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Sex Therapy
Addressing desire, intimacy, and sexual concerns.
What it is
Sexual concerns show up in therapy regularly. In couples, this often looks like a mismatch in desire levels, arguments about who initiates, and tension between the emotional and physical aspects of sex. Negative dynamics around sexual media, social media, or external relationships also show up (see our page on compulsive sexual behavior). Some individuals carry painful or traumatic sexual burdens from previous experiences. These can be some of the most vulnerable and difficult things to talk about, especially when there are feelings of resentment or betrayal.
Sex therapy at ISDR utilizes Self-Determination Based Therapy (SDBT) to assess the motivational and relational dynamics underlying sexual concerns. SDBT provides a framework for understanding how the different motivations impact desire, connection, and satisfaction — and how to address the underlying issues that may be influencing sexual challenges. Our approach integrates evidence-based practices from sex therapy to address your specific concerns.
What we work with
- Desire differences between partners
- Low or absent sexual desire
- Sexual anxiety and avoidance, including performance concerns
- Intimacy after trauma
- Erectile dysfunction, premature or delayed ejaculation, and other sexual functioning concerns
- Conflict surrounding sexual initiation or emotional connection
- Individual concerns about sexual identity, desire, or functioning
- Navigating religious or cultural beliefs that impact sexual connection
- The impact of sexual media, social media, and external relationships
- Sexual difficulties arising during fertility treatments
How we work
ISDR takes a sex-positive approach to therapy. We understand that every individual has their own unique desires and experiences with sexuality, and we work to create an environment where those can be explored without shame or judgment. Mindfulness often plays a central role in sex therapy at ISDR.
The format of sex therapy depends on the specific issue. Couples therapy can sometimes address sexual issues much faster than individual therapy alone because of the relational dynamics involved in sex. Individual therapy can also be powerful for addressing personal sexual concerns and building self-awareness.
ISDR does not provide sexual surrogacy services. Sessions do not involve any physical contact.
Specializing Therapists
Also consider
If sexual behavior feels out of control, see our page on Therapy for Compulsive Sexual Behavior.
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