ABSTRACT
Sex therapy is best conceptualized as a subspecialty of couple therapy. As is typical for couple therapy, the majority of clinicians conducting sex therapy are female. In addition, it is typically the woman who initiates couple therapy because she is disappointed in the man and the marriage, and hopes that therapy can resolve the problems. If sex therapy is initiated because of a female sexual problem (female inhibited desire or nonorgasmic response), the man is generally a willing participant. However, if therapy is initiated to address a male sexual problem (especially inhibited desire, erectile dysfunction, or ejaculatory inhibition), the man is often a very reluctant client. In such cases, he often avoids therapy. A little known fact is that when couples totally stop being sexual it is almost always the man’s decision (McCarthy & Metz, 2008). He has lost his comfort and confidence sexually. Sex is now a source of frustration and embarrassment rather than desire, pleasure, and satisfaction. His decision is typically made unilaterally and conveyed non-verbally. In fact, often the man blames the woman rather than being honest with himself and his partner. The woman often feels confused, not sure whether to blame him, herself, or the relationship.
