Lauren Jordan, LCSW, CST is Licensed Clinical Social Worker, and a Certified Sex Therapist (through AASECT). She has been providing therapy for individuals, couples, families and groups since 1986 in her Dallas, Texas private practice. Her website is www.BoostYourLowLibido.com. She can be emailed at lauren@BoostYourLowLibido.com, or contacted at the phone number below.
Lauren Jordan, LCSW, CST7557 Rambler Road, Suite 612 Dallas, TX 75231 214-692-6100
1. Explain why a woman or a couple would see a sex therapist instead of a regular marital therapist?
I wrote a blog called “I wish we had seen a Sex Therapist” earlier this year because I was hearing from many clients who expressed frustration that they had chosen to see a general Marriage and Family Therapist (MFT) when they had a sexual concern like low libido, difficulty with arousal and orgasm, erectile dysfunction or early ejaculation.
They told me that they felt that they had wasted time, energy and money seeing therapists who seemed embarrassed even broaching sexual subjects. It is so difficult for anyone to go to therapy for a sexual issue, but if you get there and your therapist is literally blushing when you mention his erection problems, or your difficulty achieving orgasm, you will likely feel worse than you did originally! And that is precisely what these couples told me – they felt like they had already DONE a lot of therapy, and they were feeling cynical and even hopeless about tackling their problem. With education, this doesn’t have to happen to even one more couple!
Another problem with working with a MFT is that they have not had specialized training about sexual functioning, and sex therapy techniques. This means that even if they are comfortable dealing with the subject matter, they usually focus on resolving OTHER issues that may be contributing to your sexual problems, thinking that if these issues, such as communication problems, a lack of time together and connection, or conflict resolution skills are added, the sexual problems will JUST GO AWAY. What Sex Therapists know is that the data does not prove this to be true.
Yes, Sex Therapists do address other issues that may contribute to a woman’s low desire, or a man’s early ejaculation – but we know this is not enough without specific sex therapy techniques such as talking in very detailed ways about what happens in the bedroom, and in both partners’ minds and bodies; and then using carefully crafted exercises and interventions to remedy them.
Most of these clients told me that they had done so because the MFT was a provider on their insurance panel, so they had considerably less out of pocket expense. Most Certified Sex Therapists (CST) do not take insurance directly, because we are specialists in high demand – there are only a handful in the Dallas-Ft. Worth metroplex. Ironically, a decision that was made to save money, ended up not only not doing so, but had an emotional and relational cost that was incredibly higher.
If you have a sexual problem, see a specialist – a Certified Sex Therapist. Seeing a Marriage and Family Therapist is like going to your Family Practice Physician when you have heart disease and need a Cardiologist.
2. We sometimes advise couples to seek help from a sex therapist, but find they are very apprehensive about going. Can you explain what a couple can expect on their first visit to see you?
So many women have told me that their physician gave them my card a year ago – and have had a tremendous struggle with actually making that first call. It takes a lot of courage to call a Sex Therapist! One reason for this is that people are not sure exactly what Sex Therapists do and do not do – and some think a CST is actually a Sex Surrogate, who has sex with her clients to help them resolve their sexual problems. Certified Sex Therapists do not have sex with clients – ever! It is highly unethical, just as it is with a Marriage and Family Therapist. We do not have you do sexual activities in our offices, whether you are there individually or with your partner.
Sex Therapy is a focused type of talk therapy. We talk about your concerns. In the first sessions, we do just that, in order to get a full idea of what your current life is like, and what you would like it to be like. I do give a lot of homework assignments, which may be writing assignments, or non-sexual touching assignments, and usually progress to more sexual kinds of touching assignments – all of which you do in the comfort and privacy of your own home. There is not one prescription of exercises, as they are designed specifically for you and your partner to help you overcome the challenges that you have.
Another reason that people may carry my card around for a year before contacting me is that our society is profoundly sex-negative. Yes, on the one hand we are inundated with sex on tv, advertising, etc. But unfortunately, most of us, especially women, were never given gentle guidance and information about our bodies (beyond menstruation and reproduction) sexual functioning. The silence can be deafening – we are left to think that if no one talks about it, it must be very bad! This is how sexual shame, which I discuss a lot of my site, and with my clients, is born. It doesn’t come out of nothing.
