Founder and Clinical Director Matt Lundquist on Sex Therapy (And Why Your Therapy Also Needs to Be Talking About Sex) in The Cut

Sex therapists are skilled specialists who have something to offer that even a very sex-positive and sex-savvy therapist doesn’t. However, if you’re not also talking about sex in therapy, whether couples therapy or individual therapy, your therapy is lacking. Our Founder and Clinical Director Matt Lundquist recently spoke to The Cut about what to look for in a sex therapist and why talking about sex is integral to good therapy.

In “A Beginner’s Guide to Sex Therapy,” Matt explains that sex therapy is “a symbolic space where you can talk about sex.” Beyond gauging the demand for a particular sex therapist (“The restaurant in town with the line out the door is probably a good restaurant,” Matt notes), it’s key to search for a sex therapist who isn’t “super-heteronormative.” “Somebody who can hang with a fetish, who can hang with the idea that certain individuals or couples might get off in ways that might not be conventional. Sex is a domain where we need to be able to invite in some of our wonderful uniqueness and strangeness,” he says.

Though not in the article, there are couples who, when things get tough emotionally in couples therapy, deflect by musing, “Maybe we should just see a sex therapist.” This is both an escape from other stuff but also a way of saying, “You, our couples therapist, are separate from sex.” That isn’t correct—or shouldn’t be if you’re getting good therapy. The reality is, as Matt emphasizes in The Cut, some therapists “shy away” from sex. However, if sex isn’t talked about in therapy, at best there’s an area of a patient’s life left out that can’t be made use of. Therapists don’t only talk about sex to identify problems but to comprehend the fuller picture. 

For instance, skilled couples therapists understand how issues in a relationship can show up or “hide” elsewhere in ways that may not be apparent to the couple. Emotional issues can frequently hide behind sex. There may be a conflict that a couple can’t acknowledge, but they find themselves avoiding sex or attempting to have sex and are misaligned in regard to arousal. There can also be unacknowledged anger that expresses itself through withholding sex.

The opposite can be true too. Sexual issues can hide behind emotional ones, such as partners who are struggling to work through some things sexually and find themselves bickering. Couples therapy starts with the assumption that everything expresses itself everywhere (Of course, certain conflicts at the dinner table express themselves sexually, and, of course, sexual tensions show up in conflicts around packing for a vacation). Looking at how this happens around sex exposes new facets of the ways couples are with one another.