Psychosexual Therapy
Psychosexual therapy is a form of talk therapy that addresses sexual difficulties and the psychological, emotional, cultural and relational dynamics that shape them. It rests on the premise that sexuality cannot be separated from the rest of a person’s life — early experiences, attachment patterns, body image, beliefs about intimacy, medical and psychiatric history, and the current state of a relationship all play a role in how desire, arousal, and connection unfold.
The work is entirely conversational. There is no physical examination or contact of any kind. Sessions explore the developmental, relational, and contextual factors contributing to a concern, and may draw on cognitive-behavioral, psychodynamic, attachment-based, and family systems approaches. Structured between-session experiments such as reading, focused touching and journaling are an important aspect of the therapeutic process.
Common concerns addressed in psychosexual therapy include low or mismatched desire, difficulties with arousal or orgasm, erectile concerns, pain during sex, sexual aversion, out of control sexual behavior, the impact of medical conditions or medications on sexuality, and the sexual aftermath of trauma, infidelity, or major life transitions. The work can be done individually or with a couple, depending on the presenting concern and the goals of treatment.
Logistics Psychosexual therapy addresses sexual concerns within the broader emotional, relational, developmental, and cultural context in which sexuality exists. Offered individually or for couples, the work focuses on understanding patterns of desire, intimacy, arousal, and connection through entirely conversational treatment. Upper East Side NYC and virtual | By appointment only | contactdrherwitz@gmail.com
Frequently Asked Questions
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A form of talk therapy that addresses sexual difficulties and the psychological, emotional, cultural and relational factors that shape them.
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Low or mismatched desire, difficulties with arousal or orgasm, erectile concerns, pain during sex, sexual aversion, compulsive sexual behavior, the sexual impact of medical conditions or medications, and the aftermath of trauma or infidelity, among others.
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Sessions are conversational. We discuss the history of the concern, relevant developmental and relational factors, and current patterns in your life or relationship. There is no physical examination or contact.
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Experiments extend the therapy beyond the consulting room to support the work being done in session. They have a meaningful impact on the pace and depth of progress. Experiments are tailored to the concern and may include behavioral exercises such as focused touching of oneself or a partner; psychoeducational reading and reflective journaling; and worksheets designed to uncover sexual temperament, history, and preferences. These experiments are introduced gradually, discussed in detail beforehand, and reviewed together in the following session.
I call these “experiments” rather than “homework” intentionally. Homework implies a right answer and a wrong one, and tends to make people anxious about performance or compliance. Experiments, by contrast, are learning opportunities — there is no failing grade and no penalty for not completing one. Whether an experiment is carried out, partially attempted, or left undone, the outcome is informative. What came up, what got in the way, what felt easy or impossible — all of it tells me something useful about the underlying dynamics, and becomes material for the next session.
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Both. Some concerns are best addressed individually, others within the couple, and sometimes the work moves between formats over the course of treatment.
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Couples therapy addresses the relationship broadly. Psychosexual therapy focuses specifically on sexual functioning, though it always addresses the relational context in which sexuality lives.