If you have shame about sex – it will be very vulnerable and embarrassing to call a Sex Therapist for help with a sexual issue. First, you will be breaking the code of silence, about not talking about sex, and second, you may feel that you should never HAVE a sexual problem! That is a double-whammy! People do have sexual problems – just like they have relationship problems, financial problems, parenting challenges, work & career problems, and on and on. Thinking that you are the only one, and that you shouldn’t have any issues with sex, just makes it harder to take steps to resolve the problem.
So your first visit to a Sex Therapist would include filling out paperwork, then discussing your concerns, and then leaving with some homework to do on your own, and bring back to the next session. That’s it. You should feel respected, understood, and that your therapist seems to be someone who can help you. If you don’t, you might consult another Sex Therapist, as it is always important to feel there is some “fit” with your therapist.
3. Can you give examples of homework exercises that you might give a couple?
Some of the written exercises ask couples to think about how they learned about sex, and what they learned about it, to help them understand how it affects them today. I also use questionnaires which help determine what factors (there are many) are getting in their way of desiring or enjoying sex.
A common touching exercise would be to take an hour and take turns being the giver and receiver of touch, without any touching of the genitals, buttocks or breasts. The couple is also told NOT to have any type of sex during or after the exercise. Often couples have either gotten into ruts with their sexual routines, or have so little time that they rush through foreplay, and don’t take the necessary time to get fully aroused. An exercise like this can help couples reconnect with touch, explore what types of touch they like to give and receive in an atmosphere free of pressure to perform.
4. Does it always work best for both spouses to come together, or is there ever a time where it is best to just work one on one with the wife or the husband?
I have certainly worked individually with people on sexual issues, and it can work to do so. In general, it helps to see the couple together to get both partners’ perspectives. It depends upon what their concerns are as far as whether it would be an option for them. Of course, some partners may never be willing to come in, so individual or group work is the only option.
5. We know you aren’t a “Christian” therapist, but do you have any experience seeing women who are struggling with feelings of shame and/or guilt in their marriage because of strict teachings from their parents growing up, or from the church?
A huge part of the work I do with both men and women involves addressing sexual shame and guilt generated from sex-negative teachings from parents, schools, and religious institutions. Some of the messages were direct, such as “all boys want is to get into your pants” and some were indirect as in never talking about sex in the family at all. Silence can be a profound message: this subject is so bad that we will not utter its name in our house.
I find that doing the women’s workshops and groups are a great way to reduce shame and guilt. Women tell me that they felt liberated to be in an environment where it could be talked about openly with other women who have struggled as they have. The “I’m not alone!” feeling is very healing.
6. Can you share your opinion on what role masturbation could play in marriage?
I know that a lot of folks think that masturbation is wrong. While I do not share that view, and will respect a client’s decision about whether to include self-stimulation in his or her program to resolve sexual problems, I do think it can have a positive role in a marriage.
First, masturbation is a wonderful training ground for learning your own body’s sexual arousal and response. Learning alone can take the pressure off because you aren’t worried that your partner will get tired, bored or frustrated, or take it personally if you don’t have an orgasm. For this reason, I will broach the possibility of using masturbation as a step in the process of couples therapy. Some women (I say women because men usually begin masturbating in adolescence, and it is the rare man who has never masturbated) can allow themselves to use masturbation in this limited way, knowing that the purpose is moving them towards a fulfilling sex life with their husbands. Some are never going to feel this is ok, and there are other ways of working on this. I would never insist that anyone try masturbating if they do not feel right about it.
For women who have low libidos, masturbating can actually help to increase their libidos, which is the opposite of what one might think. Women tell me, “with so little desire, I should direct what I have towards my husband!” Self-stimulation can help a woman learn what she wants from her partner, and can make sex more satisfying, so that she wants it more frequently. It also helps her to acknowledge the sexual part of herself.
