Couples can work out many of their sexual issues without professional help. Success requires commitment to each other plus diligence and perseverance to work on maximizing the positives in their sexual relationship. Certain situations, however, may demand assistance from a competent professional. This is particularly true if a man’s premature ejaculation is severe, if he struggles with erectile dysfunction, or if he is controlled by sexual addiction. Professional help would also be necessary for a man who is unable to ejaculate at all (inhibited ejaculation). For the woman, professional help may be necessary if she has difficulty getting aroused, is unable to experience orgasm, or has pain during sex. If either of the spouses is unable to feel desire for sexual activity, this, too, would suggest the necessity for professional help. In some situations, the main barrier has to do with coordinating religious beliefs and sexual responses that a person finds incongruent. Here, a Christian helper would be needed.
WHO CAN HELP?
There is much confusion as to the difference in qualifications and competence of the various professional helpers. Let us briefly state their backgrounds and qualifications. All of the professions listed here could be helpful with a sexual difficulty, but may not necessarily be trained to help with sexual issues. Let us begin by talking about physicians. There are several medical specialties that tend to be helpful in dealing with sexual difficulties.
Psychiatrists, who have received a medical degree and then specialized in psychiatry, would be one obvious source of help. Yet many psychiatrists have neither the specialized training nor the interest to work specifically in sexual therapy. Their focus may be more on a hospitalized population or on long-term, psychoanalytically oriented therapy. More and more gynecologists, urologists, and family practitioners are being trained in the treatment of sexual dysfunction. These are the main specialties among physicians who would be able to provide sexual treatment.
Psychologists are trained with many different areas of specialty. There are educational psychologists, social psychologists, industrial psychologists, and clinical psychologists. Those who provide sexual therapy are usually designated as clinical or counseling psychologists. All clinical psychologists are now required to receive a minimal amount of training in human sexuality, but this does not qualify them to work as sexual therapists. Further specific training would be necessary. Psychologists normally have a Ph.D. degree.
Psychiatric social workers (M.S.W.), marriage and family counselors (M.A.), and nurse therapists (R.N. plus M.N. or M.Sc.) may also be of assistance with a sexual dilemma if their background and training meet the qualifications.
Finally, ministers (B.D., M.Div., D.Min., Th.D., or Ph.D.) may all function as pastoral counselors. Some have been trained to work with sexual problems. One sign of a competent counselor is that he or she knows his or her area of expertise and refers patients to other helpers when needed.
All of the above-mentioned helpers would be competent only if they were specifically trained and experienced in doing sexual therapy. Some will work as a team, others will function individually. Both approaches have been found to be effective.
CHOOSING A HELPER
Any time you are going to open your inner world to someone, you want to be convinced that he or she is the right person for you. You want to be confident that the helper will not lead you in a wrong direction. Make your selection by asking questions. Any helper who is threatened by your questions or unwilling to answer them should be suspect. Look for someone else.
What kind of questions can you ask? Ask what qualifies them or what qualifications they have as a sex therapist. Inquire as to their training. Was it a one-day workshop, or was it more extensive? Did they have any supervision? What approach were they trained in? Find out also what approach they are currently using. All counselors who provide sexual therapy should be able to outline in brief their own particular approach. Determine what their previous experience has been. All professionals have to get started sometime, but if they are going to start on you, you need to know that and make the choice. Most successful therapists gain experience while being tutored by an experienced and competent sexual therapist. Ask questions about their success rate. Anyone who claims phenomenal success or uses terms like “always,” “100 percent,” or “the great majority,” needs to be questioned further. There are always those situations that do not work out for many different reasons. If a therapist is unwilling to be honest with you about failure, you have reason for reservations.
In addition to asking questions about competence, it is absolutely necessary that you be personally comfortable with the helper you choose. If he or she gives you the creeps, seems disinterested or boring, or evidences any other personal trait that gets in the way, move on to someone else. You do not need to have communication problems with your therapist. A sense of ease with him or her is an absolute necessity. A good therapist will always be aware of this issue as the therapy proceeds.
Is it essential to find a Christian therapist? Obviously, if you can, find a person who is fully qualified and shares the same faith. That will facilitate communication, since you already are committed to the same faith and understand the same language. However, effectiveness is not limited to professionals who accept the Christian faith. There are many who do not impose their own value system on their patients, nor do they try to alter your thinking in any way. If you have to choose between an unqualified Christian helper and a qualified secular helper, you will probably receive the greatest benefit from the most qualified person. Merely being a believer does not qualify a person to be effective as a sexual helper.
SEXUAL THERAPY AND HOW IT WORKS
All sexual therapy, wherever it is practiced and by whomever it is practiced, is quite similar. The first task is to make a thorough assessment of your sexual dilemma. The counselor will attempt to understand your history, recommend any medical tests or examinations that seem necessary, and get a detailed and precise picture of your current sexual activity. Once the assessment has been made and all agree on the problem, goals will be defined together so that everyone is working in the same direction. As a rule, specific communication and experience assignments will be given. Limitations regarding sexual intercourse will be spelled out. The couple will be instructed to back up in the sexual relationship to a stage where both are comfortable; then the retraining begins. This is what sexual therapy is about: retraining the couple to function in a way that brings satisfaction to both partners. The emphasis will often have to be redirected away from the goal of achieving orgasm and toward the enjoyment of pleasure.
As the various experiences are undertaken, barriers may develop that block further progress. Sometimes these have to be dealt with either as a couple or individually before the sexual therapy can continue. Thus it becomes obvious that there is no one narrow routine that everyone must pursue. Following the general principles of sexual therapy, every treatment planned for each couple will have its own variations and special emphases. At all times, the couple will be encouraged to share their feelings with each other as well as with their helpers in an attempt to avoid any further sexual miscommunication. Your therapist will always want to know your opinions, your feelings, and your reactions. To hold back can only hurt your progress.
Be encouraged. Much change can take place in a relatively short period of time. Many have gained sexual fulfillment and happiness after years of frustration. You can, too!