In a recent webinar, Liz Selzer-Lang, MFT, CST licensed MFT based in Los Angeles, shared her knowledge and insights on sex therapy. Drawing from her background in private practice, training through the American Association of Sexuality Educators, Counselors, and Therapists (AASECT), and extensive experience working with individuals and couples, Liz offered valuable perspectives on the field. This blog highlights some of the key takeaways from the session, providing mental health professionals with new tools and approaches for addressing sexual issues with clients.
Liz emphasized the importance of challenging outdated ideas around sexual response and function. For example, she highlighted the work of Masters and Johnson, who debunked the Freudian concept of "mature" vaginal orgasms versus "immature" clitoral orgasms. She also discussed how sexual response varies greatly among individuals, noting that many therapists should recognize the diversity in sexual experiences and avoid applying one-size-fits-all models.
During the session, Liz encouraged therapists to be more inclusive and aware of diverse sexual identities, such as asexuality, graysexuality, heteroflexibility, and homoflexibility. She highlighted the importance of asking clients about their sexual and gender identities in an open and nonjudgmental way, recognizing that these identities exist on a spectrum. Liz also stressed the need to stay updated with evolving language and terms to provide better care and understanding to clients from all backgrounds.
Liz shared her approach to reframing language in therapy to reduce stigma and promote a more open dialogue around sexual concerns. For instance, instead of referring to clients' issues as "problems," she suggests using the term "concerns" to create a more supportive environment. Liz also mentioned that many clients feel shame or discomfort when discussing their sexual lives, so it is crucial to validate their experiences and reassure them that their concerns are common and normal.
One of the techniques Liz often uses with her clients is mindfulness and body awareness, particularly through the practice of sensate focus. This method, originally developed by Masters and Johnson, involves non-demand touch exercises that help clients focus on their own sensations and emotions rather than their partner's reactions or performance anxiety. Liz noted that these exercises can help clients, especially those experiencing anxiety, learn to stay present and connected to their bodies.
Liz highlighted the value of using holistic assessment tools to gain a deeper understanding of a client's sexual history and concerns. She shared her approach of incorporating handouts, reflection exercises, and detailed assessments that cover various aspects of a client’s life, such as family, religion, and cultural influences. By exploring these factors, therapists can better understand how a client's past experiences shape their current sexual identity and behaviors.
In her work with couples, Liz often deals with complex dynamics like mismatched desire, discordant libidos, and emotional disconnects. She shared that many couples face challenges such as reduced desire, guilt, and shame, often exacerbated by a lack of communication. Liz stressed the importance of addressing these underlying issues and helping couples reframe their perspectives on intimacy as a form of playful connection rather than a source of conflict.
Liz underscored the importance of collaboration with other professionals, such as sexual medicine doctors, pelvic floor physical therapists, and intimacy coaches. She noted that many sexual concerns are multidimensional, requiring a team approach to provide comprehensive care. Liz also discussed knowing when to refer clients to specialists, particularly when therapists encounter cases beyond their expertise or experience countertransference.
Liz emphasized the importance of recognizing and managing countertransference when dealing with sexual topics. She shared her experience of working in challenging cases, including clients with erotic transference, and stressed the need to maintain professional boundaries. Liz highlighted that when therapists feel discomfort or find themselves unable to manage their reactions, it is appropriate to refer the client to another professional who might be better suited to help.
Liz concluded the session by encouraging mental health professionals to become more comfortable discussing sexual issues with their clients. She believes that therapists don’t necessarily need to become certified sex therapists but should aim to be better educated about sexuality and more comfortable in addressing these topics. By doing so, therapists can provide more comprehensive care to clients and help them navigate the complexities of their sexual lives in a supportive and nonjudgmental manner.
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