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Why You Shouldn't Fear Going to a Sex Therapist

A gynecologist talks with a sex therapist about how to reignite the spark

By Barb DePree, M.D.

The idea of going to a sex therapist may be so scary that you wouldn’t even consider it. You’re probably not alone. That’s why Next Avenue decided to talk with Sarah Young, a sexual therapy specialist with a Christian-based practice in Zeeland, Mich.

Young’s philosophy is that sex is not just sacred, it’s meant to be enjoyed. “It’s still such a taboo issue,” she says. Her goal is to help people find a “voice” for their sex lives, to talk about it and explore it freely without shame or guilt. Highlights from our conversation:

Next Avenue: What’s the biggest 'fear factor' or misconception people have about sex therapy?

Sarah Young: Sex is such a personal, intimate thing. People are afraid they’re going to have to get naked and perform: 'Oh, my gosh, am I going to have to take my clothes off and show her what we do?' That’s not how it works at all.

Let’s talk about how it does work: How do you get started?

A lot of my referrals come from doctors working with women, so I’ll usually start with her. We’ll just have a conversation at first. Patients often ask how I got into sex therapy, and that gives me the opportunity to establish my professionalism, my ethics and how I feel about the sacredness of sex, which always makes them feel more comfortable.

Then we’ll begin by talking about the bigger picture, her world as a whole: What are her other life stressors? I need to get an idea of everything that’s going on in her life, the larger dynamic, because it’s all entwined in the bigger circle. It’s not a simple matter of just getting immediate details.

Facing failure goes against what Hollywood says your sex life should be; it’s very threatening for people. So I try to validate her in that first session — here’s where you are and this is fine — and to offer her hope.

Then in the second session, I’ll usually engage in a pretty in-depth sexual history just to find out where she’s coming from. What are her thoughts about sex, how has her body image been formed and what other experiences are part of her reality? Some of the questions are very difficult for people, like whether she is masturbating, and if so, how often.

Once we uncover all the issues, we’ll talk about a game plan. At that point, I usually give it three weeks to a month between sessions, so she can just go through a cycle of life. Because you need to give this time; one week you might have a hormone issue, the next week, everything is OK. You need that whole cycle to give it a framework.

What kinds of issues do you typically deal with in older women?

One big thing, of course, is menopause and all the changes that come with it. Women sometimes feel defective when they’re going through it, which is understandable. Often it’s a matter of shifting their perspective to just normalizing it; it is what it is, you need to take it one chunk at a time.

Other issues might be aging in general, or a partner’s infidelity, or the reality of cancer and mastectomies: How am I still supposed to feel sexy when my breasts are gone?

And the empty nesters: The kids have gone off and Mom and Dad haven’t paid attention to each other for years. Now all of a sudden, she’s thinking, I don’t even know how to be his friend, let alone his lover.


So a lot of it is empowering people to reignite the passion and the friendship they once had; they’re in a place when they can engage in a more mature perspective.

Once a person starts therapy, how long might it last?

It really depends. I have couples I’ll see every few weeks for three months and they’ll check in after that every few months to update, or if they’ve hit a glitch or want to talk through it. Every case is different.

At what point does the woman’s partner usually get involved?

Typically, I work with a woman for about a month before bringing in her partner. At that point, I try to get a feel for where he’s coming from, whether he wants to meet individually. If he does, we might move ahead where every other session is with the couple – so it’s couple, individual, couple, individual, through the duration of the therapy.

Can you give an example of a successful case involving a husband and wife?

There was a woman who came to see me because she wasn’t enjoying sex; for her entire married life it had been, “Okay, let’s just get this over with...” Come to find out, when she was a little girl, she was experimenting with masturbation, as kids often do. Her mother, who was very uptight about sex, discovered her and flipped out, making her filled with shame and guilt over it.

First we had to deal with her wounds, dissolving some of the lies she believed and getting her to see her sexuality from an adult perspective, rather than through the eyes of a seven-year-old.

We talked about how a person’s sexuality is not just limited to the bedroom; it’s part of who you are every day. I gave her some exercises to increase her confidence. For instance, a lot of women will look in the mirror and just see sagging breasts and cellulite. But I had her stand in front of the mirror and take joy in her hands, the hands that had held her children and made food for her family. And instead of keeping her sex drive on a low boil, I told her to go get some red underwear to remind herself that she’s a beautiful, sexual woman who has a right to enjoy and to be enjoyed by her husband.

Over a period of time, she began to gain confidence, becoming more mentally present with him in the bedroom. And it just kind of took off from there. She’s still working on not feeling uptight, but she’s doing really great.

Barb DePree, M.D. Dr. Barb DePree is a gynecologist who has been providing health care to women for more than 25 years, and has devoted her practice to midlife women since 2006. She is the founder of Read More
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