The Role of Sex Therapy In Healing From Sexual Trauma

Content warning: This page contains information about sexual violence and may be triggering if you have recently experienced sexual assault of any kind. 

Healing after sexual assault is an intensely personal and courageous journey. For many, the path to recovery involves not only addressing the emotional wounds, but also reconnecting with their body and discovering pleasure in ways that feel safe, empowering, and pleasurable. If you’ve experienced sexual trauma, whether in childhood or as an adult, know this: you are not alone, and there is no timeline or right way to heal.

This blog post isn’t about rushing or pushing yourself–it’s about offering gentle guidance, hope, and validation as you take steps toward reclaiming what was always yours: the ability to feel safe, pleasure, connection, and intimacy within your body and romantic partnership (if you are in one). Whether you’re beginning to explore this part of your healing or have been on this journey for a while, I hope this space feels like a safe space to start. 

How sex therapy supports trauma recovery

Sex therapy can be a vital part of healing from sexual trauma, offering a safe, supportive space to rebuild trust, intimacy, and connection. It helps individuals regain control over their bodies, address emotional challenges like shame or anxiety, and re-establish a positive relationship with their sexuality. For couples, sex therapy fosters open communication, improves trust, and deepens intimacy. 

It also supports individuals in reconnecting with their bodies, gradually overcoming fear or discomfort, and embracing pleasure. Most importantly, sex therapy emphasizes that healing is unique for everyone, providing a compassionate and non-judgmental environment where individuals can grow, learn, and reclaim a sense of empowerment.

Understanding the impact of sexual trauma on pleasure and intimacy

Sexual trauma can profoundly affect one’s relationship with pleasure and physical intimacy, often in ways that feel confusing or overwhelming. Sexual trauma involves such a personal and vulnerable part of who we are, it can create lasting ripples in how we experience our bodies, emotions, and connections with others. 

For many survivors, physical intimacy can feel complicated. Touch that once brought comfort, joy, or pleasure may now trigger feelings of fear, discomfort, or even numbness. The body, in its effort to protect itself, might react with pain, tension, or even dissociation, making pleasure seem out of reach. Some may notice a loss of interest in sex altogether, while others might become hypersexual and seek it out frequently in ways that they feel disconnected or unsafe. 

Pleasure, too, can feel like a challenging concept. It’s not uncommon for survivors to struggle with their feelings of shame or guilt around enjoying pleasure within their bodies again, especially when the trauma made them feel powerless or violated. There might also be a fear of letting go–of surrendering to pleasure–because it can feel too vulnerable or unsafe.

These responses are not signs of failure; they are the body and mind’s way of protecting and keeping you safe after experiencing harm. But here’s the hopeful part: with time, healing, and the proper support, you can rebuild a sense of safety, trust, and pleasure in your body. Pleasure can be reclaimed–not as something that defines your worth, but as something that is yours to explore on your terms, in your own time. 

Reconnection with your body: A gentle approach

After experiencing sexual trauma, feeling at home in your own body can be incredibly challenging. Sexual trauma often disrupts the sense of safety and connection we have within ourselves, making it hard to trust or fully inhabit our physical selves. But know this: your body is not broken, and healing is possible. Rebuilding the connection with sexual desire, arousal, and pleasure takes time, patience, and a lot of self-compassion, but it can also be a deeply empowering journey. Here are some gentle ways to begin reconnecting with your body:

Practice Mindful Awareness

Healing begins with simply noticing your body in non-judgmental ways. This might look like:

• Create a quiet, safe space where you will not be interrupted.

• Begin by paying attention to your breath as it moves in and out. Take six deep diaphragmatic breaths before moving on to the next step. 

• Feel the ground beneath your feet or the texture of your clothing.

• Place one hand over your heart and the other on your stomach, and notice the warmth of your touch.

• Notice where you are carrying tension throughout your body. Breathe into those areas and just notice them.

• Ask yourself what emotions you are experiencing right now, and where do you feel them in your body?

• What would they want me to know or understand if my emotions could speak?

• What would it feel like to show me kindness when difficult emotions arise?

• Journal your responses to the previous three questions. 

These small acts remind your body that it’s okay to feel again and be in your body, one moment at a time.

Move In Ways That Feel Good

Movement can help you reconnect with your body, but it doesn’t need to be strenuous or intimidating. Try gentle practices like:

• Stretching in bed or on the floor.

• Take a walk and notice the rhythm of your steps.

• Exploring yoga or dance in a way that feels safe and empowering

The goal is not performance but simply exploring how it feels to inhabit your body. Find some non-sexual ways that you enjoy connecting with your body. 

Practice Non-sexual, Comforting Touch

If touch feels difficult, start with non-sexual and nurturing forms of contact. You might:

• Wrap yourself in a soft blanket.

• Use lotion or oil to gently massage your hands, arms, or feet. Experiment with different types of touch and pressure. Start by doing this yourself before inviting your partner (if you are in a relationship). 

• Hold or hug a comforting object, like a pillow, stuffed animal, or a pet. 

These small acts can help rebuild trust with your body and remind you that touch can be safe, soothing, and pleasurable. 

Create Rituals of Care

Acts of self-care can become rituals for reconnecting with your body. Try:

• Take a warm bath and focus on how the water feels on your skin.

• Mindfully eating something you enjoy, savoring the textures and the flavors.

• Use scents you love, like candles or essential oils, to create a calming environment.

These practices invite you to experience pleasure and grounding safely and intentionally. These practices can also help you tap into your sensuality, which is linked to your sexuality.

Setting boundaries and finding safety in intimacy

Rebuilding a connection with your body means learning to honor its signals. If something feels uncomfortable, it’s okay to pause or say no. Mutual safety, consent, and respect are essential for a positive sexual experience. Sex therapy can provide a supportive space to explore these aspects, in-person or online, helping you discover your boundaries. Healing happens when you permit yourself to go at your own pace. 

Seek support when you are ready

You don’t have to navigate sexual trauma by yourself. A sex therapist or a support group can provide guidance and encouragement as you rebuild your relationship with your body. Remember, reconnecting with your body isn’t about reaching a specific destination–it’s about creating a relationship of trust, care, and love with yourself. Your body is yours; you deserve to feel safe and home again. Take your time. You are worth it.

Get Started with sex therapy in Scottsdale, Arizona

As you take steps toward healing, remember that you are not alone and healing is possible. You are entitled to all the pleasure your body can experience. At The Connection Couch, we are qualified to support you every step of the way. Follow these steps to start your journey toward reclaiming safety, pleasure, and connection within your body:

1. Connect with us for a free 15-minute consultation

2. Arrange your first sex therapy appointment and get started

3. Discover how sex therapy can help you heal from sexual trauma at your own pace.

Comprehensive Therapy Services Offered in Scottsdale, AZ

As a sex therapist located in Paradise Valley, I am qualified to provide therapy for individuals and couples looking to improve their intimacy. Additionally, I help couples heal from betrayal and infidelity, as well as support those recovering from sexual trauma.

Evidence-Based Sources Compiled by a Sex Therapist:

• Haines, S. (2007). Healing sex: A mind-body approach to healing sexual trauma. Cleis Press. 

• Maltz, W. (2012). The sexual healing journey: A guide for survivors of sexual abuse 3rd ed. William Marrow Paperbacks. 

• Richmond, H. (2021). Reclaiming pleasure: A sex-positive guide for moving beyond trauma and living a passionate life. New Harbinger Publications. 

Expert Resources From a Sex Therapist:

Arizona Attorney General’s Office of Victim Services:

• 642-542-4911

• https://www.azag.gov/criminal/victim-services/victim-compensation-restitution#:~:text=For%20more%20information%20about%20restitution,Restitution 

National Sexual Assault Hotline: 

• 1-800-656-4673

What To Do When Sex Is Painful With a Paradise Valley Sex Therapist (In Training)

This one is for my ladies and vulva owners who are dreading penetration because it has been so painful and have previously just been trying to endure it rather than enjoy it. Perhaps you are not even able to experience penetration because your pelvic floor muscles are so tight, making it difficult even to insert a tampon. Maybe you are experiencing burning and stinging in your vulva area. You long to be sexually intimate in your romantic relationship, but every attempt to have penetrative sex leaves you feeling broken. You worry that this is just how sex is going to be from now on, and you are fearful of what could happen long-term if you are unable to meet your partner’s sexual needs. 

