Day in the life of a sex therapist

Cheryl Swan deals with all of Calgary’s sexual ups and downs

The identities of the following sex therapy clients have been disguised in this article to protect their anonymity.

Visualize yourself in a sex therapy session. What do you see? A leather couch? Maybe a stuffy academic sitting off in the corner, nodding incessantly and scribbling down God knows what as you divulge your deepest fantasies and fears.

Or perhaps you see yourself lying face down on a massage table as the therapist gives your anus and prostate a gentle once-over before laying out a strict penis-exercise regime to help you master your domain.

If that last bit raised your… ummm… eyebrow, then read on and enter the world of local sex therapist and educator Cheryl Swan, who seven years ago started Holistic Sex Therapy & Education. It’s a unique venture that combines the psychological and emotional aspects of counselling with hands-on bodywork.

“It’s ironic that we think we can deal with sexual issues without dealing with the body…. I just find that bizarre,” says Swan, 41. Her university degrees in education and fine arts merged well with therapy-related training and she is a member of the Sex Information and Education Council of Canada. “Sex is one of the great places where adults can play. Human beings are creatures of touch. We can live without sex; we can’t live without touch.”

So, are the citizens of this notoriously button-down, conservative prairie metropolis looking to reach out and be touched? You bet, says Swan, who describes one client’s tendency to hook up with fellow drivers — strangers — during rush hour before continuing home to be with her husband. “That’s the straight-laced business Calgary. That’s what happens.”

“We pretend to be so good, so straight, so perfect,” she says. “But the same person sitting at church or at work being perfect is seeing three hookers a week or has a dungeon in their basement.”

Fast Forward Weekly pries open Swan’s schedule book to see what a typical workday for an atypical sex therapist looks like. (Names and identifying details have been changed.)

10:00 a.m. – John and Lisa. Three-month couples rejuvenation.

Originally they sought therapy because they were only having sex four times a year and now thye’re half -way through a three-month couples rejuvenation package. They have both been in for an individual session and today is their first joint session.

Night after night, John plants himself in front of his living room TV. His partner, Lisa, does the same — in the bedroom. A once active sex life has all but dried up and left town, dropping by to visit only as often as the seasons change. They’ve sought alternatives to spice things up — swing clubs, online dating — only to find themselves increasingly disassociated from one another.

This, says Swan, is an “astonishingly common” scenario — a symptom of a near pathological need to overachieve on a professional level, while utterly failing in the relationship department. It’s a situation she labels DINS (double income, no sex). “I think a lot of people are having boring sex. Or they’re not having any. We’ve all got Gucci handbags, but no one’s having any orgasms or connecting.”

When couples try to legitimize this situation by insisting they have a good relationship in every other way, the needle on Swan’s “bullshit metre” hits red. “Sex is communication, so obviously it is a symptom of communication failure. What I hear over and over with couples is, ‘Oh yeah, we talk all day long.’ But they talk about other things: the weather, Tiger Woods, the stock market… none of that matters. That’s what I emphasize to them.”

Swan first meets with the couples on an individual basis to suss out the situation because, as she puts it, “people will be totally dishonest. Even if they’re husband and wife and been together for 25 years, they’ll sit here and lie.” She then conducts a joint session and assigns homework and intimacy-based strategies to reconnect the troubled couple both emotionally and physically.

“It takes some patience and willingness on both sides to let the bricks of the wall come down,” she says. “It can feel a little weird only having sex four times a year and now having it more often.”

Noon – Steven. Coaching on longer-lasting orgasms.

Steven's wife originally called looking for information because his premature ejaculation issues were really starting to affect his self-esteem and their ability to connect and enjoy sex.

Most men, like Steven, measure their masculinity on the quality and duration of their performance. Even a rare occurrence of jumping the gun can be a blow to the male ego. If it becomes common, it can be devastating and turn a once-firm relationship flaccid.

“Often the greater problem with (premature ejaculation) is that it affects every part of their life because their self-esteem is destroyed,” says Swan. “It affects relationships because it feels as though they've let down their partner time after time. They don't want to talk about it; they don't want to feel like a disappointment. It causes fights and all sorts of things.”

If a medical exam by a doctor turns up nothing worrisome there are unique skills men can learn to gain more control over their erratic erection, says Swan.

­While the first half of the session revolves around a sit-down discussion of Steven’s problem, the second half involves a more hands-on approach. But let's be clear: this is not a handjob, but rather a kegel training session for men. “The idea is there are certain set skills involving muscle groups in the body — to tense and relax at appropriate times — that need to be learned,” she says. “I’ve done it without the body-work portion and invariably people come back and say, ‘It didn’t work.’ But it always works when I do the body-work portion.”

Swan is currently working on a new book, Owner's and Operator's Guide to the Penis, in which she shares these skills learned through various courses and on-the-job training.

2:30 p.m. – Alex. Sex addiction session.

Alex has attended a 12-step program for several years but has found it is no longer moving him forward. He believes that words have power and re-identifying himself as an addict at every meeting is bothering him. He also finds it victimizing to claim he has no power and has a sickness. Because of additional stress in his life lately, he fears he may act out again. Alex is seeking a more accountable, empowering approach to dealing with his addictive nature.

Addiction of any kind is complex and often requires a great deal of patience and understanding to endure the inherent successes and failures. Treating sex addiction, however, is unique in that, unlike drugs and alcohol, the objective isn’t to abstain completely from the activity, contends Swan. “It’s healthy; it’s good for you. There’s research that shows the more we have sex, the more happy and satisfied human beings we are. So we don’t want to take that away.”

Swan approaches the addiction in a way she believes is less counter-intuitive than many other treatments. Clients, like Alex, are coming to her seeking an environment where the treatment mentality is less about being a victim of a disease and more about developing empowerment strategies.

“With all this new consciousness around us, people are saying, ‘I don’t want to say I’m an addict.’ We don’t say that every single day of our lives; we don’t identify in that way. So what about, ‘I’m healed,’” says Swan. “Saying ‘I'm an addict’ every day is really the complete opposite of an affirmation; you're affirming negative.”

4:30 p.m. – Mike. Prostate and pelvic floor pressure point massage.

Mike was originally referred by his doctor. He has had every test known and medications were of no assistance. Mike has come in for one talk therapy session and now comes in once a month for prostate and pelvic floor massage.

Up until the ’70s, prostate massage was a common treatment for prostatitis — inflammation of the prostate gland — but has since fallen out of favour. Because of the vulnerable nature of this work, sessions are generally conducted individually. “It’s too vulnerable,” says Swan, “and the masculine energy is basic competition between men, ‘I’m not going to admit my weaknesses to another guy. No way.’”

She does offer couples sessions as a way to learn to massage each other and add “another tool in the toolbox.”

“Some people are challenged with the body-work portion,” says Swan. “They don’t understand it. You say the word ‘anal’ and people are freaking out. [Europeans] can’t even fathom how we’re so uptight. [Body-work] is really common in other parts of the world, but in Calgary it’s not that common, yet.”

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