People often go to therapy to find someone who won’t be judgmental when they spill the uncomfortable feelings they’ve buried. Or they might want to find someone who can help them unearth those feelings they’ve stuffed down deep.
So when you start seeing a therapist, you might promise yourself that you’ll hold nothing back—you’ve found a safe space, and you’re committed to “doing the work.” Sometimes, however, that’s easier said than done, especially when those feelings revolve around sex. Sex is something many people don’t discuss with their closest friends or even their partners. So as much as you want to be an open book in therapy, talking to your therapist about sex might still feel awkward. Is it okay to talk about sex if your therapist isn’t specifically a sex therapist? How can you even start the conversation? And what will you get out of it if you do?
To help you out, we spoke to several people who’ve had sex-related breakthroughs in “regular” therapy without seeing a dedicated sex therapist at all. Here’s what they have to say, followed by some tips for starting this conversation with your own therapist if you’re feeling ready.
“I’m realizing that internalized anti-fatness has really messed with the way I think about sex.”
“I’m a fat woman,” Julie B., 29, tells SELF, adding that she does identify as fat, though people might not be comfortable with the term. “Through therapy, I’m realizing that internalized anti-fatness has really messed with the way I think about sex.”
She explains that, when a partner doesn’t make the first move, she assumes they’re not attracted to her. “My current partner has a low libido, and even though she’s told me that she doesn’t usually get turned on until I’m turned on, I constantly feel like she…doesn’t actually like having sex with me.”
Julie’s therapist is helping her realize that anti-fat culture has made her believe she’s not attractive. Her therapist has also encouraged her to notice all the other ways her partner shows love and desire. “With my therapist’s help, my partner and I have scheduled special intimacy time during which we might have sex, but we might also just make out a little or talk about how we each experience sexual desire,” Julie says. “So I can understand her perspective when my brain spirals.”
“I had been so in my own head, I didn’t consider external factors.”
When the pandemic hit and Abigail G., 24, suddenly wasn’t as interested in sex, she asked her therapist for solutions. “I felt so disconnected from my identity—plus, I felt a huge weight that I wasn’t able to please my partner sexually. I was putting a lot of pressure on myself to feel aroused and just couldn’t get there,” she tells SELF.
Abigail’s therapist asked her to take a moment to consider how her overall circumstances might be impacting her libido. She and her partner had moved in with his parents for six months, and then, after they went home, her sister crashed on the couch in their one-bedroom apartment for three months. “Thin walls and family are certainly the antitheses of setting the mood,” Abigail explains. “But I had been so in my own head [about my sex drive], I didn’t consider those external factors.”
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Illustrated by: Paola Delucca.
Feelings About The Therapeutic Process
If your therapy sessions are leaving you feeling frustrated, it can be an understandably uncomfortable thing to bring this up. “It can be really awkward to share feedback or feelings with the person directly, and it can be a challenge even in therapy where there is space to do so,” Justus says.
But not discussing your pain points with the therapy itself is fruitless, too. “If therapy is not going well, that feedback can help the client and therapist to come up with new goals,” Justus says.
You might also just not “click” with your therapist, and that’s okay.
“If you don’t feel comfortable with your therapist, please tell us and we will be happy to help you find someone else,” Dr. Norman says. “We don’t take it personally.”
If you’ve ever thought “can I talk about ___ in therapy?” the answer is yes. There are quite a few topics considered “taboo” in society: it’s impolite to talk about your salary, to discuss politics, or to bring up religion in polite company. But therapy isn’t polite company. It’s a place for you to explore all facets of your life, including the parts that might seem awkward or uncomfortable to talk about. Below, we discuss some topics that are hard to bring up in therapy, but are totally okay to talk about if they’re relevant to you.
Let’s talk about sex, baby
Sex is probably the most uncomfortable topic to bring up in therapy. It’s hard enough to talk openly about it with our partners, let alone with a therapist. But because there are physical, emotional, and mental connections to sexual behavior, it makes sense to talk about it in a judgment-free zone. I always ask about a client’s sex life in my intake sessions to demonstrate that they can explore it in therapy. Whether you’re sexually active or not, you can talk about your concerns about sexuality and sexual practices, masturbation, desire, and pornography. Some therapists specialize in sexuality and relationships, so if this is something you’re specifically looking for, you can find someone to support you in exploring these ideas.
