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Articles by Dr Janet Hall

CD/Audio Therapy

Common Sexual Problems Encountered in a Sex Therapy Clinic:
How Audio Therapy Can Accelerate Successful Treatment

© Dr Janet Hall

Summary:
Many people have minimal or incorrect sexual education and find it hard to attend a sex therapy clinic, discuss their intimate sexual history and perhaps admit to a sexual problem. They may be sceptical about the help they might receive by attending a sex therapist. If they do attend, they want to invest minimal amounts of time and yet get maximum help. They may feel consistently embarrassed about their problem and want reassurance that they are not perpetually doomed to an inadequate sex-life.

In our clinic, we find that audio recordings are an extremely useful adjunct to our provision of sex therapy services. The recordings are used as introductory material and as therapeutic bibliographic aids.

The therapy-based recordings provide information on sexual issues which are commonly understood.

They also provide examples of successful treatment with people experiencing sexual problems. Some recordings provide a brief hypnotic sequence which allows a person to repeatedly visualize and rehearse positive sexual performance. The recordings allow couples who have mismatched libidos, conflicting values or expectations to resolve their differences through focus on recommended communication exercises and sexual practice.

The recordings are particularly useful for the busy person whose lack of time and high stress levels have probably contributed to the sexual problem in the first place and certainly have precluded successful self-treatment before attendance for sex therapy.

The most commonly presenting problems include the non-orgasmic woman, the man with erection difficulty, and the man with premature ejaculation. Hypnosis is included on the recordings for these issues as well as supportive encouragement for the sexual partner.

Many folk suffer from problems with their sex life and are unsure of what to do to help.

Some may have tried to ignore the problem in the hope that it may go away. 'Assumed celibacy' may work for a single person but does not contribute to a happy relationship for couples. If one person consistently opts out of the sexual relationship, their partner will eventually express their upset strongly and may even seek sexual expression elsewhere, which usually precipitates the end of the relationship.

Typically, when the sex problem has assumed crisis concern – the single person may have had a negative sexual experience or finally realised that 'no sex is no fun', or the couple may know that their relationship is on the line if their sexual problem is not resolved – sex therapy may be considered.

Unfortunately, this consideration may not equal a dedication to succeed.

For the experienced and well-trained therapist there are some significant challenges to the delivery of sexual therapy.

Challenges to Sex Therapy Delivery

The stigma.

Most people are very private about their sex life. This applies both to those folk who may actually have a lot of sexual confidence and have a very successful sex-life (especially Australians, who suffer from a national psychological cringe called 'The Tall Poppy Syndrome', where criticism is immediately levelled at anyone who claims credit for an achievement) and to those who reluctantly admit to sexual inadequacy and ignorance. Attendance at a sex therapy clinic is not something that people do easily. They fear that 'someone will find out that they are not sexually normal or good in bed' and this would be catastrophic.

Example: One couple recently attended for assistance with the wife's lack of libido. The therapy rapidly turned into conflict resolution because she told someone at work that they were getting counselling.

The husband, who had the strong ethnic principle that no-one was to know about their private life, was furious that she had broken his trust.

The Taboo

Most people have never had adequate and open education about sex.

When I ask my clients this simple question: "What did your parents teach you about sex?", they almost always reply resoundingly - "Nothing!"

School sex education tends to be clinical and brief, so most people learn about sex through their peers, popular magazines and erotic and pornographic literature and videos. This clandestine education perpetuates a belief that sex is not something that people should talk about or can easily talk about - especially with a stranger, even if they are a qualified sex therapist.

Example: A forty-year old man attended for therapy because his new girlfriend insisted that he get help with his lack of ejaculation with her during sex. He was perplexed as he had experienced this phenomena before with women, but over time, had been able to ejaculate and had never seen it as a problem.

She was adamant that he seek help although she refused to attend. Eventually she talked to the therapist and admitted to a lack of sexual experiences and to inhibitions about sex. She was tense and anxious throughout the session and obviously hated being there. Later, she told her boyfriend that the therapist was "too blunt".

