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Faced with a sexual functioning problem or compulsive sexual behaviors, therapy may not be the first option a student thinks of.
But Dr. Chris Kraft, a clinical psychologist and clinical director for the Johns Hopkins Center for Sexual Health in Baltimore, Maryland, helps students, couples and other individuals overcome these hurdles every day through his private practice.
He described the purpose of sex therapy and common patient challenges in an interview with The Towerlight.
SEX THERAPY IS A PRETTY BROAD CATEGORY. Most people who seek our services are usually dealing with some type of sexual functioning problem. These are known as sexual dysfunctions.
The most common sexual dysfunction is lack of desire, or desire discrepancy (between the man and the woman), or difficulty reaching orgasm for women. For guys it can be difficulty with ejaculation timing or erection maintenance.
I work with a lot of guys who feel like they're spending excessive amounts of time looking at internet pornography. I also work with people who find themselves sexually aroused in non-traditional ways. Individuals who are same sex orientated or find themselves drawn to fetishes or other non-traditional sexual activities can experience social stigma or guilt and shame.
YEAH, WE DEFINITELY SEE COLLEGE STUDENTS. A common college-age sexual functioning problem for men is premature ejaculation and performance anxiety. This can be the result of a lack of sexual experience and from not learning how to connect their bodily sensations with their mind. We find that males get better with ejaculation control as they get older.
For women, it can be discomfort or pain with intercourse and difficulties reaching orgasm. Women can have difficulty feeling comfortable with touching their genitals or stimulating themselves to orgasm.
Masturbation still carries a taboo in our culture. There is a high correlation between lack of masturbation experience and difficulties reaching orgasm with a partner.
We have a sexual double standard in our culture in that for men it is good to be sexual including looking at porn and masturbating and for women the message can be the sex is bad or dirty and if you partake you are viewed as promiscuous.
A LOT OF SEX THERAPY IS COUPLES THERAPY. Some couples can have sexual functioning problems in the beginning. Women can have problems with intercourse discomfort or a lack of orgasm and this can result in a lack of sexual desire. For males they can have inefficient erections or feel like they ejaculate too soon which can lead to performance anxieties.
Males can feel a lot of pressure to create a perfect sexual experience for their partner and if they lack experience or have functioning problems they can feel inadequate as a sexual partner.
Unfortunately most of us learn about how to be sexual through the media including watching pornography. This leads to an emphasis of performance including perfect erections, orgasm longevity, and multiple/simultaneous orgasms.
Most couples assume that the woman should orgasm during intercourse. Only about 30 percent of women can orgasm from penetration alone so it is important they learn how to stimulate themselves in other ways during intercourse.
EVERYBODY'S SO GOAL-ORIENTED. We all think it needs to be this perfect sexual experience that concludes with simultaneous orgasms. We tend to engage sexually from a linear path, kiss, caress, genital stimulation, penetrate, and orgasm. We don't feel comfortable leaving out or only focusing on one of those steps.
Why not leave out intercourse sometimes and not even have an orgasm every time we are sexual? There's not enough emphasis on romantic foreplay experiences like message, stimulating the genitals by hand or mouth and being verbally expressive.
So it's about breaking down the linear stereotypical model of sexual activity. It's all about communication - talking about what we like and what feels good.
Just listen to what each other's needs are and what they think might help trying not to take it personally if your man doesn't get hard or if your woman is unable to orgasm. Work as a team.
Many people don't feel comfortable talking about sex. They want to act like they know what they're doing. But in reality everybody's learning about themselves and their partner and through good communication and adequate sexual knowledge and experience most people create satisfying sexual relationships.
For more information on Dr. Kraft's services, call 410-616-7150 or e-mail ckraft@jhmi.edu.
For a national database of sexuality educators, therapists and counselors, visit http://www.aasect.org/.
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