Religion and spirituality
Do you practice a specific religion? Is your faith better described as spiritual? Are you exploring different religions to figure out what best fits your world view? Are you deconstructing from the religion that you were raised in, but no longer subscribe to? Are religion and spirituality things you don’t connect with? Let’s talk about all of that. No matter your religious or spiritual practices, faith might come up in therapy. Religion and spirituality are both deeply personal and culturally influential, so it’s natural to explore what it means to you. In therapy we might also talk about creating nurturing rituals, which may or may not have a spiritual component, depending on your needs.
One state, two state, red state, blue state
Politics: everyone’s favorite topic. It seems like we can never escape its influence, especially in the DC area, where the day-to-day of the federal government is the day-to-day reality of many working people. We all know the feeling when we sense a conversation is swiftly turning into a heated argument. Healthy debate and discourse are so rare these days – it feels better to blame everything on the “other side.” Talking about politics in therapy isn’t about changing anyone’s mind, but rather a chance to explore how you’re impacted by what you believe and the beliefs of those around you.
Race
Let’s just get right down to it: most art therapists are white women, likely from a middle or upper-class background. This doesn’t describe all of our clients, nor do we want it to. At Alexandria Art Therapy, we value equity and diversity in our practice, and we recognize the systems of oppression that impact our clients. We’re not perfect, but we’re actively engaged in understanding race, power, and privilege in our clients’ lives and in the therapeutic relationship. There are many ways of having to navigate the world, and many of them are unjust. We don’t want to deny or ignore this; whether you have firsthand experience of a racist act or are working to undo your biases, therapy is a place to question ideas and learn new things.
Bills, Bills, Bills
Whoever said that “money can’t buy happiness” probably never lived paycheck to paycheck. Money is one of the greatest stressors in life because, let’s face it, exposure and good vibes do not keep the lights on. Whether you’re worried about paying rent, negotiating a salary, contemplating a large purchase, paying off debt, or trying to understand your insurance deductible, discussing finances is not off-limits in therapy. If it’s important to you, you can bring up the topic of money in therapy.
Abuse
We encourage disclosing abuse – physical, sexual, verbal, and emotional – in therapy, but we understand that it’s really hard to do that. Talking about such vulnerable topics is a personal choice, and we want you to do it when it’s safe enough to do so. Establishing a good relationship with your therapist, developing trust, and implementing grounding skills will probably be the therapeutic goals you tackle first. Doing this allows for transparent disclosure and in-depth exploration of abuse.
Disclaimer: therapists are considered mandated reporters for things like child abuse and neglect. A therapist will talk about confidentiality, and the legal/ethical limitations of this, during your first sessions.
Death, grief, and loss
It doesn’t matter if your experience of death and loss occurred several years ago or just last week, we know that grief looks different for every person. You might have certain family or cultural expectations and rituals around grief in addition to processing it in your own way. It’s even okay to mourn the loss of a beloved stranger. We want to help you through this in a way that works best for you. Loss is a broad topic – even if we haven’t experienced loss in the form of death this year, 2020 showed us a lot about loss. You might not feel like your loss is “big enough,” but there’s no such thing as a “big enough” loss. Loss is loss, grief is grief.
Drugs and alcohol
If you’re concerned about alcohol or substance use, therapy is the perfect place to begin exploring any questions you may have. You’re not going to get into trouble if you talk about your substance use in therapy, and your therapist isn’t going to report you to anyone. Your therapist wants to keep you safe and help you make the best choices for yourself. It might not be easy to share this with someone – there can be shame and stigma attached to addiction – but starting conversations about it can help you begin to figure out what to do with it.
Son of a nutcracker!
Can I swear in front of my therapist? Yes, you can. Therapists have heard it all before, trust me! There are actually some surprising benefits of swearing. I don’t discourage clients from swearing in session, but over time I like to talk about emotional literacy, which is the ability to identify and express exactly what you’re feeling. This means that swearing in session might become less frequent as you learn emotional language, but it’s never fully off the table, because sometimes a well-placed swear word is the only thing that will do.
When it comes to difficult conversations in therapy, it’s healthy to acknowledge the thoughts and emotions behind the topic. So often we feel the need to avoid what makes us uncomfortable, and we know that therapy is sometimes only discomfort. It’s okay if you don’t want to talk about any of these topics, but know that your therapist will be open and receptive to anything you want to discuss.
