Sex therapy

The Sex therapy is a conversational form of psychotherapy and psychiatry for the treatment of sexual disorders. The spectrum of treatment in sex therapy covers from sexual dysfunction, emotional trauma to pathological symptoms from mild to severe sexual diseases.

What is Sex Therapy?

Sex therapy describes the psychological and psychiatric treatment of sexual problems and emotional and sexual diseases. The simplest forms of sex therapy begin with a psychotherapist or alternative practitioner and deal with sexual problems and disorders that are not yet of any disease value or even endanger the patient and others.

For example, sex therapists deal with sexual problems in the couple relationship, with the sexual sensation of their patient, the living out of sexuality or with sexual trauma and negative experiences. Some of the diseases that sex therapy deals with are also physical in nature with effects on sex life. In addition, there is the treatment of sexual disorders with disease value, in this area sex therapy is in part transferred to psychiatry. Sex therapy relies heavily on talk therapy, while drugs are rarely used and often prescribed by other medical specialties.

Behavioral therapy and depth psychology, systemic procedures, drug treatment of physical disorders and of course the practical application of what has been learned from sex therapy are common treatment methods. The aim is to make the patient's sexuality as physically and socially comfortable as possible for him and to reduce the level of suffering.

Treatments & therapies

Sex therapy can initially help people who find their own sexuality unsatisfactory. Be it through a lack of partnership, listlessness, orgasm disorders or impotence, together with the patient, the therapist finds out what is causing the dissatisfaction during sex therapy. The key question for sex therapy is whether the patient feels stress - if he can make friends with his situation, he does not need sex therapy.

An unfulfilled desire to have children can also become a case for sex therapy, starting with the phase of accepting medical support through to dealing with the case that a child is not possible. Patients who are not able to lead a normal sex life for physical reasons such as illness or malfunctions are also cared for by sex therapy and ways are found to live out their sexuality in a satisfactory way. While sex therapy focuses on finding out the reasons for the disorder and dealing with them through conversation, it can also receive support from other medical specialties, for example through drug or surgical treatment of the cause of the disease.

While these forms of sexual disorder only become cases for sex therapy when they are under pressure, as they do not endanger the patient or others, sex therapists also deal with sometimes more dangerous paraphilias. Disorders of gender identity or coping with homosexuality, which also do not always require treatment, are harmless. On the other hand, therapy can be more difficult with fetishism, such as exhibitionism or sadomasochism.

While not all those affected need to be treated for these paraphilias, sex therapy borders in its most demanding areas on diseases such as sex addiction or pedophilia. Since in these cases of extreme sexual disorder there are sometimes other mental illnesses or those affected would injure or kill third parties in order to satisfy their sexual needs, sex therapy sometimes falls into the field of psychiatry.

Diagnosis & examination methods

Most of the time, sex therapy comes to a solution to the problem with a profound anamnesis procedure as well as conversation, behavioral and systemic therapy as well as depth psychology. As part of the anamnesis, the sex therapy proceeds very carefully and asks about the sexual history of the discovery of sexuality, the parental handling of it and previous sexual experiences.

Then the patient describes his problem and his level of suffering and, together with the sex therapist, develops possible solutions and situations with which he can live. With this thorough anamnesis, sex therapy finds out whether the problem is purely emotional or physical, and can find the appropriate therapy and decide whether medication or surgery is advisable. A mental trauma that today leads to orgasm disorders or sexual listlessness, and in the worst case even completely suppressed by the patient, has to be dealt with in a completely different way than a lack of desire for sex due to relationship problems with the current partner.

Sex therapy also asks about medical history, as many sexual disorders are also due to hormonal imbalances and hormone therapy is the way to get better. In the case of persistent sexual disorders that could endanger third parties, a similar anamnesis is used in sex therapy, but also the exact determination of the factors that arouse sexual pleasure in this case. In this way, the therapist and the patient can try to find ways to either deal with this sexual pleasure in a different way or to steer it completely in a different direction.

Particularly in the case of strongly pronounced paraphilias, whose sufferers tend to endanger third parties, admission to a closed psychiatric ward is recommended, since in some cases it can never be ruled out, or only after successful sex therapy, that they have their paraphilia under control to the point that they live safely for themselves and others in the midst of society.