What It’s Really Like To Be A Sex Therapist
Redbook magazine recently reached out and asked if they could interview me about what it’s really like to be a sex therapist. I’m used to getting lots of questions about what my job is like, and I always jump at the opportunity to clear up some of the misconceptions about sex therapy. So I did an hour-long interview with one of their staff writers, and they turned it into this fun feature!
One of my favorite parts of the interview was talking about the misconceptions people have about my sex life. I wish they had included more of what I had said in the final piece. I’ve recently started sharing more about my personal life with members of my email list (are you a part of it yet?) because I think it’s so important to have these honest conversations.
Most people think that I’ve got it “all figured out” when it comes to sex. The truth is that I struggle with many of the same issues you do. I grew up developing the same insecurities and hang-ups around sex. I have parts of my body that make me feel self-conscious.I’ve felt embarrassed about trying out a new technique. I’ve felt shy asking for something I wanted.
I’ve also been with my husband for 10 years, so I know all about the challenges of keeping the spark alive in a long-term relationship. I know what it’s like when you’re both stressed, exhausted, and disconnected. I know what it’s like when one partner wants to be intimate and the other is completely not in the mood.
The only difference between me and you is that I have more tools in my toolkit. I’ve use myself and my relationship as my guinea pigs for all of the exercises I’ve developed for my clients over the years. I’ve figured out what works for me, and my husband and I have figured out what works for our relationship. I still feel all of those insecurities, frustrations, and fears, but I know what to do with them when I do.
It’s so important to me to normalize the fact that we all struggle with sexuality in one way or another. If I can help you feel less embarrassed or ashamed about your own struggles, it will help you feel more comfortable taking steps to learn those same tools.
So, without further ado, if you’ve ever been curious about how I even thought to be a sex therapist in the first place, how my family reacted, or what this job is really like behind the scenes, read on!
I grew up in an amazing, loving, open family where we talked about a lot of things — everything except for sex. At a young age, I remember thinking, I want to talk about sex, what’s this all about? But without my parents saying anything, I could tell I wasn’t supposed to ask questions. The one time my mom and I had “the talk” when I was 11 or 12, she told me that if I had questions I could ask, but the underlying message was: “I’m asking if you have any questions — but I’d really rather not talk about this.”
I grew up in an amazing, loving, open family where we talked about a lot of things — everything except for sex. At a young age, I remember thinking, I want to talk about sex, what’s this all about? But without my parents saying anything, I could tell I wasn’t supposed to ask questions. The one time my mom and I had “the talk” when I was 11 or 12, she told me that if I had questions I could ask, but the underlying message was: “I’m asking if you have any questions — but I’d really rather not talk about this.”
I always wondered, Why is sex so embarrassing? What’s wrong about this? Does it have to be this way? These were questions I had before knowing what therapy was and how it could turn into a career. When I was thinking about the future, I bounced between approaching sex medically versus psychologically. Anyone can call themselves a sex therapist — it’s not like a psychotherapist — and there’s no governing board, no standard. I really struggled with figuring out what training I’d need and what the best way to follow that path would be.
I decided I needed a foundation in therapy and Brown University was one of four schools in the country that had an undergraduate program in sexuality. I was the only person who graduated that year with a degree in sexuality, which included an interdisciplinary education in sexual therapy history, research, English, psychology, sociology. After that, I attended graduate school at the California Institute of Integral Studies, where I focused on counseling. I started seeing clients in San Francisco, but now spend my time between California and Germany.
When my family found out I was going to become a sex therapist, they were really accepting of it and it ended up opening up amazing conversations among us. I wrote a sex column at Brown and my mom would get all the issues and it would lead to conversations — some that I didn’t want to have! It even led to more open conversations with extended family like my very Catholic conservative grandmother.
I see clients one on one, and made the switch a few years ago to also counseling people on video chat because it’s more convenient and I can work with people who don’t live near me. In addition to offering sex counseling, I also offer five programs. My Finishing School Orgasm program is for women who have never experienced an orgasm. I walk them through having their first orgasms alone. I have a second version of Finishing School for women who can orgasm on their own but who can’t replicate it with their partner. My third program is for men and addresses performance pressure, early ejaculation, delayed ejaculation, and increasing their sexual confidence. The fourth is a program designed for women who are survivors of sexual abuse — it helps teach them how to repair their sex life in a way where they feel safe and can experience pleasure. And the fifth program is called Pleasure Principles — it’s not specifically focused on sex but helps women who are nervous about accepting pleasure (it’s especially good for Type A women).
There are definitely still misconceptions about what I do and about sex therapy. People assume I have everything figured out as a sex therapist — that I have a great, really fun sex life with my partner. I do have a fun sex life, but I’m not a “sex master.” There are always ways to learn and improve. Another big misconception some people have: that there’s sexual contact between a sex therapist and client. There’s no touching — there’s only talking and therapy. People tend to sensationalize this job a little bit. They think sex therapy involves people with uncommon fetishes (not that there’s anything wrong with fetishes!). But it’s actually more everyday people with run-of-the-mill issues, like how lot of men and women think that they’re just supposed to feel the desire for sex spontaneously. That might be true in the honeymoon stage of a relationship, or when we’re teenagers. But for most of us, we have to make an active effort to cultivate desire. Maintaining your sex drive actually requires a lot of effort! When I’m working with a client, I start with that education, so they understand what’s required of them. Then we start working on tangible ways for them to make that effort. I’m big on giving my clients concrete, realistic suggestions, so I’ll give them specific exercises to try out. As the work progresses, we figure out what’s working and what’s not, and refine the exercises even more. That feeds into another common issue — mismatched sex drives. In any relationship, there’s always one partner that wants sex more.
But the challenges I encounter the most as a sex therapist are women trying to learn how to orgasm as well as men and women who have lost touch with their sex drives and who have lost that connection with their partners. I’ve been married to my supportive partner for five years and we’ve been together for 10 years so I know about some of these problems. I think it’s really important to keep talking about sex, even if things aren’t going well. Relationships go through ebbs and flows and it’s vital to acknowledge what’s going on, check in with each other, think about what you can do to feel connected, and make an effort to make it happen. I think one of the biggest myths is that good sex is just supposed to happen. You think something is wrong in a relationship if sex just isn’t going well. But it takes an active, ongoing effort to make sex happen — and that might mean taking steps to feel sexy, making sure you have a date night, and being thoughtful with your schedule.
Living in Germany part of the time, I’ve discovered that Germans are more open and frank about sexuality. There’s a magazine here that’s their equivalent of Teen Vogue, it has a sex section that includes some of the best, most straightforward, and most educated sex questions I’ve ever read. They even have a photo in each issue of a fully naked man and a woman where body parts are correctly diagrammed. German people aren’t ashamed of their bodies in the same way I think some Americans are — sex is in our face everywhere in the U.S., but there aren’t open, honest, educated conversations about it. Pretty much all of my clients have a moment where they’re like, “Oh my God, that’s normal? I had no idea!” and it’s usually followed by tears. We have the tendency to feel abnormal, broken, like there’s something that needs to be fixed. That’s why I think it’s important to offer sex education in schools and at all ages, to see more body diversity in media — and most importantly, to keep having conversations about sex.