Therapy in L.A.

  article of the month
May 2001
By Carol Boulware, MFT, Ph.D., ABS Certified Sex Therapist

Diplomat, American Board of Sexology - Clinical Fellow, American Academy of Clinical Sexologists

Do you have any of these concerns?

  • Consistently low sexual desire?
  • Problems getting and maintaining erections?
  • Difficulty controlling ejaculations and timing?
  • Difficulty reaching orgasm?
  • Difficulty relaxing and enjoying sex?
  • Loss of sexual intimacy in your relationship?
  • Anxiety or pain during intercourse?
  • Embarrassment, shame or guilt about or during sex?
  • Sexual trauma or abuse as a child or an adult?
If you can answer "Yes " to any of these issues, you are not alone. Many individuals and couples experience sex-related problems at some point in their lives. Sexual problems are often the result of a troubled relationship, past sexual trauma, low self-esteem, depression, health problems or medications. All of these can negatively affect sexual functioning.

Fortunately, Sex Therapy can help you resolve these issues.


According to a recent study in the Journal of the American Medical Association, 3 out of 10 men, and 4 out of 10 women, experience sexual problems. The types of problems most commonly reported by men are premature ejaculation, erectile dysfunction and low sexual desire. Women most commonly reported problems with arousal, low sexual desire and pain during intercourse.

In addition to these concerns, people seek sex therapy when they have tried to resolve their problems themselves without success. They may want to improve their communication during sex, or are unable to resolve the differences in their desired frequency of sex. An individual or couple may feel inhibited or fearful about sex or some aspect of sex. Others may have experienced past sexual trauma, such as forced sexual contact or abuse that has troubled them for years, perhaps from childhood.

These sexual issues can have a major impact on one's self-esteem, as well as on one's intimate relationships. That's why it is so important to seek professional diagnosis and treatment at the earliest opportunity. You and your partner deserve to have pleasurable and satisfying sex lives.


Sex therapy can successfully treat a wide variety of problems that interfere with health and fulfilling sexual activity. Some examples of the sexual difficulties that can be treated effectively with sex therapy are:

    problems that interfere with health, fulfilling sexual act
  • Inhibited sexual desire (low or lack of sexual desire)
  • Erectile dysfunction (Impotence)
  • Premature ejaculation (PE) or inhibited ejaculation
  • Sexual aversion (anxiety, fear, disgust)
  • Orgasm difficulties
  • Dyspareunia (Painful intercourse)
  • Vaginismus (Involuntary spasm of the muscles surrounding the vaginal opening)
  • Sexual trauma (rape or sexual abuse as a child or adult)
In addition, relationship and intimacy problems that may affect sexual functioning can also be successfully treated by a sex therapist.


The first step in therapy is evaluating and assessing the presenting problem or problems. A sexual history is taken which asks the patient to describe his/her sexual experiences. If it is a couple, each partner's sexual history is taken. (Any information you give or conversation you have with your sex therapist will remain strictly confidential).

The therapist carefully analyzes the medical and historical data, together with any issues or related circumstances described by the patient, to identify all the strands that weave into the patients current condition. This evaluation results in a diagnosis and detailed treatment plan.The treatment will vary depending on the diagnosis, but it usually involves special exercises for each individual or couple.

Sex therapy is not "just talking." Each week the therapist will suggest new experiences for the individual or couple to try in the privacy of their home. These at-home "sensate focus exercises" are designed to take the pressure and worry out of sex. In subsequent sessions, the at-home exercises are discussed and any difficulties are explored. The exercises help the individual or couple "re-learn" more satisfying sexual behavior.

The therapist functions as a sex educator, providing accurate information about anatomy, physical response that is specific to the clients sexual concern. The patient may be given books to read or educational videos to watch.


If you feel that a sexual difficulty you have experienced for a period of time is not getting any better, you will probably benefit from seeking professional counseling. The earlier you take action, the sooner the problem will be addressed and corrected. It is also important to consult your doctor for a medical evaluation early on. A sex therapist can work with a physician when medical treatment is indicated.

If a man or woman continually worries about how they will perform prior to the sexual activity, a cycle of anxiety can turn into a condition called "performance anxiety." The longer he/she worries the more established the "performance anxiety" becomes. Sex therapy can help interrupt these cycles and restore sexual functioning to normal.

If the issue is premature ejaculation and a man has tried reading books, the stop-start technique, the squeeze technique, creams, etc. and is still not able to "fix" the problem, it will probably be helpful to contact a sex therapist to explore what other issues may be at play in the condition.


A Certified Sex Therapist is a licensed professional, specifically trained in the diagnosis and treatment of sexual problems. In addition to their education and background in psychology or medicine, therapists certified by the American Board of Sexology have extensive training and supervision and have passed strict professional requirements to receive their certification.

Use of the terms "sex therapy or "sex therapist" is not clearly defined in most states. There are many self-appointed experts who call themselves sex therapists on the Internet, in magazines or phone books but lack the proper training and qualifications. The only protection for the consumer is the presence of certification. A Certified Sex Therapist educates and guides patients towards discovery and resolution of their sexual concerns. Sex therapy sessions never involve sexual contact, or any other kind of sexual activity or nudity in front of the therapist. Certified Sex Therapists are expected and bound to conduct themselves in a professional and ethical manner with their clients, at all times.


Therapy sessions are usually weekly and last anywhere from a few weeks to a few months, depending on the severity of the difficulty. It is perfectly natural to feel embarrassed about a sex-related problem and it often takes courage to seek professional advice.

The Good News

In my 24 years of treating patient with sexual problems, I have helped many people who have experienced a wide spectrum of sexual difficulties. Individuals or couples involved in a sexual crisis should not ignore it in hopes that it will disappear by itself. It rarely or never does. Here is the good news -- there is an excellent chance that your symptoms can be reversed through sex therapy, medical treatment, or a combination of the two. Remember, no matter what problem your are experiencing, you are not alone, and there are caring professionals available to you.

Carol Boulware, MFT, Ph.D.
ABS Board Certified Sex Therapist #1466
Licensed Marriage, Family, Therapist MFT11632
Board Certified Expert in Traumatic Stress
EMDRIA Certified in EMDR, Level II-'94
EMDRIA Approved Consultant
3130 Wilshire Blvd., Suite 550
Santa Monica, CA 90403 - (310) 395-3351
Redondo Beach (310) 395-3351


Copyright 2001 Carol Boulware, Ph.D.

Dr. Boulware is a psychotherapist in practice in Santa Monica and Redondo Beach. She is a member of the Independent Psychotherapy Network.

back to article of the month

home | article of the month | featured therapist | news & events
psych bytes | book review | about our group
therapist profiles | locate a therapist

Copyright Independent Psychotherapy Network ©1998