Health Care Challenges 

Vulva owners seeking medical care for pelvic floor pain are sometimes dismissed, misdiagnosed, or recommended interventions and treatments that fix the root cause. After reading this blog post, I want you to feel hopeful and empowered about your healthcare options. I want you to know that healing is available to you. You do not need to suffer through painful sex a second longer. Our bodies have a remarkable innate ability to heal, and it is simply about finding the right treatments to relieve the symptoms of painful penetration. You deserve all the pleasure that your body can give you. 

So, let's get to it! 

Pelvic Floor Basics 

You may be as shocked as I was to discover that the pelvic floor consists of a group of muscles, ligaments, and connective tissues that span the bottom of the pelvis, forming a supportive hammock for the organs (bladder, uterus, and rectum), in the pelvis. The pelvic floor is crucial in many bodily functions, including urinary and bowel control, sexual function, and core stability. It is apparent that our pelvic floor plays a significant role in our health, and a lot of stress and tension can be held in this area, especially for women and vulva owners. 

Pelvic Floor Dysfunction Symptoms 

• Urinary issues:

  • Frequent need to urinate (most people urinate 6-8 times a day)

  • Urinary incontinence (leakage)

  • Difficulty starting urination or fully emptying the bladder

  • Painful urination 

• Bowel Issues: 

  • Constipation or straining during bowel movements

  • Fecal incontinence (involuntary leakage of stool)

  • A feeling of incomplete bowel evacuation

• Pelvic Pain:

  • General discomfort or pain in the pelvic region

  • Pain during intercourse (dyspareunia)

  • Lower back pain

  • A sensation of heaviness or pressure in the pelvic area 

  • Pain during or after sex

  • Inability to experience penetration (vaginismus) 

  • Burning, stinging, irritation, or rawness (vulvar vestibulitis) 

  • Muscle spasms in the pelvis

  • Difficulty relaxing the pelvic muscles  

If any of these sound familiar, keep reading! You are one step closer to finding solutions that will work and not only have the ability to heal your pelvic floor but also your relationship with sex. 

Pelvic Floor Physical Therapy

Pelvic floor physical therapy is available, and it is an absolute must if you are experiencing any of the symptoms listed above. Run, do not walk, to find a physical therapist who specializes in treating the pelvic floor near you! I cannot encourage this enough. Below is what you can typically expect from your first pelvic floor therapy appointment. 

Comprehensive Medical History

The therapist will ask about your symptoms, medical history, lifestyle, and specific concerns. This might include questions about urinary and bowel habits, sexual function, and pain. 

Physical Examination

The therapist will conduct a physical exam, which can include an assessment of posture, spine, and hip alignment, as well as an external and internal examination of the pelvic floor muscles. The internal exam helps the therapist assess muscle tone, strength, coordination, and any areas of pain or dysfunction.

Assessment of Pelvic Floor Function

The therapist will evaluate how well your pelvic floor muscles contract, relax, and coordinate with other muscles. Then, the physical therapist will establish a treatment plan based on your individual needs and concerns. Similar to healing any other injury, healing the pelvic floor takes time, consistent effort, and patience from you and your sexual partner. Your pelvic floor therapist may assign you some restorative yoga poses to help relax and stretch your pelvic floor muscles. Ready to take action?! Here are some exercises you can practice today that, over time, can help alleviate pelvic floor pain. 

Basic Pelvic Floor Exercises 

Deep Diaphragmatic Breathing

Set a timer for 10 minutes, and then begin by lying flat on your back on a comfortable surface. Place both hands on your lower belly and breathe deeply through your nose, ensuring your lower belly and rib cage expand with each inhale. Notice how, with each inhale, your pelvic floor expands like you blow air into a balloon and contracts back to a resting position with each exhale. Do this for 10 minutes a day, every day. 

Legs Up The Wall

Set a timer for 1 minute, and then lay flat on your back on a comfortable surface. Then, place your legs up the wall, forming a 90-degree angle with your legs and torso. Use your deep diaphragmatic breathing while waiting for the timer.

Cat Cow Pose

If you have ever tried yoga, you may already be familiar with this pose, but if not, no worries; it is easy to do and relaxing. On a comfortable surface (cushion, carpet, or yoga mat), begin kneeling and placing both hands on the ground like you are about to crawl. On your inhale, arch your back by moving your head and neck toward the sky. On your exhale, round your back by moving your head and shoulders into a downward position like a cat. Repeat for one minute, arching your back on the inhale and rounding your back on every exhale.

Childs Pose

This is my personal favorite. Get ready to sink into this relaxing pose and have the ground hold and support you. Begin by kneeling and pointing your knees in opposite directions to create a V shape. Lean forward, keeping your buttocks on your heels, and rest your forehead on the floor with your arms outstretched in front of you above your head. Practice your deep diaphragmatic breathing for 1 minute. 

Frog Pose

Move to a kneeling position. Spread your knees wide from all fours, with your shins parallel to your yoga mat. Bring your hips in line with your knees and rest your elbows and chest on a block or the ground. Breathe deeply again using your diaphragmatic breathing for one minute. When coming out of the pose, slowly move your body forward, dropping your stomach flat onto the ground. 

When practicing any of these restorative yoga poses, the most important thing to remember is to meet your body where it is and modify these poses to meet your body’s needs. Yoga is for everyone, and don’t forget to breathe deeply! 

When To See A Sex Therapist?

Painful sexual experiences can create a negative cycle where the anticipation or memory of pain causes anxiety and muscle tightening. This muscle tension restricts the blood flow to the tissues, reducing circulation, which leads to less lubrication and increased muscle tightness. As a result, the pain gets worse, perpetuating this cycle. The cycle of pain must be interrupted. Treatments to decrease pain are not instant and require patience and consistent effort. EMDR is an effective treatment for breaking the pain anticipation cycle. 

While an enjoyable sex life has little impact on a couple’s satisfaction in the relationship, sexual problems have significant adverse effects. During this time, it is crucial that the couple maintains hope and finds other ways to maintain intimacy. A sex therapist can help you and your partner expand your sexual repertoire while simultaneously working on different treatments to decrease pain. I recommend finding a good lube and spending more time receiving foreplay-like penises, vaginas get erections, too. A couple’s sex therapist can also assist both of you in understanding your emotions that can get in the way of enjoying sexual intimacy and that leave you both feeling misunderstood and disconnected.  

Dilators

Another resource that your pelvic floor therapist or sex therapist may recommend is dilators. Dilators are medical tools often used to help stretch or relax tissues, particularly in the vaginal area. They are commonly used to treat conditions such as vaginismus or vulvodynia. Dilators typically come in sets of different sizes, from small (about the size of a finger) to gradually increasing in diameter. This allows for progressive stretching of the tissues over time. 

How To Use

I recommend using the dilators while taking a hot bath. This can help soften the skin, making it easier to stretch, plus it's super relaxing. Apply a small amount of lubricant on the dilator and begin to relax the pelvic floor with deep belly breathing. After a few minutes, insert the dilator into your vagina and leave it there for one minute. Practice this three times a week, working up to leaving the smallest size inserted for 10 minutes. Once you can insert the smallest size comfortably for 10 minutes, move up to the next size and repeat this process.  

CBD Lube and Sexual Pain 

Applying CBD-infused topicals to your genitals is a highly effective way to reduce pain and enhance pleasure. These topicals can provide relief without causing any psychoactive effects. CBD can help with sexual pain during penetration by relaxing muscles, reducing inflammation, and providing pain relief. It may also enhance lubrication, reduce anxiety, and improve blood flow, making the experience more comfortable and enjoyable. 

Topical CBD products like creams or lubricants can be applied directly to the affected area for targeted relief. Everyone’s body responds differently, so it's best to start with a small amount and see how it works for you. If you're considering CBD, consulting a healthcare provider is always a good idea, especially if you have any medical concerns. It offers a gentle, natural way to improve comfort and enhance sexual well-being. Some of the most reputable names in CBD sex oils are Foria, Kush Queen, Quim Rock, and Velvet Swing. Foria is my favorite brand out of the four. 

That’s All Folks

Taking an active approach to healing your pelvic floor dysfunction is essential for long-term progress. I hope you are feeling more seen and guided in your healing journey. Remember, like any other injury, recovery takes time, and every step you take can bring you closer to creating the vibrant sex life that you desire. Feel free to contact us at The Connection Couch if you have any other questions or need further guidance about our in-person and online sex therapy sessions. We also host free workshops every month to learn about how CBD can help with painful intercourse. Send email inquiries to find out when and where they will be hosted. Every body is different, and finding the right strategies and support is vital to your success. 

