Sexist: Sex Therapy 101

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culture

We talk to a sex therapist about what it takes to solve people’s most intimate problems.

Each month, Sex-ist examines topics related to sex and sexuality in and around the GTA

We have a pretty strong relationship with our body. If you broke your leg, you would see a doctor. If you can’t get an erection, that same doctor may give you a little blue pill. But what if the problem doesn’t end there? What if those little blue pills are causing you angst or anxiety? What if they make your partner sad or uncomfortable? You may want to call your friendly neighborhood sex therapist.

Joan Marsman is such a therapist. She has been practicing family and marriage counseling for thirty years, and at 55 she is quite comfortable working with clients on topics as diverse as BDSM, pain during sex and sexually transmitted infections. . She deals with the emotional element of sexual issues, working on “tools and strategies” to help people get the most out of their sex lives. A typical treatment cycle for a couple can take eight to twenty sessions every two weeks, and Marsman also sees an equal number of single men and women.

Marsman began her career as a sex counselor working with pregnant teens. “At the time, I was led to do what they call reducing recidivism, which is to say ‘don’t let them get pregnant again’. My job was to work with these young women, to provide them with advice, to introduce them to sexuality, ”says Marsman. She worked at Planned Parenthood for almost a decade, before leaving in 1991 when she realized she could never work with people over 25. She is still a member of the planning committee of the Guelph Sexuality Conference, and member of Sex Therapy Review Board and Counselors in Ontario, a professional association of therapists.

Our interview with Marsman — about the difference between a doctor and a sex therapist, how Ashley Madison changed her job, and the importance of My stepfather, my parents and I-is inferior to.

torontonian: How did you get interested in sexuality as a subject? What made you decide to create your own practice?

Joan Marsman: I couldn’t find a deep, dark reason. It’s fun, it’s interesting. I come from a time when sexuality was very repressed. A good friend got pregnant in high school and I saw how badly she was treated. I was an aspiring feminist. I wanted to help people, and I was definitely going in that direction. I grew up in a household with very traditional values ​​around the roles of men and women, and I was not happy with that. I thought my brother should do the dishes too. In a way, I was a little more angry and a little pissed off by some of the gender restrictions. If I was going to find a way to have fun, why not have sex? Nobody wants to talk about it. When I moved to the University of Guelph I was like, Truly? Can you take courses in human sexuality? Sign me up!

There really isn’t any work for sex therapists, so if you want to work in this area you pretty much have to be in private practice. It was handy as a new mom to develop a practice. I had young children and could stay home, earn money and be very family. If I wanted to do this kind of work, I was going to have to figure it out for myself.

What kinds of issues do you deal with in your practice? What is the spectrum and what types of things do you see most often?

The line of traditional sex therapy would be pain issues, such as pain during intercourse – I specialize in that area a bit; orgasm difficulties; erectile difficulties; lack of sexual desire, which is huge; differences in desire between couples; business is big.

It’s changed. Nowadays, a lot of it is about the desire and fear that a partner is not interested in sex. Business has always been there. More and more men are comfortable calling and coming for therapy. I think men have evolved. I think men have become more comfortable asking for help. It would be a generational thing. These are more often men under the age of fifty. I get people calling in their twenties and thirties, saying: I have this sexual problem, and it is affecting my relationship. Women are more empowered, so they say they’re not going to take care of it. You have a problem, you should fix it! They are more independent, more comfortable with their own sexuality, more willing to say that they want to have a good sex life.

Let’s say I’m in a couple, had an affair, and we want to come see you. What kinds of things would we talk about in our first session?

At first, people came to tell me a bit about their relationship: how long have they been together? What is their relationship status – dating, living together, being married, whatever – and how they met. And what is going on? The person will take the time to tell me this story. I want to hear from all of them. Then we’ll finish with what people are trying to accomplish. I’m going to ask a bunch of questions in between. The initial date gets me up to speed and talks about what they hope will happen when they come to see me.