The Fear of Judgement?

Most people, especially men, fear failure or incompetence. This fear is particularly strong when it comes to owning up to sexual problems. Many men prefer to see a female therapist, trusting that she will be more sympathetic and less judgemental about his difficulties.

Scepticism

People who have suffered a problem for a long time and felt that they have explored every other avenue of advice may be particularly sceptical about the success of the assistance they may be getting from a therapist. They think "Why should anything work after all I've tried?"

Resistance to Practice

All therapists have been challenged by their clients' lack of homework practice.

This is particularly common in sex therapy. It's as if people 'put their heads in the sand' and think that the successful sex will occur through wishing it so. But of course, homework must be done. Practical application is essential if sexual competency is to be attained.

In our sex clinic, we find that audiotherapy can overcome many of the challenges outlined above.

How Audiotherapy Helps Overcome the Challenges to the Delivery of Sex Therapy

The recordings may be listened to in the privacy of one's own home and therefore privacy and anonymity is assured.

The recordings provide essential information which is presented in 'user-friendly' language and a humorous and supportive tone which helps listeners relax and boosts the potential for learning,

The sexual information is repeated in various ways, so that the listener can learn steadily, with confidence.

The hypnotic part of the audio recordings offer some sceptics a 'magic wand'. Because they believe in the power of hypnosis, they are reassured by the prospect of success and motivated to listen to the recordings.

In listening, they of course profit from the essential information on the rest of the recording.

If only one person has come for therapy, they can ask their partner to listen to a recording. This may safely and subtly enrol the resistant partner in the therapy. Then, the couple can listen to the same information at the same time. This may support open discussion and guide their communication about sex.

Because they can stop and start the recording, they can practice the sexual strategies as they study the information.

Additional advantages of audiotherapy are:
The take-home practice also allows the person to truly assimilate the information that may have been given in the session but may not have been truly processed because of the person's embarrassment and tension in revealing their intimate thoughts and experiences about sex.

Examples are given of other people who suffered with sexual problems and how they overcame their own challenges. This both reassures the new client that they are 'not the only one in the world who has experienced difficulties with sex', whilst providing models of strategies and the process of coping through the therapy which may help the new person set realistic expectations.

Example: A common experience for younger men, although one that few know about, is the 'Madonna Syndrome'. This is where the man may have been confident in his sexual performance with many women, but when he meets the one he truly loves, he is unable to get an erection. This is most perplexing for him and he is immediately reassured when he learns from the audiorecording that this is not a rare phenomenon and that other men like him have also encountered it.

The audiotherapy recordings in the Sensational Sex Series developed by Dr Janet Hall provide information, an opportunity to 'normalise' the problem, coaching, facilitation, specific suggestions for strategies for communication and sexual techniques as well as enhancement of sexual arousal through fantasies and the opportunity to rehearse successful sex with visualization and hypnosis.

Case Studies:
Please note, patients are always asked to attend their medical doctor for a physiological assessment prior to their sex therapy, in order to eliminate organic dysfunction as a cause of the sexual difficulty and to assist in identifying the best psychological approach for treatment.

The following descriptions are brief and focus on the application of the audio recordings as adjunctive therapy.

Of course, other psychological interventions were also implemented where appropriate.

Non-orgasmic Woman
D is a beautiful twenty-five year old dancer, who is now teaching at tertiary level. She describes herself as a perfectionist who endeavours to control everything in her life. She was engaged to J, a dynamic thirty year old salesman, also a top achiever. J had just postponed the wedding for the third time. He confided in me - 'How can I marry D when she sees sex as a chore and gets no pleasure out of it?'.

D admitted that she had never masturbated, thought her genitals unattractive, never orgasmed with sex and would prefer if marriage could be a fairy tale - without the sex part. D was very anxious, embarrassed and resistant to disclosing her sexual beliefs and history.

D was asked to listen to the audio recordings on 'How a Woman can Achieve Orgasms' and 'Masturbation'.