Start your healing journey with sex therapy in Paradise Valley

At The Connection Couch, we understand how challenging painful sex and pelvic floor dysfunction can be. You are not alone in your pain. These issues can deeply impact your quality of life and intimate relationships. As compassionate sex therapists in Scottsdale, Arizona, we are here to provide a safe, supportive space for your healing journey. Begin today by following these steps:

1. Get started with a complimentary 15-minute consultation

2. Set up your first sex therapy appointment and take the first step toward change

3. Discover the positive effect sex therapy can have on individuals struggling with painful sex.

Additional Services Offered Within Scottsdale, AZ

As a sex therapist in Paradise Valley, I offer therapy for individuals and couples who are looking to improve their intimacy, as well as couples dealing with betrayal and infidelity. Additionally, I offer therapy services for those recovering from sexual trauma.

Sources:

• Hertlein, K. M., Weeks, G. R., & Gambescia, N. (2020). Integrative sex and couples therapy: A therapist’s guide to new and innovative approaches. Routledge. 

• McCaffrey, K. (2019). Merry Jane: The CBD solution. Greenleaf Book Group Press. 

• Stein, A. (2009). Heal pelvic pain: A proven stretching, strengthening, and nutrition program for relieving pain, incontinence, IBS, and other symptoms without surgery. Echo Points Books and Media. 

Resources Collected by a Sex Therapist in AZ:

Pelvic Floor Therapists in Arizona: 

• https://desertpt.com/

• https://pelvicwellnessaz.com/

• https://shept.com/

CBD Infused Topicals: 

• https://www.foriawellness.com/

• https://kushqueen.shop/

• https://itsquim.com/

Instagram:

• @vaginarehabdoctor

Online Sex Therapy in Paradise Valley, Arizona

What is online therapy? 

Online therapy, also known as telehealth therapy or virtual therapy, refers to mental health counseling or therapy sessions conducted over the Internet. These sessions involve video or phone calls between a licensed professional therapist and a client. They allow individuals to access mental health support from the comfort of their homes, providing convenience and accessibility, especially for those who may have difficulty attending in-person sessions due to distance, time constraints, or mobility issues. 

Online therapy can cover a range of services, including individual counseling, sex therapy, couples therapy, and group therapy–we will get into the nitty gritty of online individual and couples therapy later. Various platforms and apps facilitate this service, connecting people with qualified therapists to help based on the individual’s specific needs. Telehealth therapy has grown in popularity due to its flexibility and the ongoing integration of technology into healthcare. 

Pros of online therapy

Online therapy has a lot of great benefits that make it easy for many people to get help. If you are anything like me and will do anything to avoid leaving the house and driving, online therapy may be a great fit for you. Here are some other reasons online therapy is an excellent option:

Easy to Fit Into Your Life

• You can talk to a therapist from the comfort of your home or during your work day, so you don’t need to worry about traveling. This can save you time, energy, and money. You don’t have to worry about traffic, getting in a hot car, spending more on gas, or taking more time off work to make it to your appointment.

Helps More People Get Help

• If you live far away from a therapist’s office or find it hard to leave home, online therapy lets you get the support you need, no matter where you are. This is especially helpful for people who live in a small town and are concerned about dual relationships with their therapist. 

More Choices

• You’re not limited to therapists near you, so you can find someone who understands your needs, even if they live far away. 

Feels Safe and Private

• For people who feel nervous about therapy, talking to someone from the comfort of home can make opening up easier and can add an extra level of privacy.

Stays Consistent

• If you move or your therapist moves, you don’t have to stop therapy. You can keep talking to the same therapist. One caveat with this perk is that your therapist must be licensed in the state you live in. So, if you move and your therapist does not hold a dual license, you must find a different therapist. 

Different Ways to Communicate

• You can choose how to talk to your therapist–by video, phone, chat, or even email–so you can do what feels best for you.

These reasons make online therapy an excellent option for getting the help you need conveniently and comfortably. 

Cons of online therapy

Let's get into the things about online therapy that might not work for everyone. 

Internet Problems

• As we all know, the internet can be a finicky bitch. Having a smooth therapy session can be challenging if your internet isn’t strong or reliable. Video or audio might freeze or get disconnected, which can be frustrating. 

Not for Everyone

• Some people need in-person help, especially if they are dealing with severe mental health problems. In-person therapy may be better for things like body language and hands-on support. For some, talking through a screen can feel different than talking face-to-face. Some people might miss the feeling of being in the same room with their therapist. 

Distractions at Home

• It can be harder to focus during therapy if you’re at home, where things like pets, kids, or noise can interrupt. You might need to find a quiet place to focus on your session.

Tech Comfort

• Some people aren’t very comfortable using technology. If using computers or phones for therapy feels too confusing, online therapy might not be the best choice for you. 

These are some things to think about if you’re considering online therapy. It works great for some people, but others might prefer face-to-face sessions. It’s all about what feels right for you. 

Does Sex Therapy work online?

Yes, online sex therapy can be very effective for many people. Just like in-person therapy, it offers a safe, confidential space to explore and address concerns about intimacy, communication, and sexual health. For some, the added convenience of accessing therapy from home can make it easier to open up and have honest conversations, especially around sensitive topics.

Of course, like any type of therapy, the success of online sex therapy depends on the connection between you and the therapist, your openness to the process, and your willingness to engage in the work actively. But for many, it can be a transformative experience, helping to improve communication, resolve sexual difficulties, and foster deeper, more fulfilling relationships.

If you're considering it, it's worth looking for a licensed therapist who has specific training and experience in sex therapy. Finding the right fit can make all the difference.

Does EMDR work online? 

The answer is YES, and EMDR works just as well online as in person. Your therapist will still follow the eight-phase EMDR protocol and do everything the same way online as they would in person, but instead of using their fingers, a stick, or buzzers for the bilateral stimulation (BLS), they will send you a link to an online program that performs the BLS manually. The online EMDR BLS programs are simple and easy to use, and they usually require one button click on the client’s end to get them up and running. 

Does Couples therapy work online?

Yes, online couples therapy can work! Many couples find it helpful because it offers a convenient way to discuss their problems with a therapist from their homes or workplaces. Online therapy can be especially beneficial for couples with young children who cannot find childcare or whose work schedules make it difficult for them to be in the same place. As long as both people are open to the process and committed to making things better, online couples therapy can be just as effective as meeting face-to-face. 

To wrap up, online therapy can be a great way to get the help you need in a way that fits your unique life. Whether you are looking for support in your romantic relationship, sexuality, or coping with sexual trauma, it’s nice to know help is just a click away. If you think it might be right for you, don’t hesitate to contact us at The Connection Couch. Taking care of your mental health is essential, and online therapy makes it easier than ever to get started.

start sex therapy in Paradise Valley and Online

Ready to learn more about online therapy? We understand that opening up about difficult thoughts and emotions can feel overwhelming. You are not alone and deserve to feel supported. As experienced sex therapists in Scottsdale, we are here to provide a safe, compassionate space for your healing journey. Get started with The Connection Couch by following these steps:

1. Reach out today for a 15-minute consultation at no cost

2. Start healing with your first sex therapy appointment

3. See how online sex therapy can effectively support you from the comfort of your home.

More Therapy Services Provided In The Scottsdale Area

As a sex therapist in Paradise Valley, I offer therapy services for couples and individuals seeking to improve their intimacy. I also specialize in helping partners navigate betrayal and heal from infidelity. Additionally, I offer support for those healing from sexual trauma.

Is Sex Therapy Right for You? Signs It Might Be Time to Seek Help

Let’s face it: talking about sex can feel awkward. Even in today’s world of open conversations and trending hashtags, many of us still clam up when it comes to discussing what goes on (or doesn’t go on) behind closed doors. But here’s the truth: our sexual well-being is just as important as our physical and mental health. And just like you might see a physical therapist for a sore back or a counselor for anxiety, a sex therapist can help with intimacy-related concerns.

So, how do you know if sex therapy is right for you? Let’s explore the signs that might indicate it’s time to seek professional guidance—and don’t worry, we’ll keep things warm, professional, and maybe even a little lighthearted.

Intimacy Has Taken a Back Seat

Life is busy. Between work, kids, laundry, and endless scrolling on social media, it’s easy for intimacy to take a back seat. But if “date night” has turned into “Netflix and no chill” for months on end, it might be worth examining why. 

Sex therapy can help you and your partner reconnect emotionally and physically. It’s not just about the act itself; it’s about understanding the barriers to intimacy and finding ways to reignite the spark. 

