Sex Therapy & Sensate Focus Therapy

It can be common for individuals to experience sexual challenges such as sexual dysfunction, difficulty feeling aroused, performance anxiety, unwanted sexual fetishes, or low self-esteem. Although there may be stigmas about receiving support for sexual challenges, there are over 1,009 sex therapists in the US offering support, and the number is growing. 

In addition, you don't have to have advanced sexual dysfunction or mental health concerns to see a sex therapist. Many individuals choose to meet with a provider for intimacy support or to discuss a past adverse event. One type of therapy often used as a tool to support any of these individuals is sensate focus therapy, which is also a technique used in standard sex therapy.

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Despite outdated preconceived notions, for others, sex may not be a vital aspect of a relationship. Many individuals do not experience sexual attraction and identify as asexual. However, due to society's ideas of specific sexual orientations, they may face discrimination or difficulties in relationships. Discussing this with a sex therapist can be beneficial, not to change their sexual orientation but to accept it and find healthy, fulfilling relationships without sex. 

In addition, differing sexual needs or comfort levels can cause challenges. When one partner feels uncomfortable with sex or struggles to meet their partner's needs, it can cause an imbalance and may incite shame. Shame and guilt surrounding sex can be discussed in sex therapy. 

Sex therapy can address many needs, identities, and concerns. You do not have to have a mental illness or diagnosis to reach out for support. Although there are many methods of sex therapy, sensate focus is one of the most popular. It may allow you and your partner or you as an individual to feel more comfortable with your body and sexual connections. 

A certified sex therapist can help you discuss your emotional health related to sex. If you have sexual challenges in a relationship with a partner, talk therapy can help you and your partner make agreements and learn more about each other. Couples find that working with a clinical social worker or counselor in an educational environment that is also therapeutic can lead to a fulfilling sex life. 

Sensate focus therapy

Sensate focus therapy was developed by sex therapists Masters and Johnson in the 1960s. In their study, Masters and Johnson worked with participants to refocus their attention on their own sensory perceptions and sensuality instead of the goal of sexual intercourse. Clients are guided with their partners or on their own through a sensate focus practice to sensually touch, practice consent, and learn about what causes pleasure and distaste. It is often about building intimacy and confidence before continuing to sexual arousal and sexual intercourse, if applicable. 

A sex or sensate focus therapist works with individuals or couples to address sexual challenges through this technique. Couples' sensate focus therapy is one of the most common therapy types, but there are many other ways a sex or sensate focus therapist can be helpful.

How a sensate focus counselor can help 

There are several challenges and situations in which a sensate focus therapist may offer benefits to a couple, including the following. 

Addressing sex and masturbation addiction

Some sexual challenges may occur on an individual level. For example, sex and masturbation addiction or dependency can cause behavioral concerns and emotional distress for an individual, which can lead to unhelpful acts or unwanted thoughts and emotions. For many, these experiences adversely impact relationships. 

Sensate focus can help these individuals focus on finding other ways to touch, be touched, and learn to express love without focusing on sexual intercourse or desire. Instead, they can find ways to be physically close that can allow them connection without the compulsion of sexual behavior. 

Supporting couples with sensate therapy

Sex or sensate focus sex therapists may also work with couples. Many couples face challenges connecting in the bedroom. For example, one partner might struggle to feel comfortable in their body or experience touch. On the other hand, both partners might feel that their sex lacks intimacy or struggle to find enjoyment. 

When a couple wants to work together to break down those barriers, a sensate focus therapist can offer support. At the beginning of sessions, the sensate focus therapist may ask questions and prompt the couple to discuss their challenges and understand the root of these concerns. The therapist may try to learn more about the couple's behaviors, desires, and fears. 

Once the challenges have been determined, the therapist may use sensate focus techniques to help the couple learn about each other in more detail. The sensate focus therapy process involves using touch to make partners more comfortable with physical contact progressively. Often, these exercises are verbally taught during the session, and then the couple practices them at home outside of therapy. 

One example of sensate touch can include slowly kissing or cuddling in bed. Mindful mutual touching can help a partner’s body become more comfortable and feel ready for more in the future. Pleasant physical sensations may get a person to the point where they become accustomed to physical touch. During the practices, partners can continue taking turns and communicating. Consent can be a central theme of these exercises. Before touching each other, the partners can ask, "may I touch you here" and get a verbal "yes" before continuing.

