Sex is one the most frequently searched terms on the internet, and among the most commonly searched phrases is: “How to have good sex?” Clearly, it is something a large number of us are secretly wondering about.

Good sex can be complicated by many factors – preferences, experiences, history, age, social norms, and culture are just a few. Therapists who work with clients on these issues need resources for addressing the broad range of challenges in this area.

Quickies: The Handbook of Brief Sex Therapy, 3rd Edition is edited by professors of family therapy Shelley Green and Douglas Flemons, who answer all questions sex-related using brief, relational, and profoundly useful strategies.

“Engaging in transformative conversations about clients’ sexual concerns requires thoughtful consideration and understanding – of how our bodies work (in terms of desire, arousal, anxiety, and so on), of our comfort level when discussing sex overtly, and of how sexuality informs and contextualizes human relationships,” write Green and Fleming.

Sex can act as a lens into relationships, and it is through discussing their clients’ sexual lives that Green and Fleming are able to access strengths and connections that would be otherwise unavailable.

“Sexual experience is profoundly personal; it is often, though not always interpersonal; but it is always, always relational. Desire/withdrawal; arousal/anxiety; pleasure/pain; intimacy/loneliness: All reflect and contribute to recursive communal loops between conscious awareness and the involuntary body responses of both self and partner,” write Green and Fleming.

Instead of attempting to help clients free themselves from these loops, Green and Fleming suggest joining with them, committing to “collaborating with them in a process of disentanglement.”

Sometimes the disentanglement involves overcoming an affair. Green and Fleming describe their work with Maria, who had, only ten days earlier, walked in on her husband making love to another woman. Through using empathic statements, making sense of Maria’s overwhelming desire for justice, and connecting her with her strength, commitment, and passion, Green is able to move Maria to a place where she can begin working on rebuilding trust with her husband, Alex, in joint sessions.

Much of psychotherapy, notes chapter author Monte Bobele, “depends on the therapist’s ability to create a context that will enable the client to follow the intervention.”

This context, for brief therapists like Bobele can often be created in the first session.

“My colleagues and I have found that a well-conducted single session of therapy can lead to a number of improvements in clients’ lives – often beyond those presented as the original complaint,” write Bobele.

Yet the field of sex therapy has chronically suffered from many problems, including lack of a unifying theory, gender-biases, and heteorsexist assumptions, such as the interpretation of rapid ejaculation, which is considered to be a serious problem for males, but a cause for celebration for females.

“The sex therapy field has, historically, paid too little attention to cultural, contextual, theoretical, and interpersonal competence. As Apfelbaum (2000) pointed out, the societal enthusiasm that greeted the introduction of Viagra highlights a continued emphasis on sustained erections,” write Scott Fraser and Andy Solovey, who pen the chapter, “The Process of Change in Brief Sex Therapy.”

Small changes, Fraser and Solovey contend, can lead to a shift that alters chronic relational cycles. They describe their work with Alicia, who wants more sexual contact, and her husband, Dave, who has lost interest. Through encouraging Alicia to remove herself from the pattern of trying to get Dave’s attention and instead re-engage in her own interests – in a sense becoming more mysterious to Dave – and allowing Dave’s desire for Alicia to naturally return, they are able to rekindle the love that originally brought the couple together.

Brief therapy also opens possibilities that clients may not have previously considered.

“Language and time steer us toward one-dimensional definitions of our experience and ourselves. By being inclusive, therapists invite clients to experience polar opposites simultaneously, going beyond mere acceptance of contradictions to a more expansive embracing of the self. Such widening of client’s sense of self can break inner logjams,” writes Bill O’ Hanlon, the author of the Chapter, “Come Again?: From Possibility Therapy to Sex Therapy.”

Exploring possibilities for sexual relationships can also mean challenging beliefs, assumptions, and norms for both couples and therapists alike.

“All therapists who are willing to examine and challenge their own assumptions and biases can work successfully with clients who are non-monogamous, as long as they honor the polyamorous relationship and embrace what the clients want, rather than imposing their own views,” writes Tina Timm, who authored the chapter, “Brief Therapy with Consensually Non-Monogamous Couple: Challenging the Status Quo.”

Gathering some of the best minds in brief sex therapy, Green and Flemons offer an impressive collection of efficient approaches to the wide range of sexual problems that can arise between couples, all while respecting their unique cultural, contextual, and sexual experiences. Their book should be required reading for every clinician.

Quickies: The Handbook of Brief Sex Therapy, Third Edition
Edited By Shelly Green and Douglas Flemons
W.W. Norton & Company
January 2018
Softcover, 448 Pages

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