Issues of Desire, Arousal and Orgasm
My Modern Integrated Approach:
I provide an integration of the EMDR 3-Pronged Protocol and traditional sex therapy methods. While EMDR focuses on the neurological and emotional "blocks" held in the brain, traditional sex therapy—often called Psychosexual Therapy—is more behavioral and educational. It focuses on the "here and now," providing practical tools to change how you interact with your body and your partner.
EMDR 3-Pronged Protocol
Therapists use EMDR to desensitize memories that have "locked" the body’s sexual response in a state of inhibition or fear.
Sexual Trauma: Reprocessing experiences of assault or abuse to decouple the physiological response of arousal from the memory of the trauma.
"Small-t" Traumas: These include childhood events like being shamed for masturbation, "slut-shaming," or religious/cultural messaging that links sex to guilt.
Attachment Wounds: Addressing early experiences of neglect or betrayal that make the vulnerability required for desire and orgasm feel unsafe.
In this phase, the focus shifts to current situations that cause the body to "hit the brakes" on arousal.
Body Image: Reprocessing negative beliefs like "I am unattractive" or "My body is broken" that arise during intimacy.
Sensory Triggers: Desensitizing specific sounds, smells, or touches that inadvertently trigger a shutdown or "freeze" response during sex.
Physical Pain: For disorders like vaginismus, EMDR is often paired with pelvic floor rehabilitation to reduce the anticipatory anxiety and muscle tension associated with penetration.
The final stage uses Positive Installation to help the client envision healthy sexual encounters.
Performance Anxiety: Reprocessing the fear of "failing" to get aroused or reach orgasm.
New Associations: Developing a "Future Template" where the client visualizes staying present, grounded, and connected to pleasure without the old negative cognitions (e.g., replacing "I won't be enough" with "I am allowed to enjoy this").
Psychosexual Therapy
A major component of sex therapy is correcting misinformation. Therapists often provide education on:
The Dual Control Model: Explaining how the brain has both "accelerators" (arousal) and "brakes" (inhibition).
Anatomy and Response: Clarifying how the body actually functions versus how media portrays it.
Normalization: Validating that many issues are common, which reduces the "spectatoring" (anxiety-driven self-monitoring) that kills arousal.
"Plumb Line" is a metaphorical concept used to establish a baseline of what is "normal" or healthy for an individual, separate from societal pressure, shame, or trauma.
The gold standard of traditional sex therapy is a series of structured exercises called Sensate Focus. Developed by Masters and Johnson, it involves:
Phase 1 (Non-Genital): Partners take turns touching each other’s bodies (excluding breasts and genitals) with the goal of noticing sensations rather than achieving arousal.
Phase 2 (Genital): Gradually incorporating sexual areas but with a strict ban on intercourse or orgasm.
The Goal: By removing the "goal" of sex, the pressure is lifted, allowing the nervous system to relax and arousal to return naturally.
Traditional therapy uses Cognitive Behavioral Therapy (CBT) techniques to challenge the "internal critic."
Example: If a client thinks, "If I don't reach orgasm, I've failed my partner," the therapist helps them reframe this to, "Pleasure is the goal, not a specific physical finish line."
Many disorders of desire and arousal are actually symptoms of relationship friction. Therapists teach:
Sexual Intelligence: Learning how to articulate likes, dislikes, and boundaries without shame.
The "Menu" Approach: Expanding the definition of sex beyond penetration to include a "menu" of activities that feel safe and enjoyable.
Let's get started..
Note: Because sexual dysfunction often has medical roots, it is standard practice to consult with a physician to rule out hormonal or physical causes before beginning sex therapy.
