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Sex Therapy

Some myths about sex therapy - a short interview with Dr. Barry McCarthy.












































(this is raw unedited text transcribed directly from the audio)


Sex Therapy

Some myths about sex therapy - a short interview with Dr. Barry McCarthy.

(this is raw unedited text transcribed directly from the audio)


Movie clip


Male: What am I going to do? I think about sex all the time. Sex. Help. Four times five is 30. Five times six is 32. Naked girls. Naked women. Oh, stop me.


Dr. Kenner: You're having problems with your sex life. You and your partner are really having problems and your doctor says, "Why don't you go to a sex therapist?" You look at one another, you and your husband or you and your wife, and you think, "Oh my gosh. A sex therapist? We have to talk about what's going wrong? We don't even talk about it with one another." What goes on behind the closed doors of a sex therapist's office? With me today to discuss this is Dr. Barry McCarthy. He is a professor at American University. He's a certified marital and sex therapist and he has a private practice in Washington, D.C. He's presented over 150 workshops around the globe on a range of relationship and sexual problems. And he's very prolific. He's written many, many articles and book chapters and with his wife, he's co-authored eight books on relationships and sexuality, including a book Rekindling Desire. Dr. McCarthy, it's a pleasure to have you on the show.


Dr. McCarthy: I'm glad to be here and I always like talking about sex therapy and talking about what it really is and the myths about it.


Dr. Kenner: The myths about it, I can imagine the myths people have. If somebody told me, say, 30 years ago, "Ellen, why don't you and your husband go to sex therapy," I would think, "Oh my God, are they going to make us practice in front of them and show us what goes wrong? Do I have to talk about an orgasm and oh my God, this is so embarrassing." I'd be flushing already. I know a lot more about it now, but can you explain what is the procedure if, say, my husband and I were to come to you or a couple were to come through your doors. What would happen?


Dr. McCarthy: Usually sex therapy is approached as a couple problem. You get away from the blaming of who is at fault. Am I at fault? Is my spouse at fault? Think about it as we have to work together to develop a comfortable way of being sexual. There's never any nudity in the office. You never do anything sexually in the office. That's a very important thing to understand. And sex therapists are certified by an organization called The American Association of Sex Educators, Counselors and Therapists. For those people who use the web, you can get on and it'll give you certified sex therapists in your area. And then after the initial couple session, what then happens is each of you have one individual session where you get a chance to tell your story. How you learned about being sexual, what are the strengths of your sexual relationships and what are the problems with it? A therapist's role is not to make you do something you're uncomfortable with. In fact, the therapist in the sexual field, tends to be very respectful of individual value and cultural differences. It works within your value system.


Dr. Kenner: Assuming it's not abusive.


Dr. McCarthy: Right. Because we're definitely not going to be supportive of anything which is harmful to you or to anyone else. But we work within your value system to try to develop a way, a comfortable way, of thinking, talking and experiencing sexuality in your life so that it plays a healthy role in your life, rather than it being such a source of stigma and such a drain for you personally and a drain your marital relationship.


Dr. Kenner: I think just taking a sexual history would be eye-opening for almost everyone. Because how many people sit down and actually assemble all of those thoughts of where, when did my problems begin? When have I been most aroused? What are the type of questions you would ask in a typical sexual history?


Dr. McCarthy: We start off with histories, talking about how the person learned about sexuality. Did they learn it from their parents? Did they learn it in terms of sex education classes? Did they learn it through their religious organization? Did they learn it on the street? What have been the healthiest learnings? What have been the most unhealthy learnings. When in their life did they feel best about sexuality? When in their life has it been the most difficult or the most problematic? We want to talk not just about problems, but we also want to talk about what are their positive learnings and positive resources? We also want to talk about issues that are particularly sensitive, whether those issues had to do with child sexual abuse, had to do with sexually transmitted diseases or unwanted pregnancies, had to do with feeling sexually embarrassed or humiliated. You want to give the person a chance and listen in a respectful and empathic way to their story. You also want to hear where sex now sits in their lives and what are their hopes and wishes and desires for themselves and their relationships sexually? What are some of the concerns they have about their partner? It's interesting that women, by and large, find couples sex therapy much more helpful and much easier than men do, especially men with erection problems or desire problems.


Dr. Kenner: Why do you think that's the case?


Dr. McCarthy: I mean, men generally are thought of as sexual experts. They know all the answers. It's not masculine to ask questions. Now, one of the best examples of that is males who are really upset about their erection functioning. They often won't tell anyone or they'll go on the internet and get a pro-erection medication like Viagra or Cialis or Levitra and hope that magically does it and don't even tell their spouse that they've done that. The approach in couples sex therapy is to think about the problem as a bio/psychosocial problem. You want to look at medical factors, psychological factors as well as relationship factors. 


Dr. Kenner: But you help them to open up a lot more, so if they're hiding secrets like, "I'm taking Levitra and not telling you," you want that to be not a shameful secret that the husband is hiding or the male partner is hiding, but something he can say, "Hey, I need to use this a little bit," and not make it a self esteem issue. Not making it something he's afraid to talk about. So a sex therapist would work with him to normalize it.


Dr. McCarthy: Not only that, but also rather than to hope that the medication - which is I think, I'm in favor of the medication - but the problem is they over promise in their advertising. That the man is hoping he's going to go back and be sexual the way he was in his teens and 20s.


Dr. Kenner: So somebody in their 50s or 60s may think that, "Oh, great, Levitra will give me that same potency that I had as a kid."


Dr. McCarthy: Right. It's also, he's not going to ask anything from his partner. What we say to couples is if you're going to regain your comfort and confidence with sexual desire or with erection, you've got to do it as an intimate team. That's one of the nice things about sexuality is that the two of you can work together to regain that comfort and confidence. It isn't the medication alone.


Dr. Kenner: It's both of you. And I want to thank you so much. I wish we had more time to talk about sex therapy because I know you give homework and I know that you really encourage the couples, the partners, to open up with one another. I've been talking with Dr. Barry McCarthy who has written a book, Rekindling Desire. Dr. McCarthy, how can people get one of your books?


Dr. McCarthy: It can be to go to the bookstore or on Amazon and two most relevant books would be Rekindling Desire and the other one, the second author with Michael Metz, we wrote a book called Coping with Erectile Dysfunction, which actually came out in 2004. 


Dr. Kenner: Thank you so much for joining us today.


Dr. McCarthy: Thank you.