Sex therapy is a professional and ethical treatment approach to problems of sexual function and expression. It reflects the recognition that sexuality is of legitimate concern to professionals and that it is the right of individuals to expert assistance with their sexual difficulties. Sex therapy, then, is the focusing of specialised clinical skills on helping men and women as individuals and/or as couples to deal more effectively with their sexual expression.

Sex therapy is the result of relatively recent scientific attention to human sexual function and dysfunction. Out of the increased knowledge of the physiology and psychology of human sexual behaviour has come a new professional appreciation for human sexual response. At a time in our society when sexuality is being more openly discussed, we are beginning to realise how uninformed many people really are about this important personal topic.

The importance of sexual function for individuals varies, of course, but for many it is closely tied in with their total concept of self identity. For these, problems in sexual function may lead to devaluation of self - "When I cannot feel good about my sexuality, how can I feel good about myself?"

We are also in a time when marital and family units seem to be quite vulnerable. Concepts of these traditional relationships are being re-evaluated, challenged and restructured. Alternatives to marriage are now being more openly tried and are becoming more widely accepted than at any other time in our history. Regardless of the structure of the intimate relationship shared, sexuality serves a valuable function for most couples. It becomes an expression of caring, not only for the partner, but for oneself. It can become a powerful bonding element in a relationship, which, in today's society, must withstand considerable demands on time, energy and commitment.

Dissatisfaction with the sexual relationship and the loss of that shared intimacy, in many instances, may lead to negative feelings and attitudes which are destructive to the relationship. Many marriages end therefore, because of unresolved sexual differences and difficulties.

The sex therapist works with a wide variety of problems related to sexuality. People seek help with such problems with arousal (impotence and frigidity), as well as problems with orgasm (either inability to climax or the inability to control ejaculation). In addition to seeking medical evaluation and treatment, many people who experience painful intercourse also seek the assistance of a sex therapist. Couples often seek help when it becomes apparent that differences exist in their sexual desires or when they sense that their sexual relationship is not growing, as they would wish.

The qualified sex therapist is also available to those wishing to resolve troublesome sexual inhibitions or change undesirable sexual habits. People with questions about their sexual identity or sexual preferences seek out the trained sex therapist for consultation. Parents consult the therapist about the sexual curiosity and experimentation of their children and seek insight into ways to foster the healthy development of their youngsters through effective sexual education in the home. Sex therapists also assist those experiencing sexual difficulties as a result of physical disabilities or as the consequence of illness, surgery, ageing or alcohol abuse.

Sex therapy employs many of the same basic principles as the other therapeutic modalities, but is unique in that it is an approach developed specifically for the treatment of sexual problems. That is, sex therapy is a specialised form of treatment used with one aspect of the wide range of human problems. Here lies its value and also its limitation. Sex therapy techniques, when applied by an unskilled counsellor or therapist, might focus too readily on mechanical sexual behaviour, to the exclusion of the total individual and the total relationship.

As with any therapy for personal or behavioural difficulties, sex therapy has its limitations. Although usually brief and effective with most sexual concerns, sex therapy does not offer a miracle cure for all interpersonal problems.

Success of treatment depends upon many factors, not the least of which are the nature of the problem, the motivation of the client, the therapeutic goals and the therapist's skills. The motivated prospective client and/or couple should choose a therapist carefully and establish realistic goals early in the counselling.

If you are not comfortable with your therapist or feel that the therapist has set unrealistic performance goals for you, discuss these concerns with him/her. All therapy depends upon trust and mutual respect, but this is particularly true when working with intimate issues of sexuality.

Dr Janet Hall
Accelerated Success Centre, 69 Erin Street, Richmond, Victoria 3121