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What it Takes to be a Good Sex Therapist: My Perspective(05/04/2004) by Miriam Biddelman, CSW I believe that a sex therapist should have every available tool and technique at his/her disposal. I trained first as a psychotherapist with the idea that understanding the individual as a whole, living within their environment, and understanding everything from the "blahs" to mood disorders, personality disorders, phobias, fears, conflicts, obsessions, underlying issues and relationship problems, was a necessity before undertaking the education and practice of sex therapy. In my opinion, you cannot do sex therapy in a vacuum without a complete understanding of the individual. I would recommend, although, at this point, it is not necessary, from a State Education point of view, that a sex therapist only become one after becoming a psychotherapist first, working in the field exclusively for at least 5 years with good supervision, and then getting the training necessary to do sex therapy. Having said that, there are a variety of approaches to sex therapy, and I try to maximize the experience as much as possible, not only going for a complete understanding of who the person is, and making a comprehensive diagnostic assessment, but also keeping in mind those items that can enhance sexual desire, arousal and the full cycle of sexual enjoyment; not only from a psychodynamic and behavioral point of view, but also being aware of, and using over- the- counter preparations and pharmaceuticals, if I feel they will be helpful. Since the practice of sex therapy and sexual function is really multifactorial, it is always helpful to be affiliated with a well known medical institution that has a team working exclusively in the area of sexual functioning, whether it is under the aegis of urology or gynecology. Depending upon the problem, and on whom the patient is, I will often speak with their physician, with the patient's permission to check out the hormonal blood profile, and any recent bloodwork that might add more information. And, in my last article, while I mentioned that there is no magic bullet in treating many of the sexual problems people suffer, there nonetheless are aids. While men are using Viagara with great success, there is an increasing underground of women who are using Viagara as they feel it is benefiting them. Women are increasingly also being introduced to DHEA, which in the body is an adrenal steroid, but as an additive capsule may enhance libido and has been said to increase ones sense of well being. DHEA can be bought at any health food store, but given differing strengths and some health food store differing ingredients, I like to use the Women's International Pharmacy, where all, (even over the counter drugs) are standardized. Often, physicians will use varying strengths of DHEA and some will use testosterone to enhance both male and female libido. Clinically, in my practice, despite the various administrations of testosterone, creams, patches, pills and combinations with estrogen, I have seen limited success with testosterone in women, nonetheless there are ongoing clinical trials, looking at effectiveness and dosages. But a physician needs to make the determination of the selected drug, deciding on dosage and method of delivery, hopefully with input from the therapist. I have recently come across a lubricant/stimulant for female sexual arousal enhancement called Prosensual, which can be bought over the Internet under http://www.Prosensual.com. This is not a pharmaceutical, it is a natural lubricant that one would use, but unlike a lubricant to enhance wetness or easibility of intercourse, this lubricant gives a woman a tingly, warm feeling in her vulva that is arousing and enhances sexual pleasure. I have tried it, and I like it. I would suggest going to the website. In my practice I also suggest videos, books, breathing techniques, meditation, sensate focusing, and sometimes I will actually take a patient on a field trip to one of the local sex "toy stores" to look at toys, such as mini or maxi vibrators, books on varying subjects, such as tantric sex; we examine different kinds of dildos, beads, and even remote control vibrating panties, which I think are a wonderful prelude to an evening of romance and sex. Most toy stores are online. Toys in Babeland, Good Vibrations, Eve's Garden, and Dr. Ducky. Toys can be purchased over the Internet, and if patients are embarrassed, or their is not a toystore near you, the Internet is perfect, and less embarrassing if your patient is skittish. In conclusion, a good sex therapist has: an underlying degree in psychology or other counseling or social work field; has worked under the supervision of another practiced sex therapist for several years; uses a comprehensive biopsychosocial approach; continues their education so that they are apprised of cutting edge information and products that are in the marketplace, both over the counter, on the Internet, or by prescription that may be valuable adjuncts to the specific talk therapy; and has the ability to talk to the physician who is treating the patient, either getting test results, or suggesting that certain hormone and or metabolism tests be ordered. I am always available for any queries from patients or professionals. Submitted by Miriam Biddelman, CSW This article appears in the following topics: |
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