Sex Therapy in a Tech-Driven World

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Every therapist will at some point encounter a client seeking help with sexual issues. The client will be worried about too much sex, not enough sex, no sex, bad sex, strange sex, compulsive sex, porn sex, and any number of other sexual issues. All of which are likely to have been impacted in various ways and degrees by digital technology.

Unfortunately, not all therapists are adequately trained to handle sexual issues, and even among therapists who are trained in and specialize in sexuality, there can be a tremendous lack of knowledge regarding digital technology and its ever-expanding role in sexual expression and interaction.

If you or someone you care about is experiencing issues related to sex and romance, it is imperative that you find the right therapist for your situation. And if that situation involves "sexnology"—webcams, apps, porn, sexting, texting, virtual reality, or any other form of digital sexuality—your therapist needs to be fully up-to-date on what those sexnologies are, how they are used/misused, and the nuances of how to overcome the various issues they create.

Issues You Might Be Facing

• Infidelity: In today’s world, infidelity increasingly begins and takes place online. Hookup apps, affair apps, porn, webcams, and even social media provide ample means for meeting, flirting, romancing, and being sexual. And the fact that infidelity takes place in the digital sphere rather than in person matters not at all. Cheating is cheating, whether it’s online or real world. The loss of relationship trust hurts the same either way. That said, cheaters who engage in problematic behavior using various forms of digital technology must take that into account as they implement meaningful changes, and doing so requires guidance from a fully knowledgeable therapist.
• Sexual Dysfunction: Much of the time, erectile dysfunction, genitopelvic pain/penetration disorder, and related issues can be addressed with medication and by helping clients adapt to the age-related changes that naturally affect sexual functioning and desire. Pretty much any sex therapist knows how to handle such issues—until technology, especially pornography, enters the picture. Pornography in particular leads to issues with sexual performance, including erectile dysfunction, delayed orgasm, and anorgasmia (the inability to reach orgasm). If this is the case, a more specialized and knowledgeable therapist is needed.
• Compulsivity: With the proliferation of online sexual content and contacts, it is easy for some people to become excessively preoccupied with sex, creating not only relational but countless other life problems (trouble at work or in school, loss of interest in other activities, inability to stay emotionally connected and present with family and friends, and more). At times, compulsive sexuality, especially online, can be used as a coping mechanism—a form of emotional escape engaged in when the user feels stress, anxiety, boredom, shame, or other types of emotional discomfort. As a result, the behaviors can become incredibly difficult to quit, again suggesting the need for a highly specialized and knowledgeable therapist.
• Offending: There are two definitions of sexual offending. The first is the legal definition, which varies by jurisdiction. The second is the clinical definition, which is nonconsensual sexual activity. Either way, sexual offending often begins, or entirely occurs, online. In such cases, you need a therapist who not only can handle offenders but who knows the ins and outs of online offending.
• Orientation, Kink/Fetish, Paraphilia: Sexual orientation is defined by the gender (or genders) to which a person is sexually and romantically attracted. Kink is a non-conformist sexual behavior used to spice up one’s sex life. Fetish is basically kink on steroids, meaning the behavior is necessary for a person to experience sexual arousal. Paraphilia is a sexual desire that creates negative self-image or negative life consequences. The internet has opened many people’s eyes to sexual variations in the world—porn is especially potent in this regard—prompting countless people to seek therapy related to what turns them on. Once again, when digital technology enters the picture, the right therapist is paramount.

So, How Do You Find the Right Therapist?

Once again, not every therapist is the right therapist for every issue. Each clinician has specific training and areas of specialization, so before embarking on a course of treatment, you should ask questions to make sure you’re talking to the right person. If you are dealing with sexual issues that are affected by digital technology, here are some questions you should ask a prospective therapist:

• Do you have specialized training in sexual issues? If so, which sexual issues?
• My issue is [state what you need help with]. Do you have experience with this? If so, how much, and what is your approach to treatment?
• Digital technology has impacted my issue by [state the impact of digital technology]. Do you have training or experience with this? If so, can you describe that training and experience?
• Do you view online sexual behaviors as being as meaningful and impactful as in-person sexual behaviors? Why or why not?
• Are there different ways that you approach digital versus real-world sexual issues? If so, please explain what they are?

These and similar questions should help you decide whether a particular therapist is the right therapist for you and your current situation. If you do not feel comfortable with the answers you receive, look for another clinician. Therapist-shopping is not taboo; in fact, it’s highly recommended. And the more specific your issues are, the more specialized your therapist should be.