ABSTRACT
Everyone has sexual thoughts, feelings, and experiences that are integral to their sense of who they are and how they relate to the world. Sexual problems often manifest and mask
themselves in the major symptoms that bring patients to treatment; depression, anxiety, failure to achieve, low self-esteem, and the inability to engage in intimate relationships. Yet patients are shy about revealing their sexual concerns. It feels so private, so awkward, so potentially embarrassing that many are reduced to paralyzing inarticulateness. They dread being asked, but they long to be asked. They know for sure that they need to be asked if it is ever to come out. Too often, therapists find themselves reluctant to initiate an inquiry. They rationalize, “If my patient doesn’t bring up sex, it must not be an issue and I should not be asking about it.” At best, this can lead to a missed opportunity to be helpful; at worst, it can lead to the wrong therapy plan.
