How Sex Therapy Works

David Yarian, Ph.D., AASECT Certified Sex Therapist
Sandi Anders, MDiv, AASECT Certified Sexuality Counselor

Sex Therapy Includes an Educational Component

Human sexual behavior is learned behavior; it is not instinctually based, as in most animals. Our society does little to prepare us for adult sexual relationships, providing children few opportunities to gain balanced and accurate information about sexuality. Adolescents through their own ingenuity usually figure out the mechanics of sexual intercourse, but without active participation in open discussions with trusted adults it is difficult for them to develop a healthy sexual identity. This can have a profound effect on their future relationships.

Our society is sex-obsessed; we are bombarded with sexual images in the media. It is easy to think that one should be having great sex all the time. On the other hand, our society is sexually repressed. Most children are not given adequate information about healthy sexuality, but are left to figure it out on their own with the “guidance” of locker room talk, romantic novels and movies, and pornography.

There is No "Normal" in Sexual Behavior

There is enormous variability in human sexual behavior. Kinsey was astonished at the degree of variation in sexual practices he discovered in his research sixty years ago. There is no “normal” – yet in the context of widespread ignorance in sexual matters, many worry about themselves and whether their desires, urges, and behaviors are normal.

Sexual behavior is highly responsive to its context. When one feels loved, wanted and accepted it is much easier to relax and be open and sexually expressive. When one feels unwanted, criticized, disliked, frightened, unsafe, or overly vulnerable, it is not possible to respond in a relaxed and open way.

The Sex Therapist Assesses Sexual Dysfunction and Relationship Difficulties

Sex therapy looks at two primary areas to assess sexual dysfunction and intervene therapeutically. Individual issues may include performance anxiety, depression, lack of sexual knowledge, sexual fears and inhibitions, shame, guilt, and intimacy issues. Issues within a relationship which may lead to sexual dysfunction include unresolved conflicts, communication difficulties, lack of knowledge, and unwillingness to experiment with new behavior.

Sex Therapy May Be Useful with Medical Conditions

Many medical conditions may affect sexual performance. Diabetes, heart conditions, vulvar pain syndromes, interstitial cystitis, and many other illnesses may make sexual responsiveness difficult or impossible. It is always important to be examined by a physician to rule out any physical component in sexual dysfunction.

Sex therapy may be useful where medical issues are present, to help the individual or couple find alternative and satisfying ways to be sexual. Age, handicapping conditions, and physical illness do not close the door on sexuality!

Partner's Participation in Sex Therapy Is Useful

The likelihood of obtaining a successful outcome in sex therapy is increased when both partners in a relationship are willing to work together. Both individual and relationship issues may thus be addressed. It is possible to work on individual issues with sexuality when only one partner comes to therapy.

Questions About Sex Therapy

What kind of training does a sex therapist have? What types of problems can be treated by sex therapy? What happens in sex therapy? Is the sex therapist bound by a code of ethics? Read more »

The Sex Therapist

The sex therapist is knowledgeable about human sexuality, sexual anatomy and physiology, and the range of human sexual behavior. The sex therapist facilitates the client's process within the therapy session. Read more »


I welcome persons of all sexual orientations, lifestyles, and preferences to my practice.