An interview with a sex therapist
Feb. 10, 2008
Imagine having a job that would require youevery dayto listen to the trials and tribulations of peoples sex lives!Wouldnt that be interesting. Well, last week Northern Express caught up with Dr. Barbara Jones Smith, a Traverse City licensed clinical psychologist and certified sex therapist, whose phone is ringing off the hook right now (shes checking to see if theres a full moon). Luckily, she agreed to squeeze in this interview.
Dr. Smith said shes been listening to peoples sex problems since 1975. She counsels male/female couples, same sex couples, and people who have life problems that have nothing to do with sex. When shes away from her office, she likes to ski, fly fish, kayak and practice tai chi. She needs respite from all that intensity, right? Now, enough of this foreplay. Lets get to the interview.
NE: What ever motivated you to become a sex therapist?
BJS: That actually started when I was getting my masters degree at Wayne State, and one of the classes I took was from a psychologist, who was also a sex therapist. He taught a class on human sexuality and I found it fascinating.
NE: What was fascinating about it?
BJS: I was studying in the 1970s the era of the love generation when there was a lot of curiosity. But at that time, sex was an area of study I didnt think had been legitimately explored to a great extent. I think things have changed since then. Back in the 1970s, the work of Masters and Johnson, the Kinsey Institute -- their research was relatively new.
NE: When someone asks what you do for a living, does it cause any awkwardness on your part?
BJS: No, you just get over that. In fact, I was just visiting my daughter and son-in-law, and he made some comment that was sexual in nature, and he said to my daughter, Wow, your mom didnt even react to that. Well, you hear so much everyday, and then with your training, you dont even flinch. You dont become callous, but it just becomes everyday. Like talking about food.
NE: Whats your advice to a young man or woman who is new to sex?
BJS: Be clear about mutual consent, be respectful of yourself, focus more on enjoyment than performance, and consider sharing your mind before sharing your body.
NE: What would you say is the single biggest sex problem people come to see you for?
BJS: I would say, it would be sex desire. Where theyre just not able to get the kind of passion they had in their lives and maybe never had.
NE: So what do you say to them?
BJS: We have to start tapping into their ability to be in the here and now. Tap into all of their senses their sense of smell, their sense of taste, sense of touch. I think when someone begins to have a problem, they think a lot about it, but in a negative way, instead of what they can do. I also want to say, that I often de-emphasize the sex and focus on how the couple is relating to each other.
The other issue is the performance issue. There are women who have low sex desire, but not based on male standards. This is based on female standards. And for males, its more about performance where its the typical problems of ejaculation, premature ejaculation, erectile deficiencies.
Whats complicating the field of sex therapy today are prescription drugs. When I first started, it was very rare there was a complication due to medication. Usually, you were looking at a mental health issue or a physical disability, such as a spinal injury or diabetes. There are so many more complications due to medication. The early beta blockers caused problems. Now its anti-depressants. Theyre notorious for all sorts for sexual dysfunction. People are left with the decision, are they going to be depressed or are they going to feel balanced and lose their sexual desire? Its a tough choice.
NE: Speaking of prescriptions, do people ask for a pill to take to improve their desire?
BJS: People would love to take a pill for anything that doesnt work, although there are a number of people who are into alternative or complementary medicine. They dont necessarily want to take a pill. They wonder, are there foods I can eat?
NE: Hmmm, are there?
BJS: Sometimes people describe their food experiences in sexual terms, and then there are the infamous movie scences that incorporate food into a sexual experience. But as far as specific foods? That is speculative.
NE: Ive read that some people take testosterone for increasing their sex drive.
BJS: There are women Ive seen who have been prescribed testosteroneIve seen very limited success with my female patients, but a positive difference with my male patients. I defer that question to physicians. They need to go to their urologist, gynecologist, internist or family doctor. Part of the issue is whats going on hormonally for women. Theres so much we dont know, and so much more well probably find out.
NE: Whats the weirdest problem youve seen?
BJS: There is a wide range of paraphilic (sexual disorder) behavior 500 or 600 different disorders necrophilia people desiring to have sex with a dead body. Wearing a diaper to get turned on sexually. People suffer with this because its within their normalcy and its hard to turn off. Its like asking a stereotypical male to not be sexually turned on by a blond, blue-eyed woman.
