Sex Therapy With Colette Malan 

What goes on in a sex therapy session?
We focus on making the person comfortable because they usually have never talked to anybody usually about what they’re coming in to talk about. We do a really comprehensive evaluation where we look at four different things: Biological factors, psychological factors, relationship factors, and skill factors.

Is sex therapy only for people who need serious help in the bedroom?
No. If you have relationship issues that are unresolved, it shows up in the bedroom. It’s a barometer of where you are in your relationship and your life. I think the movies get people into this idea that something’s wrong with them because they aren’t having orgasms, or it’s not as great as they thought it would be.

Couples need to know that these are typical things that you’re going through. And sometimes just knowing that, then you can go, OK, we’re okay, we are where we’re supposed to be, we just need to get these skills and work through these things. People don’t usually talk about their sexuality, but when they finally have someone who they can talk to, it’s such a relief.

We are taught to be good mothers and to keep our house clean and be good cooks, but we’re not really taught the importance of good lovemaking skills. That’s what we teach. There are some major areas of our life where we’re taught not to be sexual and receive some very negative messages. I have these people coming into me with the idea that their sexuality is bad or dirty, and we have to reprogram that. That’s a huge part of sex therapy.

How important is sex in the overall quality of marriage and relationships?
It’s hugely important. I was shocked to find out how important. A lot of men say, “I don’t know if she loves me. I don’t know if I’m attractive to her.” Men measure whether they’re loved or not by the frequency and the quality of the sexual relationship.

The sexuality is like the music. If you see a movie and it doesn’t have music, you don’t get as much from it. But if you really love each other, emotionally, and you have that sexually, it’s like the music, and it just really feels … !

What do you say to couples who didn't have a magical Valentine’s Day?
Have a sense of humor. There are times that you have the idea that you want to have this great experience, and it’s not, you just have to say to yourself, “That was a nice fantasy” and just roll with it, not be so perfectionistic. Especially with women, because we are so cyclic. Some times of the month, we’re really in the mood. And other times of the month, we’re, “No way.” And it’s hard for men to know when that is. I have women track their sexual desire and plan their lives around that.

Do LGBT couples face the same challenges as straight couples?
I’ve had a lot of gay or lesbian couples who come to me, and they have to hide their relationship a lot of times. To have your primary relationship always be secretive … there’s just so many challenges there. And every relationship already has enough challenges.

To not be accepted by society is so painful. If you’re depressed and you’re suffering, it affects the relationship, how you see each other. In these relationships that aren’t accepted, there’s all this negative association that you build up to each other. Gay and lesbian couples need someone on their side, somebody who understands relationships and can say, “This is not a sign that you shouldn’t be together. You need to understand that what you’re going through is normal.”

Is sex addiction for real?
There are some red signs, like you have to more and more and more and more in order to feel satisfied. You can’t do anything else. You spend exorbitant amounts of time, you can’t keep a job, and you can’t keep relationships, it damages the things that are most important to you, and you sabotage those things despite the fact that you really want them. There are some signs like that. It’s a sign of being out of balance. It’s not so much the sex that’s the problem as that you’re out of balance in your life.