# Does sex therapy work?



## Cletus (Apr 27, 2012)

I'm referring to couples counseling specifically geared towards sexual issues.

On the one hand, you have self-proclaimed sexperts like Dan Savage (who is not a licensed therapist, but certainly knowledgeable in the area) who claim that sexual incompatibility is a DTMFA offense - too hard to fix and basically not worth the effort, depending of course on what you decide is the definition of incompatible. 

On the other, you have folks like Laurie Watson from the Foreplay podcast who is a licensed sex therapist and who claims that 90% of her clients come out of therapy with a much improved sex life - almost certainly a self-serving number. She will also tell you that the majority of those seeking therapy suffer from differences in desire.

My half-hearted attempts at scouring the internet hasn't turned up much in the way of actual data other than the platitudes you hear from those with a vested interest in getting you to come and sit on their couch.

Anecdotes are great, but they are also not data. Does anyone have any idea what the long term success rate is?

Does anyone have better data than me? Has anyone reading this board had real experience at a sex therapist's office, good or bad? We toss off the "you should see a MC" like that advice is meaningful and useful. Is it?


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## Mr.Married (Feb 21, 2018)

It's like lawyers, girlfriends and wives. Some are great.....some are terrible. Good luck finding the right one!!!!!!

We never tried but both my daughters had a couple sessions when they were in the early teens and it helped them both. (regular ... not sexual)


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## bobert (Nov 22, 2018)

I've spent plenty of time with sex therapists. Some are good, some are bad - just like every other profession. Some work great for certain people, and not so great for others. So you have to find someone that you BOTH click with.

Yes, sex therapy works... If you find a good therapist AND if both you and your spouse put in the work. If one or both spouses aren't truly committed to doing the work (and it can be HARD) then even the best therapist in the world won't help. That goes for every type of therapy, not just sex therapy.


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## Lila (May 30, 2014)

My ex husband and I did marriage counseling. The first one was awful. The second one was his sex therapist who we went to for MC when I noticed how disconnected my ex seemed. He told us we were "a great couple" and released us after 3 sessions. Ex asked for a divorce 2.5 months after that. All this to say that my experience with MC was a bust and at an average of $250 per 50 minute session (none of it covered by insurance) a complete rip off.


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## Cletus (Apr 27, 2012)

bobert said:


> Yes, sex therapy works... If you find a good therapist AND if both you and your spouse put in the work. If one or both spouses aren't truly committed to doing the work (and it can be HARD) then even the best therapist in the world won't help. That goes for every type of therapy, not just sex therapy.


When you say it works - can you expand on that? Are you willing to share details?


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## Tasorundo (Apr 1, 2012)

My wife and I have seen a many counselors and the last one was also a sex therapist.

We are much better off than we were before we saw him. The quality, frequency, attitudes, and feelings around our sex life are much healthier than they were before we started there.

Like Bobert said though, it takes both people being willing to work on it and the therapist isn't a magic wand. Just like going to church doesn't make you a Christian, seeing a sex therapist doesn't make you better.


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## Ragnar Ragnasson (Mar 4, 2018)

It would seem the most likely scenario for a successful sex therapist being used - would be where a couple has already committed to improving their sex life, and would take active roles in making use of sound advice when received. 

Without that pre-set condition, the therapy objective may be for one SO to convince other SO has wrong perceptions of what a normal sex role is. This, not so productive. 

And there are cases where one SO does have atypical beliefs of what good sex is, and what's normal is something that SO has fought to insist they're right, and the other SO is looking for reinforcing outside advice to try and adjust that SOs way of thinking. 
Also perhaps not as successful in high numbers perhaps.

Many landmines in all circumstances. 

Just my two cents.


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## Cletus (Apr 27, 2012)

Tasorundo said:


> My wife and I have seen a many counselors and the last one was also a sex therapist.
> 
> We are much better off than we were before we saw him. The quality, frequency, attitudes, and feelings around our sex life are much healthier than they were before we started there.


So how did that go, in broad terms, if you don't mind sharing? How did the therapist help you bring about this improvement? 

