Sex by educating patients and their partners

Sex is a normal part of adult life, but sometimes people have issues with sex. Where can people turn when they have sexual dysfunction? In this lesson, we’ll examine what sex therapy is and how sex therapists help patients with sexual dysfunctions.

Sexual Dysfunction

Kenny has a problem. Whenever he and his wife become intimate, he can’t seem to sustain an erection.

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The doctors say there’s nothing physically wrong with him, but he feels frustrated and depressed.Julie wants to be in a loving relationship. She comes from a very traditional family and culture and really wants to marry a nice man.

But she’s not really attracted to men; she finds herself attracted to women, and this makes her feel very anxious. As a result, she’s developed a pain whenever she’s engaged in sex.Phil, on the other hand, has never really been interested in sex. His whole life, he’s enjoyed the company of others, but even with his wife, he just isn’t really into it.Kenny, Julie, and Phil all have different types of sexual dysfunction.

Sexual dysfunction is a general term used to refer to a number of disorders that lead to sexual problems.There are many causes of sexual dysfunction disorders, including physical, psychological, and sociocultural. For example, Kenny’s erectile dysfunction disorder might be caused by a problem with blood flow, a fear of not satisfying his wife, or a combination of both.

Julie’s pain during sex is caused by the psychological distress brought on by the difference between her sexual orientation and the sociocultural pressures of her family and community.Phil’s hypoactive (meaning ‘unusually diminished’) sexual desire disorder might be a result of a physical issue, like a low level of the hormone testosterone, or it might be a result of a childhood psychological trauma.Regardless of the cause of sexual dysfunction, many people find that they need help dealing with the symptoms and stress associated with issues around sex. Some psychologists and psychiatrists are trained to deal specifically with sexual issues. They are called sex therapists, and the work they do is sex therapy.


Sex therapy is not unlike other types of psychological therapy.

The session usually involves talking with the therapist in his or her office and then some exercises to do between sessions.Sex therapists follow certain guidelines to increase their effectiveness. These guidelines are often referred to as the PLISSIT model of sex therapy.The ‘P’ in PLISSIT stands for permission. Because sex and sexuality are hot-button topics for many people, it’s important for the therapist to build trust by getting permission from the client to talk about sexual issues and giving permission to the client to bring up any questions or issues they have with sex.The ‘LI’ in PLISSIT stands for limited information. Many people are just not completely aware and educated about sex issues.

The therapist needs to expand their knowledge base by educating patients and their partners about the problems they face.The ‘SS’ in PLISSIT stands for specific suggestions. Besides just educating clients about sexual disorders, the therapist needs to offer suggestions that are specific to the patient’s problem.The ‘IT’ in PLISSIT stands for intensive therapy. Patients might need more than just a sex therapist to help them out.

They might also need to see a medical doctor, for example, if they have a physical issue that underlies the sexual dysfunction. A good sex therapist will be able to see what therapies are best for the client.

Sex Therapy in Practice

Remember Kenny? He and his wife are really concerned. Kenny wants to have a healthy sex life with his wife, but he can’t figure out why he’s not able to sustain an erection.

He sees a doctor to no avail. He goes to a psychologist, who recommends that he go see a sex therapist. When he goes to the sex therapist, she suggests that Kenny and his wife come to therapy together.That’s one difference between sex therapy and some other types of therapy.

If a patient is in a sexual relationship, it’s usually recommended that both partners come to the session together. Many sexual dysfunctions are caused or exacerbated by communication issues between partners, so a large part of sex therapy involves opening and supporting the lines of communication between partners.When Kenny and his wife talk with the therapist, they discover that part of Kenny’s problem is his anxiety about not being able to please his wife. As they talk in a supportive environment, they are able to begin to assuage his fears and their sex life improves. Their therapist builds that supportive environment by using the ‘P’ in PLISSIT: permission.Sometimes, though, talking just isn’t enough. Phil and his wife talk, and while it brings them closer together and makes their relationship stronger, it doesn’t really help with Phil’s problem with desire.

When communication doesn’t work by itself, sex therapy can also involve certain tools or techniques used to help patients deal with their problems. For example, Phil’s therapist suggests that Phil and his wife go home and try out a few different foreplay options to see if they can get Phil revved up. These are specific suggestions, which is the ‘SS’ in PLISSIT.Of course, sex therapy isn’t just for couples. Julie isn’t in a relationship, but she still wants to be able to masturbate or have sex without pain. Her sex therapist works with her to talk about the anxiety and guilt she feels over her sexual orientation and also suggests some things she can do on her own or with another person to help relax herself during sex, which can decrease the pain.

Lesson Summary

Sex therapy is a specific type of counseling that deals with sexual dysfunction. Sex therapy often involves counseling a couple together, though sometimes people approach therapy alone. It can strengthen communication between partners and offer activities to be done between therapy sessions to help treat sexual dysfunction. Many sex therapists follow the PLISSIT model, which involves permission, limited information, specific suggestions, and intensive therapy.

Learning Outcomes

After watching this lesson, you should be able to:

  • Explain what sex therapy is
  • Identify and discuss the components of the PLISSIT model, and how it helps patients with sexual dysfunction

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