Uneasy About Sex?

by Jeff Hickey LCSW, CST

Remember a time as a therapist when you’ve had that ‘we’re not in Kansas anymore’ feeling? Like something very new and different has replaced what you’re comfortable with as a clinician? I had it a lot while going through sex therapy training. It wasn’t the information related to sexual functioning, or practices or treatment, although that expanded my horizons some. It was in actually using it with clients as we worked together to resolve sex related problems. Like most therapists new to sex therapy, I wasn’t accustomed to asking people questions about what they do sexually, how it goes when they do it and then getting even more specific when there’s evidence of a problem. Some of it was that I’d always drawn too broad of a line between sex and other relational problems so it was hard to see them overlapping as much as they really do. But to be honest, the main reason was I just felt nosy and embarrassed. I can wade into deep emotional waters with clients, but it just took some practice of asking about vaginas, oral sex, erotic fantasies, etc. to feel more comfortable. In fact one of the key reasons sex therapists have an easier time talking about sex is they do it a lot. Basic desensitization.

What if you’re not there yet? What if it still feels awkward or even taboo to bring up the topic of sex with your clients?

A great place to start is to simply allow the discomfort. It’s always about something, right? Respect it and give it some room to be felt and heard. In fact, embrace it – the last thing we want is to get heavy handed with ourselves, because sex is often such an emotionally laden aspect of our identity. And often the feelings that arise can make it difficult to step back and see where we are.

Next, look at your attitudes about the gamut of sex: how it gets expressed culturally; practices you can accept and where you draw the line; feelings about sexual minorities; how your own background and other experiences shape you values about all of the above, just to name a few.

Now, reflect on the role of sex in your own life: where you learned what you know; how your beliefs came to shape your sexual expression; your feelings about the role of sex in your relationships, again just to name a few.

Finally, take a moment and ask your self what, if anything, you’d like to change about these attitudes, beliefs and feelings. The answer might point the way to what you need to begin to feel more comfortable discussing sexual concerns with your clients. I can almost guarantee you that as you become more at ease, they will too, and they’ll appreciate you opening that door.