I am considering the option myself, but we are pretty far apart in our natural sexual styles. I'm curious how the counselor facilitates this thing that two people cannot seem to manage on their own.


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## Taxman (Dec 21, 2016)

From the standpoint of people that have been referred to sex therapists from my adjunct divorce counsel, I would have to say that apparently therapy works. I have questioned clients, as I do not really talk to the therapists our counsel recommends. I have been able to glean from conversation that there are exercises (yup, homework) that are assigned. The exercises, at least in one case are based on mindfulness. I have used that, over the years, to calm myself before public speaking and definitely when I took exams many years ago.


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## bobert (Nov 22, 2018)

Cletus said:


> When you say it works - can you expand on that? Are you willing to share details?


My wife and I have a lot of issues that we have been working on. The things that we've been working on may not be what you are hoping to improve, so I'm not sure how applicable it will be to you. Most are related in one way or another, but as a bit of a breakdown:

-Differing sex drives and inconsistency in my wife's sex drive
-Differing ideas of what is "good" sex
-Resentment towards my wife and withholding sex
-Performance issues
-Communication issues (or, refusal to talk about sex at all)
-Issues stemming from infidelity
-My wife's sexual trauma (OCD, triggers, dissociating/staying in the moment, relaxing, feeling pleasure, etc)
-Religious non-sense from my wife's childhood
-Orgasm problems (for my wife)
-Issues after childbirth (which has also involved a physiotherapist and doctor)

Some of those issues have been fixed, some are improved, and some still need work. If there is something that you want me to expand on, let me know and I'll try.

As an example, the first in that list is differing sex drives and inconsistency. My wife's sex drive is very inconsistent. At her "normal" her sex drive is high but there are several factors that can change it and lead her to a period of refusing sex. My sex drive is pretty low. So she might want to have sex 1-2x a day, while I'd be happy with a few times a month (and not throw a fit over less). A lot of fixing that problem has been communication. So, looking into why her sex drive is the way it is and why mine is the way it is. Then working on communication and understanding, as well as working on the underlying causes. There are several reasons why my sex drive tanked, and it started almost 11 years ago. So trying to close the gap involves dealing with all of those underlying causes. My sex drive has increased as those underlying reasons have been worked on. Then for closing the gap from my wife's side, that involves looking into why my wife's sex drive is high. Understanding the reasons for that, improving communication and adding in other things to fill in that gap. For the inconsistency, that is just part of life but the key is communication, knowledge, and acceptance.

Sex therapy is a lot of talking and homework. The communication is worked on first because without that the homework won't do any good. The therapist is there to guide you towards your goal(s) when what you've tried so far hasn't worked. I think the success rate depends on the reason you are there, the couple, and how you view success.


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## Elizabeth001 (May 18, 2015)

bobert said:


> My wife and I have a lot of issues that we have been working on. The things that we've been working on may not be what you are hoping to improve, so I'm not sure how applicable it will be to you. Most are related in one way or another, but as a bit of a breakdown:
> 
> 
> 
> ...




And how much BOTH people do the work. If one person refuses the advice or doesn’t even try it, it’s a lost cause & money wasted  

ETA: XH’s counselor and our MC gave him great homework. He would read it but never enact it. If he had, we might still be married today. 


Sent from my iPad using Tapatalk


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## Tasorundo (Apr 1, 2012)

Cletus said:


> So how did that go, in broad terms, if you don't mind sharing? How did the therapist help you bring about this improvement?
> 
> I am considering the option myself, but we are pretty far apart in our natural sexual styles. I'm curious how the counselor facilitates this thing that two people cannot seem to manage on their own.


So as someone in a similar marriage with different natural styles, it gave us a place to open a real dialog. It gave us definitions, words, tools, to convey thoughts in a safe place, with a moderator to clarify feelings and intent. It helps to get other people to provide insight into the thoughts of your spouse and you, rather than reading into things and inferring or implying things that don't get through.

It helped me get insight into a lot of my thoughts and feelings about why I wanted what I did or felt how I did. It created an additional layer to how I can process through my thoughts and desires.

I think a good couples therapist, sex or not, is in both corners, trying to get people to the middle of the ring and that is what happened.


