What Happens In Sex And Intimacy Therapy?

Intimacy or sex therapy can be described as a type of counseling that can help individuals address concerns with physical intimacy. People can attend intimacy therapy one-on-one to work through challenges on their own, or couples can attend sessions together to address their difficulties and improve their relationship health. This type of therapy usually involves talking with a therapist about the challenges you’re experiencing and how to address them. It does not involve any kind of physical contact with your therapist or partner during the session. This type of therapy can be accessed in person or online.

Sex vs. intimacy

While the words “sex” and “intimacy” are sometimes used interchangeably, they are different. Understanding the distinctions between these terms can be helpful for couples as they navigate relationship challenges. 

What is intimacy?

Intimacy generally refers to a sense of closeness with another person, and can have different meanings to different people. Intimacy may have elements of trust, honesty, acceptance, affection, and compassion. People who are intimately connected may find it easy to openly communicate about their thoughts and emotions and be vulnerable with one another.

Intimacy can come in many forms, including emotional, spiritual, intellectual, experiential, physical, and sexual intimacy.

What is sex?

Sex can be categorized as a type of physical intimacy. However, you can have different types of intimacy without having sex, and you can also have sex without emotional intimacy. For example, some couples may be emotionally connected but lack the desire to have sex, while other couples may have regular sex while being emotionally disconnected. 

Every relationship is different, but for couples who value having sexual relationships that include both intimacy and sex, intimacy therapy can be a way to understand the factors that may be affecting their intimate connection and how to work through them.

Are sex therapy and intimacy therapy the same thing?

The terms “sex therapy” and “intimacy therapy” are often used interchangeably, but they aren’t always the same. Intimacy counseling can help individuals or couples explore various factors that might prevent them from forming a close connection or bond. These factors can be related to sex, but they don’t have to be. Intimacy therapists can help people learn how to overcome roadblocks to many types of intimacy, including emotional, spiritual, and experiential intimacy, for example.

What do sex therapists do?

Sex therapists can be defined as mental health professionals with special training who can help individuals identify and address sexual concerns. They can treat a variety of sexual difficulties with psychological causes or that affect people psychologically, and they can also guide people through addressing challenges related to sexual pleasure or desire. 

In general, sex therapists are not medical doctors and cannot treat physical issues that may affect sex drive, like hormone levels or medication side effects. A sex therapist is usually trained to use a variety of evidence-based approaches to help people improve their sex lives, which may include focusing on intimacy issues in other areas. They may use a variety of techniques, such as teaching communication skills, providing sex education, and focusing on sexual interaction. While nothing physical happens in sex therapy sessions, therapists may give homework assignments to encourage couples to work through their sexual difficulties outside of sessions.

Reasons to see a sex therapist

There can be many reasons to see a sex therapist, including the following:

To address sexual desire discrepancy

Sexual desire may naturally ebb and flow, but in couples, a discrepancy between partners’ libidos can be challenging to manage. Some people may prefer a low-sex relationship from the start, but for couples who saw sex as an essential part of their relationship from the beginning, it can be challenging to cope when levels of sexual intimacy and desire change. Sex therapy can address these challenges and help partners grow closer.

To process sexual trauma

Healing from sexual trauma can be challenging, and some people who have experienced non-consensual sexual contact may struggle to have fulfilling sex lives. A sex therapist can help survivors who want to improve this area of their lives become more comfortable with consensual sexual encounters. 

To become closer to your partner

Sex and intimacy are not necessarily the same thing. Some people may have regular sex with their partner but still sense they are disconnected or that something is missing in the relationship. Sex therapy can help couples explore various aspects of their physical relationship to deepen their emotional and physical connections.

To overcome anxiety about sex

Sex can be a significant source of anxiety for many reasons. Individuals may encounter challenges related to sexual performance, trauma, body image, and self-esteem, among other sources of anxiety. Sex therapists can help people address these concerns as they relate to sexual activity and guide couples as they learn to work through these roadblocks.

What happens in a typical intimacy or sex therapy session?

During a sex therapy session, you and your therapist may work together to identify any behaviors, thoughts, beliefs, or past traumas that may be affecting your sex life. Your therapist may ask you to talk about your beliefs about sex, your health, your sexual background, or any specific concerns you might have.

It can be challenging for some people to share this type of information, but your therapist will usually take the time to form a strong therapeutic alliance with you that can help you become more comfortable discussing these topics.

It can be important to understand that sex therapy does not involve physical contact or sexual activity between you and your therapist. Your therapist may assign homework for you to do on your own or with your partner at home between sessions, but intimate or sexual experiences should never occur in a therapy session.

Considerations for choosing a therapist

Talking about sex and intimacy can be uncomfortable or awkward for some people. Your sex therapist should recognize this and focus on increasing your comfort level. Talking about your challenges related to sex and intimacy can be central to this type of therapy. Here are a few things to think about when choosing a sex therapist.

• You do not have to work with the first therapist you meet. You can meet with several professionals with experience in this area until you find one with whom you are comfortable discussing more intimate concerns.
• Ask potential therapists about their qualifications and if they have experience helping clients with challenges similar to yours. 
• Decide if you want to attend therapy on your own, with your partner, or both. Depending on the challenges you’re experiencing, you may find one-on-one treatment more helpful than couples therapy or vice versa. Conversely, you may want to attend both individual and couples therapy to address both personal and shared concerns.

Consider an online sex therapist 

Because of the sensitive nature of some of the topics that may arise in sex therapy, some people may not be comfortable seeking professional sex therapy in person. Online therapy can empower you to tailor the experience to match your comfort level. 

With an online therapy platform like BetterHelp (or Regain for couples), you can attend therapy sessions from home and choose between video, audio, and online chat for each session. Many people are matched with a therapist within 48 hours, and you can change providers at any time until you find the right fit for you. 

While not much research has been conducted on the efficacy of online sex therapy, a 2022 systematic review and meta-analysis reported that online interventions appear to be an effective form of treatment for sexual dysfunction. Additional research suggests that online therapy is typically as effective as its in-person counterpart.