Mismatched Libidos

Let’s talk about one of the most common challenges couples face: differing levels of sexual desire. Maybe one of you is channeling your inner Energizer Bunny, while the other feels more like a hibernating bear. It’s normal for libidos to fluctuate, but persistent mismatches can lead to frustration, resentment, or feelings of rejection. 

A sex therapist can help you navigate this tricky terrain by fostering open communication and helping you understand each other’s needs. The goal? To find a balance that works for both of you.

Unresolved Trauma or Emotional Barriers

Past experiences can cast long shadows on our present lives, especially regarding intimacy. Whether it’s a history of sexual trauma, body image issues, shame or anxiety towards sex, or unresolved relationship conflicts, these emotional barriers can impact your ability to connect with your partner.

Sex therapists are trained to create a safe, non-judgmental space where you can explore these issues. They’ll work with you to address the underlying causes and help you move toward healing and self-acceptance. It’s like unpacking emotional baggage but with someone who knows how to fold those metaphorical clothes neatly.

Physical Challenges Are Getting in the Way

Let’s get real: sometimes, things don’t work as smoothly as we’d like them to. Erectile dysfunction, painful intercourse, or difficulties achieving orgasm are more common than you might think. And while it’s tempting to avoid the issue or hope it resolves on its own, ignoring it can lead to unnecessary stress.

Sex therapy, often in conjunction with medical treatment, can help address these physical challenges. By combining education, communication strategies, and sometimes even playful exercises (yes, homework can be fun), a therapist can guide you toward a more satisfying and confident sexual experience.

You’re Struggling with Identity or Orientation Questions

Sexuality is a complex, deeply personal aspect of who we are. If you’re grappling with questions about your sexual orientation, gender identity, or how to express yourself authentically, a sex therapist can provide support and guidance. 

They can help you navigate these explorations with compassion and understanding, ensuring you feel empowered to embrace your true self. Think of them as your personal cheerleader in the journey of self-discovery—pom-poms optional.

Communication About Sex Feels Impossible

If every conversation about intimacy with your partner turns into an argument, or if you’re avoiding the topic altogether, it’s a clear sign that some outside help could be beneficial. Effective communication is the cornerstone of a healthy relationship, and yes, that includes the bedroom.

A sex therapist can teach you and your partner how to talk about your needs, boundaries, and desires without the fear of judgment or criticism. The result? Less tension and more connection—and who wouldn’t want that?

Struggling with Out-of-Control Sexual Behaviors

If you find yourself engaging in sexual behaviors that feel out of control or acting outside of your relationship agreements, it may be time to seek help. These behaviors can lead to feelings of guilt, secrecy, or strain in your relationship. 

A sex therapist can help you identify underlying issues, set healthy boundaries, and develop strategies to regain balance and integrity in your intimate life.

You’re Curious but Hesitant

Maybe nothing is “wrong,” but you’re curious about how sex therapy could enhance your relationship. Perhaps you want to explore new intimacy aspects, deepen your connection, or better understand yourself and your partner.

Sex therapy isn’t just for “fixing” problems; it’s also a tool for growth and exploration. Think of it as upgrading from standard to high-definition—everything becomes clearer, richer, and more fulfilling.

If You’re Considering Opening Up Your Relationship

So, you and your partner are thinking about opening up your relationship. Maybe you’re curious about polyamory, ethical non-monogamy, or just exploring new dynamics together. First of all, kudos to you for having the courage to explore this honestly! But let’s be real—navigating these waters can be tricky without a solid roadmap (or a GPS with a reassuring voice).

A sex therapist can help you and your partner establish clear boundaries, foster open communication, and address any underlying fears or insecurities before taking the plunge. Think of it as a relationship tune-up before you hit the open road. Plus, it’s always good to have a neutral party who can help you spot potential potholes before they become full-blown sinkholes.

What to Expect from Sex Therapy

If you’re considering sex therapy, you might be wondering what actually happens during a session. First things first: it’s a lot less awkward than you think. You won’t be asked to overshare or do anything that makes you uncomfortable. Instead, your therapist will guide the conversation, helping you explore your thoughts, feelings, and experiences in a safe and supportive environment. Some sessions may include your partner, while others might focus on you as an individual. 

Taking the First Step

Deciding to see a sex therapist is a brave and empowering choice. It’s an investment in yourself, your relationship, and your overall well-being. So, if any of the signs above resonate with you, consider reaching out to a qualified professional to schedule in-person or online sex therapy. After all, everyone deserves a fulfilling and satisfying intimate life—and sometimes, a little help can go a long way.

Remember, sex therapy isn’t about fixing what’s “broken.” It’s about creating a space where you can grow, heal, and connect. And who knows? You might even discover that talking about sex isn’t so awkward after all.

Discover The Benefits of Sex Therapy in Scottsdale, AZ

Ready to take the next step? As experienced sex therapists in Paradise Valley, we are here to provide support to help you develop a better relationship with your sexuality. At The Connection Couch, we specialize in helping individuals and couples navigate the complexities of intimacy with warmth, professionalism, and care. Start your journey toward deeper connection and fulfillment by following these steps:

1. Contact us for a free 15-minute consultation

2. Book your initial sex therapy session

3. Experience how sex therapy can transform your relationships and overall well-being.

Explore Other Therapy Services Offered in Scottsdale, Arizona

As an expert sex therapist in Paradise Valley, I offer therapy services for individuals and couples aiming to improve their intimacy. Additionally, I assist couples in healing from betrayal and infidelity. I also provide support and guidance for those recovering from sexual trauma.

Resources From a Sex Therapist:

Arizona Attorney General’s Office of Victim Services:

• 642-542-4911

• https://www.azag.gov/criminal/victim-services/victim-compensation-restitution#:~:text=For%20more%20information%20about%20restitution,Restitution 

National Sexual Assault Hotline: 

• 1-800-656-4673

Overcoming Performance Anxiety and Erectile Dysfunction With a Paradise Valley Sex Therapist (in training)

Erectile dysfunction (ED) and performance anxiety are related, but they’re not quite the same thing. ED is the physical experience of difficulty getting or keeping an erection. Performance anxiety is psychological and is more about the worry or fear of not being able to perform sexually, which can lead to ED.

The link between Performance Anxiety and Erectile dysfunction

Performance anxiety or sexual stage fright can stem from all sorts of things like past sexual experiences, religious backgrounds, body image concerns, stress, childhood sexual abuse, childhood abandonment, rejection or neglect, relationship factors, and unhealthy societal ideals about men’s sexuality. The pressure to perform can create a cycle where worry leads to being unable to obtain or sustain an erection, which creates a cycle that continues to get in the way of maintaining an erection.

Performance anxiety can cause ED because the stress and worry that comes with it can interfere with sexual arousal. When someone feels anxious, their body can go into “fight or flight” mode, which isn’t helpful for sexual response. We need to be relaxed to get aroused and experience pleasure. This cycle can then make ED worse, especially if someone begins to expect it to happen each time they’re intimate.

On the other hand, ED can sometimes have physical causes that aren’t connected to performance anxiety, such as health conditions like diabetes, heart disease, or the effects of certain medications. In these cases, ED can still lead to performance anxiety as someone may begin to worry about their ability to perform, which can add a layer of stress to sexual intimacy.

So, while they are different, ED and performance anxiety often go hand in hand. Erectile issues are frustrating, and they can lead to feelings of embarrassment, anxiety, shame, or self-doubt. The good news is that understanding this relationship can make it easier to find the appropriate solution and support to address the underlying cause of the erectile issue.

What impacts how erections are sustained?

Getting and maintaining an erection is a process that involves your body, mind, and nervous system working together in harmony. Sustained erections depend on many factors, such as:

Diet

• Trying to have sex after a big meal can impact your body’s ability to sustain an erection. This is because after eating, blood is diverted to your intestines, away from the penis to help with the food digestion process.

Alcohol

• Alcohol can dampen the brain’s ability to send clear signals to the body, including the signals needed to allow blood flow to the penis. Alcohol widens blood vessels temporarily, which makes it harder for the blood to stay trapped in the penis long enough to maintain an erection.

Hydration

• If you are dehydrated, your heart has to work harder to pump blood to your penis, which makes it more challenging to maintain an erection.

Sleep

• Sleep also helps regulate stress levels. When we are well-rested, we’re usually more relaxed and able to focus, feel connected, and get aroused.

