Susan Lee, Ed. D. 
The gynecologist relates to the practice of sex therapy as an adjunctive tool to traditional practice. Sex therapy involves the awareness of the role of sexuality as it affects patients’ quality of life and her interpersonal relationship. The recognition of the multi-factorial and multi-dimensional causes of sexual problems, e.g., psychological, organic, medical, cultural are taken into account, as the gynecologist recognizes the centrality of sexual intimacy to the emotional well being of their female patients.

Assessment of the individual and the couple in order to understand the nature of the sexual disorder is multidisciplinary and complex. 

Medical advances in sexual physiology, neurological response, and pharmacology have proven that female sexual health is on the forefront of current research. Based on the premise that women are entitled to sexual pleasure, whether they are single, lesbian or heterosexual, the female patient is actively seeking solutions to simple or complex problems in the bedroom. The evaluation of the sex life of a heterosexual couple depends on our understanding of male sexual dysfunction and how sexual activity manifests specifically in the relationship. Sex therapy brings sensitivity to the patient’s need for intimate pleasure as well an understanding of the variations in human sexual activity.

The process of sex therapy depends on the nature of the presenting problem, the structure and depth of individual psychopathology, and the dynamics of the couple relationship. One goal of sex therapy, unlike traditional psychotherapy, is the expectation that changes in the sexual behavior of a female’s intimate relationship brings relief to the  cause of the  patient’s sexual disorder, regardless the presenting of the problem.

Through the endeavors of practitioners interested in the etiology, diagnosis and treatment of sexual dysfunction, the development of sex therapy as a specific diagnostic and treatment modality has been recognized. 

 Sex therapist’s offer specific and relevant techniques such as communication, non-genital and genital treatment methods developed for the relief of patients’ presenting with psychogenic difficulties. Today, these methods often become prominent in the repertoire of gynecological treatment.

Developing in the “60’s and 70’s, the brief therapy model of “sex therapy,” seen as an exquisite and well organize methodology, was accepted by clinicians in psychiatry, psychology, and gynecologic and urologic practice. The mosaic of techniques using prescribed sequential tasks to be practiced by the couple at home is the cornerstone of sex therapy practice. 

The creative “homework” assignments are relaxing and sensual, designed to alleviate anxiety and/or fear about sexual intimacy. The therapy counteracts defensive avoidance of erotic activity and feelings, and break patterns of excessive preoccupation with sexual performance. 

Subsequent therapeutic sessions with the couple explore their success or failure to comply with the “sensual dates” or  “homework: assignments,” and then gently analyzing the couple’s resistance to treatment. The series of sessions are based on exploring positive ways the couple to practice in order to find ways to be sexually complimentary.

The sex therapist deals openly with sensitive and painful issues. Sexual dysfunction is the cause of mental anguish and relationship discord in men and women. Broadly defined, female sexual dysfunction is a problem within the human sexual response cycle, i.e., sexual desire, sexual arousal, orgasm, or pain causing mental, emotional, occupational and/or physical distress.  Many sexual problems are rooted in adolescent or childhood as well as adult experiences. The mind is the executer of sexual motivational choices, Therefore, patients’ may be functional in one part of the cycle, yet experience sexual disorder in another, i.e., female has healthy sexual desire, but once sexual activity begins she is unable to feel aroused or reach orgasm.

The context in which the woman’s problem is present is significant.  A patient may be suffering from ignorance about sexuality, fear of partner rejection, poor body image, performance anxiety or remain in a present hypervigalent during sexual activity.

Creative behavior modification attempts to bring about rapid symptomatic relief by changing the associations surrounding unhealthy sexual adaptation and learned response.

The sex therapist spends an hour with the female patient and/or couple. Thus, the luxury of time is strategic in building the sexual skills by scheduling sessions in which the couple will gain a greater understanding of their patterns. The sex therapist guides the couple by suggesting positive structured sexual activity to be competed in the privacy of there home. 

The gynecologist is able to bring these skills into his or her practice using consultation sessions dedicated to sex therapy. It may fit in nicely in a practice model.

Since 1993 I have been committed to develop and offer sex therapy certification programs dedicated to teaching the diagnosis and treatment of sexual dysfunction to postgraduate psychotherapists and gynecologists. “The Florida Postgraduate Sex Therapy Training Institute.” Became the first of its kind in the state

The programs provide the participant with specific sex therapy counseling skills and highlight the integration of medical, organic, psychological, cultural and relational issues which contribute to the sexual dysfunction.

Sex therapy certification institutes have been the goal of my career,  and I have presented 120-hour programs in Florida, Hong Kong, and New York.  

Most recently, a gynecologist and myself direct a continuing education program leading to sex therapy certification entitled “Medical Sex Therapy,” This eight-day, sixty hour course is part one of complete sex therapy certification course. Formulated as a state-of the art continuing education course, integrating sexual medicine with the sex therapy approach. 

I present the art of empathic listening, compassionate interpretation, defining patient’s conflicts, understanding the patient’s early development of personality constructs and defense mechanisms, addressing current life struggles, interpreting relationship themes, and sexual thoughts.

The mindset of the sex therapist is of a healer, joining his/her patients in finding a path towards greater sexual satisfaction. The unique treatment model is a blend of the exquisite pairing of acceptance and encouragement of the patient in her relationship, and ever evaluating their willingness towards change and the acceptance of the emotional challenges within the relationship. Feeling attractive and wanted is the wish of the female patient who yearns for a sensual relationship.

Sexuality, being a sensitive topic, becomes an open and heartfelt topic of communication when it is brought to the sex therapist’s or gynecologist’s office. Understanding couples’ difficulty in modifying habitual behavior and guiding them to replace it with new ideas towards sexual activity is a challenge.  In my experience, this approach leads to positive results.  I have seen noticeable relationship changes and improvement in sexual functioning within a few weeks of beginning treatment. Through sex therapy treatment, many have discovered ways of relieving the emotional pain and unhappiness of their sexual situation. This improvement reflects in a harmonious family milieu devoid of the tension, partner rejection, and insecurity characteristic of the relationship prior to sex therapy treatment.