Let's Talk About Sex

For many years, everything I knew about sex and “normalcy” came for Cosmo articles and romantic comedies. Luckily there are much more reliable sources of information available now. I find many women may benefit from sex therapy as well, and we are so lucky to be able to have a guest post this month! Erica Thomke is a therapist at Philadelphia Institute for Individual, Relational and Sex Therapy.  She has graciously answered a few questions for us about sexuality and sex therapy.


What does sex therapy entail? 

 Sex therapy is much like any other psychotherapy: therapists use a variety of approaches and interventions tailored to the client. There can be misconceptions that “sex therapy” describes a specific treatment approach, but, in my experience, it’s more a descriptor of the work. For example, we would call it “anxiety therapy” or “depression therapy” if those were the central focus.  In actuality, treating anxiety and depression are hugely relevant. A large portion of the work is identifying and healing barriers to sexual/relationship functioning or sexual/relationship satisfaction. These barriers often have roots in depression, anxiety, or trauma.  Sex therapy is generally pretty un-sexy.  

What types of problems can sex therapy be effective for? 

Oh my. Human sexuality is quite expansive; those who specialize in the subject are trained to work with everything from the developmental to the physical to the mental/emotional to the relational. This can include addressing issues related to gender identity, sexual orientation, low libido or sexual dysfunction, trauma, fetishes and kinks, and relationship conflict –to name a few. Trauma often appears as a barrier to sexual satisfaction, even when the trauma itself isn’t sexual. Many women find their sexuality affected after serious medical issues or significant bodily trauma (which includes consensual sex encounters and pregnancy).  

How many sessions do you generally have with clients? 

 Treatment is open-ended depending on client need. Some people prefer a more brief and intensive approach, while others prefer a slow and reflective process. We meet on varying frequencies, balancing therapy with external demands on time and energy.  

What is something you wish more women knew about sexuality and sexual health? 

 More things are normal than you think! Depictions in media are skewed and your friends are most likely only sharing the best/worst of their experiences. It is so rare to find a realistic depiction of the day-to-day. There’s a whole gamut of normal, common, shared experiences that go unseen or unknown because these topics are so intimate or taboo.  

Also, the mind-body connection is never more relevant. How you think about your body, how you think about sex, how you think about your partner impacts the experiences you have. Likewise, what you put into your body – food, medication – impacts your mind. Your endocrine system is critical in the sexual response cycle, so if you’re finding “sudden” challenges in desire or sexual responsiveness after beginning a medication or changing your diet, discuss this with your gynecologist.  

Any parting thoughts? 

We’re all subject to differing familial, generational and cultural messages about sex and our bodies. It’s okay if you’re not comfortable with the subject; there’s no benchmark in comfort you have to achieve –an issues exists only if you want something about your attitude or your experience to be different than it currently is.  

Fortunately, we live in a region with an abundance of trained sexuality professionals, due to programs at Widener University and Jefferson University. Conveniently, there’s a database called AASECT of certified educators, counselors and therapists. (Though be aware there are plenty of therapists from accredited human sexuality programs that have not joined the AASECT community. You can cross-reference with Psychology Today.) 

Of course, every therapist has their niche. It’s helpful to have a therapist trained in sexual wellness if this is your treatment focus, but if you can find one that ‘specializes’ in your particular issue, even better. Their profiles on Psychology Today or their practice website should give you a good idea if your challenges are in their wheelhouse. But also, when you reach out to make an appointment, don’t hesitate to ask!  


Erica has a Masters of Education in Sex Therapy from Widener University. She can be found at https://phiirst.com/therapists-media/erica-thomke/ . Her phone number is 267-225-6927  and her email is erica@phiirst.com.

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