Academic journal article American Journal of Psychotherapy

Coming out of the Sex Therapy Closet: Using Experiential Psychotherapy with Sexual Problems and Concerns

Academic journal article American Journal of Psychotherapy

Coming out of the Sex Therapy Closet: Using Experiential Psychotherapy with Sexual Problems and Concerns

Article excerpt

Mahrer's Experiential Psychotherapy provides a valuable alternative to conventional sex therapy with individuals and couples. Experiential Psychotherapy uses the sexual complaint as it would any situation or scene described at the outset of therapy, as an entry point to the client's deeper experiencing. Several of the advantages of the methods employed are listed. Specifically, the ways in which Experiential Psychotherapy is ideally suited to dealing with forbidden, haunting, and disturbing sexual feelings, fantasies, and urges are highlighted. Clinical illustrations are presented of experiential dream work with a sexual assault survivor and of a couple referred for treatment of his erectile dysfunction and her low sexual desire. Experiential Psychotherapy effects profound changes in the person(s), connections within and with others, and in bodily phenomena. These outcomes, including freer choices, heightened pleasure and embodiment, extend beyond the predominant treatment paradigm's amelioration of sexual symptoms and disorder.


My business card is somewhat deceptive. It advertises "Sexual and Couples Therapy", which tells all what I do but does not indicate the way that I do it. I approach sexual and couples' problems and concerns with Mahrer's (1996/2004) Experiential Psychotherapy. Although this mode of psychotherapy was designed to be used with individuals, it lends itself to use with couples and groups, for example, with groups of survivors of child sexual abuse. (In my practice, about two-thirds of the clients seek couples therapy, and the rest are seen individually or in groups.) Experiential Psychotherapy is especially well suited to dealing with bodily phenomena, such as migraines, hypertension, and asthma, (Mahrer, 1996/ 2004) and thus, is ideal for working with sexual concerns (Kleinplatz, 1998, 1999, 2004; Mahrer & Boulet, 2001). More broadly, it works to create powerful, profound, pervasive changes in the person, the body, and connections within and with others, i.e., in the couple. The purpose of this article is to highlight the advantages of Experiential Psychotherapy and especially its methods, over those of conventional sex therapy treatment.


A session of Experiential Psychotherapy for sexual problems and concerns follows the four steps described by Mahrer (this issue; 1996/ 2004). In step one, experiential psychotherapists and their clients search for moments of strong feeling. Finding the peak instant in a scene of strong feeling allows access to the client's deeper experiencing. The second step involves welcoming the inner experiencing by naming it, identifying its accompanying bodily sensations, and establishing a friendly relationship with it (Mahrer, 1996/2004). The third step entails living as the "new" person (i.e., the freshly accessed, inner experiencing in the context of earlier life scenes; the client is to be this deeper potential in two or three past scenes, for example, when the inner experiencing was poised to appear. In the final step, the client is to consider, experiment with, and try on the possibility of living as the person he/she could become beyond the session (Mahrer, 1996/2004).

When using Experiential Psychotherapy with clients who have sexual concerns, steps one and four are somewhat different, especially when the sexual partner is in the room during the session. As a sex therapist my clients desperately want help. I have the advantage of not having to work at the first step, which involves locating and living in scenes of strong feeling. People who come to see me are in acute turmoil, their feelings roiling and raging and accompanied by very strong bodily sensations and images; all I need to do is get out of the way and simply ask, "What brings you here today"? …

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