Consultation or Sex Therapy?
Question: Dear Limor,
How does a couple know when they should seek a sex therapist, or whether a course is good enough? What is the difference between consultation and sex therapy?
Many different types of professionals address the issue of healthy sexuality, which can be confusing. There are three types of guidance in this field:
Instruction and guidance.
To clarify the difference between these types of intervention, let's use an example from the field of nutrition.
One day, David decided he would like to make better nutritional choices. In order to do so, he understood that he needs guidance by someone who can provide information regarding the food groups, ingredients, healthy eating habits, the digestive system, and more.
Similarly, in order to study principles for adopting a healthy sexual lifestyle, one should seek guidance in this field; this can be done through turning to a private guide or a workshop, who can provide information and guidelines for healthy sexuality. A kallah teacher or a chatan teacher are also great options who can provide information, tips, and principles.
Later in life, David occasionally began to feel unwell. He went to a doctor, who sent him for blood tests, and informed him that his cholesterol levels were high, and that he had to take steps to improve his nutrition to prevent short and long term risk.
In this case, David should seek out a professional nutritionist, who can analyze his situation and create a nutritional plan that is tailored to his needs. In this case, the nutritionist has to take responsibility for the advice provided based on David's situation; if the situation proves to be more complex than his expertise allows, he is responsible to refer David to an appropriate professional.
In the sexual realm, one who encounters problems in normal sexual functioning, lowered libido, or pain during intercourse, should seek professional counselling. Sometimes the problem may be resolved with information, but a counsellor is also equipped to analyze the specific situation and built a tailored program to cope with the specific problems encountered by the couple. A counsellor will also be aware of questions that are beyond his/her areas of expertise, and will be able to provide a referral to other professionals in the field. In the process of my training as a sexuality counsellor in Bar Ilan University, we spent a year studying phenomena that require other expertise, and where these cases should be referred. We studied the different types of medications available for sexual dysfunction and depression, which included a practicum with dozens of case studies to ensure my clients were safe both physically and mentally. Upon graduation I received a certification. Sexual counsellors should have a certificate, and you should not hesitate to ask to see it.
After seeing a nutritionist who created a meal plan tailored to David's situation, he came home to some bad news, and binged on an entire shelf of cookies. This behavior repeated itself even as he continued his counselling; after a few days of balanced eating, David would return to binging uncontrollably.
Emotional eating that is harmful to one's health, just like any other addiction, trauma, or emotional disorder, demands intervention by a licensed therapist. We live in an intense world that includes many threats to our emotional well-being, and seeking the help we need is the best way to cope.
When problems arise in the bedroom that are not resolved over time with the guidance of a counsellor, one should seek the help of a professional sex therapist.
When seeking a professional sex therapist in Israel, make sure s/he is licensed by the ISST (Israeli Society for Sex Therapy). Don't be shy about asking to see a license and get all the relevant information before seeking counsel in this sensitive area.
Tips for finding the right sex therapist for you:
Chemistry and personal connection can be more significant than expertise; one therapist can be a great choice for one couple and a terrible choice for another. Try to find out what you can about the therapist in advance; look for lectures, articles, or any other indications that this person would be the right fit for you.
Ask for certification. In my own clinic, I always introduce myself, my training, and my boundaries, and I show my certification.
Do not hesitate to change your mind and seek another professional if you feel uncomfortable.
Make sure you're seeing the expert in your specific area of need. A few months ago a woman who participated in one of my workshops booked a private meeting, and told me her spouse was addicted to pornography. I referred her to an organization whose expertise is pornography addiction, which also provides support for spouses. The woman, who had had a difficult time opening up in the first place, wanted to continue seeing me, and I had to convince her that it was best to seek out the counsel of those who were best equipped to deal with this specific issue.
Seek help. It may be difficult and confusing, you may not always know the right address, you may be frightened; but your happiness is too precious to give up on getting the help you need.
Wishing you joy and love!