disabilities, chronic or acute pain, arousal difficulties, aging, body image, self esteem, performance anxiety, and orgasm difficulties.

Couples

Couples come to me for a variety of reasons that may be causing sexual difficulties within their relationship. This also begins with an assessment of their individual sexual history, but then goes on to explore how their sexual relationship has evolved throughout their time together and where they are currently feeling stuck. Common relational issues include feeling emotionally disconnected from one another due to major stressors such as raising young children or navigating fertility treatments, aging and seeing one’s body change over time, emotional ruptures that need repair, and having a history of negative sexual experiences together. Sex therapy looks at the couple system from a biopsychosocialspritual and sexual lens that takes into account all of the contextual factors that may lead to desire discrepancies, sexual dysfunction, performance anxiety, and loss of intimacy. 

Team Approach

Sex therapy is most successful for both individuals and couples when we look at the issue through a holistic approach that considers the multifaceted pieces of the human experience.  Relational issues are often complicated by individual sexual and emotional difficulties and vice versa. It is common for sex therapy to include working with other sexual health professionals such as pelvic physical therapists, urologists, gynecologists, pain specialists, and other mental health therapists to create a collaborative treatment plan that best fits a clients’ needs.

Sex therapy is not just a treatment to have better sex or orgasm more often (although a fun side effect), it looks at our life and explores how we can live more fully into our authenticity to experience individual and relational pleasure. It challenges the limitations we or society have placed on our bodies and our sexuality and seeks to expand our ability to love ourselves and others as we naturally are. If you are curious about your relationship to sex, I invite you to try out this type of therapy and see if this curiosity can open you up to finding pleasure and bliss in your day to day life and relationships. 

Caitlin Minniear is a Self Space Seattle therapist who helps people navigate complex relational issues involving trauma, depression, anxiety, acculturation, chronic illness, and life transitions. She also works with individuals exploring sexuality, gender, and identity and dealing with grief, loss, and transgenerational trauma.