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Sex Therapy It’S More Than Just Being Comfortable Talking About Sex

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Sex Therapy It’S More Than Just Being Comfortable Talking About Sex Sex therapy It’s more than just being comfortable talking about sex INTERVIEWS WITH FOUR SEX THERAPISTS: DR. DANIELE DOUCET, DR. DAVID MCKENZIE, DR. TEESHA MORGAN, AND DR. PEGA REN BY CAROLYN CAMILLERI et’s say a woman tells actually dealing with something such erection and sustain it. Treatments you she has low libido or as vaginismus, and this woman needs for behavioural issues start with what the quality of her sex life specific guidance to heal, such as seeing Morgan calls “homework assignments.” has diminished. As her a pelvic-floor therapist,” says Morgan. Once biological and behavioural aspects counsellor, you start to ask Pain during intercourse is just one have been addressed, she assesses for Lquestions and learn she has pain during common issue Morgan sees in her office. psychological concerns, such as anxiety intercourse. The next step illustrates a “With women, it’s predominantly and depression. key distinction between couple therapy low libido or pain during intercourse or “There are three things to look and sex therapy. a difference in a couple’s sex drive,” says at: biological, behavioural, and Dr. Teesha Morgan would ask, where Morgan. “With couples, much of the psychological. If you’re missing one of is the pain located? What kind of pain time, it’s quantity and quality of sex — those three categories, you’re dropping is it? How often is it occurring? In her either one or both has become an issue, the ball on the whole thing,” says mind, Morgan would be assessing for and they want to communicate around Morgan. “You can’t just look at one vaginismus, dyspareunia, vulvodynia, their sex life in a more effective way.” and hope that you’ve found it, because clitodynia — medical terms to describe With men, the predominant oftentimes, one is causing the other.” problem is erectile dysfunction, which different types of vaginal pain under the Her holistic approach comes from broad category of Genital Pelvic Pain Morgan calls an umbrella term for a very specific training in human sexuality. Disorder — and then she would provide multitude of issues. When a client specific suggestions to treat it. presents with erectile dysfunction, MORE THAN A DEFINITION “We can talk with a woman and Morgan starts by referring him to, at PROBLEM empathize, but if you’re just tackling the bare minimum, a GP to check The term “sex therapy” is not protected it from an anxiety perspective or a testosterone, prostate, diabetes, blood nor are there official requirements for relationship perspective, a safety or pressure, and other possible causes that using it. Technically, anyone could say communication perspective — and those may be biological. She then addresses they are a sex therapist, even without all might be important factors of what behavioural aspects by assessing the training. “Sexologist” is another is going on — you may be missing a client’s masturbation tendencies and term that can be misused. Dr. David key component or diagnosis, that we’re their effect on his ability to get an McKenzie offers clear definitions. LEARN MORE ABOUT OUR EXPERTS AND WHAT THEY DO Dr. Daniele Doucet (Nee Duplassie): Dr. David McKenzie: Dr. Teesha Morgan: Dr. Pega Ren: www.shanti-centre.com/danielle-duplassie/ www.davidmckenzie.ca www.teeshamorgan.com www.smartsextalk.com 14 INSIGHTS MagaZINE INSIGHTS MagaZINE 15 “There are THREE THINGS TO LOOK AT: BIOLOGICAL, BEHAVIOURAL, AND PSYCHOLOGICAL. IF you’re missing one OF THOSE THREE CAtegories, you’re DROPPING THE BALL ON THE Whole thing.” about that, guilty even,” says McKenzie. do so,” says Dr. Daniele Doucet, adding “Someone would come to me regarding that most training opportunities are in issues around human sexuality, and the U.S. I could be sympathetic, I could give To date, regulating bodies in Canada suggestions, but I didn’t have any haven’t made training in human training as to how to treat it, where sexuality mandatory. If it were, Doucet to go, what to do. In my own training, believes more graduate programs would which was extensive, I never got any offer it. It’s an issue in the medical kind of training in sexuality.” community, too. Ren facilitates a four- “Sexology is simply the study of The issue goes deeper than not hour workshop for graduating medical human sexuality, and sex therapy having training. McKenzie points out doctors called Sex Therapy for Non Sex requires a counselling background,” that many counsellors don’t even Therapists. She may be the only person says McKenzie. “Sex therapy has a ask about sexual issues. “They’re who talks to them about sex. much broader perspective that takes uncomfortable. They’re not in