Extraordinary Sex Therapy

Creative Approaches for Clinicians

Gina Ogden

• Publisher: Taylor & Francis
• Year: 2017
• eBook ISBN: 9781317551331
• Edition: 1
• Topic: Psychology
• Subtopic: Human Sexuality in Psychology
• Index: Psychology

How do we help our clients discover the depth and breadth of sexual healing? Extraordinary Sex Therapy offers a range of innovative health-based approaches and models to explore the complexities inherent in sexual pleasure and potential as well as in trauma, pain, and dysfunction. The practitioners whose work is represented here expand the clinical conversation about sex beyond performance goals and tread courageously into unquantifiable realms of sexual and relational desire, health, and transformation.

All of these practitioners describe work that embodies therapeutic collaboration with their clients as they confront sexual concerns that include body image, emotions, meanings, and nuances of partner interactions along with the influence of neurobiology, language, gender, addiction, socioeconomics, and cultural conditioning about pleasure. Their interventions range from education, visualization, and role-play to identifying erotic archetypes, coaching about sensual touch, and using plant spirit medicines to activate imagination and spiritual connection. Their descriptions ring with singular authenticity, depending on their training and the particular clients and issues they address. Each practitioner provides clinical examples and techniques in enough detail so that readers can incorporate elements of these approaches into their own practices.

This book was originally published as a special issue of the Journal of Sexual and Relationship Therapy.

INTRODUCTION

Are we asking questions that help our clients?

“Out beyond ideas of wrongdoing and rightdoing, there is a field. I’ll meet you there.”

—Jalal ad-Din Rumi

What questions are we asking our clients?

“How many times do you have intercourse per week/ month/ year?” This was a question considered primary to my sex-therapy training in the mid-1970s. I was coached to follow it closely with: “How often do you achieve orgasm?” These and other performance-focused questions to address with clients were rooted in the then revolutionary concepts that it is possible to quantify sexual response (Kinsey, et al., 1948, 1953) and that the success of sex therapy can therefore be based on behavioral goals and measurable outcomes (Masters & Johnson, 1966, 1970).

Quantifiable approaches to dysfunctions of intercourse and orgasm have proven effective, even launching a booming pharmaceutical industry since 1998 with the advent of Viagra. But effectiveness has been mainly for clients who present with issues that require no attention to emotional and relational complexities that accompany sexual problems. Despite their limitations, performance outcomes remain a fixed idea in much of sex research and sex therapy training today, too often inhibiting what we ask our clients about the depth and breadth of sexual healing, pleasure, and potential, and what we ask ourselves about which approaches and models are most appropriate to use.

To complicate matters, today’s focus on performance and goals also discounts advances in neuroscience (e.g., Fisher, 2004; Komisaruk, et. al., 2006) along with the combined wisdom of a spectrum of therapies that indicate sexual experience to be far more complex than outlined by quantitative research; it is rooted in the fabric of our clients’ lives, from physiology, mental conditioning, emotional engagement, and spiritual meaning to the influences of socioeconomics and culture (e.g., Bateson, 1972; Britton, 2005; Bass & Davis, 1988; Daniluk, 1998; Ellison, 2000; Herman, 1992; Jung, P., et al., 2001; Klein, 2006; Kleinplatz & Moser, 2006; Maltz, 1987; McCarthy & Metz, 2004; Morin, 1995; Perls, 1969; Savage, 1999; Schnarch, 1991; Zilbergeld, 1992).

The truth is, there is no objective way of defining sex, let alone sex therapy, whether the purpose of sex therapy is to help clients recover from sexual abuse or create optimal conditions for ecstatic union. For solidarity in this belief I am in debt to colleagues who publicly posit the inherent complexities and suggest that the academic and scientific conversation about sex and sex therapy may be in danger of becoming so narrow as to create a kind of dysfunction in itself (Britton, 2005; Eisler, 1995; Kaschak & Tiefer, 2002; Kleinplatz, 2001; Perel, 2006, Whipple, et al., 1992).

Separately and together, many of us have sought to broaden the therapeutic conversation about sex beyond specific performance outcomes, and I am doubly in debt to these colleagues and many more for support in my conducting an independent survey: “Integrating Sexuality and Spirituality” (ISIS) (Ogden, 2002, 2006a), which has evolved into the integrative ISIS approach to further both therapists and clients in exploring the intangibles of sexual experience: feelings, meanings, and relationships, as well as behaviors (Ogden, 2006b, 2008, 2009, 2012, 2013).

It was this collegial spirit that moved me to welcome the invitation to edit this issue of SRT—to offer a place for new voices along with established ones. This issue does not pretend to be definitive. The range of sexual concerns is admittedly vast, well beyond the scope of these pages. You will note omissions, including age-related factors, most gender and cultural intricacies, the sequelae of affairs, and more. The intent of this SRT issue is to go deep and be thought-provoking and practice-oriented, rather than be broad and inclusive. The practitioners whose work is represented here explore the complexities of sexual and relational health, pleasure, and even the nature of transformation. Their models and approaches are “extraordinary” because they expand their practice of sex therapy beyond specific outcomes to incorporate realms of sexual experience that cannot be counted and measured by methods currently available to sexual science. Transpersonal psychiatrist Carl Jung called such realms the “irrational facts” of experience (1970, p. 505).

What Is Extraordinary Sex Therapy?

