Years ago, I saw a cartoon that really made me laugh: In a therapist’s office, a woman is lying on the typical Freudian couch, and says to the therapist, “You know, doctor, there are some things I don’t tell you.”
And the therapist responds, “I want you to know, Mrs. Jones, that I really appreciate that!”
Like most of the best jokes, it hits on a deep truth that we rarely acknowledge—we don’t know what we don’t know, and maybe don’t even want to know.
As a sex therapist, I give talks to groups of other therapists around the country, and I often ask for a show of hands of those who have had any kind of sex-therapy training, even a one-day workshop. In a roomful of 50 or 60 therapists, I usually get no more than a half-dozen hands. If I give a talk on problematic sexual behaviors, marital therapy, or sexual abuse, I fill a room. If I offer a talk on helping individuals and couples with sexual pleasure , less than half as many people will show up.
Is it not striking that in a profession seeking to help people in their relationships and personal struggles, that such a fundamental element as sexual intimacy is either avoided or not deeply studied by therapists? During therapy, when sexual issues arise, even those of us who have had any sex-therapy training will often fall back on their training about sexual trauma, sexual abuse, and problematic sexual behaviors, seeking out these dark pathologies in order to deal with them.
“I used to be one of you,” I tell attendees. “I was a long-time therapist, and went down this very path until I discovered research and clinical training on healthy sex, and realized without a single day of training in this how wrong I had been in my approach to my clients.”
Once I sought out the training, I came to understand such an oversight as egregious, a disservice to my clients, and even unethical. This doesn’t mean that I still don’t, today, examine possible trauma driven and pathological reasons for why a client comes to my office who is sexually suffering. It does mean, however, that I also have tools on how to look at their issues with informed healthy sex and sexuality information.
Couples are coming to us with problems in their relationship, but they usually have problems in their sexual side of their relationship, as well, and we are not trained to deal effectively with these. There needs to be two separate, parallel conversations, one about relationship and the other about sexual health. Many people think that if the relationship gets better, then the sex will get better as well, or vice versa. That’s a myth.