Every therapist should be talking about sex with their clients

Talking about sex in your sessions can seem scary, especially if you’ve never done it.

I train therapists to work with sex issues, and many therapists have told me they are nervous to talk about sex in therapy. They worry they might be seen as inappropriate, or make their clients uncomfortable. The topic could lead anywhere, and they might end up outside of their comfort zone or scope of practice. Since most therapists don’t have much (or any!) training in this area, it makes sense they are cautious. 

But sex is an important part of many people’s lives, and sex-related concerns arise for everyone now and then. Many have never talked with anyone about sex, including their partner. Sex is generally perceived as a taboo topic; accurate information is hard to come by and bias and stigma abound.

Discussing sex may seem uncomfortable - or even terrifying… until you have done it a few times. Here’s my language: “Is there anything about sex or sexuality you think you might want to talk about in the course of our work together?" Go ahead and give it a try; I think you will find that most clients want you to ask, in part because nobody ever has - and that can be a lonely experience. These discussions almost always create trust, comfort, and rapport. You are opening the door to some deep and reparative conversations, normalizing sex and reducing sexual shame through the simple act of including it in your conversation. And if you happen to be working with a client who doesn't have a sex-related concern, that's great! You can just let them know if anything arises, you're here for the discussion.

Why it’s important:

Pleasure and consent matter. Sex is and can be a beautiful, affirming, heartening activity. But for many people, it has become disconnecting, alienating, and distressing, in part because of a serious lack of quality information and guidance. Media depictions of sex are no substitute for accurate information, and a warm and open conversation about the complexities of sexuality and sexual intimacy. If you’re concerned you don’t know enough, just remember that being alongside your clients’ curiosity and emotions - and normalizing sex as a topic - is what matters. Just don’t provide information you’re not sure of; instead guide them towards research (and maybe do a bit of researching yourself)!

Many people struggle to understand what brings them pleasure, let alone communicate it to a partner. Navigating the challenges of sexual interactions can be fraught; consider what is involved in just gaining a nuanced understanding of consent, and then practicing it. You can make a significant difference in your clients' lives with these conversations, as well as affecting their present and future relationships. 

Your clients may have issues rooted in sexual difficulties.  If your client is running into a sex-based issue, not talking about sex isn’t an option. Full-stop. There’s also always the possibility that sexual frustrations are impacting other issues your client may be facing. Being able and willing to talk about sex will help put a finer point on any of those overlapping issues as well.

It’s also worth remembering that untangling communication issues is not a cure-all. Not every sexual issue is going to be resolved with improved communication, or even a closer emotional connection. Some of them may be, but it’s literally impossible to know which can and which can’t without talking about sex in the first place. 

Talking about sex can unlock rich and rewarding outcomes for your client. Whether that comes in the form of consent education, confronting misplaced feelings of shame, or by easing the path to joyful fulfilment, there are a lot of enormous takeaways to be discovered. There is a staggering amount of information and emotion entwined with sex, and you can do a lot of good by discussing it openly. 

It’s clear: you should be talking about sex with your clients. Leaving it out of your therapeutic conversations can close off a multitude of roads to amazing progress. And if you find yourself out of your depth, you can always take a course, consult with an expert, or make a referral. While I’m an AASECT-certified sex therapist, you don’t need to be a specialist to start discussing sex. In fact, I encourage you to start now, if you haven’t already. I know it can feel scary, but you stand to do a lot of good.

Imagine a world when every client who experiences any concerns related to sex and sexuality knows they can easily discuss it with their therapist. That’s a world you can co-create just by opening a conversation about a taboo topic. What better project for therapy? 

If you’re unsure on how to get started, I have a free workshop  just for you. 

Originally published on Psychology Today.