Therapy’s Shocking Secret: What Therapists-in-Training Don’t Learn About Sex

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I’m in Los Angeles this week, speaking to 500 therapists at the Couples Conference. One of my talks is called 10 Crucial Things About Sex That Therapists Don’t Learn in School. It could be 100 Crucial Things, but we only have so much time.

I love therapists, and I’m proud to be one. But it’s scandalous how little our students are taught about sex—especially the sexuality of the general population they will definitely see in their practices, using the words everyday people use.

Every therapist-in-training learns that children get molested, and that it damages them (although the actual fact is that it damages MOST of them). Every therapist-in-training learns that women get pressured, manipulated, and forced into sex, and that this damages them (although only a fraction of therapists learn how many men are brutally raped in prison every week).

But learning about damaged sexuality is NOT the same thing as learning about healthy sexuality, or about common sexual practices.

Here are a few of the dozens and dozens of things about sex that most therapists DON’T learn during their training:

* What’s a vibrator? Why do people use them? Do people get addicted to them?
* What does healthy sexuality look like in a four-year-old? An eight-year-old? A twelve-year-old?
* If a man likes anal stimulation during sex, can he really be heterosexual?
* If someone occasionally fantasizes about sex with a 12-year-old, is he or she dangerous?
* How do the success rates of monogamous and non-monogamous relationships compare?
* If a married man goes to a massage parlor every three or four months for a “happy ending,” is that infidelity?
* Which men with erection problems should NOT use erection drugs like Viagra?
* Is there a place for masturbation within marriage? If so, how much is a “reasonable” amount? What should someone do if they feel rejected by their partner’s masturbation?
* How many sexual predators are out there? How dangerous are strangers to the average child?
* What actually drives sexual desire in adults? (hint: sometimes it’s NOT romantic love.)
* How much of adult pornography is violent?

Some therapists-in-training even learn things about sex that UNDERMINE effective treatment. For example, it’s popular for training programs to focus on the differences between male and female sexuality rather than the similarities. It’s also popular for training programs to assert that monogamy is the highest form of sexual intimacy, and to pathologize people who find it difficult or undesirable.

Unfortunately, most therapists don’t learn about sex as it actually is for the majority of the adult patients that they will see in their practice. And most therapists don’t learn how to relate to sexuality in a relaxed, curious, joyful way—so if they’re relaxed about it in their personal lives, they might be able to do that professionally, but if not, than they probably won’t be able to.

Does that mean that people shopping for a therapist need to ask “So, are you comfortable with sexuality in your personal life?” That’s a pretty depressing thought. And the public should be outraged by it. After all, they’re the ones putting their lives into the hands of insufficiently trained professionals.

Ultimately, here are the most important questions most therapists don’t study in school: why do real people have sex? What do they want from it? And why do they stop doing things that make sex enjoyable when they don’t want the results?




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