Sensate touch example

Below is an example of a couples sex therapy techniques that you might partake in after discussing the activity in detail with a sensate touch therapist: 

1. Sit across from your partner so that you are close enough to touch. 
2. Choose which partner will be touched first. 
3. The partner doing the touching can ask, "may I touch your arm from your hand to your shoulder for 20 seconds?"
4. The second partner will say "yes" or "no." For this example, the partner says yes. 
5. The partner giving touch will respond with "thank you." They can then lightly touch one of the other partner's hands and arm, feeling their skin, the curve in their arm, and any unique physical features. 
6. During the touch, both partners mindfully focus on how it gives them pleasure and how it feels. 
7. After touching has happened for 20 seconds, the partners switch roles and repeat the exercise. 

Although touching arms is not necessarily a sexually oriented activity, it can prepare partners for the act of giving and receiving touch and consent. It can also increase sensory awareness and show each partner what it feels like to mindfully focus on touch without the expectation of an orgasm or sexual performance. 

Where does sensate focus therapy occur?

The talk therapy and preparation for sensate focus exercises take place at the therapist's office. However, the practice of sensate focus techniques and touching occurs safely at home and is a choice for the partners to participate in. During sensate focus exercises, sex therapists may suggest that you start initiating physical contact with each other with non-sexual touching before moving into the last step of heavier activities. 

For example, you may start with non-genital touching requests such as holding hands for a certain period or caressing the other person's face, arm, or leg. This activity may progress into cuddling and exploring more intimate areas like the breasts or genitals, and finally through a sexual encounter or oral sex. If you're not ready, your therapist may work with you on additional training in these areas. One of the genital touch techniques is called hand riding. The receiver puts their hand over the toucher’s hand, and directs them to increase pressure at times, as they sit between the legs of the toucher. Besides enhancing sensory awareness, this exercise also allows for explorations with expectations. With all of these techniques, you can go at the pace most comfortable to you. 

A therapist should not ask you to partake in an uncomfortable activity. In addition, if you're uncomfortable speaking to the therapist in person, you can meet over telehealth sessions to receive your sensate focus therapy assignments from home. However, you will still partake in the sexual touching exercises outside of the session without your therapist present. 

Benefits of sensate focus therapy

Often, the purpose of sensate focus therapy is to allow couples to become familiar with each other's touch, the act of consent, and being immersed in physical intimacy without sex. It may break down barriers for partners who have a fear of their bodies or being seen by another person. With repetitive non-sexual exercises, partners can increase tolerance and connection over time. 

There are several potential benefits of sensate focus therapy, including the following. 

Sex therapy exercises can gradually increase comfort levels in clients. If one partner in a relationship is uncomfortable with touching a penis or vagina, they may be able to open to the idea of other types of touching until they feel safe. However, the end goal of sensate therapy is not necessarily sexual intercourse. For some couples, learning to touch each other in non-sexual ways can improve intimacy on its own. 

Sensate focus therapy can improve the connection between a couple. It may allow those uncomfortable to become more comfortable with their bodies over time. Sensate focus is also an indicated treatment for various types of sexual challenges. These techniques have been used to treat erectile dysfunction, premature ejaculation, instinctive thrusting patterns, and pain during sex. This type of mindfulness can lead to greater physical awareness, more sensual intercourse and a more satisfying sexual experience for many. 

Masters and Johnson believed those who have arousal disorders or challenges with sexual desire could benefit from sensual touch. Even couples who have a sex life may find some benefits from engaging in sensate focus techniques. It can improve sexual satisfaction while giving a couple time to learn to express their love positively. 

Finding a sensate focus therapy professional

If you are interested in sex or sensate focus therapy, you may be able to find it by searching for a sex therapist in your area online. Many major cities have therapists who can offer support for sexual challenges. When you contact a therapist, ask them if they offer individual or couples sessions and whether they are trained in sensate focus techniques. 

Those who do not live in a large city or have few therapy options nearby may wish to search for other options. Online therapy is an effective choice for anyone seeking sensate therapy. It can be cost-effective and puts you in control of the scheduling. Although your insurance company may not offer insurance coverage, online therapy can be cheaper than co-pays or insurance plan costs per month.

Online therapy options 

Online sex therapy is an option for individuals or couples facing sexual challenges and barriers to in-person treatment. You can work with your therapist from home by choosing between phone, video, or live chat session formats. In addition, you can set a flexible schedule and meet with a provider using a nickname instead of your real name. If you attend as a couple, you may be able to attend sessions from two different rooms or locations. 

Online therapists through a platform like BetterHelp for individuals or Regain for couples are fully licensed, vetted, and experienced. They can offer guidance as you discuss your sexual concerns and learn more about various sensate focus exercises. Many online therapists practice the same types of therapy techniques as traditional in-person therapists. In addition, the American Psychological Association (APA) has found telehealth therapy to be as effective as in-person counseling for many challenges.