I was in my third trimester of a respected Marriage and Family Therapy graduate program when a classmate of mine fired the question to the director of our division. “Where’s our sex class?” she asked. The answer was nowhere. We didn’t have one.
We could take it as an elective, we were told. To do this, we had to compete with the division of counseling psychology for spots in the class which was housed in their program, not ours. On top of this, the sex course was on the same weekend of another class—one that was required for our degree. I don’t know anyone who went.
When we took our couples therapy class, it came up again. There was almost no sexuality content in the entire trimester course. When we protested, we were told that sexuality was a specialty that could be studied after we graduated. I wonder how many of us did? Yet we were all graduated proudly as the Marriage and Family Therapists of tomorrow.
That was in 1996. In 2013, the situation has not improved much. Most therapists, whether they be psychologists, clinical social workers, MFTs or counselors have little to no education about sex. Our clients don’t know this, which is critical, but many of us are equally unaware of how poorly prepared we have been to deal with the very complex bio-psycho-social-spiritual issue that is human sexuality until it walks into our session room–and it’s always in the room.
Most therapists have been decently introduced to sexual orientation, which is a common exception to the “no sex in school” rule, and gender identity is now in its heyday in terms of attention on the therapeutic front, but pleasure? Techniques? Bio-medical causes of sexual functioning? Desire discrepancies in couples? Sex and disability? Basic anatomy, for heaven’s sake? All are missing from the typical graduate school curriculum.
If you’re someone who has been to a therapist for a sexual issue, a light bulb may be going off for you right now. You could be saying to yourself, “No wonder that didn’t work!” If so, please let me be the first to say that it probably wasn’t the fault of your therapist. I’m sorry that our field let you down. Some of us are working very hard to change this.
If you’re a therapist yourself, you may feel defensive. I can sympathize. I now train therapists and others in human sexuality, but at one time I was in private practice and I know how many issues walk through the door. How are we supposed to choose what our professional development hours should look like? Should we choose trauma training? There’s certainly a lot of trauma. What about gender issues? Also very important. Infidelity counseling competence? Good idea! The choices can be overwhelming, but I am going to make a bid for every therapist now reading this blog to consider some sexuality training as soon as you can. Sex is FAR more important than we may think it is.
In our society, we have a tendency to minimize the importance of sex. We treat it as though it were juvenile, self-indulgent, trivial or sinful. We act as if sex is completely separate from love or intimacy or care. I was recently on a very disappointing discussion board where multiple therapists were insisting that sex has nothing to do with love, or that it was a “lower” form of love. These people were no doubt passing these ideas on to their clients. What a terrible shame. It is because of this minimization that we are unable to become our full, actualized selves. Sex is a part of us. It can create much joy. Cutting it off and de-valuing it is harmful and creates an artificial schism between body and mind.
For another, according to Maslow, self-actualization is aided by peak experiences. The more peak experiences someone has, the more likely they are to be self-actualized, and happy. The thing is, peak experiences are often hard to come by—unless you bring sex into the picture. Orgasm and ecstatic sexual experiences are readily available to most of us, even if we don’t have partners. If Maslow is right, then sex can be an inroad to a happier and more fulfilled life.
Another reason therapists should make sex a priority in session and in evaluation is that so many issues that look like other things are linked to sexuality. Is it a depression problem, or is it a sex problem causing the depression? How does an anxiety problem impact a person’s sex life, and how might that exacerbate the anxiety? We don’t know if we don’t ask. If a therapist doesn’t inquire about sex in the evaluation, or check in about it every once in awhile, clients don’t know that it’s OK to talk about it. A client could come in with a sexual problem and never discuss it unless the therapist poses the right questions. I have had far too many people tell me that they never had a therapist ask them about sex, not even in an evaluation.
If you’re a person who has been to a therapist or is thinking about seeing one, did you feel comfortable talking about it with your therapist? Would you bring it up if they did not ask? I encourage you to ask your therapist if you can talk about sexual issues with them. If they act uncomfortable or unfamiliar with the request, you may want to consider another therapist.
Don’t we have other things to think about? What about family, intimacy, communication? My answer is simple: sex is an adult training ground for all of these important skills. How are many families created? Sex. How can we deepen intimacy with our partners? Really good sex. How can we hone our communication skills? Nothing sharpens them faster than good sexual communication. It takes true maturity and skill to reveal what we want, what we don’t want, ask for advice from our partner on how to please them, to stop when things aren’t working, to share fantasies without judgment. Even partners who have been together for many years often don’t have these skills, and yet taking them for a spin impacts our entire relationship and deepens our connections.
My take? Sex is the life force, whether it’s being used for recreation or for procreation. Sex is the only thing on this planet that can both create life and take it. That force, that power, is going to express itself in us somehow. Personally and professionally I’d like to see it expressed in creative ways rather than destructive. I’m not only talking about having babies or avoiding STDs. Sex can be a tremendous creative expression of self–very healing, very exciting, and very real.
We cannot claim true healing until we have attended to our sexual healing. The field of psychology was founded by sexologists—we should go back to our roots.
Dr. Rosalyn Dischiavo
