It Takes A Village, and Maybe a Sex Therapist, Too

After suffering from depression for well over 20 years, I’m taking it seriously in a way I never did before. It used to be I’d take an anti-depressant and go to therapy once every two weeks, not feel that great but manage to take care of my life so, okay, good enough. Not anymore. Considering that this latest episode of severe depression has lasted several years and cost me an interesting if overly demanding job, I am not playing around with it anymore.

Now I have a whole team in place. I see my E, my truly trusted therapist, twice a week. I see my new psychiatric nurse practitioner about every two weeks so we can micromanage my medication reduction and use of supplements. I have a depression coach through my insurance company who checks in by phone every few weeks to make sure I’m getting supports I need and to encourage me to eat well and exercise and otherwise behave like a healthy person. I get a massage every two weeks–which to me is part of taking care of myself. I meditate daily and am taking a mindfulness workshop this coming weekend.

So all that’s missing is the sex therapist.

You might be snickering. Okay, fine, go ahead. But I’m seriously considering it.

Here’s why: I have been struggling, a lot, to talk about sex in therapy. There is so much shame mixed up with sex for me. To put it briefly and bluntly, it comes from having experienced some arousal in abusive situations. Having those things connected in my head is beyond confusing. It distorts everything. I question everything about my sexuality. What do I really like? What does that say about me? How do I know what is really “me” versus what is an effect of negative experiences I had?

I feel like I want to work on these questions. That is ultimately the purpose behind the sex-ed class I’m giving myself (more on that another time). I want to create positive feelings around sex, a sense of love and celebration instead of shame and uncertainty and an urge to hide myself away.

But I can’t talk about it. I am tongue tied in therapy in a way I’ve never been before. E asks me questions, and I leave long silences or reply with a word or two. I’m not trying to be difficult. I just can’t get the words to come.

In the last week or so, I started thinking it might be helpful to go work briefly with a sex therapist. Why?

  1. It will be someone who just works on issues of sexuality, so she (I can only imagine doing this with a woman) will be extremely comfortable talking about sex, and maybe that will make me more comfortable. She will probably have techniques for putting me more at ease with it.
  2. I won’t be invested in my relationship with her. So if she reacts with surprise or disgust, or if I even project on her that she is reacting that way, I won’t go through the pain I would experience if I thought E was reacting to me that way.
  3. I could practice talking about it with this person I’m not so attached to, and as I got more comfortable, I could carry that comfort back into therapy with E and integrate it with the work we are doing.
  4. Maybe because she focuses on sexuality and will have heard so many people’s experiences, she could help me answer the question of whether my sexuality is twisted and distorted and needs fixing, as I often feel it does.

I actually texted the idea to E last week, saying I was thinking a sex therapy practice might be a place I could feel it was more “normal” and less shameful to talk about the things I am struggling with. Was this a crazy idea?

She responded that it was not a crazy idea at all and gave me the link to someone she knew and respected. I said I’d look that person up and liked the idea that if it didn’t go well, I wouldn’t be messing up my relationship with her. Of course I knew she would say it wouldn’t mess up our relationship, but that doesn’t prevent me from feeling anxious.

I did look up the person she recommended. I bet she’s great. But she looks so mild and clean somehow. I was imagining someone with hair dyed black and purple, someone with a lot of piercings, maybe someone who wears a black bustier on her website. Ha, okay, I’m kidding. (I think?) But part of the idea I think is to talk to someone who is way beyond being shocked. Unshockable.

In my Monday therapy session, E wants to explore this idea more. She reassures me that nothing I tell her will change our relationship. I think she believes there is some memory I am withholding that I am ashamed to tell her about. But it’s more complicated than that. It’s not a single memory but a whole sense of myself.

She tries to encourage me to go ahead and take the risk and tell her what it is I’m struggling with. I explain that it’s not one thing, but a tangle of things, and I don’t even know what string to pull on. Oddly enough, this awkward explanation seems to make more sense to her.

“Of course,” she says, “it makes sense that you would have a tangle of contradictions. On the one hand, you have experiences that felt so wrong, like such a violation. At the same time, some part of some experiences felt good, because there was a sexual part of you that wanted to flower, to bring forward that sweetness.”

Phew. For the first time I felt like she started to get it. Although she is still probably framing it too positively.

Somehow from this insight, we agreed that I would start to write down all the conflicting messages I felt and we’d sort through them together. This still feels like an anxiety-provoking activity, but not one that I can’t grapple with. So perhaps we have a tentative way forward now.

Which does not, in my mind, settle the question of whether it would be helpful for me to add a short-term sex therapist to the list of people on my getting-healthier team.

It does seem, sometimes, to take a whole fucking village to help an adult heal from childhood sexual abuse.


  1. I think the sex therapist is a fantastic idea! And if she’s a dud, you don’t have to go back, as you know. I think it’s a fantastic idea partly because she has that specific skill set and might be able to help you organize your thoughts and feelings in a way that you could bring to E, like you said in #3. It’s not like you’re trying to keep E out of the loop. I think E knows that.
    You’re right, it does take a village… and you have a village… so many people to care about you; I know you can see that and hope you don’t ever forget it. WP is a small part of that village, but we are here. xoxo


  2. That’s exactly how I felt. I found it difficult enough rehashing the sexual abuse, accepting finally it was not my fault and I did nothing to provoke it, however, I didn’t want to approach my present sex life at all with my therapist. Frankly, I was embarrassed being a married woman afraid of sex because I imagined I’d see my abuser instead of my husband during sex. Bizarre isn’t it? I also wanted to go to a sex therapist but thought no, I don’t want to deal with any more guilt as to why sex isn’t that important to me now, even though I’ve dealt with the entire abuse crap. Sexual abuse completely ‘screws’ with everything.


  3. I love the idea of a sex therapist too. And it does definitely take a village to raise up an adult who was abused as a child. Since I got lots thinner and had a labiaplasty, I’m finding a sensation that I liked as a teenager and that was touching myself through the seam of the crotch of my jeans, but I don’t know how to take it further than that. I think I need somebody to help me…is there a person who can do that? Cause once I try to go further, I get this huge sense of shame…and nothing can get through that wall. Sorry, that was probably TMI.


  4. it sure does take a lot of people to heal from abuse. i have my therapist, psychiatrist, OT, nutritionist, mentor, social worker, the list is endless. I hope it helps if you go forward and go for it. xxx


  5. I think it’s a great idea to see a sex therapist as well for all the expertise and comfort level reasons you’ve listed, but I would sound a note of caution: even if the work you’re intending to do with another therapist *seems* very focussed, it’s highly likely that attachment issues and transference will come into play regardless, and if/when they do, they may be much more difficult to manage in that less secure relationship or if the therapist does not have the skills to recognise and manage them. When you’re dealing with sexual abuse or abusive relationships it all gets messy and complicated. Hopefully E will help you navigate that if necessary.


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