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## Spicy (Jun 18, 2016)

I wish I could figure out how to find a good one. I’m not gonna poll my friends. Our small area finally has more than one. I also figure along the lines of @Elizabeth001 post...mine won’t even read about it. So I was thinking talking about it all with a Dr might help. He certainly won’t read the homework. I have a lot to say on this, but I’m kinda grumpy with him today and will reconsider my thoughts tomorrow. I know what y’all are gonna say...if he won’t read it and do it, divorce him. No, I am in love and love our life together. The regular posters all know that.

If I had a good O (or several) I wouldn’t be this way today >


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## Elizabeth001 (May 18, 2015)

Spicy said:


> I wish I could figure out how to find a good one. I’m not gonna poll my friends. Our small area finally has more than one. I also figure along the lines of @Elizabeth001 post...mine won’t even read about it. So I was thinking talking about it all with a Dr might help. He certainly won’t read the homework. I have a lot to say on this, but I’m kinda grumpy with him today and will reconsider my thoughts tomorrow. I know what y’all are gonna say...if he won’t read it and do it, divorce him. No, I am in love and love our life together. The regular posters all know that.
> 
> 
> 
> If I had a good O (or several) I wouldn’t be this way today >




*hugs*


Sent from my iPad using Tapatalk


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## Holdingontoit (Mar 7, 2012)

As to homework, much of it is actions rather than reading and thinking. We were given exercises such as hug for a full minute without letting go, get naked and sit across from each other and look at each other for 5 minutes, get a mirror to look at your body and draw a picture of your penis / vagina. These were ways to try to get comfortable about being naked, looking at ourselves and each other while naked, and being vulnerable. But they were actions rather than lectures. Your spouse might not be comfortable getting naked and sitting a cross from you if there is a chance you will request sex. The point of doing this as "homework" is to take sex off the table.

So while it is true that the process is pointless if your spouse will not participate, don't think of "homework" as reading and writing. It is about interacting in a way that is explicitly non-sexual in order to get more comfortable interacting sexually.


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## Young at Heart (Jan 6, 2015)

Cletus said:


> When you say it works - can you expand on that? Are you willing to share details?


I was in a sex starved marriage and started reading just about every relationship book I could find. I wanted to save my marriage, but I knew I could not last in a sex starved marriage. I figured out that I was part of the problem and that there were things I could change about myself. Ultimately, my wife started to feel better about the way she was being treated and curious about what I was reading. She started reading some of the books. Ultimately, I said that we needed to go to a marriage counselor who was a sex therapist. I gave her a list of some in the area, and she refused and gave me a list of three provided to her by a woman doctor she saw.

I researched them and found a nationally known sex therapist that I thought had her head screwed on right.

We went to couples treatment/counseling, about once a week for about 4 months. Expensive but cheaper than two divorce attorney's. She asked why we weren't having sex. She tried to provide sensate focus exercises to get us to touch and learn to be touched. My wife didn't want any part of that or any part of ever having sex with me again. The therapist provided readings on what a good sex life can add to marriage emotionally. She provided Sinclair Institute videos on how to have better sex. My wife dismissed them as porn. 

The therapist was becoming a bit frustrated with my wife, when I asked what should I do when my wife refuses to do the joint home work assignments. The ST said, I was not to try to force my wife to do anything as that was the game my wife liked playing with me. The ST said that the reason my wife can do or not do things is her choice, but the consequences of her actions will also be hers and hers alone. The ST asked my wife what will happen in our marriage if we never have sex again. My wife avoided answering and the ST kept bringing her back to the question. Ultimately, my wife said reluctantly we would probably divorce. The ST immediately asked me if I had ever thought about divorce.

I said that yes, I had. That I had researched the requirements and typical time line for divorce in our state and that I had promised myself that I would be in a loving sexual relationship by my next birthday. I wanted it to be with my wife, which was why I was changing and working with an ST, but if it couldn't be my wife, I would divorce her and find someone else to be in a loving sexual relationship with. My wife and the ST were both stunned.