Mood/Emotions

• Positive emotions like happiness, love, and excitement create a sense of ease, which helps the brain send clear signals to the body for arousal and blood flow. On the other hand, feelings of stress, anxiety, sadness, guilt, or shame can make it challenging for these signals to come through. If you are anxious, depressed, have OCD, ADHD, PTSD, or substance abuse issues, on top of erectile issues–I encourage you to seek support from a mental health professional who specializes in treating sexual problems as well. SSRIs can significantly impact men’s sexual health.

Attraction to Our Partner

• When we feel emotionally and physically drawn to someone, it sparks a sense of desire, excitement, and connection. This positive feeling creates a flow of signals between the brain and body that supports arousal, the physical response needed for an erection.

Relationship Issues

• If the relationship is challenged, there are feelings of disconnection, or there is a lack of emotional intimacy, these can affect how we feel toward our partner, which might influence our body's physical response to arousal and desire. If a partner feels rejected by their partner’s inability to maintain an erection, this can also perpetuate the cycle of performance anxiety. Trust the wisdom of your body and have the courage to do the work and fix your relationship issues.

Hormones

• Hormones regulate many processes that drive sexual arousal and function. One of the key hormones involved is testosterone, which is crucial for sexual desire and the ability to get and maintain an erection. Healthy levels of testosterone help keep libido strong and support the body’s physical response to arousal.

Cardiovascular System

• The cardiovascular system plays a vital role in sustaining erections, as it is responsible for the flow of blood throughout the body, including the penis. Good circulation means that blood can flow freely and quickly into the penis when needed, helping to create and maintain an erection. If there are issues with the cardiovascular system–such as high blood pressure, clogged arteries, or poor circulation–it can affect how easily and how long blood flows into the penis.

Blood Pressure

• Healthy blood pressure helps ensure blood flows freely and in the right amounts to create and sustain an erection. Blood pressure medications can impact men’s sexual health.

Pelvic Floor Health

• Pelvic floor muscles are directly involved with sexual function. The pelvic floor muscles surround the base of the penis and are responsible for helping trap blood inside the penis during an erection, which keeps it firm. These muscles also help control the release of blood, allowing for a steady and sustained erection.

Erectile issues are like check engine lights. They mean something is going on under the hood, and we need to do additional digging to determine the issue's root cause.

physical causes of erectile issues

As we are learning, there can be many causes for erectile difficulties, and it can be overwhelming to know where to go for answers and solutions. The first step is to get a complete physical from your primary care doctor to rule out physical causes such as diabetes, cardiovascular problems, or hormonal issues. An important thing to note about testosterone replacement therapy (TRT) is that it can have long-term consequences, such as shrinking the testicles, and can ruin our body's ability to generate testosterone naturally on its own. So, consider obtaining a second endocrinologist's opinion before starting TRT.

methods to rule out physical causes of erectile issues

Another way to rule out physical causes is to purchase a Firmtech cock ring. Firmtech’s technology allows penis owners to track their body’s nocturnal erections. Suppose you have two or fewer erections during the night. In that case, it’s likely your erectile issues have a medical cause, and it’s time to see your primary care doctor so they can refer you to a urologist, cardiologist, or endocrinologist. Otherwise, if your nocturnal erections are in the normal range, the root cause is most likely occurring psychologically or in your relationship.

One other way to decipher if the origin of your erectile issues is physical or psychological is by asking yourself if you can get an erection when you are home alone, masturbating, getting down with yourself, or me՜nage a՜ moi ing it. This can give you a good indication of what needs to be addressed.

Psychological causes of erectile issues

You’ve done the work, gone through the process of elimination, and have determined with your primary care doctor that the root of your erectile issues is psychological or relational. The wonderful news is that erectile problems do not determine whether you can give pleasure to your lover. You have fingers, a mouth, sex toys, and, more importantly, your presence and heart to make love with. Your value as a lover cannot be reduced to your penis. The more heart and vulnerability you bring to your sex life, the depth of your intimacy will grow within your relationship.

how Shame and Fear Can Lead to erectile issues

Our societal norms and expectations of men paint a picture that they should always be able to perform effortlessly in bed. Men should never have any problems getting aroused or obtaining an erection, much less sustaining it throughout the entire sexual experience.

The idea that men should always be able to take charge and perform sexually can lead to a negative cycle of feeling embarrassed, inadequate, personal failure, sexual shame, anxiety, and avoidance of sex entirely. A penis owner can have difficulty with an erection one time, then worries that the next time it will happen again, then attempt to have sex and can't be present due to worry and is unable to get an erection. He worries that something is wrong with him and his penis, and the cycle continues over and over again.

Trauma is stored throughout the body. If a penis owner has a history of relationship trauma, it can impact their ability to be intimate and vulnerable in a long-term relationship. Childhood experiences of abandonment, neglect, and rejection can unconsciously make a person feel like getting into a long-term committed relationship is unsafe, even dangerous, and can affect a man’s ability to obtain and maintain an erection. Pay attention to what you are feeling and experiencing in your body.

Best therapies for treating erectile dysfunction

Sex Therapy

Sex therapy is a type of psychotherapy that focuses specifically on sexual issues. It can help individuals or couples address both the emotional and physical aspects of ED. Sex therapists work with clients to improve communication, resolve relationship problems, reduce sexual anxiety, and explore any emotional or psychological blockages related to sex. This therapy is beneficial for ED who have relational or emotional roots, such as performance anxiety or trauma-related issues.

Mindfulness-Based Stress Reduction (MBSR)

Mindfulness practices, including meditation and body awareness exercises, can help reduce anxiety and increase relaxation, which may improve sexual function. Mindfulness encourages non-judgmental awareness of the present moment, which can help reduce stress and performance pressure during sex. By focusing on the sensations of intimacy rather than on specific outcomes (such as achieving an erection), individuals may experience less anxiety and more satisfaction in sexual encounters. Mindfulness has been found to reduce symptoms of anxiety and improve overall sexual functioning in some people.

Couples Therapy

ED can sometimes result from relational issues, such as lack of communication, unresolved conflicts, or emotional distance. Couples therapy addresses these issues directly. A trained therapist can help partners communicate more openly about their needs, fears, and desires, which can reduce stress around intimacy. It also helps improve emotional connection, which can enhance sexual desire and function. Couples therapy can be beneficial if ED is affecting a relationship or if there is a lack of intimacy or emotional closeness.

EMDR

EMDR (Eye Movement Desensitization and Reprocessing) can be a deeply transformative therapy for people who experience erectile issues rooted in emotional trauma or unresolved psychological distress. While it’s often associated with trauma recovery, it has also shown promise in helping individuals with sexual dysfunction, mainly when emotional or psychological factors play a role. EMDR can help remedy erectile issues by releasing emotional baggage, alleviating performance anxiety, and healing negative beliefs.

Other solutions for erectile dysfunction

If you find yourself caught in a negative cycle of anxiety about your erections, come into the present moment. Pay attention to your five senses. What does your lover's skin feel like? What do their lips taste like? Draw your awareness to your breath and focus on deep belly breathing. Talking during sex can be another effective way to keep your mind focused on the present moment. Talking can be as red hot, dirty, or vanilla as you and your partner like.

What kinds of stories were you told about erections? Are they bad? Dangerous? Something to be ashamed of? What is your spiritual relationship to your eroticism and sensuality? Erotic meditations and Lingam massages are a way to practice healing touch and love instead of expectation and desire for the penis to behave in a performative way–getting hard and getting off.

Building a Pleasure-Centered Approach to Sex

Communicate with your partner about switching the focus to pleasure rather than performance during sexual intimacy. Prioritizing pleasure above all else during sex is the foundation for a successful sexual experience. In a long-term relationship, sex will be great, something in between, and disappointing at times. Practicing acceptance of each other and the situation for what it is without blame or shame will minimize anxiety and the pressure to perform over time.

Cock rings can be a surprisingly handy–and fun–tool for dealing with erectile issues. They work by gently restricting blood flow out of the penis, which helps maintain a firmer erection for longer. Firmtech is a company that uses science to design cock rings that are safe and comfortable to use. Don’t be afraid to incorporate more toys into your sex life!

One of the most effective and, by far, my favorite way to enhance sexual pleasure and blood flow to the penis is THC-infused topicals during intercourse. THC topicals create an effect called vasodilation, which means they increase blood flow, swelling, and heightened sensation in the penis. If applied topically, it will not have the high effect that would occur if you ate, drank, or smoked it. My favorite brand to purchase THC topicals from is Kush Queen.

