Understanding the Difference Between Sex Therapy and Psychosexual Therapy

Sexuality is an integral part of human identity, influencing relationships and personal well-being. For those who struggle with sexual issues, seeking help can be a significant step towards recovery and fulfillment. Two forms of therapy often discussed in this context are sex therapy and psychosexual therapy. While they may seem similar, there are distinct differences between them. This post aims to clarify these differences, explore how psychosexual therapy can aid survivors of sexual assault, and highlight key theories underpinning these therapeutic approaches.

What is Sex Therapy?

Early sex therapy approaches focused on active, symptom-based interventions to address sexual dysfunction (Kaplan, 1974). Sex therapy is a specialized form of psychotherapy that addresses sexual difficulties, concerns, and dysfunctions. This therapeutic practice focuses mainly on the psychological aspects of sexuality and sexual relationships. Therapists often help individuals and couples manage various issues such as:

• Low libido

• Erectile dysfunction

• Premature ejaculation

• Sexual aversion

• Difficulty with arousal

  
  

The goal of sex therapy is to educate and empower clients to engage in healthy sexual behaviors. Techniques may include communication exercises, sensate focus, and cognitive-behavioral strategies. By fostering understanding and promoting open dialog about sexual issues, clients can gradually overcome their challenges.

A cozy therapy room designed for open discussions

What is Psychosexual Therapy?

As outlined by Harrisson-Lee (2021), sex therapy often focuses on sexual difficulties within current relationships, while psychosexual therapy explores how past trauma, emotional pain, or bodily responses can disrupt sexual intimacy.

Psychosexual therapy, on the other hand, goes deeper into the psychological aspects of sexual functioning. It often combines traditional psychotherapy with sex therapy principles. This type of therapy not only addresses sexual dysfunctions but also explores emotional and psychological issues related to a person’s sexuality. Sexual desire is not always spontaneous and may emerge from safety, emotional connection, and context rather than physical arousal alone (Basson, 2000). Psychosexual therapy may involve examining:

• Past trauma

• Guilt or shame associated with sexuality

• Relationship dynamics

• Identification of unhealthy patterns stemming from earlier experiences

  
  

Therapists may utilize various modalities within psychosexual therapy, including psychodynamic therapy and relational approaches. The goal is to help clients develop a comprehensive understanding of their sexual identity and how past experiences influence their present sexual relationships.

A library shelf filled with books on psychology and sexuality

How Psychosexual Therapy Can Help Survivors of Sexual Assault

Psychosexual therapy is especially crucial for survivors of sexual assault. The trauma from such experiences can have profound and long-lasting effects on an individual's sexual health and emotional well-being. Survivors may encounter a myriad of challenges, including:

• Avoidance of sexual intimacy

• Difficulty in trusting partners

• Flashbacks or intrusive thoughts during intimacy

• Feelings of worthlessness or shame

  
  

Through psychosexual therapy, survivors can explore these issues in a safe environment. Therapists trained in psychosexual approaches can guide clients through the emotional lethargy and develop coping strategies. This therapy can help individuals reclaim their sexual identity and empower them to engage in healthy relationships.

Theoretical Frameworks Supporting Psychosexual Therapy

Several theories underpin psychosexual therapy, providing a robust framework for practitioners and clients alike:

1. Freudian Theory: Sigmund Freud's theories on psychosexual development remain influential. According to Freud, unresolved conflicts during developmental stages can manifest as sexual dysfunction in adulthood. Understanding these conflicts can help individuals work through their issues.

   
   

2. Attachment Theory: Developed by John Bowlby, attachment theory posits that early relationships significantly affect adult relationships, including sexual intimacy. By examining attachment styles, therapists can help clients understand their relational patterns and how these impact their sexual lives.

   
   

3. Cognitive Behavioral Therapy (CBT): CBT techniques can be valuable in treating both sexual dysfunction and the emotional aftermath of sexual trauma. By addressing negative thought patterns, clients can improve their emotional responses and behaviors related to sexuality.

   
   

Challenges in Seeking Help

Despite the benefits of sex therapy and psychosexual therapy, many people hesitate to seek help. Barriers may include cultural stigma, misconceptions about therapy, and personal embarrassment. However, understanding the differences between these therapies can encourage individuals to explore their options.

For those considering therapy, the following steps may help ease the process:

• Educate Yourself: Understanding what to expect can alleviate anxiety. Research both modalities and their approaches.

• Seek Recommendations: Ask trusted professionals or friends for referrals to reputable therapists.

• Trust Your Therapist: Establishing a good rapport with a therapist is crucial. Don’t hesitate to switch practitioners if you feel uncomfortable.

• Be Open to Progress: Therapy can take time, and progress may not always be linear. Be patient with yourself.

  
  

A tranquil garden scene conducive for therapy reflections

Final Thoughts on Choosing the Right Therapy

While both sex therapy and psychosexual therapy address sexual issues, they do so from different perspectives. Sex therapy focuses on improving sexual function and enhancing relationships, while psychosexual therapy delves deeper into emotional and psychological barriers surrounding sexuality. Understanding these differences can empower individuals to choose the therapy that best fits their needs and circumstances.

For survivors of sexual assault, psychosexual therapy may provide a path towards healing and resilience. By addressing past traumas and emotional challenges, this form of therapy helps individuals reclaim their sexual health.

By fostering open conversations about sexuality and mental well-being, we can help break down the barriers that prevent individuals from seeking the help they deserve. Remember, seeking therapy is a sign of strength and a vital step toward a fulfilling life.

Whether you are a survivor or someone grappling with sexual challenges, don't hesitate to reach out for support. You are not alone, and there are professionals ready to help.

References: For more info

Harrisson-Lee, M. (2021). Understanding the basics of psychosexual therapy [Lecture]. Counsellor CPD, Counselling Tutor.

Basson, R. (2000). The female sexual response: A different model. Journal of Sex & Marital Therapy, 26(1), 51–65.

Kaplan, H. S. (1974). The new sex therapy: Active treatment of sexual dysfunctions. Brunner/Mazel.

Other leading researchers & commentators

Trauma, the body & sexual impact

• Rothschild, B. (2000) – The Body Remembers - Trauma responses during intimacy are often physiological rather than cognitive (Rothschild, 2000).

• van der Kolk, B. (2014) – The Body Keeps the Score→ Useful for linking trauma, memory, and sexual functioning

  
  

Attachment & intimacy

• Bowlby, J. (1988) – A Secure Base→ Attachment patterns influencing adult intimacy

• Johnson, S. (2008) – Hold Me Tight→ Widely used in UK/NZ practice; excellent for couples and sexual connection

Psychodynamic & psychosexual foundations

• McDougall, J. (1989) – Theatres of the Body→ Psychodynamic understanding of sexuality and symptom expression

• Mitchell, S. A. (1988) – Relational Concepts in Psychoanalysis→ Supports relational/psychosexual therapy framing