Is Your Therapist Giving You Bad Sex Advice?

Chances are, your therapist received almost no clinical training in human sexuality. In fact, there are very few human activities that therapists get less training in.

As we know, Western culture is full of ambivalence, fear, and misinformation when it comes to sex. Therefore, we shouldn’t be surprised if your therapist has absorbed a lot of that negativity—since it probably wasn’t challenged during their training. When you add in a strong dose of contemporary political correctness, would-be therapy customers need to be careful, especially if their concerns are sexual.

Here are examples of what many therapists think they know about sex—but they’re wrong.

“Interest in kink reflects childhood abuse.”

America’s general awareness of kinky sex increased as a result of two things: the mainstreaming of homosexuality and the spread of broadband internet (i.e., pornography and social media). Each of these brought nonstandard sexual arrangements into public consciousness.

Broadly defined, “kink” often involves playing with taboos and/or power dynamics. Participants give themselves permission to fantasize sexually, whether that involves costumes, equipment, role-playing, or exploring what might feel good—even if that isn’t what it looks like from the outside.

Since most therapists get little or no training in any of this, they may react to patients’ stories that sound masochistic, sadistic, confusing, or just plain weird. Instead of asking patients what it feels like to spank or be spanked, they may simply observe “It sounds abusive to me, so I’ll treat it like second-hand abuse.”

Many therapists feel capable in working with “abuse” or “trauma,” so they’re more comfortable seeing kinky sex that way, rather than expanding their own concepts around eroticism, lust, and pleasure.

“To resolve infidelity, the cheater must reveal every moment of what they did.”

Someone who’s been cheated on needs comfort. Their reality has been destabilized, so they need some information. They need a sense of what to expect going forward, so they need ongoing communication.

What they don’t need—no matter how much they demand it—is a looong series of tiny details: Where did you do it? In which positions? Did you use lube? Did you shower together? What restaurants did you go to?

Therapists should understand that somebody asking a million questions like this might not be the best judge of what they need. But if a therapist is judgmental, if they see one selfish evil-doer and one innocent victim, they won’t think clearly, either.

Will the therapist ask if the individual had withdrawn sexually? If the betrayed was sympathetic to the “cheater’s” concerns about aging? If the couple were physically connected in nonsexual ways?

Most importantly, will a therapist ask “Why do you want to know if [for example] the cheater was listening to music during sex?”

“You’re upset? You have PTSD.”

Life is upsetting. Nobody gets everything they want—or need. And our loved ones sometimes mistreat us. It’s important that everyone feels they’re allowed to get upset and to express their upset.

In the face of mistreatment, however, we need to be resilient. This is what we teach our kids: “I know you’re unhappy, I know X isn’t fair, but you still have to go to school, do your chores, and be friendly to me and your sister.”

Therapists can train patients to be fragile, anxious, and victim-oriented. They can emphasize others’ pathology (“Your wife, whom I’ve never met, sounds like a narcissist”) while not confronting a patient’s collusion in their own powerlessness (for example, by not challenging a patient’s idea that they’re “too nice” when they’re selfishly conflict-avoidant).

Posttraumatic stress disorder used to be a technical, very narrow diagnosis with harrowing features—which always included serious suffering. Too often it now means “You’re understandably upset and can’t be expected to energetically pursue options to overcome this situation.”

“A woman has a right to a porn-free home.”

This raises a bigger issue: How are couples supposed to navigate values differences? To put it another way, what are legitimate ways to use power?

To put it more practically, if a couple votes on an issue, and it’s a one-one tie, what do they do? Joe wants to eat Italian tonight, while Kalpana wants to eat Chinese; how they decide where to go is a good predictor of how healthy the relationship is.

Very few therapists would say, “He should get what he wants because he’s insecure” or “She should get what she wants because she’s a woman.” So, if a couple votes (metaphorically) and he wants to watch porn (in private) in their house, and she doesn’t want porn watched in their house—how do they resolve this?

Where would anyone get the “right” to insist “We have to do this my way,” especially if that wasn’t the way a couple usually resolved conflict? In general, therapists don’t support such a “right”—until the subject is sex.

As it happens, “I have the right to a porn-free house” generally means “I don’t want you watching porn.” This latter way of putting it is more likely to eventually lead to understanding (if people ask and answer each others’ questions honestly), and possibly even some consensus. In contrast, the language of “rights” is dangerous in a relationship, typically pushing partners away from each other.

“Men and women are basically different, especially about love and sex.”

On certain dimensions, the average man and the average woman are predictably different. For example, ask 100 men how often they masturbate, and average the number; ask 100 women how often they masturbate, average the number, and compare it to the men’s number. The men’s number will be higher. The same is true for other things, like height (men are typically bigger) and head hair (women typically have more).

But no one is actually the “average man” or the “average woman.” Knowing that some anonymous person masturbates once per day or once per year doesn’t tell us someone’s gender.

Most adults of all genders want the same things from sex: to feel special, to feel connected, to feel competent, to feel pleasure. And most adults are anxious about the same things: their “performance,” their attractiveness, their aging bodies, and being compared to others.

When patients ask me to explain “men” or “women” to them, I say, “You don’t need to know that unless you’re planning to have sex with thousands of men or women. On the other hand, if you want to understand Jorge or Emily better, don’t ask me—ask them.”