What’s the First Session Like in Sex and Couples Counseling?

There is no such thing as TMI in sex and couples counseling.

We discuss a whole range of topics in sex therapy, from your sexual history to mental health, relationships with family, trauma, your sex habits. Why? Because to engage in sexual activity is human, as human as eating, sleeping, and breathing. We are sexual beings, and it is part of human nature.

So often in counseling we ignore that part of ourselves or think it’s too inappropriate to discuss. Culturally we may have been taught that sex is “bad” in some way or that we should be embarrassed about it. In sex therapy, it’s our job to uncover what those preconceived notions are, especially if it’s problematic to our lives.

Sometimes mental health issues are caused by medical issues, and vice versa. For instance, someone who feels depressed, sluggish, and has a poor appetite may have a diagnosis of Major Depressive Disorder — or, I may ask them to get their thyroid checked out by a specialist, just to rule that out before I start teaching you coping skills.

If it’s medical, counseling interventions may work a little, but no amount of counseling I do will cure a medical issue. In addition, I wouldn’t want to refer you to a psychiatrist for mental health medications when you’re actually in need of thyroid medications.

If you’re looking for someone like me who specializes in sex and relationship counseling, it’s likely you’ve been to a doctor or two to be checked out for sexual issues on the medical side and been told it’s a mental health thing. If you come to me and you haven’t, we may want to refer you to a physician to rule that kind of issue out first.

There is very little that I haven’t heard in my time as a counselor. My primary goal for when we start our counseling journey is to create a space for you to feel safe and comfortable. Counseling basics 101 is that I maintain a position of non-judgement, empathy, and positive regard for you, the client. After all, the counseling relationship is the number one predictor of client success. If you don’t like your counselor, it’s hard to make any kind of progress, so I hope to help you feel safe in our sessions, especially considering the nature of the topic.

That’s all for now, have a mindful day, and be well!