How well did your graduate program prepare you to talk with your clients about sex? It would not surprise me if you completed your training feeling as uncomfortable with the topic of sex as you felt on Day One. Despite the fact that 45% of women (Pereira, Arias-Carrión, Machado, Nardi, & Silva, 2013) and 38% of men (Shaeer & Shaeer, 2012) struggle with some sort of sexual dysfunction, human sexuality is often largely omitted from graduate programs for mental health practitioners. I trained in the late 1990s, and although my professors and supervisors were some of the top researchers and clinicians around, I received very little training on the topic of sex. In fact, as I shared in my TEDx talk, I was told that once a couple is able to communicate more effectively, their sexual problems will resolve on their own. This, by the way, is largely untrue!
It makes sense how we got here. Therapists, professors, and supervisors are a product of the larger culture and our collective discomfort with the topic of sex makes total sense given that:
- Sex education in the US (as well as most parts of the world) is usually incomplete and inaccurate, and it nearly always omits topics like sexual communication and pleasure.
- Many families struggle to talk with their kids and teens about sex.
- Many religious institutions give shame-loaded and gender-rigid messages about sex.
- Mainstream pornography can stoke our fear and embarrassment about the imperfection and emotional messiness of real life sex.
Therapists and coaches have erotic growing edges right alongside the erotic growing edges of the clients we serve.
I spent a decade teaching the Intimate Relations course in Northwestern University’s Masters of Marriage and Family Therapy (MSMFT) Program. I would talk with these budding therapists about their “sexual inheritances” (from school, religious institutions, family, and media) in order to help them identify and transform the constraints, fears, and biases they bring into the therapy office. I encouraged them to become lifelong learners when it comes to sex, for their own sake and for the sake of their clients. I also taught them the importance of asking directly about the sexual lives of individuals and couples during the early assessment sessions. By asking about our clients’ sex lives early on, we are sending a clear message that it is safe for them to bring this tender topic to us. Our clients take their cues from us, and if we leave sex out of the therapy office, our clients likely will too!
One of the goals of Taking Sexy Back to is to provide a deepened sense of Sexual Self-Awareness. I hope that you will engage with Taking Sexy Back to support your own learning, healing, and growth. From your own deepened sense of Sexual Self-Awareness, you are well-positioned to help your clients explore their relationship with the erotic.
The Five Pillars of Relational Self-Awareness
Relational Self-Awareness (RSA) is a meta-skill composed of these five pillars: Self-Reflection, Self-Knowledge, Sexual Self-Awareness, Self-Expression, and Self-Expansion. The table below defines each pillar and directs you to the parts of the book that address each pillar. As you can see, Sexual Self-Awareness is a pillar that I began to explore in Loving Bravely, but explored much more deeply in Taking Sexy Back. To learn more about helping clients grow the other pillars of RSA, take a look at this article.
|Self-Reflection:Creating Narrative Coherence
|Understanding the self in the context of the family system in order to understand how roles and dynamics shape relational experiences and expectations.
|Loving Bravely Part 1
|Self-Knowledge:Integrating Cultural Identities
|Locating the self at the intersection of cultural identities in order to understand how these identities shape relational experiences and expectations.
|Loving Bravely Part 2
|Sexual Self-Awareness:Nurturing Sexual Maturity
|Filling in gaps in understanding of sexual health so that sexual choices are respectful and celebratory of self and others.
|Loving Bravely Lesson 11 and Taking Sexy Back book
|Self-Expression:Navigating Relational Rupture
|Practicing internal emotion regulation and taking a systemic approach to relational dynamics in order to feel empowered during inevitable relationship conflict.
|Loving Bravely Part 3
|Shifting to growth beliefs about relationships in order to meet relationship ebbs and flows with curiosity and resilience.
|Loving Bravely Part 4
Recommended Client Population
The primary audience for the Taking Sexy Back book is vulva-bodied people, or those who have been socialized in the feminine. Ideally, women find this book when they are beginning to explore their sexuality so that they are able to understand themselves, articulate their boundaries, and claim pleasure from their first experience onward! That being said, I have heard amazing stories about women in their 30s, 40s, and beyond appreciating the chance to reclaim the connection to their erotic selves. My favorite story is of a 20-something woman who was home for Thanksgiving. She was reading Taking Sexy Back on her couch, and her mom was curious. They tucked in and read the book together. Talk about intergenerational healing!!
