What Really Happens…

Grace Woman
October 2003

What really happens behind the closed doors of a sex therapist’s office?

A fun and healthy sex life contributes more than you realize to your overall happiness. Even though we go to the doctor when we have physical symptoms or a psychiatrist when we have emotional ones, most of us never think of going to a “sex doc” when our sex life is not what we want it to be.

Most people are so embarrassed about their sexual problems already that the last thing they want is to tell a total stranger about them. (“Nice to meet you. Did I tell you about my lack of sexual desire for my husband and his erectile dysfunction problems?”) Sex therapy was born in the 1960s when married sex researchers William Masters, M.D., and psychologist Virginia Johnson pioneered the field. Sex therapy was the newest to join the mental health professions of psychology, psychiatry, social work and marriage counseling. To become a certified sex therapist today, most therapist must have a master’s degree in social work or a Ph.D. in psychology, as well as having practiced psychotherapy for at least 1,000 hours a year for several years, followed by specific training in human sexuality.

. “Almost everyone has the ability to improve their sex life,” says Dr. Ava Cadell, a certified sex therapist in Los Angeles. So why do people go to a sex therapist? The primary reasons include lack of sexual desire, inhibitions, low sexual self-esteem including poor body image and performance problems—lack of orgasm for women and premature ejaculation for men. (If they could get guys to slow down, maybe women would have more orgasms!)

For every sexual problem, there is a solution. And that’s what sex therapists are for. Once they diagnose the problem (such as inability to reach orgasm), they offer a solution. “My biggest piece of advice to women who have this problem is that every woman has to take responsibility for her own orgasm,” says Dr. Cadell, whose practice includes couples and single women and men. “You can’t always rely on the man to provide it for you.” (Most of us have been there with an “It’s all about my orgasm” kind of guy.) She offers these women everything from specific techniques to teach their lovers or, if they don’t do the trick, vibrators and creams to take matters into their own hands. “Every woman can be orgasmic,” Dr. Cadell says. “She just needs to discover the right kind of stimulation.”

. “I think erotic videos can have therapeutic value,” she says. “I try to encourage women to watch them. Anything by Andrew Blake is good. He has beautiful locations in his videos and beautiful people. It helps women get over their inhibitions.” What’s interesting about watching is that you never know what might arouse you.

Sexuality, of course, is not just physical. Our emotions also play a big part in the quality of our erotic lives. While some problems are purely physical (for example, a man doesn’t know how much foreplay his girlfriend needs), others have psychological causes. According to Dr. Cadell, many couples are secretly mad at one another, which is certainly not conducive to a good sex life. The conflict can revolve around frequency of sex, lack of sexual satisfaction, degree of commitment to the relationship, the father not sharing responsibility for the kids and money issues.

To help couples overcome their anger, Dr. Cadell has each person first fill out a profile that includes questions such as, “What are you unhappy about in your relationship?” “What would you like to change?” and “What are your fantasies?” She also has them list what they love about their partner and what they don’t.

Although every couple has different sexual problems, Dr. Cadell gives many married or live-in duos a six-week plan for putting passion back into the relationship. The plan, which she dubs “Passion Power,” Her hope is that the sexual passion will “offer each partner enough satisfaction that together they will seek solutions to what is bothering them emotionally.” The first stage in the plan is forgiving your partner for a hurtful action. “Without forgiveness, you can’t have good sex.” Next she has the couple “give and receive emotional compliments, rethink the art of passionate kissing and rediscover nonsexual touching.” The plan also includes telling the husband things not to say in bed, discovering each other’s erogenous zones, practicing breathing techniques, artfully seducing each other and even trying playing things like nude wrestling.

In her book, Confessions to a Sexologist (Peters Publishing, 1999), Dr. Cadell chronicles the story of a couple “whose religion didn’t allow them to have sex before marriage, so when they did make love, they discovered his penis was way too big for her!” When I asked Dr. Cadell what her solution for their sex problem was, she replied: “I told the husband to focus on foreplay. Then I gave the wife three sex toys of different sizes and told her to go home and practice!”

After hearing some of the tips described here, I started to think everyone should go to a sex therapist, whether they have sex “problems” or not. (The guys I’ve dated in the last few years could all use an appointment.) And it is true: Everybody can be better in bed and have more fun while they’re in there. Like the sign above Dr. Cadell’s office door says, “And they lived happily ever after…”