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Here’s What Really Happens In Sex Therapy

Here’s What Really Happens In Sex Therapy

Because things aren’t always what they seem.

When Desiree Spierings tells people what she does for a living, she tends to be met with raised eyebrows.

Rather that strolling down a conventional career path, Spierings chose to dedicate her considerable intellect and communication skills to something far less mainstream. Sex therapy. A job involving psychology, emotional counselling, and contrary to popular belief, no physical contact.

“Nothing physical is done in the session itself,” Spierings insists.

“The only physical elements of therapy are the specific homework tasks related to addressing the physical components. These homework tasks could address different things, such as sensual or sexual exercises, working on deepening the emotional connection, and of course working on communication between couples.”

As a sexual therapist and relationship counsellor, Spierings is no stranger to the anxiety faced by couples when it comes to a decline in bedroom activity, and seeks to demystify intimidating notions of sex therapy.

When I ask Spierings what drove her to pick a career many would consider beyond the norm, it’s obvious she’s at ease discussing sex.

“I am originally from The Netherlands, and when I arrived here more than 16 years ago I noticed a big cultural difference in terms of openness about sexuality. In Holland it is less of a taboo or private topic, and is talked about more openly. This cultural difference sparked my interest in this area. I have never regretted it, and truly love what I do.”

Undeniably, there is a serious market for sex therapy. It’s perfectly normal for relationships to go through periods of time where sex is not on the proverbial cards. Whether it’s a result of working long hours, ill-health, hormonal imbalance, or just not being in the mood, instinctively boycotting the sexy times you had in the honeymoon stages can be frustrating, embarrassing, and put a definite strain on the relationship.

However, there is a certain stigma about those who seek sexual therapy. Society places so much emphasis on self-worth as defined by sexual prowess, it’s all too easy to think you’ve ‘failed’ in your coupling. Spierings is fully aware of the insecurities admitting you have a problem can breed.

“It is very brave for people to seek help, and it is not uncommon for someone to find it very daunting to go and see a sex therapist, since it is such a private issue. People do not tend to talk about sex with their friends, and if they do, it is often only bragging. What cool or good stuff happened during sex, not how we couldn’t perform, or what difficulties we’re having.”

It’s this discomfort around talking about sex Spierings seeks to remedy in her sessions, along with stressing the importance of addressing sexual issues on an emotional level in order to find gratification on a physical one.


“It is very common they have had their problems for years; not feeling confident enough to seek help, until it really starts to negatively impact their lives, and gets so bad they have to do something about it.”

But what actually happens in a session? According to Spierings, the initial appointment is really an assessment process, in which she tries to figure out what the issues are and where they’re coming from. She also ascertains what kind of people her clients are, and will ask a little bit about the history of a relationship to do so. Once all this is established, she can get along with what the couple has come for; healing.

Of course, the road to healing is fraught with emotional obstacles. As sex is such a personal topic, Spierings says it’s very common for crying, screaming, anger, fear, and every other reaction a person may need to move through. Fortunately, years of experience have given her a strategy to navigate a particularly emotionally charged session.

Ever calm, Spierings looks at the situation rationally.

“I take this in as part of understanding the couple, and look at their communication styles. It proves if it gets this bad in front of me, imagine when I am not there. I try to stop or contain this quite early on, because if one or both partners start flooding, that is, when the heart rate goes over 100 beats per minute, it is hard to tap back into the rational mind. This has a negative effect on the sessions afterwards.”

Spierings’ philosophy when it comes to anger or frustration between couples is simple; anger is a secondary emotion. There is a primary emotion behind it, such as pain, hurt, and sadness. Once she has reminded them of this, she encourages her clients to express this ‘softer’ emotion instead.

“I explain they can do all this fighting at home, and then maybe try new ways of communicating in my sessions. When they express themselves in a softer manner, it is much more likely their partner understands and hears them more clearly.”

Once Spierings has re-established communication between couples, she says the difference between the first and last sessions can be profound. If a couple is willing to do the work, and to open their minds and hearts to each other once again, progress can be made.

“When I see a couple who initially don’t even talk to each other, and are completely closed off, we will work on lowering the barrier and getting them to let each other in again. And often at the end of our sessions they are holding hands, laughing and feeling connected,” she says.

However, this is not always the case. Regardless of whether they do the work, and of Spierings’ expertise, some couples decide they are not a good fit for each other. But Spierings is quick to assert that this doesn’t mean the therapy was moot.

“At least they feel they can tell themselves ‘I have tried everything I could to make this work’.”

After spending some time with Spierings, it’s hard not to see she’s a woman who’s extremely passionate about what she does and the antithesis of the commonly held stereotype of a sex therapist.

Sexual therapy is certainly not the daunting, degrading process many people are led to believe it is. Like any other form of counselling, it is a psychological analysis followed by a tailor-made solution. In no way is therapy a one-size-fits-all process.

“It is about understanding their whole story, the broader picture, in order to start helping them and understanding what factors play a role,” says Spierings.

This philosophy, coupled with a healthy serving of empathy and a side of patience, is what makes sexual therapy such a poignant exercise for couples who are struggling with intimacy issues. The hardest part is simply deciding to seek it, but once you’ve made that decision, there’s no looking back.

Comment: Have you ever tried sex therapy?


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