I’m not a therapist, but I think it’s fun to read books written for therapists. I really appreciate reading real life examples of what happens in therapy settings. Outside of going to therapy, most people only see therapy in TV shows and sometimes in fiction. But these accounts are often simplified, overly dramatic, or completely unrealistic. Hearing stories of what happens in therapy – both from patients and providers –can help make therapy more normal and less scary. It’s nice to see a wide range of how people bring up certain topics and get insight into how therapists think during sessions. Accounts of therapy from providers and patients have been really helpful to me in learning about what “good” therapy might look like for myself, in broadening my understanding of what could be possible in therapy, and better seeing how therapy “works.” I like to understand how and why things work.
I recently read Sex Therapy with Erotically Marginalized Clients by Damon M Constantinides, Shannon L. Sennott, and Davis Chandler. This book is written for therapists, but it’s far less academic than many books for that audience.
Sex Therapy offers nine principles of clinical support. For survivors, really for anyone seeking therapy, many of these may be helpful to look for in a provider. The principles that make up the contents of this book are also helpful for patients to know about. For me they offer some framework on how I can treat myself and others, even outside of the context of therapy.
- Maintain transparency and name systemic and individual oppressions
- Challenge binary thinking and its constrictions
- Support willingness to experience the anxiety of uncertainty
- Practice a relational and dialogic approach to sex therapy
- Emphasize clients’ own words, knowledge, and narratives
- Locate oneself and respond to clients’ meta-communication
- Support participation of family and communities
- Practice active allyship
- Build a community of colleagues
(A note on #4 – this is the most academic/field specific language used. This principle centers around recognizing the relationship between the provider and client, possible power differences in that relationship, and naming identities and beliefs that may be going unspoken.)
The first three principles especially resonate with me, for how I want to treat myself, treat others, and live my life.
“It is ethically essential that therapists be able to recognize and name the intersections of identities related to sexuality and oppression.”
This quote lays one of the foundations of this text. In my advocacy work, I’ve often used the phrase “name the injustice.” I think there’s overlap here, with the idea being that it can be helpful and validating when support people, especially those with some power – like therapists, case workers, and advocates – name and acknowledge the harm that is happening and that the world isn’t fair or just. It’s not right that people are assaulted. It’s not right that survivors of violence are often the ones who have to leave their homes. It’s not right that trans people are denied basic rights. I can’t count the number of times that it has helped me to have someone else hear me talk about something and say back to me – that’s terrible.
Throughout this book, examples of challenging mainstream ideas about what sex and relationships should look like abound. This book offers many examples of non-monogamous people and relationships. Even a seemingly simple question like, “Can you tell me what marriage means to you?” (p16) has nuance to it. Many people assume that they know what marriage means and that it is the same for everyone. People often assume this about love, dating, sex, and so many other things. But by asking the question, we acknowledge that it could actually be really different from person to person and we don’t know what assumptions people are making unless they tell us. I’ve found similar questions so interesting and helpful in my life: What does dating mean? (I ask my friends too because I’m curious and nosy, not just people I’m dating (whatever dating means!)).
This reminds me of a scene in Heartstopper Season Two, when Isaac asks Charlie, “How do you know you like someone?” That’s such a great question. How do you know? What does it mean to you to like someone? Is it different than liking a friend? How is it different?
Having a professional to explore these questions with can be beneficial, and there’s ways that we can start thinking about this within our loving communities as well.
In addition, this book invites us to challenge mainstream ideas of sex and the purpose of sex. Sex does not have to be goal oriented, and if it is, the goal does not have to be orgasm. Sex and sexual connection can be about fun, pleasure, connection, a particular scenario, a type of touch, and so much more. Again, this is a place that we get to explore with others – what does sex mean to us? Why do we want it? What meaning do we attach to it?
The Circle of Sexual Pleasure is a tool the book references (p 51). This tool helps individuals identify actions or experiences that they find pleasurable. This can help shift from an idea of goal oriented sex and embrace a wider range of pleasure. While for some this is a tool that could be explored on their own or with supportive people, for others, this may be a tool best approached with professional or trained support as unfortunately pleasure and trauma and sex can all be very complicated in our lives – especially for trans folks and/or survivors.
For many survivors, sex and relationships may be places of trauma or reminders of past trauma. They may also be places of healing. Talk therapy isn’t for everyone and there are a lot of different providers and methods of therapy out there. Finding a therapist who is comfortable talking about sex and relationships in a non-judgmental, holistic, inclusive way can be healing.
Sex Therapy has many different examples, both shorter vignettes and longer case studies. These allow the reader to see a range of therapeutic styles and experiences. The stories are all from the therapist’s perspective. One thing that’s helpful about this is it gives insight into the process the therapist goes through – what they notice and think about during sessions and how they relate to their clients. That can be helpful in taking some of the anxiety out of therapy – by seeing the compassionate, human responses therapists have behind the scenes.