Why therapists must talk about sex

ABOUT THE EPISODE

What we cover

Psychosexual and relationship psychotherapist Lu Cook discusses why therapists need to make space to talk about sex.

• Opening conversations about sex
• Sexual wellbeing and relationships
• Medication and libido
• Working with discomfort in the therapy room

How can therapists make space to talk about sex?

Sexual wellbeing can be relevant to relationships, identity, physical health and emotional distress, but clients may not know whether it is acceptable to raise in therapy. Lu Cook discusses the value of opening the subject rather than waiting for every client to introduce it themselves.

An invitation does not require the therapist to assume that sex is a problem or push for details the client does not want to share. It can simply communicate that this is an area the therapy room can hold, with the client retaining choice about what feels useful to explore.

Why does therapist discomfort matter?

Therapists bring their own uncertainty and assumptions to conversations about sex. If discomfort leads to changing the subject, speaking vaguely or overlooking sexual wellbeing altogether, potentially important parts of the client's experience can remain outside the formulation.

The episode considers relationships, medication and libido alongside the practical task of beginning the conversation. This gives therapists a way to notice their own response while staying curious about what the subject means for this particular client.

Related listening: For another conversation about material therapists can feel unsure about raising, listen to The Role of Religion in Therapy, covering assumptions, bias, faith transitions, spiritual trauma and thoughtful self-disclosure.