Integrative
Sex &
Couples
Therapy
A Therapists Guide to
New and Innovative Approaches
Edited by Tammy Nelson , PhD
World-renowned expert in relationships and sex therapy
Copyright 2020 Tammy Nelson
Published by
PESI Publishing & Media
PESI, Inc.
3839 White Ave
Eau Claire, WI 54703
Cover: Amy Rubenzer
Editing: Jenessa Jackson, Marietta Whittlesey
Layout: Amy Rubenzer & Bookmasters
ISBN: 9781683732570
Library of Congress Control Number: 2020934733
All rights reserved.
Printed in the United States of America
pesipublishing.com
Acknowledgments
This book could not have been written without the authors contributions. Thank you to authors Gail Guttman, Daniel Rosen, Pebble Kranz, Wendy Miller, Pamela Finnerty, James Wadley, Malika ONeill, Neil Cannon, Amanda Holmberg-Sasek, Deborah Fox, Janet Brito, Einat Metzl, and Stephanie King. Thank you also to contributors Sylvia Rosenfeld, Sophie Slade, Orli Wahrman, and Jen Gunsaullus. With special thanks and great appreciation to Linda Jackson, Marietta Whittlesey, and Jenessa Jackson at PESI Publishing.
To my program assistant Scarlett Ross and to all my students and faculty at the Integrative Sex Therapy Institute, who trusted me when I began the program and believed me when I said everyone wants to and should be a certified sex and couples therapist. To all of the certified sex and couples therapists out there: You are ahead of the pack. Keep up the great work. To those who are just discovering this work and are still on the path: Good luck, keep going, and know that you are doing important work in changing the world.
Table of Contents
We are sexual beings, and our sexuality is part of the pulsating energy of life which we express through mind, body, and psyche.
Harville Hendrix
For many years, the field of psychotherapy has focused on the treatment of the individual. It has focused on the gestalt of the person, including object relations from their past, their family history, and the analysis of their deeper desires, dreams, and fears. Although family therapy and couples therapy have recently been added as an adjunct treatment modality, sexuality is still considered only a small piece of the treatment process as it relates to a whole persons life span.
However, in todays society, sexuality and relationships are primary to the experience of a persons life. Our sexual development and education around sexual identity, orientation, and sexual relationships are a complex narrative of eroticism, trauma, guilt, and pleasure. Much like any other lifelong practice, such as a commitment to yoga or meditation, our sexuality can be fraught with difficulty and also contain untold thrills and joys along the way. Contemporary therapists must be able to hear these narratives and sit with the stories, experiences, and struggles. They must have the tools, interventions, and magic, if you will, to bring to light the cause of sexual dysfunction, help repair relationships, and create states of safety and trust wherein clients can find pleasure and joy in their life, both physically and emotionally. There has never been a time in our profession when integrative sex and couples therapy is more needed.
When I initially sought training as a psychotherapist, I was interested in relationshipsnot only with regard to relationships between couples but also with regard to partnerships of all kinds. It seemed the most interesting part of psychology. I thought counseling was meaningless if it didnt focus on what I believed to be the most fundamental part of a persons life: ones connections to other people. Although my graduate and postgraduate program focused on the complexities of human relations, they never talked about sex. I found this odd. Adult marriages and committed partnerships are not simply roommate relationships. However, my program did not train me to deal with what is simply a primary part of existence: sexuality.
Therefore, I subsequently pursued a PhD in sexology and became certified as a sex therapist. I made it my mission to train therapists to talk to their clients about sexuality and wrote a book integrating sexuality with Imago Relationship Therapy (IRT) techniques called Getting the Sex You Want. I worked with thousands of couples to improve their relationships and their sex lives. More and more couples came to therapy not just to improve their sexual lives but to repair their erotic relationships. Affairs, betrayals, and disconnection of all kinds led me to write The New Monogamy: Redefining Your Relationship After Infidelity. I spoke around the world to couples and clinicians about how to heal their erotic lives, repair their intimacy, and move forward into a new vision of hope.
Through my work, it has become readily apparent that therapists are continuing to miss a vital part of training: the integration of couples and sex therapy. While greater numbers of therapists are being trained as sex therapists, they are not receiving training in relationship systems. They are being trained to work with sexual dysfunction, sexual inadequacy, and performance disordersbut they are not being trained to work with couples. Similar to the lack of sexuality taught in old family therapy courses, few relationship skills are taught in current sex therapy programs.
Psychotherapy is going to have to focus on relationships and sexuality in order for us to continue to help people. For our profession to support the growth of humanity, we can no longer avoid the conversation around sexual intimacy; we have to train clinicians in the skills necessary to teach individuals and couples how to have healthy relationships. Although integrating sex and couples therapy can be a challenge in sessions, the combination of these skills is the only way to treat people who long for healthy, connected, and intimate partnerships.
In this book, I have gathered the best experts in the field of integrative sex and couples therapy, which is a new field of psychotherapy. In each chapter, the authors describe the techniques and strategies they use to combine their unique and contemporary psychotherapeutic work. Because sex therapists have traditionally been taught little about couples therapy and relationship systemsand couples therapists have had little education in sex therapythis book introduces a myriad of ways that clinicians can bring this combined skill set into their practice. In these chapters, you will find step-by-step instructions and case examples that will help beginning practitioners expand their field of knowledge and allow even the most advanced clinicians to incorporate new skills immediately into their work.
describes the foundations of sex therapy and its roots in cognitive behavioral therapy. The chapter explores how sexual issues in relationships and intrapsychic factors can affect self-esteem and the capacity for connection in the couple. This chapter reviews how therapists can attune with each partner in couples work and intervene with regard to specific sexual dysfunctions. The chapter unravels the dance between the couple and gives specific suggestions to help couples communicate about their relational space. These interventions create a path toward positive, healthy sexuality.
is written by a married couple, a certified sex therapist and a sexual medicine physician. Together they have created a Collaborative Sexual Wellness Model that combines the treatment of sexual dysfunctions, sexual disorders, anxiety, and relationship problems by integrating medical, social, cultural, and psychodynamic aspects within a couples counseling framework. Their collaborative model incorporates couples counseling, sex therapy, and sexual medicine in order to provide comprehensive, whole-person-centered care for couples with sexual concerns.
