Coaching Clients Toward Sexual Intergrity

When I began my career as a therapist, I never intended to specialize in sex therapy. It just seemed to organically evolve. The more I worked with individuals and couples on matters related to sex, the more I realized I was not prepared to effectively navigate these cases. Unfortunately, at that time and place, there were few viable options for these clients. At least I could be empathetic and nonjudgmental. Eventually, I pursued certification as a sex therapist and a Ph.D. in clinical sexology.

It has been over thirty years since I began my career as a therapist. I have seen clients in both inpatient and outpatient treatment settings. Half that time I have spent in private practice specializing in clinical sexology, the science of sex. I have discovered that compromised sexual integrity is the common thread through every sex therapy case I have had.

Integrity is the virtue of honesty and transparency. Sexual integrity is the experience of knowing who you are as a sexual being and allowing others to know you as a sexual being as well. Until we fully own our sexual truth, we will never be able to achieve a relationship that is both emotionally intimate and sexually fulfilling. I help clients accept the reality of who they are as sexual beings. I coach them to lean toward their instincts and desires. For sexual relationships to flourish there must be sexual authenticity. A relationship where you cannot be yourself is a relationship built on lies and deception. Hypocrisy is the opposite of integrity.

While "The Sexual Integrity Coach®" is my registered trademark, the concept of sexual integrity is not new, and I am not the first to use that term. Others have written and spoken on the subject. "Sexual Integrity" is the title of several books, including my own, Sexual Integrity: Finding the Courage to be Yourself. We authors don't all approach the subject from the same perspective. Some write from a religious opinion and as you can expect, take a very different approach than I. While some books coach the reader to repress their sexual truth, I coach my readers to embrace it.

Sexual oppression is imposed from external forces that seek to control the sexual thoughts and behaviors of others. It can occur overtly through laws that punish those who do not conform. It can occur covertly by denying people access to other options or even the knowledge that other options exist. Sexual repression is internally imposed as a result of living in a sexually oppressive environment. It is how the individual attempts to control themselves to comply with the demands of the oppressor. Both are barriers to sexual integrity. Both are a product of a sex-negative culture.

From early childhood we are taught to dissociate our sexuality as if it is alien to our true self. We compartmentalize it in our mind like an alter ego. Instead of embracing our sexuality as a healthy expression of our unique individuality, we regard it as a mere activity that can only occur under certain prescribed circumstances. We spend our lives trying to live inside the tiny box we have been given. We are a nation obsessed with sex, yet we are sexual illiterates. Most states in the US do not offer science-based sex education in public schools or even universities. Where attempts at sex education exists, it can be so censured that it is un-relatable for the average person. Sexual myths prevail over facts. This is a consequence of living in a sexnegative society.

Individually, each of us are sexually unique. Our sexuality is influenced by our biology and our environment. Our date of birth, where in the world we grow up, the religion we are born into, our parent's socioeconomic status, and their level of education will influence what we learn about sex and how we view ourselves as sexual beings.

Biology is our best chance for predicting sexual behavior without the influence of time or culture. When we see the same patterns of sexual behavior across time and cultures, we can establish a good baseline for determining what is typical. Things like masturbation, same sex attraction, nonmonogamy, and non-binary gender identification have been documented in all cultures across history. This lets us know that we have an innate potential to sexually think and behave in ways that are unlimited by time, religion, or politics. Political and religious institutions can attempt to regulate sexual behavior, but they are powerless over sexual thoughts and desires. The authentic self will find its way out.

Most states have no special licensing requirements for sex therapists. In those states If you are licensed in any of the psychotherapy disciplines, you are considered qualified to practice sex therapy. Unfortunately, healthcare providers, including therapists, receive little or no training in clinical sexology. When it comes to matters of sex, the average consumer has no clue that their therapist has no clue. Many therapists are relying on their own personal experience to help clients with sexual problems.

Additionally, therapists are trained to measure the success of couples therapy based on keeping the relationship together, not based on the happiness of the individuals involved. When taking this approach with a couple who are obviously sexually incompatible, one or both will have to shut down their erotic self to keep the relationship intact. Most couples are unsuccessful at this, and the relationship will continue to be a source of pain for all involved. The therapist has good intentions and wants to help the couple save the relationship. Most therapists don't know they don't have all the tools they need to help couples navigate sex. The fault lies with the health boards of the states they practice in and the educational institutions that trained them.

