Discover when and why seeking help from a sex therapist can be transformative and explore solutions for common issues such as desire discrepancies, sexual function challenges, and the complexities of open relationships.
Hey Dr. Carolin! Thank you so much for taking the time to tell us more about what Sex Therapy is all about, who it is for, and the types of sexual concerns Sex Therapy can help with. Can you describe the range of sexual concerns that clients typically bring to you at the West Coast Centre for Sex Therapy?
Dr.Carolin: Clients come to our Centre with pretty much every kind of sexual concern.
These include desire discrepancies in couples;
- concerns about sexual function (desire, arousal/erectile function, and orgasmic function),
- sexual pain;
- sexual trauma;
- sexual shame and anxiety;
- problematic sexual behaviours (or what many clients term sexual addictions);
- and atypical or less common sexual interests.
In addition, we have individuals, couples, and other partnership configurations come to our office to explore new ways of being sexual.
This can include:
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exploring open relationships/non-monogamy;
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exploring new ways of being sexual after a medical condition or injury affects sexual function and mobility;
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or helping people who just want to broaden their ideas and approaches to sexuality so that their sexual relationships continue to evolve rather than becoming stale and mundane.
It’s intriguing to realize that Sex Therapy isn’t just about resolving problems; it’s also about exploring new ways of experiencing sexuality. How can someone determine if their sexual anxieties or difficulties warrant seeing a sex therapist?
Dr.Carolin: If your sexuality and sexual relationships are causing you confusion, anxiety, frustration, or any other form of distress, and you feel stuck on how to resolve it, then that’s a great reason to turn to a sex therapist for professional help. In other words, it’s not the extent of the problem, but rather the extent of one’s distress and desire for change, that might be a great cue for when to see a sex therapist.
At the same time, there are others who aren’t necessarily greatly distressed, but who value continued growth in all aspects of their lives – including their sexuality – who may find a lot of benefit from seeing a sex therapist. Just like people go to professional massage therapists, dentists, personal trainers, and financial advisors – both to address problems and to prevent them in the first place – the same can be true in seeing a sex therapist: sometimes it can be great to see a sex therapist to prevent a problem – not just to fix one.
Building on that, it’s often said that one of the most common issues bringing couples to sex therapy is desire discrepancies. How do you approach helping couples who experience desire discrepancies and have different levels of interest in sexuality?
Dr.Carolin: Great question, as this is one of the most common reasons couples come to see me. The first thing is to figure out whether it’s a true difference in values and interest in sexuality, and/or whether it is a difference that is the result of other factors. In other words, some couples truly value sexuality very differently: for one person, sexual expression and pleasure may be incredibly important for quality of life and feeling connected to their partner, whereas for the other, they’ve never thought of themselves as very sexual, don’t miss it when they aren’t sexual for a while, and feel connected to their partner through other activities.
In this case, it can be more difficult to resolve the discrepancy because the two individuals truly don’t derive the same benefits from sex. Therefore, one will always be more motivated and desiring of sex than the other. In this case, the first focus of treatment is on helping them to understand and appreciate their differing perspectives and on helping them to not see each other as deficient (i.e., ensuring they don’t view the higher desire partner as wanting sex “too much”, and the lower desire partner as having something “wrong” with them that they don’t desire sex more).
And then the second focus is on helping them to consider possible solutions. These possible solutions can range from the higher-desire partner becoming more accepting of a relationship that doesn’t include as much sex as they might hope for; the lower desire partner committing to being sexual more often to honor their partner’s vision of a more frequent sexual relationship; and/or considering alternative ways for the higher-desire partner to be sexual in ways that are ok for the lower-desire partner (be that more solo sexual exploration for the higher-desire partner; considering some form of an open relationship; or the couple engaging in more sexual activities that require less from the lower-desire partner, such as the lower-desire partner being present but not feeling pressure to either give or receive touch during a sexual experience).
On the other hand, there are also many couples where both people value sexuality similarly but where life circumstances are leading one partner to have lower desire because something is getting in the way of the brain desiring sex.
Examples can include one partner having lower desire due to depression, anxiety, significant work or family stress, feeling overwhelmed and over-stimulated by children/parenting; sexual/genital pain; relationship conflict; medical issues/illness; and/or feeling that there is a difference in the kinds of sex the two people in the partnership desire such that one person’s ideal sex is a turn-off for the other. In this case, therapy is focused on identifying these factors and working to resolve them so that the couple can get back to experiencing a similar desire for sex with one another.
How do you provide support for individuals or couples exploring open relationships or other non-traditional relationship structures, a topic increasingly discussed today?
Dr.Carolin: This is definitely something we are seeing more and more couples consider. In fact, when I completed my training and started working in this field more than 15 years ago, it was rare for couples to come to my office asking to explore this. But now, couples regularly contact our office wanting a professional space to learn more and explore this idea in a thoughtful, respectful way that continues to prioritize (and even strengthen) their primary relationship.
In terms of supporting clients considering opening their relationships, the first step is helping them to identify their values (for example, values of freedom of sexual expression, personal exploration, trust, and bodily autonomy), and how opening their relationship may (or may not) be in line with these.
For many people, an open relationship that allows each partner to have full bodily autonomy and that values freedom and sexual exploration is, in fact, in line with their values. But emotions such as fear, jealousy, hurt, and shame get in the way of acting on these values. So these emotions, and ways to most effectively manage them, often become part of the focus of therapy.
In addition, many people don’t have role models for how to actually go about the process of opening the relationship. As a result, many clients have questions and seek guidance about what should be discussed and agreed to in advance, how this might actually/practically play out, how to talk about this with others (including older children), etc. And because the primary relationship is usually still a priority, therapy also focuses on how the couple can ensure that this continues to stay strong and continues to evolve in beautiful ways.
Fantastic and final question, what are the key benefits of sex therapy to improve sexual relationships and overall quality of life?
Dr.Carolin: Sexuality is a fundamental and important part of quality of life for many people. But we live in a society that does not support talking openly about sexuality. As a result, most people don’t know what’s “normal”, are afraid and embarrassed to talk openly about sexuality with their partners, have shame about some aspects of their bodies and sexuality, and aren’t having the best sex they could be. That’s really sad. Sex therapy can, fortunately, help these people to have a safe, non-judgmental, and informed space to talk about sexuality in a positive way that focuses on increasing connection and pleasure with oneself and one’s partners. As I like to say, sex therapy isn’t about helping people to have more sex; it’s about helping people have a better connection with sex. Which leads to healthier, happier relationships with ourselves and our sexual partners (and sometimes more sex!).
Thank you, Dr. Carolin Klein, for sharing your insights on the various sexual concerns clients bring to the West Coast Centre for Sex Therapy. Your expertise and compassionate approach provide valuable guidance for individuals and couples seeking to enhance their sexual well-being.
If anyone is interested in learning more or scheduling an appointment, please contact the West Coast Centre for Sex Therapy at:
Phone: 604-734-1511
Email: info@westcoastsextherapy.com
Dr.Carolin Klein Instagram: @drcarolinklein
West Coast Sex Therapy Instagram: @westcoastsextherapy
Website: https://westcoastsextherapy.com/