Pros and cons of using Viagra for erectile difficulties

Taking Viagra for erectile difficulties can be a helpful option for many men, and it comes with its own set of pros and cons. Here’s a balanced look at what it can offer and some things to consider.

Pros:

• Improved Blood Flow and Responsiveness

  • Viagra helps increase blood flow to the penis, making it easier to get and keep an erection when sexually aroused. For many people, it’s a reliable way to support a more natural sexual experience.

• Boosts Confidence

  • Viagra can relieve some of the worries around performance, allowing some people to focus more on connection and enjoyment without the added stress of whether or not their body will respond as they hope.

• Quick Acting

  • Viagra starts working within 30 minutes to an hour, making it easy to plan for intimate moments without a long wait. The effects can last several hours, allowing for some flexibility in timing.

• Widely Tested and Trusted

  • As one of the most commonly prescribed medications for erectile difficulties, Viagra has been studied extensively, so its effects and side effects are well-understood by healthcare providers.

Cons:

• Temporary Solution

  • Viagra doesn’t treat underlying causes of erectile difficulties. It’s a “quick fix” that helps at the moment but doesn’t address deeper causes.

• Possible Side Effects

  • Some people experience side effects like headaches, facial flushing, upset stomach, or vision changes. In rare cases, men can get Priapism, which is an erection that lasts more than four hours. It is painful but not very common.

• Not Suitable for Everyone

  • Certain health conditions–like severe heart problems, low blood pressure, or interactions with specific medications, can make Viagra very unsafe.

It’s always best to check with your healthcare provider to ensure using Viagra is a safe option for you.

Closing thoughts from a sex therapist in AZ

Erectile difficulties are a shared experience and nothing to feel alone or ashamed about. From lifestyle changes and relaxation techniques to medical options and communication skills with your partner, there are many ways to support your sexual health and confidence.

Remember, you do not have to navigate this journey alone. If you’re facing erectile difficulties, reaching out to a healthcare provider or a trusted professional can open doors to personalized support and guidance. At The Connection Couch, we are qualified to help you embrace this conversation with yourself and your partner. Reach out for additional support if you are ready to take the next step toward greater intimacy, connection, and peace of mind.

Overcome Performance Anxiety & ED with Sex Therapy in Scottsdale, AZ

We know how challenging it can be to discuss concerns like performance anxiety and erectile dysfunction. These struggles can impact not only your confidence but also your relationships and overall well-being. As experienced sex therapists in Paradise Valley, we are dedicated to providing compassionate, evidence-based care in a safe and supportive environment. Begin your journey with The Connection Couch by following these steps:

1. Request a free 15-minute consultation

2. Schedule your first sex therapy appointment and begin the healing process

3. Uncover the life-changing benefits of sex therapy for individuals struggling with performance anxiety and erectile dysfunction.

Other Therapy Services Offered In The Scottsdale Area

As a sex therapist in Paradise Valley, I provide therapy for couples and individuals seeking to improve their intimacy. I also specialize in helping partners navigate betrayal and heal from infidelity. Additionally, I offer support for those recovering from sexual trauma.

Sources Related To Sex Therapy:

• McCaffrey, K. (2019). Merry Jane: The CBD solution. Greenleaf Book Group Press.

• McCarthy, B. W., & Metz, M. E. (2004). Coping with erectile dysfunction: How to regain confidence and enjoy great sex. New Harbinger Publication.

• Watter, D. N. (2022). The existential importance of the penis: A guide to understanding male sexual health and masculinity. Springer.

Resources Provided by a Sex Therapist:

Pelvic Floor Therapists in AZ:

• https://desertpt.com/

• https://pelvicwellnessaz.com/

• www.shept.co

Topicals and Toys:

• https://myfirmtech.com/

• https://kushqueen.shop/

Erotic Meditation and Lingam Massage:

• https://www.youtube.com/watch?v=p0e2AKwvj7g

• https://www.youtube.com/watch?v=zYyhs3Whjqo

Understanding and Managing Out-of-Control Sexual Behaviors with a Paradise Valley Sex Therapist (in training)

This blog post may be different from what you were expecting. It may challenge a lot of what you believe to be true about sex addiction. By incorporating insights used in sex therapy, I hope that you can keep an open mind and walk away with a healthier way to understand and categorize out-of-control sexual behavior.

Sex Addiction

Sex addiction is a term used when someone has trouble “controlling” their sexual desires, thoughts, behaviors, and actions. The American Psychiatric Association has rejected the concept and diagnosis of sex addiction consistently for over forty years because there is no definite science that says it exists. It is not listed in the Diagnostic Statistical Manual of Mental Disorders, DSM-5 (the book all mental health therapists and professionals use to diagnose their clients).

You might be saying, I have had personal experience with a sex addict, or if it does not exist, then why is the term so widespread? Let’s get into the history of how this term came to be and how our culture and media have shaped the way we think about and view sexual behavior.

History of The Term Sex Addiction

The term sex addiction was created in the early 1980s. During this time period, our society was struggling with AIDS and the HIV epidemic. The terms sex addiction and pornography addiction became a way to make people, especially gay men, feel guilty or ashamed for their sexual preferences.

During the 1980s, our society was shifting its ideals on sexuality and gender norms. Before, powerful, rich white men were often allowed to do whatever they wanted when it came to sex. They could get away with having mistresses, prostitutes, etc, without facing consequences. But, during this time, people began to speak up and push for fairness so that everyone, no matter their gender, would be treated more equally in sex and relationships. The idea of sex addiction is a social phenomenon; it’s not clinical, medical, or based on any research.

Throughout history, every time we allow social morality to dictate medical and psychological treatment, terrible things happen to people. In the 1800s, when the belief was that masturbation was immoral, it led to horrible things being done to children; women who enjoyed sex were labeled as nymphomaniacs or female hysteria, which led to them being institutionalized and receiving lobotomies, same with gay people being forced to undergo electroconvulsive therapy. We hurt people when we allow social morality to make decisions about our sexual, medical, and mental health treatments.

What Science DOES Tell Us About “Sex Addiction”

Some of the latest research studied what the people involved in “sex addiction” therapy looked like, also known as the demographic. What they found was over 90 percent of the people receiving this type of therapy were men, over half were white men who made over eighty-five thousand dollars a year, and that gay and bisexual men were three times at risk of being labeled as a “sex addict.”

What this tells us is that the sex addiction industry is continuing to label homosexual behaviors as an illness. While offering an excuse for wealthy, white, powerful men who get caught engaging in selfish and harmful sexual behaviors, an excuse of having a “disease” to avoid responsibility for their actions that they do have control over. There is also not a single published study that shows that sex addiction treatment programs help people to make different choices. So, if this is the case, then why do so many mental health professionals struggle to agree on this issue?

A Profession Divided

Unfortunately, mental health therapists receive little training on sexuality issues. Only five percent of mental health professionals have received training beyond how to diagnose sexual disorders that are listed in the DSM-5. This leaves therapists subject to making decisions about their clients’ sexual issues based on their biases-YIKES! In the words of the famous sex researcher Charles Kinsey, “Anyone with the diagnosis of a nymphomaniac is someone who has more sex than the therapist.”

Men Use Sex To Cope

Men, more frequently than women, use sex as a coping strategy for negative emotions. Sadly, our society teaches men that they cannot have emotions, much less talk about them. This makes it difficult for men to understand and process feelings healthily. This can lead them to turn to sex or pornography to cope with stress and other challenging emotions to make them feel better, not the other way around. Pointing the finger at porn and sex is just a distraction from the root of the issue that men are not allowed to express their feelings. Men need safe, nonjudgmental spaces to learn different ways to cope with complicated emotions and life experiences. Sex therapy can help men navigate their emotions and develop more effective coping strategies.

A new way of understanding out-of-control sexual behaviors

Think of sexual behaviors on a spectrum. One end is rigid, and the other is out of control. In the rigid category, we may see men who are in distress because their spouse has labeled them a sex or pornography addict. After a thorough assessment of their behavior, we discover that they are only watching porn and masturbating a couple of times a month, at home, in private. This is an example of a moral incongruence– a mismatched experience between what a person believes is right and what they do. People from religious backgrounds are more likely to label someone as a sex or porn addict and experience a moral incongruence.

On the other side of the spectrum, we have out-of-control sexual behaviors. Men in this category are sexually behaving more recklessly. They may have multiple affairs, may not be careful to use contraceptive methods, and potentially are spending thousands of dollars paying for sex, whether it be sex workers, cam girls, or massage parlors. Men with these behaviors need different interventions, but to help them, we need to look at the problem differently and hold them accountable to their relationship agreements.