NE: So how do you help them?
BJS: Hopefully they have other areas of attraction. I have them branch over to that. The real difficulty is if they dont have that resource. That issue gets into pedophilia, when they have an interest in children. In that case, they have to completely curb their sexual interest unless there is something else they can draw on. There are those that do. Some are also interested in adult women and males.
NE: So do you help people who have problems on the dark side?
BJS: A lot of sex therapists dont go into the field of victims of abuse or perpetrators. Some will only work with couples about their sexual function desire and sexual performance.
I saw a number of women in my early practice who were suffering with past abuse issues, which were affecting their ability to be sexual and to have partnerships. Then I wondered whats the other component with the perpetrator, though never intending to work with the perpetrators. Yet I realized that telling a five- or 10-year-old to say no, would not stop the abuse. The perpetrator would always, eventually, find a victim. The only way it would be curbed is to stop the perpetrators physical behavior. Thats when I started working with the perpetrator.
NE: Do you think youve been successful?
BJS: I think there are individuals who have been successful. Some are successful for a period of time and they relapsed, and thats really sad when that happens.
Quite frankly there is very little treatment going on these days. If they are identified, they are tried and they are put away in prison, and the treatment programs in the prison system are limited. There are programs when they come out, and theyre good. I believe that some individuals need to be in treatment all their lives. Yet there are some who might actually get worse with treatment, people who are psychopaths. So its very complicated.
NE: Is your job stressful?
BJS: Yes. Its stressful to be a therapist. But these are peoples lives, these are their stories, and I help them live their lives in a more effective way. And thats awesome.
NE: Has the Internet changed your job?
BJS: Yes. I have more cases coming from a spouse having lots of problems with either Internet pornography, and they find that offensive because their partner is spending so much time on the Internet rather than their relationship.
The other is online chat rooms, meeting other people when theyre supposed to be in a monogamous relationship. The Internet gives people easier access than they ever had before. Someone who would never stop to buy pornography in a store will go to the Internet because they think its so private. Same with chat rooms. Theyd never approach a person face-to-face, but have no problem talking to someone online.
NE: When should people seek out a sex therapist?
BJS: Right when they begin having a problem. Most times, people wait too long, so they not only have the problem, they also have anxiety built around it. So by the time I get to it, Im dealing with low sex desire, for example, and the shame that goes with it. So now its two problems instead of one. On the other hand, with the Internet stuff, the partner calls me right away. Or if they suspect their partner is involved with anyone else.
NE: Speaking of extramarital affairs, is that about sex or the relationship?
BJS: It has to do with whats going on with the person individually and personally rather than the couples relationship or with sex. It has to do more with their needs and wants and how theyve chosen to work that out. Some people seek out help, some people drink, some people exercise more. They resort to whatever they feel they need to cope.
NE: Can people live happily in a non-monogamous relationship?
BJS: Yes.
NE: Have you seen that often?
BJS: Well, if theyre coming to see me, theyve gotten into some difficulty in that situation. One of the partners became more attached to someone else and theyre trying to work that through. Actually, that was the case with one of my very, very first clients in Traverse City, and they didnt work it out.
NE: Do people ever try to get free advice from you?
BJS: No, not really. The only time it happened to me was on a long airplane ride to Los Angeles about 20 years ago. When asked, I told the woman next to me that I was flying to a mental health conference. So she told me about her partner who had been in Iran, and had hidden in the closet when everyone was murdered in the house. He was so afraid, and what should she do with him? Thats when I thought it might be a good idea to get a Walkman for my flights.
NE: How do you find a sex therapist in a specific area?
BJS: Go online and find the website for American Association of Sexuality Educators, Counselors, and Therapists (www.assect.org). They have a list.
NE: So in closing can you recommend some good books about sex?
BJS: Some of the clinical books are pretty dry. But I would say, for women and couples, try Lonnie Barbach (For Yourself, For Each Other; Pleasures; and The Erotic Edge). For men, I like Bernie Zilbergeld (The New Male Sexuality).
To contact Dr. Barbara Jones Smith, call her office at 231-947-1444.