Then I like to see each of them individually for a session. It’s to have a little experience so that I can get to know them a little as a person and find out what life experiences have influenced them. I find out what their family constellation was – I’m trained in systems theory, so people are part of larger systems from my perspective. This is the opportunity to have a frank discussion without worrying about the reaction of your partner. I am also looking for motivation to do the job, and if it is safe for them to do the job. You don’t want to become vulnerable during a session and then go home and have big fights or repercussions afterwards. You want to know that they are going to be able to respect each other while they are doing the job. And I want to make sure couples therapy helps. Are there any individual issues that need to be resolved first? Are there any secrets that will keep therapy from moving forward?

This example was sort of emotionally driven, so how does the process change when the concern is something physical, like erectile dysfunction?

I do the same thing. I’m making the whole sex story with this person. In sex therapy, when there is a sexual problem, I will include a sex story: the sexual development, the sex education they received and how their sexual experience went. I’m trying to find out if this is a positive development or if there have been negative influences. I really want to take the time to hear this person’s story. It’s usually really unique for someone to come in and do this. People don’t usually sit down to talk about how they learned about sex, and how they learned where babies are from, and who told them about masturbation or not. It is a unique and rich opportunity for people to consider what has influenced their sexual development.

In the case of something that is physically trained, do you have any partners in the medical community? Can you say to a client, “I think this part might be psychological, but for this other part, check with your doctor”?

Absoutely. Why come for hours of therapy if there is a medical solution or a medical cause? And there could be a medical cause, but because their sexual functioning is affected, there is also an emotional component that I always end up telling this person about. How do they manage the quality of life around their sexuality? For example, if you have pain during sex, sometimes it creates tension in the genital area. We can teach women to relax, but there can be relationship issues, such as fear of pregnancy. Working on emotional issues really helps, but in this case I’m working with a physiotherapist. The physiotherapist will work with the muscles and the body, and I will work with the mind.

You have been a therapist for thirty years. What has changed since you started?

What has changed is seeing couples who have great relationships and good marriages, and no sex: the “roommate” situation. It’s probably been around for five or ten years, and we’re talking more about it. We have books there now, like The sex starved marriage, and we recognize the loneliness. Dating has been a solution for a lot of men, but women have power. Now we have women who openly love sex, who want sex, who want it to be part of their relationships, and they’re talking louder. I think the new trend has been influenced by the internet. Emotional affairs, betrayals or deceptions, using chat rooms, websites like Ashley Madison or becoming addicted to porn. We didn’t have that thirty years ago in college. Talking about BDSM and kink in sex therapy is different. I didn’t have these conversations ten years ago, but now people are talking about them as part of their sexual practices. He is entering the mainstream.

How do you think the medical community and society in general perceive your work?

I think socially the information is there. The sex therapists have been on Oprah. Or in My stepfather, my parents and I, which was not the best representation, but this character made turn to the other mother-in-law and say, “What about your pleasure?” These are the kinds of conversations that are good. I think people are more open, there are more on TV, and there are a lot more books with good sex education in general culture. We have gone from sensationalism to good information.

In terms of the medical community, there is a need for more crossbreeding. There are people who do sex medicine, and they probably know sex therapists. There are doctors who are comfortable with patients who have sexual problems. Baby boomers are getting older, and Viagra gave doctors a tool they didn’t have before, and drug companies wanted doctors trained so they could prescribe it. This prompted many more doctors to receive sex education. They could then ask the right questions, make the right diagnosis and prescribe the right medication. It was a big change. New doctors belong to a more open and comfortable generation. I’ve been invited to some of their focus groups, and it was interesting to be invited and it’s great to see that opening.

How does your work as a sex therapist impact you? What do you think of what you are doing?

I like what I do. It certainly broadened my experience. I grew up in a very white middle class community, WASP-y. It really opened my mind to the variety of ways people are sexual and the lifestyles they have. I work with people who want to get married and have better marriages and better relationships. Who want to be sexual and have better sex. It is a great job to do.

Filed under Joan Marsman, sex, sex therapy, sex-ist


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