In a spirit of collaboration, I define extraordinary sex therapy here through the lens of each contributor to this issue, as if together they comprise an intelligent and sophisticated kind of convenience sample, n = 12. Think of these practitioners as being asked to describe the proverbial elephant of sex therapy, each from a unique point of view. Their descriptions ring with singular authenticity, depending on their culture, their training, and the particular clients and issues they address. They offer clinical examples and techniques so that readers can incorporate elements of each approach into their own practices. Their collective offerings reveal some cardinal principles of extraordinary sex therapy, all predicated on the understanding that many crucial facts about sexual experience are, in fact, “irrational.”

Complex thinking sparks erotic creativity

The issue of sexual complexity is addressed by Alireza Tabatabaie, whose “sexotic therapy” expresses the paradoxical nature of both sexual experience and sex therapy as grounded in his native Iranian culture, and exemplified in Persian erotic poetry. For him, extraordinary sex therapy involves a conceptual framework that acknowledges and celebrates the erotic, and helps couples travel the often surprising distances between intimacy and passion.

Inclusive language expands sexual diversity

Michael Berry and Meg Barker focus on language as a transmitter of sexual information; a vehicle through which to expand norms in a practice of sex therapy where limited language often reflects social limitations and prejudices about sexual diversity. For them, extraordinary sex therapy is based in queer-friendly consciousness and syntax that is plural enough to welcome all genders, orientations, and varieties of relationship, no matter how creative.

New information awakens sexual awareness and desire

Three innovative models address low sexual desire in women. All interweave elements of complexity, collaboration, and nuanced language.

In “Working with Archetypes and an Inner Cast of Characters,” Chelsea Wakefield offers a Jungian perspective to unlocking treatment impasses for women and their partners. For her, extraordinary sex therapy means searching for Aphrodite—helping women identify eros-inhibiting patterns of energy and discover their own erotic identities through exploring and playfully engaging the creative realm of the sexual psyche.

Keesha Ewers contributes perspectives of integrative medicine and brain research to post-traumatic dimensions of low sexual desire through her HURT model: Healing UnResolved Trauma. For her, extraordinary sex therapy includes biological, emotional, and relational methods to help women recognize the automatic negative thinking that distracts from pleasurable erotic cues so that they can activate new neuronal paths for pleasure and power.

Lindsay Jernigan’s model of Compassionate Authenticity is based on eclectic approaches to moving beyond cultural messages that women ought to sacrifice themselves in the name of caretaking others. In her model, extraordinary sex therapy involves three critical treatment goals for women: 1) Building curiosity about their own sensuality; 2) Differentiating from their sexual partner/s; and 3) Redefining the scope of sexual and emotional caretaking.

Curiosity promotes sexual healing

What is “sex addiction?” Is it an excuse for impoverished impulse control? A symptom of ADHD or PTSD? A sign that a couple is in the wrong relationship? Two authors tackle this contentious subject, each acknowledging the potential for extraordinary healing once the focus is turned from ideological argument to close attention to each client’s story.

Paula Hall presents her BERSC model for addressing the biological, emotional, relational, social, and cultural roots of sex addiction. For her, extraordinary sex therapy involves providing a here-and-now opportunity for clients to address old attachment wounds—especially effective in group therapy, which allows shared empathy and emotional attunement among group members.

Ruth Cohn de-stigmatizes sex addiction for a couple, helping them reorganize their story of compulsive porn use and blame into a coherent narrative so that rogue fragments no longer wreak havoc on their relationship. For her, extraordinary therapy for sex addiction means careful history-taking to help clients redefine the roots of their problematic behaviors, then applying a non-judgmental lens to what she calls “the geography of desperation.”

Intelligent touch wakes up our bodies

Of all the senses, touch is the first to develop; awareness of touch is as essential to life as to sexual development. Linda DeVillers offers rationale and techniques for teaching sensuous touch as part of sex therapy, where it is too often avoided or assigned as sensate focus homework for clients to fumble through on their own. For her, extraordinary sex therapy includes making sure individuals and couples know how to give—and receive—intelligent touch.

Active education creates active change

Patti Britton and Sarah Bright introduce sex coaching as an active form of sex education. The behavioral elements that coaching adds to effective sex therapy may include beyond-the-office activities such as helping a client choose sex toys, or observational bodywork, such as viewing a client’s masturbation patterns. Extraordinary sex coaching involves witnessing, educating, and supporting men, women, and trans clients in their quest for self-esteem and pleasure.

Non-ordinary paths open new sexual vistas

In the next two papers, extraordinary sex therapy is described in non-ordinary terms through aspects of shamanic principles and practice that inc...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright
• Contents
• Citation Information
• Notes on Contributors
• 1. Introduction: Are we asking questions that help our clients?
• 2. Sexotic therapy: embracing the exotic, irrational and paradoxical experience of living and loving
• 3. Extraordinary interventions for extraordinary clients: existential sex therapy and open non-monogamy
• 4. In search of Aphrodite: working with archetypes and an inner cast of characters in women with low sexual desire
• 5. An integrative medicine approach to the treatment of HSDD: introducing the HURT Model™
• 6. Compassionate authenticity: a treatment model for working with women with low libido
• 7. Sex addiction – an extraordinarily contentious problem
• 8. Calming the tempest, bridging the gorge: healing in couples ruptured by “sex addiction”
• 9. Getting in touch with touch: a use of caressing exercises to enrich sensual connection and evoke ecstatic experience in couples
• 10. “Extraordinary” sex coaching: an inside look
• 11. Sexual healing with Amazonian plant teachers: a heuristic inquiry of women’s spiritual–erotic awakenings
• 12. Reclaiming women’s sexuality: the intersection of Shamanic practices and sex therapy
• 13. In praise of “ordinary” sex therapy
• Index