A number of clients have shared with me their reactions to their initial sex therapy visit. I thought it might be instructive to those of you considering therapy to hear what they had to say.

A man in his mid fifties told me that the pre-session homework I ask of everyone had been enormously helpful. This involves answering two simple questions: “What are the problems?” and “What would need to happen for you to know the problems have been resolved?” He explained how this exercise had focused him, even before our first meeting, on the precise nature of his troubles and on his goals. He added that the questions reminded him that this appointment was dedicated solely to talking about him, which he had been avoiding for ages. This brought up mixed feelings of trepidation and relief.

Another new client, a woman in her thirties, disillusioned by the disconnection between the myth of happily-ever-after and the reality of maintaining a real-life relationship, shared her relief that she had found a place where she could admit her fears and doubts to someone who would not judge her. Though her friends offered a comfortable place to vent and share good times, they could not give her a neutral and confidential ear. She also appreciated learning accurate information about her body and its sexual functioning.

Then there was the couple who had grown so estranged that visiting me marked their last attempt to save their marriage. I noticed that they did not touch or even make eye contact. They were still emotionally connected and got along well, but it had been a long time since they had experienced any intimacy. I asked them if they would do exercises at home. They admitted they had not like the idea—felt it was juvenile and pointless—but they agreed. Their willingness to risk feeling awkward and vulnerable with each other signalled their willingness to change the character of their relationship.

Sometimes people come in just because they need a safe place to talk about something. It can be difficult to find someone non-judgmental and uninvolved, especially regarding sex. Clients generally tell me they feel a bit anxious when they first arrive, but that it doesn’t last long.

Other times clients need accurate information and want help in determining how that information best applies to their lives. Often that can be sorted out in a session or two. Still, it can feel a bit humbling to admit we don’t know something about sex. We all want to be knowledgeable about something that’s supposed to “come naturally.” I try to make the learning fun and relaxed.

Still other times clients come in who feel quite hopeless about their sexual situation. They arrive bursting with questions and emotions. I can hardly give them information and support fast enough and I watch their anxiety dissolve as the session progresses. Their body language and even their breathing change over the course of the visit. I hear phrases like “I never thought of it that way before” and “I wish I’d come in ages ago.”

Few people have contacted a sex therapist before. I’m used to that. I appreciate the trust put in me as folks stretch their boundaries to learn more about their sexuality and relationships. I hope this peek into what initial sessions can be like helps you to feel more comfortable in approaching the process of sex therapy with anticipation. It can be an exciting adventure. After all, the potential reward is great sex for the rest of your life!

© 2007. Pega Ren, Ed.D. All Rights Reserved.