Masturbation can also provide some satisfaction when your partner is ill, traveling, or just has a lower level of desire than you do. It doesn’t have to take away from the relationship – though it can if it is done excessively.
7. What therapy options are available for men and women? Do you have group therapy and individual options?
Besides doing the individual and couples sessions, I offer Women’s Groups and Workshops such as “When there’s no sex in your city: a workshop for women on sex, intimacy and desire” and “Orgasm 101”. I have done workshops live in my conference room (up to 30 people), and by phone conferencing so that women can call in from wherever they are. Discovering Your Sexual Self small groups for women meet in my office and are for 4-8 women, usually for a series of meetings over several months. All of these combine sex education, discussion and homework exercises to keep you moving towards your goals.
I also have an eBook called “No Room For Sex: How To Boost Your Low Libido” which is available only through my website at http://www.BoostYourLowLibido.com.
You can buy the book alone, or the book and two personal email consultations.
I have had women come in from other states to attend a workshop, and I am likely to begin traveling to other locations to do my workshops. So there are a number of options.
Specific sexual issues:
8. What are the top issues that you see most prevalent in your clients?
The most common complaint for women is Low Libido, and for men, it is Early Ejaculation and Erectile Dysfunction. I also see a lot of women who have never had an orgasm.
9. What are the biggest factors in low libido?
The biggest reasons for low libido in my opinion are: sexual shame and guilt, relationship issues such as general disconnection, fears of intimacy, or buried resentments; unrealistic expectations about sex and romance, negative body image, sexual trauma, and fatigue from being over-committed with responsibilities.
10. There are so many women who struggle with achieving consistent orgasms or orgasms at all. What medical conditions can effect a woman’s orgasmic function? For women for whom it is psychological, what do you suggest women do to overcome this mental block?
Medications such as SSRI anti-depressants (prozac, lexapro, Zoloft, paxil) can both decrease libido and make it more difficult or impossible to have an orgasm. Anti-seizure medications can also interfere with orgasmic ability, as can neurological disorders. Almost all of the factors that can interfere with desire can also limit or interfere with orgasmic potential. It is a huge list of factors – see my eBook for a complete description. The treatment is to determine which factors are getting in your way and work to resolve them.
11. We hear frequently from couples who are dealing with pornography, and its devastating effects on their marriage. Do you have experience counseling couples in this area? In your experience, is pornography addiction directly related to any sexual issues and dysfunctions?
I have seen a growing amount of pornography addiction in recent years. It can be devastating to a couple – as devastating as an actual affair. An addiction can be born out of the sexless marriage – especially if the low libido partner has refused to listen to the other partner’s needs and wishes, or is unwilling to do anything about it. I’m not saying this is right, just that it happens. A male who has a fear of intimacy, negative body image, buried resentments towards his wife, feels sexually inadequate,and/or performance anxiety may retreat into porn as an emotionally safer substitute.
12. Although our blog is targeted at married women, we have many male readers. Do you find that men are more reluctant to come in for therapy? Do you have any specific areas that you specialize in for men?
I think it is difficult, anxiety-provoking and embarrassing for men and women to enter sex therapy. Men can seem to have more motivation to break through this because of their generally higher sex drives. When the issue is her low libido, most men are willing to come in for couples sessions – possibly because they see the problem as hers, rather than his or theirs, and may feel less embarrassed. However, there is almost always a relational contribution to a partner’s low libido.
I work with men on sexual problems such as Early Ejaculation, Erectile Dysfunction, Low Libido, Lack of Orgasm, Sex Addiction or concern about a particular fantasy or Fetish. I think men have the additional barrier of thinking that seeking help is not “manly” and I am sure there are many men out there who would never consider sex therapy even if their problem is ruining their relationship. After the first session, often both men and women tell me that they feel a huge sense of relief after having the chance to talk openly about their concerns without being judged in a negative way. They say they feel hopeful about being able to solve their problem now.
We are so thankful for Lauren Jordan’s willingness to give us her professional perspective on these questions. They will certainly be a valuable resource for our readers and I am particularly hopeful that much of the mystery behind sex therapy has been removed.
original articles in this two part series are here and here