A fulfilling and pleasurable sex life is a vital component of overall well-being. It fosters intimacy, reduces stress, and strengthens the bond between partners. However, maintaining that connection isn’t always easy. Over time, stress, medical issues, shifting relationship dynamics, past trauma, new life changes, and the exhaustion of daily life can create significant barriers to intimacy.

For many, these challenges lead to frustration or avoidance. However, it is possible to overcome them and reconnect with your partner through professional sex therapy sessions. First, however, it is helpful to understand what these sessions involve and how they could help you and your partner.

What Is Sex Therapy, and How Does It Work?

Sex therapy is a specialized form of psychotherapy that focuses on concerns related to sexuality, intimacy, and relationships. Sessions are talk-based and take place in a private, professional setting where clients can openly discuss sensitive topics without shame or judgment.

Sex therapy may be helpful for individuals, couples, or partners at any stage of life. Some people seek couples therapy to address a specific concern, such as anxiety around intimacy or difficulty communicating desires, while others want to strengthen their emotional bond or explore changes in their sexual relationship. Regardless of their goals, therapists work collaboratively with clients to identify underlying emotional, cognitive, or relational patterns and develop personalized strategies for growth and healing.

Types of Approaches to Sex Therapy

Sex therapists use a variety of evidence-based modalities tailored to the specific needs of the client. This is because, while the presenting problem might be sexual, the root cause of the disconnect often relates to deeper emotional or psychological factors that need to be addressed through talk therapy.

Three of the most common therapeutic methods used during sex therapy include cognitive behavioral therapy, mindfulness-based interventions, and attachment-based therapy.

Cognitive Behavioral Therapy (CBT)

CBT is one of the most common approaches used in sex therapy. It operates on the idea that our thoughts influence our feelings and behaviors. For example, if a person thinks, “If I don’t perform perfectly, my partner will leave me,” they will experience anxiety, which physically inhibits arousal. CBT helps clients identify these negative, automatic thoughts and reframe them into more realistic narratives.

Mindfulness-Based Interventions

Sex requires presence. Anxiety, by contrast, takes us out of the moment and into our heads. Mindfulness techniques teach clients how to stay grounded in the present moment, focusing on physical sensation rather than performance metrics. This is particularly helpful for issues like low libido or erectile dysfunction, where anxiety is a major block.

Attachment-Based Therapy

Sexual intimacy is deeply tied to emotional safety. Attachment-based approaches look at how a client bonds with others. If a client has an “anxious” attachment style, they may view sex as a way to secure the relationship rather than for pleasure. If they are “avoidant,” they may view sex as an intrusion. Understanding these dynamics helps couples navigate differences in desire.

Common Exercises Taught in Sex Therapy

One of the defining features of sex therapy is the use of homework — experiential exercises done in the privacy of your own home. (Note: Sexual activity never takes place in the therapist’s office.)

Non-Sexual Activities

Intimacy is not solely about what happens in the bedroom; it is built on the foundation of friendship and shared experience. When sex becomes stressful, couples often stop having fun together entirely. Therapists frequently assign non-sexual dates to rebuild the emotional bond.

For example, they may recommend trying a new activity together, such as a pottery class, a hike in a new location, or cooking a complex meal. The novelty of these new activities will release dopamine, which mimics the early stages of falling in love.

Sensate Focus

Developed by Masters and Johnson, this is perhaps the most famous sex therapy exercise. It is a multi-stage process designed to reduce performance anxiety by temporarily taking intercourse off the table. The exercise may look something like this:

• Stage 1: Partners take turns touching each other (avoiding genitals and breasts) with the sole goal of noticing texture and temperature, not creating arousal.
• Stage 2: Touching includes breast and genital areas, but still with no goal of orgasm or intercourse.
• Stage 3: Gradual reintroduction of sexual interaction. By removing the goal of orgasm, the pressure lifts, allowing the body’s natural relaxation and arousal systems to come back online.

Communication Drills

Therapists often assign specific times for couples to talk about sex outside of the bedroom. A common exercise is the “Desire/Aversion List.” Each partner writes down three things they love, three things they are curious about, and three things they strongly dislike. They then share these lists in a structured, safe environment facilitated by the skills learned in the session.

Body Mapping

For individuals, body mapping involves exploring one’s own body to understand what kind of touch feels good, neutral, or uncomfortable. This promotes body autonomy and gives the client the vocabulary to guide their partner later.

Erotic Exercises

Once anxiety has been reduced and communication improved, therapists may introduce exercises specifically designed to reignite desire. These exercises could include:

• Simmering: The practice of maintaining a low-level erotic connection throughout the day via texts, glances, or brief touches, without the expectation that it must lead to sex immediately.
• Fantasy Sharing: Writing down fantasies or desires and sharing them in a safe, non-judgmental way.
• Erotica Exploration: Reading a romance novel or listening to an audio story together to spark arousal and conversation about what each partner finds exciting.

Strengthen Your Relationship Through Sex Therapy

While self-help books and podcasts are valuable resources, they cannot replace the personalized insight of a professional. This is because sexual issues are rarely just about sex; they are a tangle of biological factors, psychological concerns, and relationship history. A professional therapist can untangle these knots safely while making sure that underlying traumas are respected and that both partners feel heard.

The Institute of Personal Growth specializes in this delicate work. Our couples therapists provide a compassionate, sex-positive environment where you can explore these intimate aspects of your life without fear of judgment. Whether you are dealing with mismatched libidos, dysfunction, or simply a desire to deepen your connection, we are here to guide you. If you live in Jersey City, Highland Park, Freehold, NJ, or the surrounding areas, connect with our experts today!

Frequently Asked Questions

What does a sex therapist teach you?

A sex therapist teaches you how to understand your own sexuality and how to communicate that to a partner. This includes exploring sex education, debunking unrealistic expectations, techniques for stress reduction and mindfulness during intimacy, and communication skills to express boundaries and desires without shame. Ultimately, they teach you how to shift from performing sex to experiencing it.

What is done during sex therapy?

Sex therapy is a form of psychotherapy (talk therapy). During sessions, you will talk about your history, your current relationship dynamics, your stressors, and your specific sexual concerns. The therapist will help identify the psychological or relational roots of the problem. They will then assign specific behavioral exercises (homework) for you to do at home. There is never any nudity or sexual activity in the therapist’s office.

What can you expect in the first sex therapy session?

The first session is primarily an intake interview. The therapist will ask questions to get to know you and understand the context of your visit. You can expect questions about your relationship status, your general mental health, your medical history, and a history of the sexual problem (when it started, what makes it better or worse). It is a time to build rapport and ensure you feel safe and comfortable with the therapist.

What exercises do sex therapists do?

Therapists assign exercises based on the specific issue. Common exercises include:

• Sensate Focus: Touching exercises to rebuild intimacy without the pressure of intercourse.
• Cognitive Restructuring: Writing down negative thoughts about sex and challenging them.
• Scheduled Intimacy: Setting aside specific times for connection to reduce the “pursuer-distancer” dynamic.
• Bibliotherapy: Reading specific educational books regarding anatomy or desire.

What does a sex coach actually do?

While there is overlap, a sex therapist is a licensed mental health professional trained to handle mental health diagnoses, trauma, and complex relationship dynamics. A sex coach tends to be more solution-focused and future-oriented, helping clients achieve specific goals or learn specific skills. Coaching is often less regulated than therapy and may not address the deep psychological underpinnings of sexual dysfunction.