Until relatively recently, most people used to understand sexuality as something relatively simple and one-dimensional, linked to reproduction on the one hand and sin on the other. In recent decades this has changed a lot, but not only have we become more open to new ways of experiencing sex; we are also able to identify more problematic situations in it when something doesn’t work.

That is why the opinion of sexologists is important, because it shows how these changes in the way we think and relate to each other affect human sexuality. On this occasion we talked about it with Brenda R. Bodemer , a psychologist who focuses much of her work on sex therapy and who attends the center UPAD Psychology and Coaching.

Interview with Brenda R. Bodemer: the importance of sex therapy

Brenda R. Bodemer is a psychologist specialized in Clinical Psychology and Sexology integrated in the team of professionals of UPAD Psychology and Coaching, center of psychological assistance located in Madrid. In this interview she talks about the type of problems addressed from sexology, and the way in which cultural factors influence them.

What are the most common reasons people go to sex therapy? Are there differences between men and women?

There are several reasons why people may seek sex therapy. Most of the reasons for consultation have to do with blocks that the person has when it comes to enjoying their erotic relationships and that they do not know how to manage, given that we have not received adequate sex education and everything that has to do with sexuality is even more of a taboo subject than we would like. Not being able to talk about a problem related to our sexual behaviour, our thoughts or feelings about our eroticism, is going to be difficult to solve on your own.

The reasons for men and women to come to therapy are often different. They tend to come more for problems related to their sexual satisfaction or lack of pleasure, while men tend to have more problems with execution, that is, how their genitals respond. However, we are seeing more and more cases of men with little or no desire, more often than before, which may have to do with how today’s society is trying to break down gender stereotypes.

After all, demands change over time, which, as I have said, is closely related to the sex education received and to social standards on sexuality. For example, you see fewer cases of anorgasmia because of the access to information and the role that is being given to women as desirers and not just as desireers.

How often, more or less, are the causes of the most common sexual dysfunctions psychological?

The sexual response is a process in which both the psychological and the physiological are involved, and therefore sexual dysfunctions have both psychological and physiological causes.

Although it is sometimes easy to identify whether the root of the problem is psychological or not, it is most often difficult to discriminate the cause, especially in dysfunctions such as dyspaurenia or erection difficulties. This is precisely why, in sex therapy, it is essential to rule out (before intervening) a physiological problem that could be influencing the person’s sexual response.

However, sexual problems do not usually come in isolation. Usually (once a physical origin has been ruled out) these problems are a reflection of a bad patch in the couple, poor communication or a stressful time one or both partners are going through.

And in cases where the root of the problem is psychological. what can sexologists do to help?

As we have seen, the first step is to rule out a physical illness that may be affecting the person’s sexual response.

Once this possibility is excluded, the interventions of sexology professionals move along a continuum: sex education, sex counselling and sex therapy. Sex education is transversal, that is, it is done throughout the therapy, since in many occasions sexual problems come from our own prejudices or stereotypes that we have internalized. Counseling would go in the line of addressing those problems that are not serious but are generating discomfort, and sex therapy addresses the most serious difficulties or dissatisfactions. All this in both individual and couple formats.

Are sex therapy and couples therapy often related? How do they complement each other?

Many professionals in psychology distinguish couple therapy from sex therapy, however, in sexology we cannot make such a distinction.

There can be sex therapy without couples therapy (in the case of people who come to the clinic as single women), but there can be no couples therapy without sex therapy, even if the couple is not coming for sexual dysfunction. This is because we all have sexuality, from the moment we are fertilized until the moment of our death, whether we have a penis or a vagina, whether we are single or in a couple.

People think that when they have couple problems they have to go to the psychologist and only if they have a sexual dysfunction, to the sexologist. However, a psychologist with no training in sexology will work on a sexual difficulty or a couple’s problem incompletely, precisely because the couple is sexed as well.

Is it common that some sexual dysfunctions are not recognized as such by those who develop them?

It is, in fact, too common. In my experience, it takes couples about three years to talk about a sexual problem, and another two years to go to therapy. In other words, it takes five years from the time the problem appears to the time they decide to solve it.

This is because of what we talked about at the beginning, that sexuality is still a taboo subject, even between couples. This would be remedied by normalizing the subject of sexuality and seeing it as something natural and, in the same way, knowing that problems can arise.

In your professional experience, have you noticed any cultural changes in the way the Spanish population views sexology in recent decades?

It’s true that there is still a certain stereotype about those of us who work in sexology, according to which our job is to teach “how to be the best in bed”, “what is the most effective way to seduce your partner”, “how to flirt”, “how to do the best oral sex” and a long etcetera, when in reality sexologists pay attention to diversity.

Not to mention the gender bias of the professional. Several female colleagues have been harassed with photos of male genitalia that they have not asked for, or have made proposals to them that went beyond a mere sex-counselling consultation, something that has not happened to my professional colleagues.

However, in the last decade it has surprised me that young couples are coming more and more to therapy, deciding to make an investment to improve their couple life and their sex life, which was not the case before, because they could not afford it and, although they still can’t, they prefer to use their money on this and save from another area of their lives.

This indicates that by having more and better quality sex education, sexuality is beginning to be given the importance it deserves. Likewise, not only do people come accompanied by their partners, but single people also come, which indicates that importance is beginning to be given to sexuality not only as a couple and also gives the message that sexuality can be lived and enjoyed in singleness.

Is there still a need for more awareness that sexual problems deserve a step in therapy?

As I have already mentioned, sex education is playing a very important role in opening up a space to talk about sexual problems in an increasingly natural way. Despite this, it is clear that this is a subject that still has some way to go. The time that passes before someone decides to go to therapy is very long and this is a disadvantage, since in most cases the sooner a problem is addressed the sooner it will be tackled.