When should I go to therapy?

29 OctoberMarelize Swart

"As soon as you determine that the problem is not getting better." For example, when sex feels like another "chore" to the lower desired partner (male or female). This can then easily become a pattern where it becomes difficult to keep sex on your priority list. The longer that cycle continues of not wanting to be sexual, feeling guilty, and increased pressure goes on, the more established the problem gets and couples become stuck in a no-sex or low-sex relationship. Similarly, if a woman experiences sexual pain and/or spasm repeatedly when penile penetration is attempted, the best course of action is to suspend further attempts until the problem can be alleviated by behavior modification. In all cases, if the problem is repeated without change, it is better to stop that repetition and seek professional help. The longer a problem goes on, the better "learned" it becomes, and the longer it will take to reverse that sequence in sex therapy. How do I get my spouse/partner to go to therapy? This is sometimes difficult. The best approach that I know is to focus on the rewards of attending therapy.

It is quite common that men and women are resistant to coming into therapy - for a variety of reasons - and especially so when it comes to a sensitive issue like sexual difficulties. Some couples come in only after one spouse has threatened divorce. However, the vast majority of individuals or couples who complete a full course of sex therapy are significantly more aware of what they find to be sexually stimulating, they are significantly less inhibited about announcing what they want, and they have enhanced communication skills on sexual matters. The task is to make therapy more rewarding than not having therapy. What can I expect in and from Sex Therapy? An initial assessment to determine psychological versus medical factors. If a referral to a medical doctor is not called for, I then meet with the individual or couple to get an idea of how much the sexual issue is interfering with the relationship, and how much relationship conflicts are interfering with sex. That's why good sex therapy is also good marital/relationship therapy. I then meet with each of the partners individually to learn about their family of origin, relationship, and sexual histories.

I will often assign readings and exercises to use time outside of the therapy session as effectively as possible. I watch carefully to see how each person is responding to intervention. I role model communication and decision-making techniques. I explicitly identify and reward specific advances made in therapy. I propose milestones and benchmarks for common agreement on assessing when we have accomplished our goals. And I will usually initiate a discussion of when we should part company for regular meetings (although I remain available for consultation in the future). You can expect to be shy about describing your sexual behavior. After all, we rarely talk about sexual problems in life but we do not hesitate to ask for help when it comes to most other areas, e.g. parenting or cooking. In sex therapy, your honesty regarding what you do, how it feels, and what you want to do (or do more often) is necessary if you want your goals met (or determined to be unmeetable or unrealistic). WHAT SHOULD NOT HAPPEN: There should be no sexual contact. You should expect to talk about sexual material without either being diverted or having the therapist look distressed by what you say.

In summary:

  • You should expect to be a bit nervous at first.
  • You should expect to feel a little weird about telling a "stranger" your sexual history and current reason for asking for help.
  • You should expect to be treated with respect and dignity.
  • You should expect some set-backs
  • just because you're now in therapy doesn't mean that your therapist does all the work. You have to put forth effort.
  • You should expect the focus of attention and importance to be on you, not on the therapist.
  • You should expect to know when progress is being made and to have an idea of the behavioral milestone(s) which will signal the successful completion of your therapeutic work.
"Dont wait. The time will never be just right."