Why I Teach Anatomy to My Clients

If you’ve been reading my blog for a while, you know that I think discussing sex in therapy is crucial. Sex issues have emotional ramifications, and I hope I’ve convinced you that the ability to communicate openly and honestly about sexual desires, preferences, and boundaries is an important relationship skill, and that therapists have a role to play in helping clients develop that skill.

In addition to working with the emotional aspects of sex issues, I also very often spend time in the therapy room educating my clients on topics like sexual health and anatomy. Sex is a stigmatized subject, and many people don’t have access to trusted, reliable, and accurate information on sexuality. Many people have had only abstinence-focused sex-ed in school, or no sex-ed at all. Many people have gotten most of their information about sex from porn and peers.

Lack of access to information about sexuality can end up having all kinds of negative effects on mental health and relationships. For instance, many people feel embarrassed by the appearance of their sexual anatomy. This is the result of a lack of accurate and non-judgemental information about sex, and it can do a lot of harm to self-esteem. Sharing accurate information about anatomy can do a world of good. Even something as simple as asserting that  everyone’s body is different, and wide variation is completely normal, can make a huge different in people’s lives.

There are also cases of sexual problems that can be resolved with just a little bit of anatomical info. For instance, many people don’t realize that it takes a person with a clitoris an average of twenty-five minutes of direct clitoral stimulation to achieve orgasm. Lots of people think there’s something wrong with them or their partner if they can’t orgasm just from penetration, or if they can’t orgasm in just a few minutes. In a situation like that, you can provide a lot of relief by supplying a few facts about orgasm and anatomy.

I believe in the importance of providing accurate, non-judgemental information about topics your clients struggle with. I’m always surprised at how many people express astonishment and relief when I provide simple psychoeducation about anatomy, and debunk a myth or two. As I see it, alleviating distress in this way falls well within the bounds of a therapist’s role.

Does this leave you wondering where you can get accurate information about anatomy, and learn how to share it with your clients skillfully? You might want to consider joining my 2019 course, Assessing and Treating Sex Issues in Psychotherapy. Sign up for the waiting list now, and you’ll be the first to know when sign-ups open this February!

All Levels of Desire Are Normal

When therapists work with desire discrepancy, they sometimes fall into a counterproductive trap–identifying one partner as “high” or “low” desire, and trying to “fix” that partner’s desire level.

“High desire” and “low desire” are comparative terms. What standard are you comparing against? Is there such a thing as “normal desire” or “abnormal desire”?

I say no. Everyone’s level of desire is unique, and there is no reason to think a particular level of desire is “more correct” or “more healthy”.

As a therapist, you are in a uniquely powerful position to normalize any level of desire. The problem resides in the meaning each partner makes about their own desire level, or that of their partner, not in the level itself.

If a client were interested in shifting their own level of desire, it would only be possible in a very emotionally safe environment. Trying new things and stretching for challenging growth does not work when one feels pressured, pathologized, bad, wrong, or inadequate.

We would do better to celebrate difference in desire as expression of the uniqueness of each partner (that nonetheless can create tension), rather than pathologizing it.

Your clients probably have worked through desire issues in other areas of their lives. We all have desire differences in our relationships, whether they be about how much money to save, how clean to keep the house, or, in my house, how many cats is the right number. (When it comes to cats, I’m definitely the higher-desire partner.)

Making room for partners to hold the tension of being different from one another, and to find ways to work collaboratively with their unique differences, is both the work of couple therapy and the work of being in a long term relationship.

Here are some questions for your (and your clients’) consideration:  

  • What are your beliefs about desire? Do you believe there is a “right” amount of desire?
  • What does it mean, about you, and about your partner, that you are the higher or lower desire partner?
  • Where did you learn these beliefs about desire?
  • What other desire discrepancies have you and your partner worked through successfully?
  • What if you believed every level of desire is normal? How would that change things for you?

 

Desire is such a complicated issue because it has roots in every aspect of the relationship and of the self. That’s why treating desire discrepancy is so difficult. Reframing how you talk about desire discrepancy is a powerful first step towards freeing your clients from damaging habits and setting them on a path of personal growth.