The ST took in in stride and said that was a reasonable approach and that gave my wife time to figure out what she wanted to do. A few weeks later my wife asked if I would really divorce her over something as trivial as sex. I looked her in the eyes and said yes, its not trivial.

The ST then started to work with me on my defining in front of my wife what I meant by a loving sexual relationship. Once this was done, the ST started to focus on my wife and asked her if she had ever done such things within our marriage. My wife said yes. The ST then said it is not a question if you can, but if you want to. She told my W that she could choose to remain married or my wife could choose to be divorced by her actions. The choice and consequences or her actions were hers and hers alone.

Yes, working with a really good ST can work and did save my marriage. My wife still hates the ST. When she occasionally speaks badly of the ST, I remind her that that woman saved her marriage and that I would have divorced her had she not changed the way she treated me.


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## PieceOfSky (Apr 7, 2013)

We tried MC, but not focused on sexual issues. Not sure it even came up. We also tried a marriage retreat of sorts. IMHO, my wife was never really open to anything closing the distance between us. Looking back, I think she feared successful reconciliation most of all.

I think I was open to us growing closer, but I suppose I’d be the last to see ways in which I might have thwarted progress.

She has said a time or two she would look into a therapist focused on sexual issues, at a time long after quitting the MC therapy and when, relatively speaking, we had been getting along well. But, there was never any follow through.

That said, eternal optimist that I am, I could see how “the right couple attempting to find a solution guided by someone with training and exposure to many other couples with issues” could find something useful by going through the process. But, it would require both being truly being open to it succeeding — or at least somehow managing to keep it together on the way to developing that openness.

Despite my wife and my own failures, the process was useful. I see her more clearly, and her feelings towards me more honestly, and that’s important.


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## Cletus (Apr 27, 2012)

Young at Heart said:


> I was in a sex starved marriage ...


Thank you for your story.

If I can be so bold as to ask about the details - 

What was the nature of your sexual relationship? Were you both more or less on the same page sexually except for the fact that you were not actually having it, or were there deeper issues of compatibility?

I could easily see a therapist helping a couple get back that which they once had, or to get them to agree to do more of what is ultimately mutually satisfying but has languished. What I don't know is if there is any way to get two people who don't even agree on what constitutes a sexually satisfying relationship to come to terms. When both partners say "Sure, sex twice a week sounds great", but have very different ideas of what that really means. 

It's the difference between seeing what you like or are at worst ambivalent about as important and worthwhile vs. overcoming aversions, fear, and baseline incompatibility.

Which would you say was your journey?


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## Young at Heart (Jan 6, 2015)

Cletus said:


> ....(1).Were you both more or less on the same page sexually except for the fact that you were not actually having it, or were there deeper issues of compatibility?
> 
> ....... (2) What I don't know is if there is any way to get two people who don't even agree on what constitutes a sexually satisfying relationship to come to terms. When both partners say "Sure, sex twice a week sounds great", but have very different ideas of what that really means.
> 
> It's the difference between seeing what you like or are at worst ambivalent about as important and worthwhile vs. overcoming aversions, fear, and baseline incompatibility.


(1) Not really the same page. Prior to marriage I talked to her about a variety of things like BJ's etc, that I expected. She promised that it was too intimate prior to marriage. Early in marriage she promised she was saving it for later to keep the spark going. She has always had huge inhibitions, no doggy, no lights on, no afternoon sex. Pretty much missionary me on top or cowgirl. Don't get me wrong when she is into it she can rock both those positions. I would like some playful exploration and that is a big no. Her inhibitions and sexual frustration grew and grew. I also started to emotionally withdraw after all of the rejections and that created a bad cycle. Ultimately, I changed the cycle and figured out that I was part of the problem, even if she was the one denying sex.

(2) The ST tried to help us explore additional options through assignments and home work. I liked the idea. It upset my wife. Ultimately, the ST got my wife to start doing what she had done earlier in the marriage, and work with us on a definition of happy married sex life. Perhaps the biggest thing was to help us talk about and visualize what we wanted our marriage to look like in 10 years, 20 years, 30 years.

So yes, if you have huge issues, there is only so much the ST can do, but they can do a lot.

Good luck. It should be worth a try.


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