touch “All I have time to say is, ‘These into account the dynamics of couple with their own sexuality, or they’re just are the things that can change; these relationships, of how to treat sexual very nervous, because they don’t know are the things that can’t change, and problems, how to diagnose them, how to handle it.” you need to know what’s on each of whereas a sexologist is somebody who Dr. Pega Ren agrees. those lists, because your first job is do could be studying the history of kink. “Marriage and family counsellors all no harm,’” says Ren. “And very well- That doesn’t make them a therapist.” deal with sexual issues,” says Ren. “And intentioned people do harm. They meet Nor does training as a couple I think most never mention it, don’t issues with their own prejudices, their counsellor make one a sex therapist. know how to ask the questions, don’t own ignorance, and do their very best “Relationship counselling has a lot to know how to respond when questions to be helpful without the knowledge or do with communication concerns, but are asked of them, don’t know how training to handle it effectively.” that is just a piece of what sex therapy to incorporate sex therapy. And it Ethics are the root of the problem. is,” says Morgan. “Sex therapy is a makes sense to me that that is the “We’re not supposed to engage in specialization like trauma or addiction.” case, because most psychologists have therapeutic activities that are beyond McKenzie, who has been a sex between six and 10 hours of training in our competence,” says Doucet. “But therapist for the last 13 years of his sexuality. And many counsellors don’t people assume that if they took a basic 43-year counselling career, began his have any training in sexuality at all.” course in human sexuality or if they career as an Anglican minister trained in The lack of training comes from a took a marriage and family course and pastoral counselling. A couple asked him lack of training opportunities. read a book on human sexuality, that for help with premature ejaculation. “As it is now, there are no graduate it makes them qualified to do therapy “Medical doctors just have one programs requiring training in related to sex, and it’s dangerous.” solution: take Paxil and that should human sexuality; however, there are help, but it doesn’t always, and I didn’t people who hang up their shingles as GOOD INTENTIONS GONE WRONG know who to refer to. I certainly didn’t relationship therapists and talk about Ren says her clients contact her about know about it myself, and I felt sad sex but don’t have adequate training to a wide range of concerns, including 16 INSIGHTS MagaZINE relationship issues, unmet expectations, that may be very different from the THE MAJOR PROBLEM OF BIAS disappointment with trying to follow next person who presents us with the When McKenzie started studying the cultural script, erectile dysfunction, same symptom,” says Ren. “We need sexology and sex therapy, many of his body issues, painful intercourse, more than empathy.” assumptions were challenged. infertility, and GAS: guilt, anxiety, and Above all, sex therapists need to “For instance, being an Anglican shame. Much of it starts with a lack of listen without judgment. pastor, I was under the assumption adequate and accurate sex education. “People hold enormous shame about that the only sex that counted, the “People don’t understand how their what they do sexually and can take it sex that was good and healthy, all had bodies work. And they don’t understand nowhere, because we, as a culture, hold to be within a committed or loving when their bodies don’t work the way negative judgment about sexuality,” says relationship,” says McKenzie. “That’s they expect them to and whether Ren. “We slut-shame women. We make absolute balderdash.” that’s a problem with their body or men feel guilty for being aggressive and Nor does love and commitment the expectation,” says Ren. “And there make them feel guilty for being sissies, always connect to sex. Once McKenzie are very few avenues for them to get so they can’t win. And being able to say started in sex therapy, he found he accurate, non-judgmental information.” to someone, ‘I am a sex therapist so you had some couples coming to him who Sex therapists have comprehensive can tell me anything,’ means that for had very successful marriages, who knowledge of sexuality in all its forms, many, many people, the sex therapist is communicated and loved each other but behaviours, and lifestyles, and an arsenal the first person they speak to.” weren’t having sex. of solutions to issues that may arise. While all counsellors are trained to “There’s a myth out there that the “We have to have the answers before be sensitive to bias, sex therapy may sex life is the barometer of the rest of we start giving them.
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