She reported feeling tense as she listened but felt motivated and excited by the prospect of improving her sex-life. The couple were asked to listen to the recording 'Perfect Sex' which gives information to de-myth popular sexual beliefs and provides an hypnotic-like visualization of an ideal sexual encounter.

D was not interested in the oral sex part of the visualization (that technique was too 'high gradient' for her yet) but agreed to use the recording to guide her next sexual encounter with J.

The sex was very successful, with a cheeky-faced D reporting that the 'instructions' moved too quickly and they had to stop the recording to enjoy the good parts of the sex. J was reassured about D's potential to relax and develop her sexuality and the couple's plans for marriage continued.

Man with Premature Ejaculation
T is a forty-eight year old successful businessman who attended for sex therapy for premature ejaculation. His very attractive wife, B, also attended. (The wife does not typically attend the first interview, but she joked 'I had to make sure that the sex therapist did not appear wearing a g-string, long black boots and carrying a whip!').

The couple had been married for twenty-eight years and had never had other sex partners. T had consistently suffered from premature ejaculation throughout this time but never knew where to go to seek help.

T was of ethnic origin and described his early experiences when masturbating as being 'furtive and very quick' lest he may be discovered by his parents, who he believes would have been disgusted.

The therapist explained that this early 'training' at rapid ejaculation with self stimulation often seems to lead to premature ejaculation with sexual intercourse.

T was extremely motivated to overcome his problem and accepted with alacrity the challenge to listen to the audio recordings on 'Overcoming Premature Ejaculation' and 'How to Spark up Your Sex Life (for couples)'.

T listened to the hypnosis segment on premature ejaculation every day for two weeks and the couple used the 'spark-up' ideas to plan a a special overnight stay at a luxurious hotel. They showed immense delight with their results at next interview, when they reported that T had lasted for over forty minutes!

Man With Erectile Dysfunction
P was a forty-five year old health professional who attended sexual therapy for assistance with low libido and erectile difficulty. His wife of twenty-five years, M, attended also, because she was frustrated with P's avoidance of sex and lack of motivation to seek help.

P reported that he had never really been interested in sex. He had been brought up in a family with strong religious beliefs who thought that sex was only for procreation. At fourteen, P had been caught masturbating in the bathroom by his father, who yelled angrily at him and hit him repeatedly with a wet towel saying that he was 'bad and evil' for 'playing with himself'.

M cajoled P into taking the audio recordings on 'Achieving and Maintaining Erections', and 'Fantasies Exclusive to Men' for him to study. M took the recordings on 'Solving Sexual Conflicts' and 'How to Spark Up Your Man's Sex Drive'.

P attended for counselling to assist with resolving the pain he felt towards his father's punitive approach to sex and did listen to the recordings. He participated with inconsistent enthusiasm in the sexual exercises which were suggested. To date, P is more satisfied with the strength of his erections but still not often interested in sex. M has found great consolation in the recordings which she took, which, she says, have given her valuable insights into what to do and not to do with her man, as well as helping her have patience because she realises she's not the only woman to have faced this problem.

Recommendation
Because sex is such a taboo subject and people often have resistance to disclosing their difficulties in sex, there is a need for useful adjunctive strategies to coach them in the privacy of their own homes and at their own pace. Audiorecordings provide many advantages in this regard by giving information, opportunities to learn how other people experience and solve their sexual challenges, and imaginal rehearsal, hypnotic suggestions and fantasies which can give people additional confidence in boosting their successful sexual potential.

About the Author:
Dr Janet Hall is a psychologist in private practice who specialises in family, sex and relationship therapy.

She is the author of eight books on family issues including 'Sex-Wise Teens'. Jan has created and produced seventeen audio recordings on sexual issues ranging from sex therapy (including hypnosis) for common problems such as non-orgasmic women and men with premature ejaculation and erectile dysfunction, to sexual fantasies and strategies for 'sparking up your love life'. A regular consultant to print, radio and television media, Jan presents user-friendly information which can be easily applied in psychological practice.

For more help see Dr Jan's book: Sex-life Solutions and her CDs in the Sensational Sex Series.