Across time mental health providers have become more scientific and less judgmental in our opinions about sex. Mental health professionals are raised in the same society as our clients. We share some of the same wounding and this wounding is often a factor that attracts us to the profession. Mental health providers are increasingly sensitive to the changing sexual norms in the US. Every credible mental health professional organization now includes in its code of ethics statements prohibiting discrimination based on matters of sex, sexual orientation, and gender identity. However, that sensitivity does not equate to understanding the dynamics that influence sexual behavior and gender expression.

A basic understanding of sexology is not only important when working with sexual minorities, but also with the mainstream clients as well. Some of the most challenging sex therapy cases I have had were with heterosexuals who identified as monogamous. Sexual minorities generally realize they are unique very early in life. They see the heteronormative, cisgender models and realize they don't fit. They take the hero's journey through the repression and oppression to come out on the other side with a greater clarity about their authentic sexual self. Heterosexuals grow up in a world that gives them full permission to be straight. They believe the map given to them will lead to a happily ever after life. They feel tremendous deception and betrayal when the story does not unfold as promised.

Therapists must reconsider how we coach our clients about relationships and sex. We must accept that our culture has changed. How younger adults think, feel, and behave sexually is different from the expectations of their parents and definitely their grandparents. We must stop measuring relational success on the duration of time the couple has been together and start measuring it on the degree of happiness of those involved. Time is a good measure of endurance and tenacity but tells us nothing about the couple's degree of emotional intimacy or sexual fulfillment.

Coaching clients toward sexual integrity requires that the therapist have a good understanding and acceptance of their own sexuality. The therapist needs to work from a sciencebased model that is free of judgment. Many sex therapy clients have been repeatedly shamed about their sexuality throughout their life. Though they may not identify as religious abuse survivors, religion is often at the root of their sexual shaming.

In the therapeutic relationship the therapist provides a safe space for the client to be known authentically. The therapist mirrors back this truer image, validating the client and helping them integrate the hidden (repressed) parts of their sexuality. Coaching clients toward sexual integrity requires the client to be rigorously honest with themselves and others. Some clients can't go there, even with their therapist.

Clients routinely apologize to me for talking about sex in our sessions. They feel embarrassed for sharing their thoughts and desires and they worry I will feel repulsed or offended by listening to them or even being in the room with them. This is directly proportionate to the amount of shame they have experienced in their life. Reassuring the client and normalizing their sexual fantasies and behaviors is important.

In couple's counseling the client may worry there is even more to lose. They have spent the entire relationship hiding parts of themselves from their partner or spouse.

Even if they trust the therapist to validate and accept them, they may not trust their partner. They often come to therapy because a piece of reality has been exposed. This is the crisis. For many clients the goal is to quickly get everything swept back under the rug. I generally recommend throwing out the rug and exposing what has been in hiding all along. Transparency is an important aspect of integrity.

Sexual integrity is more of an evolving journey than a destination. We are always discovering new things about ourselves. The mind and the body continue to evolve. Needs and wants change over time. However, once the client understands they have a right to individuation and sexual freedom, they will likely self-navigate the rest of journey. Coaching couples to tolerate and value truth prepares them for effective communication about sex for the lifespan of the relationship.

Truth does not always lead to the intended outcome of greater intimacy and sexual fulfillment with the chosen partner. Some relationships will not tolerate transparency. Denial and deception is what holds it all together. It is ironic that when one partner finally gets honest or sober, the other one decides this is the time to leave. The relationship ends when the prospect of real intimacy and transparency is finally in sight.

Sexual wounds go to the core of our psyche. The trauma that happens with overt and covert sexual wounding can take years to resolve, if ever. The process of walking clients out of their personal closets can be slow and diligent. Especially if they are trying to bring their unwilling spouse or family along on the journey. Getting more honest with themselves may require that they severe relationships with those who don't want to know the truth. Intimacy cannot exist where honesty will not be tolerated.

Specializing in sex therapy has been the most rewarding part of my career. I enjoy being part of a small demographic of mental health professionals that identify as sex therapists and clinical sexologists. I know this is not a chosen specialization for most clinicians, but I do hope you will take opportunities to increase your knowledge about human sexuality and use it in a way that helps your own clients find the courage to be themselves.

Written By: Steven Davidson, PhD, LCSW

Steven Davidson is a licensed clinical social worker and a certified sex therapist in private practice in Fort Lauderdale, FL. He is the author of Sexual Integrity: Finding the Courage to be Yourself. Clients and colleagues know him as The Sexual Integrity Coach®.