Here are some of the clients who may benefit from working through the Taking Sexy Back book with you:
- Female-identified emerging adults (18-25 years old) who are single and dating. The goal would be to help them understand themselves, so they can identify and articulate sexual boundaries and advocate for their pleasure.
- Couples in which there are one or more female-identified partners especially if they are presenting in therapy with sexual dissatisfaction, mismatched libidos, or sexual disconnection.
- Female-identified clients of any age who are struggling to enjoy sex.
Because Taking Sexy Back focuses on the reader’s relationship with their erotic self, rather than a particular demographic or relationship status, you can utilize the book to guide your work with a wide range of clients. The book also explicitly attends to the intersection of culture and identity, so clients of diverse backgrounds will feel that they belong.
Taking Sexy Back guides the reader on a journey inward and is organized into three parts:
- Preparing for the Journey: These chapters introduce the reader to Relational Self-Awareness and The Map of Sexual Self-Awareness and help the reader begin to understand their sexual inheritance.
- The Journey to Sexual Self-Awareness: There is one chapter devoted to each of the seven aspects of Sexual Self-Awareness (Cultural, Developmental, Mental, Emotional, Physical, Relational, and Spiritual).
- Your Sexy is Here to Stay: With a deeper sense of Sexual Self-Awareness, the reader is now invited to look at the modern landscape of love in order to discern what they are wanting and needing. Because we know that creating change in one part of a system has the effect of “shaking the system,” this part of the book contains a chapter for men who love women who are taking sexy back, so they can understand the work their partner or friend is undertaking.
Like the Loving Bravely book, each chapter of Taking Sexy Back moves between three elements:
- Theory and research
- Narrative examples
- Reflection questions and practices to help the reader “walk the talk.”
As every therapist knows, transformation occurs when we make explicit what is implicit, giving us the opportunity to shed that which does not serve us (and perhaps never did!) and claim that which is more aligned and wholehearted.
If you assign your client one chapter per week, the process of moving through the book will take thirteen weeks. This pace will allow your client to read slowly and devote ample time and attention to each of the application exercises in the book. At this pace, your client will come to their session with much to process and explore with you. If you anticipate a shorter course of treatment, you could work at a pace of two or three chapters per week. Under this plan, you could ask your clients to hold more time to work on the reflection exercises between your sessions.
Regardless of the pacing that makes sense for your situation, ensure that you and the client have a clear and agreed-upon plan. Check in at the beginning of each session about their experiences with the work for that week. Here are some possible questions:
- When it comes to the topic of sex, what might you feel uncomfortable discussing in therapy with me?
- What are your overall reactions to the chapter(s) for this week?
- How did this week’s chapter(s) connect for you to the challenges we’ve been working on in this therapy?
- What felt surprising to you?
- What felt confusing to you?
- What was your biggest a-ha?
- What were your thoughts and feelings as you completed the exercises?
- What do you want to make sure we keep in mind going forward?
These questions will help you understand how your client is experiencing the work of the book.
If your client is struggling to make time between sessions to read and complete the exercise(s), you will need to understand what is getting in the way. The constraint may be pragmatic, in which case your client will benefit from blocking out time in their calendar for Taking Sexy Back. The constraint may be emotional. Your client may feel afraid of what they will uncover during the process of introspection. How wonderful that your client has the benefit of being able to process these strong emotions with you!
You may still want to validate beforehand that this journey of exploration is not easy, normalizing some of these upsetting feelings. And, if parts of the book feel so upsetting that they are unable to continue with their day, for example, you can give explicit permission for them to skip that part, knowing they can return to it at a later time. If you are assigning Taking Sexy Back to a couple, you can review the suggestions I made in the article, “Using Loving Bravely to Guide Your Work with Clients,” as those apply here too.
I celebrate and honor your willingness to partner with your client on the brave and tender journey toward sexual wholeness. Your client is lucky to have you as a fellow traveler! I hope this article provided you with some useful suggestions for integrating Taking Sexy Back into your clinical work, and I would love for you to share your thoughts and feedback with me.
Pereira, V. M., Arias-Carrión, O., Machado, S., Nardi, A. E., & Silva, A. C. (2013). Sex therapy for female sexual dysfunction. International Archives of Medicine, 6(1), 1–9. doi:10.1186/1755-7682-6-37
Shaeer, O., & Shaeer, K. (2012). The global online sexuality survey (GOSS): The United States of America in 2011. Chapter I: Erectile dysfunction among english-speakers. Journal of Sexual Medicine, 9(12), 3018–3027. doi:10.1111/j.1743- 6109.2012.02976.x