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Do you ever ask your clients if they’re having pain with sex?
Many therapists worry about exceeding their scope of practice, or fear that getting too far into the nitty-gritty details of a client’s sex life will be perceived as weird or creepy.
I understand the worry. But if you avoid talking about unwanted sex pain, it may lead to further complications the longer the issue goes ignored or untreated.
The truth is, if you don’t ask about sex issues, it’s very likely that your clients won’t bring them up themselves. That means you can be missing very serious issues — and huge aspects of your clients’ relational dynamics — unless you take the leap and get the conversation started.
In fact, I can’t tell you how many clients I’ve seen who told me that they dealt with sex issues for years without ever raising the topic to the therapists they were working with at the time. When I asked one client why they didn’t bring it up in session, they told me, “I knew my therapist wasn’t comfortable with it, because she never asked.”
When there’s sex pain going on, and you don’t address it…
- The underlying physical and medical issues go untreated, possibly worsening the condition.
- Your client may develop an aversion to sexual touch.
- Your client’s relationship(s) are likely to suffer; any desire discrepancy or other sex-related issue will get worse.
- The client may never learn that pain-free sex is possible, and never get to experience sex as a joyful, pleasurable, connecting act.
It’s heartbreaking to me to think about how much avoidable suffering is happening because people don’t realize that sex doesn’t need to be painful. Most forms of sex pain can be addressed effectively with a little support from the right medical provider. Your role is to get the conversation started, make an effective referral, and support your client through the medical process.
I’m sensitive to the fact that, as therapists, we’re under a lot of pressure to get things right. We can be highly judgmental of our own work, and I don’t want to heap another “should” on your head.
That said, asking about sex is not as scary as you might think. In my experience, the vast majority of the time, clients are relieved to learn that they can talk about it with you. And if they don’t want to talk about sex, that’s a great opportunity for you to model consent and demonstrate your respect for their boundaries.
You don’t need to be a sex therapist to talk about sex pain, or other sex issues, with your clients. You just need some accurate information about sex, paired with a relational stance that allows you to lean in and respond in an attuned way to your client. I’m pretty confident you’re already practiced in showing up as a relational human being, so all that may be standing between you and getting started is some clear direction about what to ask and how to follow up.
In fact, I think this is so important that I’ve created something to make it easy for you. It’s a scripted assessment that you can use to open the conversation about sex and cover all the important issues in one focused conversation. It’s free, and you can learn in about 15 minutes and try it out in your next session.