Relationship Agreements

Relationship agreements are mutually agreed-upon terms or guidelines between partners in a relationship that help define expectations, roles, boundaries, and the dynamics of how the relationship will work. They can take various forms depending on the needs and desires of the individuals involved. Relationship agreements are often used to clarify communication, prevent misunderstandings, and ensure that both partners are on the same page about important aspects of their relationship.

Here are some examples of elements that might be included in a relationship agreement:

Communication Expectations

• How and when partners will communicate, and what kind of communication style is preferred (e.g., frequent check-ins, open and honest discussions about feelings, etc.).

Boundaries

• What personal or emotional boundaries are important to each partner? These could include physical space, privacy, or no contact with ex-partners or other relationships.

Monogamy vs. Non-Monogamy

• In some relationships, the agreement may outline whether the partners are committed to monogamy or if they are polyamorous, open relationships, or other non-monogamous arrangements.

Financial Responsibilities

• How will expenses and financial responsibilities be divided, especially if the partners are cohabiting or sharing resources?

Conflict Resolution

• How disagreements or conflicts will be handled, including whether there will be mediation, time-outs, or specific methods for resolving disputes.

Sexual and Intimacy Preferences

• Expectations and agreements regarding sexual activities, frequency, boundaries, and intimacy.

Long-Term Goals

• Discussions about future aspirations, like marriage, children, career goals, or relocation, and whether both partners are aligned on these critical life decisions.

Time and Space

• Agreements about the amount of time spent together versus apart, how much personal space each partner needs, and any other commitments or priorities outside the relationship.

Mutual Support

• How partners will support each other emotionally, mentally, and physically through different life challenges or transitions.

Check-ins

• Some relationships include regular "relationship check-ins" as part of their agreement, where both partners reflect on how the relationship is going, what is working, and what might need adjustment.

Relationship agreements can be formal or informal, written or verbal, and should be adaptable as needs change over time. They are often seen as a way to build trust and clarity between partners, especially in complex relationships where expectations may need to be more obvious and easily understood.

The key to a healthy relationship agreement is ensuring that both partners feel heard and respected and that the agreement evolves as needed.

Six Sexual Health Principles

Rather than making clinical and medical decisions based on social morality, let’s discuss what makes sexual behavior problematic in a way that is sex-positive, holds people accountable to their relationship agreements, and respects sexual and erotic diversity. Doug Braun-Harvey created the six principles of sexual health. These principles are the foundation for fostering healthy, respectful, and safe sexual relationships.

• First Principle

  • All sexual activity should be consensual, with clear and enthusiastic agreement from all parties involved.

• Second Principle

  • Non-exploitation, which means sexual relations are free from coercion, manipulation, and exploitation.

• Third Principle

  • Protection from harm. This means sexual activity should involve taking steps to protect oneself and others from harm, including protection from unwanted pregnancies and sexually transmitted infections (STIs).

• Fourth Principle

  • Honesty includes open and honest communication about sexual intentions, desires, and expectations.

• Fifth Principle

  • Shared values. Sexual relationships should be based on shared values and respect.

• Sixth Principle

  • Mutual pleasure. Sexual activity should be mutually satisfying, with the needs and desires of all parties being considered and respected.

The thing I love the most about the six sexual health principles is how much they account for the diversity of sexual or gender orientation and erotic expression.

Putting it all together

Now, let's apply different relationship agreements and the 6th principles of sexual health to out-of-control sexual behaviors.

Relationship A

Let’s say we have a married heterosexual man who likes to occasionally sleep with women when he is out of town for work WITHOUT his wife’s knowledge or consent. This behavior is problematic because he is engaging in sexual activity that is not a part of his current relationship agreements and could potentially expose his partner to unwanted STIs and pregnancy.

Relationship B

Now, let’s say we have a heterosexual man, but this time, he is not married. He chooses to sleep with women on the weekends casually, and when he does, he is careful and implements safe sex practices to protect himself and his sexual partners from STIs. He is honest with his sexual partners that he is not looking for anything serious and allows the people he is sleeping with to make physically and emotionally safe decisions for themselves.

Relationship C

For our third, we have a gay man who is married, but he and his husband are in an open relationship practicing ethical non-monogamy. He and his spouse have honestly and transparently agreed that when either one of them is out of town and the opportunity arises, they are allowed to casually sleep with a person of the same sex as long as they practice safe sex to protect from STIs.

These three examples show similar sexual behaviors but are operating under different relationship agreements. Relationship A is harmful because he is being dishonest and is engaging in sexual activity that is not a part of his current relationship agreements and could potentially expose his partner to unwanted STIs and pregnancy. Relationships B and C, whether they would work for you or not, are open, honest, and based on the individual and couple's values that work for their unique relationship rather than what society told them is and is not ok regarding sex and relationships. What is ok in one relationship may not be ok in another. What one relationship may consider as too much sex and porn may not be enough or a problem in another relationship.

Another way to look at this is: What are your current relationship agreements? Are you keeping them? Why or why not? Are you okay with what you are doing? Why or why not? Is your partner(s) aware of what you are doing? Why or why not? Are you protecting others? Either the person’s behavior needs to change, or their values and relationship agreements need to change to make the sexual behavior okay.

Thoughts From a Paradise Valley Sex Therapist

From my experience as a mental health professional and AASECT sex therapist in training, working with men who are struggling with out-of-control sexual behaviors, those who want to stop can do so because their sexual actions don’t match their values and beliefs. They learn and find new, healthier ways to cope with difficult emotions and challenges. The ones who don’t stop continue because they feel like they are following society’s rules about sex, even though those rules don’t work for them. Some of these men who choose not to stop their sexual behaviors will leave their relationships and start new ones where they can make agreements that better fit their needs. Others stay because they’re afraid to speak up, fear starting over, or want to have their cake and eat it too.

At The Connection Couch in Paradise Valley, we pride ourselves on creating a safe, nonjudgmental space for men to find healthier ways of processing and coping with their emotions while holding them accountable to their relationship agreements. We are also qualified and offer support to the partners and relationships impacted by infidelity.

Begin Your Journey With Sex Therapy In Scottsdale, AZ

We understand how overwhelming and distressing out-of-control sexual behaviors can feel. You are not broken. As experienced sex therapists in Paradise Valley, we are here to provide nonjudgmental, evidence-based support to help you develop a healthier relationship with your sexuality. Your journey toward balance and self-acceptance starts here. Begin your healing journey with The Connection Couch by following these steps:

1. Book a free 15-minute consultation to get started

2. Set up your first individual sex therapy session

3. Gain the tools and support to understand your sexual behaviors, build healthier coping strategies, and strengthen your relationships.

ADDitional Therapy Services Available In The Scottsdale Area

As a sex therapist in Paradise Valley, I provide therapy for individuals and couples looking to improve their intimacy. I also help couples heal from betrayal and infidelity and offer guidance for those recovering from sexual trauma.

Resources From a Sex Therapist

• Blakemore, E. (2023). Gay conversion therapy’s disturbing 19th-century origins. https://www.history.com/news/gay-conversion-therapy-origins-19th-century

• Braun-Harvey, D., Vigorito, M. (2013). Treating out of control sexual behavior: Rethinking sex addiction. Springer Publishing Company.

• Groneman, C. (1994). Nymphomania: The historical construction of female sexuality. Signs: Journal of Women in Culture and Society, 19(2), 337-367.

• Helfer, N. (2021). The myth of sex addiction (No. 20) Healing Sols Podcast.

• Hunt, A. ‘The Great Masturbation Panic and the Discourses of Moral Regulation in Nineteenth and Early Twentieth-Century Britain’ Journal of the History of Sexuality, Vol. 8, No. 4 (April, 1998) pp. 575 – 615

• Klein, M. (2012) America’s war on sex: The attack on law, lust, and liberty (2nd ed.). Praeger. Ley, D. J. (2012). The myth of sex addiction. Rowman & Littlefield.

What is sex therapy?

What is a sex therapist?

A sex therapist is a licensed mental health professional who specializes in addressing sexual concerns and issues that individuals or couples may experience. Similar to how doctors specialize in different areas of medicine, which leads to better outcomes and more quality care, mental health professionals will specialize to do the same. Sex therapy focuses on helping people with problems related to sexual functioning, intimacy, desire, performance, and overall sexual well-being.

What do sex therapists do?

