Sex Therapy has a rich history with it’s roots in ancient societies and cultures. While not known as “therapy” in those times, the idea that people and couples needed some kind of assistance with sexual issues including sex positions, sex education, help with having pleasure, intimacy and fulfillment in their relationships was alive in human consciousness and addressed with a myriad of solutions. The evolution of sex therapy is an interesting subject as cultures vary in degrees from being sex negative and religiously controlled to open and positive and desiring of it’s members to have pleasure and access to sexual improvement. Therefore, looked at through a culturally inclusive as well as historical lense we will see that depending on the time, culture and religious views the style of therapy around sex has varied.
What is known today as “sex therapy” in the western world has it’s dawn in the days of the original sexologists of the early 1900s. With the emergence of sexology and psychoanalysis growing together side by side and being very much interrelated in the early days of Sigmund Freud, the libido theory and the work of important sexologists, the idea that there needed to be specialized therapies dealing with sexuality became prevalent.
Sex researchers Henry Havelock Ellis, Alfred Kinsey and Masters and Johnson also pushed the conversation forward throughout the western world and into the mainstream consciousness. With new developments in research there developed names, pathologies and solutions for the common needs of individuals and couples sexuality and sexual development.
Another step forward in Sex Therapy was made by Dr. Helen Singer Kaplan who modified some of Masters and Johnson’s ideas to better suit her outpatient practice, including introducing medication, cognitive behavior therapy and psychodynamic therapy. In 1976, Jack Annon created the PLISSIT model that provided a structured system for sex therapists, counselors and educators to follow and which is used by clinical sexologists, sex educators and those within the medical profession such a RNs to better assist their patients.
A huge contribution in Sex Therapy was made by William E. Hartman, PhD. And Marilyn A. Fithian who published their groundbreaking work, Treatment of Sexual Dysfunction in 1972 to describe the intensive 2 week couple’s body based sex therapy process. As outlined in the Introduction, “Our program for treatment of human sexual dysfunction includes a series of steps, activities, and exercises moving the individual and the couple toward becoming more intimately in touch with their own feelings and the feelings of the significant other”. This healing journey for the couple is described as one which elicits a myriad of emotions, uncovers sensations, determines where there can be a lack of sensation and offers an opportunity to do go into those places where sexual repression and lack of permission around pleasure can be highlighted and healed for a deeper connection between couples.
Hartman and Fithian describe their system as a “biopsychosocial approach to the treatment of human sexual dysfunction”. (Pg. 1) Their process includes: psychological testing, the taking of a sex history for each individual, physical examination, sexological examination, body imagery, caress exercises, homework assignments, and the use of audio and video aids.
The work of Hartman & Fithian continues to give enormous benefit both to the field of sexology and sex therapy as well as to sexuality professionals who are desiring to or currently working with couples. Their system and methods, well grounded in research, gives permission and credibility to the benefits of body based sex therapy methods for couples.
In the 1980s sex therapy continued to become medicalized and treatments involving both psychotherapy and medical interventions for issues such as early ejaculation, male sexual libido, and loss of sensation due to surgeries were merged to allow the use of both body and mind based solutions to most sexual concerns.
Today, we have a very wide range of possibilities within the field of Sex Therapy. From talk therapy to medication to somatic practices that are ever evolving and changing to fit the needs of clients this is an exciting time in a powerful profession that enables to support people in having the sex lives they desire and bringing them to a place of functionality and wholeness.
Anya de Montigny, DHS is a sexuality expert with over 20 years experience working with individuals, couples, and groups. Dr. Anya has a Doctor of Human Sexuality (DHS) degree, is a certified sex educator and certified sex coach and was the host of the popular radio show The O Word Sex Talk Radio. Dr. Anya has a private practice in the San Francisco Bay Area working with individuals and couples and invites straight and LGBTQ people into her practice. She also teaches adult sex education classes as well as consent & boundaries workshops at Universities and Colleges.