The Accidental Sex Therapist: Sex Therapy Tools Anyone Can Use

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Stephen Snyder, MD Related seminars and products

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Stephen Snyder, MD, is a sex and relationship therapist and the author of the new book Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship.

Speaker Disclosures:
Financial: Dr. Stephen Snyder maintains a private practice and has an employment relationship with Mt. Sinai. He receives royalties as a published author. Dr. Snyder receives a speaking honorarium and recording royalties from Psychotherapy Networker and PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Stephen Snyder is a member of the Society for Sex Therapy and Research (SSTAR) and the American Association of Sex Educators Counselors and Therapists (AASECT).

Objectives

1. Assess couple’s communication skills related to intimacy using simple questioning.
2. Teach clients communication techniques to describe their level of arousal to their partner.
3. Propose mindfulness techniques to improve the erotic climate in a relationship.

Outline

• Psychological arousal, as opposed to physiological arousal, is a more reliable indicator of sexual readiness and a better predictor of sexual satisfaction. 
• Most people report that psychological arousal has core features such as the following: 
  • Absorption in the moment 
  • Self-acceptance, lack of judgment 
  • Temporary impairment of intellect 
  • Distortion of time sense 
  • Regression to more infantile modes of being 
  • A feeling of “selfish connection” that’s different from ordinary adult interaction. 
  • A deep sense of validation  
• Questioning clients about their typical sexual experiences should include careful inquiry re the usual sequence of events (“Who typically does what to whom first? Then what happens next, and why?”), as well as re participants’ subjective experience at each stage (“How psychologically aroused do you usually feel when that happens?”) 
• Case examples will be given, showing how simple questioning along these lines can yield valuable information that clients and their therapists can use to frame interventions to enhance psychological arousal. 
• Theoretical:  The idea of a “sexual self:” primitive, regressive, and rooted in the healthy narcissistic gratifications of early childhood.  

• Once clients learn to self-observe their state of authentic psychological arousal, it often becomes clear that the major block to sexual function was that “their sexual self felt unhappy.” 
• The therapeutic question then becomes, “How can we give the sexual self what it needs?”   
• Clinical examples will be provided. 

• Most long-term, committed couples learn to make mutual orgasm the goal of lovemaking. Along the way, they forget to ask whether they’re authentically aroused.  
• Re-focusing on arousal rather than orgasm becomes a central therapeutic agenda.  
• Most long-term, committed couples refrain from experiencing arousal together unless they plan to have sex. Treatment should include practice experiencing frequent arousal “for its own sake.”     
  • Technique 1: “Simmering”: One or two minutes of mutual arousal, without expectation of sex per se.  
• Most long-term, committed couples lose the intense sexual motivation they started with when their relationship was new. Most sex advice these days recommends trying to introduce novelty, adventure, or uncertainty. This is usually unproductive, for reasons we’ll discuss. “Sex dates” tend not work either, since desire is absent and the sex can feel artificial. Instead, the following will be recommended: 
  • Technique 2: The “Two-Step”: Instead of making a date to have sex, make a date to “do nothing in bed together.” Start with mindfulness practices – to be described (“Step 1”), before letting yourself get aroused (“Step 2”). Mindfulness facilitates arousal, since “paying attention to the present moment without judgment” is at the heart of psychological arousal.  
• Most couples find that “Simmering” and “Two-Step” are far more user-friendly, feel more natural, and are more compatible with 21st Century schedules than traditional Masters and Johnson “Sensate Focus.” 

• Too few couples talk much during sex. Or they try to “talk dirty” in order to “keep it hot.”  
• Simple communication about your feelings of sexual arousal can often feel far more intimate and erotic.  
• Clinical examples will be provided.  
• A model will be provided for assessing whether a given communication is intimate or not.  

• Feedback will be solicited from attendees re possible difficulties they might anticipate in implementing the approach and techniques outlined above.  
• Solutions and work-arounds for common difficulties will be presented.  

Target Audience

• Counselors
• Social Workers
• Psychologists
• Psychotherapists
• Therapists
• Marriage & Family Therapists
• Addiction Counselors
• Case Managers
• Physicians
• Nurses
• Other Mental Health Professionals