Sex therapists help individuals and couples address and resolve sexual issues, improve their sexual well-being, and enhance intimacy in their relationships. Sex therapists treat sexual problems that have psychological causes or impacts. It is important to understand that sex therapists do not treat physical or medical conditions related to sex, such as low testosterone. You may have to see a healthcare provider first to rule out if there are hidden physical causes to specific issues before seeing a sex therapist. Sex therapists use a variety of evidence-based treatments to help couples and individuals improve their sex lives. Some of the key evidence-based practices include:

• Cognitive behavioral therapy (CBT)

• Sensate focus 

• Mindfulness-based therapy

• Psychoeducation 

• Relationship therapy/couples counseling

• Pleasure enhancement skills 

• Trauma-informed approaches such as EMDR or somatic experiencing 

• Erotic fantasy exploration and integration

• Systemic therapy

• Solution-focused brief therapy

Safety and confidentiality are critical to successful treatment. The number one indicator of success in therapy is connecting with a therapist you like and feel comfortable opening up to. This is especially important when you are discussing one of the most vulnerable aspects of your life–sex.

What issues do sex therapists treat? 

Sexual activity is a complex experience that involves the mind, emotions, and body. It’s an important part of our physical, mental, emotional, and relational health. Sex is linked to living longer, feeling happier, and being satisfied in relationships. The sexual response cycle explains the changes that happen in the body and emotions during sexual activity. It consists of four stages:

• Excitement

• Plateau 

• Orgasm

• Resolution 

Understanding this cycle can help individuals and couples better understand their sexual experiences and any issues that may arise during these four stages. A sex therapist can help with the mental and emotional aspects of many different sexual issues, including:

• Erectile dysfunction

• Premature ejaculation or delayed ejaculation 

• Sex education correcting misinformation 

• Low sexual desire

• Lack of sexual arousal 

• Feelings of anxiety, fear, or shame surrounding sex 

• Sexual trauma or abuse

• Pain during intercourse

• Difficulty achieving orgasm

• Issues related to sexual orientation or gender identity

• Communication problems between partners regarding sex 

• Cultural, religious, and societal views of sex

• Poor body image and its relationship to sex

• Coping with living with STIs 

• Dismantle shame and stigma surrounding kinks and fetishes 

• Out-of-control sexual behaviors or (sex addiction)

• Pornography viewership

When is it time to see a sex therapist?

Suppose you’re feeling disconnected from your partner, experiencing pain or discomfort during sex, having difficulty maintaining an erection, or struggling with different sexual desires. In that case, it might be time to see a sex therapist. Therapy can also be helpful if there are unresolved conflicts around intimacy, feelings of shame, guilt, or anxiety, or if you're dealing with past trauma affecting your sexual life. Even if things are going well, seeking therapy can be a way to deepen communication and intimacy. Ultimately, seeing a Scottsdale therapist is a positive step toward nurturing your well-being, strengthening your relationships, and creating a healthier connection with yourself and your partner.

What can I expect during a sex therapy session? 

Throughout your sessions, you and your sex therapist will collaborate to recognize and modify thoughts and behaviors that are impacting your sexual well-being. You may see your therapist by yourself or with your romantic partner. Initially, your sex therapist may ask you questions about your:

• Sexual history

• Medical history

• Beliefs about sex

• Sex education history 

• Specific sexual concerns and current symptoms 

During your sex therapy sessions, your sex therapist will provide correct information about sex, sexual health, and anatomy, helping clients understand their bodies and sexual responses better. They may give clients specific homework exercises to do alone or with their partner between sessions. These exercises can include activities designed to reduce performance pressure, increase comfort with physical touch, or explore new ways of experiencing sensation and pleasure. They will tailor your sessions to meet your unique individual or relationship sexual needs. 

Does sex therapy work online?

Yes, sex therapy can work virtually. Many people find talking to a therapist through video chat as helpful as meeting in person. In online sex therapy, you can discuss any concerns or questions about sexual health or relationships in a private, comfortable space. The therapist will guide you, just like in a face-to-face session, and help you explore ways to improve your sexual well-being. As long as you feel safe and open with your therapist, online sessions are as helpful as in-person sessions.

What is the success rate of sex therapy?

The success rate of sex therapy can vary depending on individual circumstances, but overall, many people find it to be a helpful and transformative experience. Studies show that sex therapy has a high success rate, with many individuals and couples reporting improvements in their sexual satisfaction, communication, and emotional connection. In fact, research suggests that around 70-80% of people who attend sex therapy see positive outcomes.

Success often depends on factors like how open and committed someone is to the process, the specific issues being addressed, and how comfortable you feel with your therapist. For many, therapy isn’t about an immediate “fix” but about building new understanding, communication tools, and deeper intimacy over time. Even if progress feels gradual, many people find that the changes, no matter how small, make a big difference in the long run.

Ultimately, sex therapy can be a powerful way to address challenges, create healthier connections, and nurture a more fulfilling sexual and emotional life. The most important thing is approaching it with patience and an open heart, knowing it’s a journey toward healing and growth.

Common myths about sex therapy

Myth: Sex therapy is only for people with severe sexual problems.

• Reality: Sex therapy is beneficial for anyone experiencing concerns or questions about their sexual health, intimacy, or relationship. It can help with issues ranging from mild discomfort or dissatisfaction to more severe sexual dysfunctions.

Myth: Sex therapists judge or criticize clients.

• Reality: Sex therapists are trained to create a non-judgmental and supportive environment. Their role is to listen, understand, and help clients work through their concerns without judgment or criticism.

Myth: Sex therapy involves sexual activity in the therapist's office.

• Reality: There is no physical sexual activity in sex therapy sessions. Therapy is based on discussion, education, and guided exercises that clients do at home. The therapy room is a safe, professional space focused on conversation and therapeutic techniques. 

Myth: Sex therapy is just about improving physical and sexual performance.

• Reality: While sex therapy can address physical aspects of sexual functioning, it also focuses on emotional, psychological, and relational factors that influence sexual health. This can include addressing anxiety, trauma, communication issues, and more.

Myth: Only people in relationships need sex therapy.

• Reality: Individuals, whether single or in a relationship, can benefit from sex therapy. Single people may seek therapy to explore their sexual identity, address sexual dysfunctions, or prepare them for future relationships.

Myth: Talking about sex with a therapist is embarrassing or shameful.

• Reality: Sex therapists are trained to discuss sexual issues comfortably and professionally. They aim to create a safe space where clients can openly discuss their concerns without feeling embarrassed or ashamed. 

Myth: Sex therapy is a quick fix.

• Reality: Sex therapy often requires time and commitment to address underlying issues effectively. It’s not a one-time solution but a process that may involve several sessions to achieve lasting results.

Myth: If a couple needs sex therapy, their relationship is doomed.

• Reality: Seeking sex therapy is a proactive step that many couples take to improve their relationships and sexual satisfaction. It often strengthens relationships by addressing issues before they become more severe. 

Myth: Sex therapists only deal with heterosexual couples.

• Reality: Sex therapists work with individuals and couples of all sexual orientations, gender identities, and relationship types. They are also trained to address the unique needs and concerns of LGBTQIA+ clients.

Myth: Sex therapists always have perfect sex lives themselves.

• Reality: Like any other professional, sex therapists are human and have their own experiences. Their role is to provide expert guidance based on training and evidence-based practices, not to model a “perfect” sex life.

Myth: You only need sex therapy if there’s something wrong with you.

• Reality: Sex therapy can be helpful for anyone wanting to enhance their sexual well-being, explore new aspects of their sexuality, or strengthen their relationship. It’s not just for “fixing” problems but also for personal growth and fulfillment.

Understanding these myths helps demystify sex therapy, making it more accessible and less intimidating for those who might benefit from it. 

Start Sex Therapy in Scottsdale or Online Throughout Arizona

At The Connection Couch, we understand how scary discussing one of the most intimate and vulnerable aspects of your life and humanity can be. As sex therapists in Paradise Valley we are committed to providing evidence-based care and a safe and comfortable atmosphere from the moment we first connect. Your sexual well-being matters so much to us, and providing ethical care allows us to continue doing what we love and are passionate about. Begin your journey with us by following these steps:

1. Reach out for a 15-minute consultation

2. Schedule your first sex therapy appointment

3. Discover the profound impact sex therapy can have on your life and relationship.

Other Therapy Services Offered in the Scottsdale Area

As a Paradise Valley sex therapist, I offer individual and couples sex therapy. I also specialize in supporting couples through betrayal and infidelity recovery. Additionally, I provide support for those who have experienced sexual trauma.