Exploring Desire and Intimacy

A Workbook for Creative Clinicians

Gina Ogden

• Publisher: Routledge
• Year: 2016
• Print ISBN: 9781138933767
• eBook ISBN: 9781317390954
• Topic: Psychology
• Subtopic: Human Sexuality in Psychology
• Index: Psychology

This integrative book is like having a wise supervisor in the room with you. Stop "fixing" your clients--engage them in their own healing through the Four-Dimensional Wheel of Sexual Experience. Gina Ogden guides you in helping your clients explore the full range of their sexual issues and challenges—including couple communication, erectile dysfunction, vaginismus, low desire, affairs, trauma, religious proscriptions, pornography use, and more. Part I offers strategies that correspond to the core knowledge areas required for certification as a sexuality professional, while Part II puts these innovative approaches into action through following five case examples from seasoned practitioners. The numerous user-friendly elements, such as quizzes, worksheets, and "hot tips," will help you see the larger picture of an issue, become fluent with a diversity of sexual identities and behaviors, and expand your ability to offer safe, ethical, evidence-based therapy.

Part I
Innovative Approaches

Strategies for Change and Transformation through the Four-Dimensional Wheel of Sexual Experience

1
Asking New Questions of Our Clients—and Ourselves

Exploring Body, Mind, Heart, and Spirit

“As you go the way of your life you will come to a great chasm. Jump! It is not as wide as you think.”

—Traditional Native American Wisdom

Opening Quiz: Your Attitudes about Exploring Clients’ Issues with Desire and Intimacy

This quiz is not a test! It is to help you recognize your own opinions and consider new ones. There are no right or wrong answers—interpret them as you wish, and write other questions on this page as they occur to you.

Circle the number that most closely reflects your views on the questions below:

1 always true; 2 sometimes true; 3 seldom true; 4 never true

Sex is mainly about intercourse	1	2	3	4
Sex is connected with every aspect of our lives	1	2	3	4
Sexual desire exists mainly in relationship with a partner	1	2	3	4
If a couple resolves their differences, the sex will take care of itself	1	2	3	4
Too much intimacy can dull sexual desire	1	2	3	4
Sexual desire and intimacy can enhance each other	1	2	3	4
Sexual desire can be scientifically measured	1	2	3	4
Sexual intimacy can be scientifically measured	1	2	3	4
Gay, lesbian, and trans clients have different desires than heterosexual clients	1	2	3	4
Clients with histories of abuse can never have satisfying sex	1	2	3	4
I don’t know enough to help clients with sexual issues	1	2	3	4
Pharmaceutical intervention is the most effective way to cure sexual dysfunction	1	2	3	4
Evidence-based treatments are the only responsible way to practice sex therapy	1	2	3	4
Effective sex therapy involves body, mind, heart, and spirit	1	2	3	4
Effective sex therapy may mean reframing dysfunction rather than curing it	1	2	3	4
Sharing personal information with a client is always therapeutic	1	2	3	4
Other issues	1	2	3	4
Other issues	1	2	3	4
Other issues	1	2	3	4

There are many effective ways of taking a sex history—which ways do you use? (Check all that apply)

• ___ A written questionnaire before or after the initial session with a client
• ___ One or more intensive sessions dedicated to sex-history issues
• ___ A sexual genogram to explore generational issues about sexual attitudes and behaviors
• ___ Relevant sex-history issues gathered over time during sessions
• ___ Questions organized around 4-D Wheel explorations of body, mind, heart, and spirit
• ___ Other ways ____________________________________________________________________________
• ___ Other ways ____________________________________________________________________________
• ___ Other ways ____________________________________________________________________________

What can we learn from our clients? Often, an uncanny combination of humility and resilience regarding ourselves. And an understanding that in order to help certain clients you may have to exercise creativity. There are seldom truly resistant clients, only uncreative therapists.

This workbook is designed as a companion for Expanding the Practice of Sex Therapy. Chapter 1 is based on Expanding Chapters 3–8, which detail the Four-Dimensional Wheel of Sexual Experience.

Expanding your take on Sex-History Taking: A Four-Dimensional Approach

What questions are you asking your clients about sexual desire and intimacy? Unless you’re specifically trained in sex therapy or counseling, you may be avoiding the issue almost entirely. If you’re a seasoned sex therapist, you have probably been taught to lead with inquiries about performance, such as: “How many times have you had intercourse in the last week/month/year?” This is a question considered primary to most sex-therapy training—and most of us are taught to follow it closely with: “How often do you achieve orgasm?” These and other performance-focused questions are rooted in the notions that it is possible to quantify sexual response and that effective sex therapy is based on behavioral goals and outcomes. They are basic tenets pioneered by Alfred Kinsey et al. in the 1940s and 1950s and William Masters and Virginia Johnson in the 1960s and 1970s.

This workbook expands sex counseling and therapy beyond performance behaviors to address desire and intimacy—both infinitely complex issues that cannot be counted and measured, much less “cured.” Here, you will find a four-dimensional approach to help you help your clients. This approach is based on a truth that has emerged for me over my years of clinical practice and sex-survey research:

Sexual experience is multidimensional.

Desire and intimacy involve our bodies, minds, hearts, and spirits.

This workbook offers step-by-step practices that walk you through helping clients identify what they want, investigate how they may be preventing themselves from having what they want, and discover multiple ways to experience more of what they want—in right relationship to their partners, if they have partners.

This workbook also expands beyond the notion that therapists have to be fully formed experts. Another emergent truth is that none of us can be expert in everything. Our clients are our teachers, sometimes fully as much as we are theirs. Moreover, our clients’ issues may strike resonant chords in us—the official name is “countertransference.” The profound lesson here is that the professional is personal, often deeply so. My hope is that the practices in this workbook inspire you to participate in them personally, so that you can experience them for yourself before you ask your clients to engage in them.

To conduct “expanded” sex therapy means that we actively and continually participate in our own awareness and growth as human beings and clinicians.

That said, each of us is expert in something important that opens us to this work. So let’s begin this work with your own expertise, as a marker to which you can always return. Please complete the sentence stems below:

Exploring Desire and Intimacy: Starting your 4-D Practice

At the heart of the expanding practice is the Four-Dimensional Wheel of Sexual Experience (4-D Wheel).

The 4-D Wheel includes the mental, physical, emotional, and spiritual dimensions that are always present in our sexual experience, whether or not we are aware of all of them. The Wheel can be used to help clients map all sorts of sexual responses—past, present, and even future. Note that each dimension includes both positive components (such as excitement, joy, and love) and shadow components (such as pain, dysfunction, and rage). Most often it is the shadow that clients bring into our offices. But shadows canno...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Activities and Exercises for Practitioners and Clients
• Informational Sections for Practitioners and Clients
• Preface
• Expanding the Title of This Book: Some Operational Definitions
• Introduction: The Four-Dimensional Wheel of Sexual Experience: A Guide to Creative Practice
• Part I Innovative Approaches: Strategies for Change and Transformation through the Four-Dimensional Wheel of Sexual Experience
• Part II Practical Applications: Protocols for Challenging Clients Using the Four-Dimensional Wheel of Sexual Experience
• Appreciations
• Index