Kelley Aiyana LCSW

Licensed Clinical Social Worker

Psychotherapy By The Sea Maui

Give Yourself  the Gift  of  Therapy

Psychotherapy & Sex Therapy

Maui, Hawai'i

(808) 281-8948

 

Sex Therapy and Psychotherapy Counseling

Sex Therapy

So why sex therapy?   Interestingly enough, in my years in graduate school while earning a Masters of Social Work degree (MSW) there were no courses or internships addressing sexuality. It was non-existent, though we had amazing instructors and courses and internships.  Years later, when working at the clinic here on Maui, it soon became clear that when individuals or couples came in with a sexuality concern, my colleagues also had not been trained in regards to sexuality issues. I was intrigued and  became very interested in getting specialized training in the field of sexuality since I saw a great need, and a lack of professionals to meet this need.  And honestly, what a great field to study.

For several years I used my vacation time to continue my education in the field of sexuality, in addition to the mental health training my position at the clinic required for psychotherapy.  I went to  many sexological conferences and intense trainings.  Meanwhile, my colleagues were happy to refer the clients over to me that required sex therapy.  The more I met with these clients and attended trainings, the more I understood how significant this work is.  We are all sexual beings, even if we are not in a sexual relationship and even if we  feel like we “don’t like sex” or “could take it or leave it.”  There is such a void growing up with so little correct, helpful information passed on to us as young, curious, sexual beings leaving many of us to fend for ourselves.

According to a recent study in the Journal of the American Medical Association, 3 out of 10 men and 4 out of 10 women experience sexual problems at some point in their lives.

The most common presenting sexual problems are:

  • Male Penile Erectile Difficulties - Can't get it up or lose erection during sex.
  • Male Rapid Ejaculation - Premature Ejaculation
  • Female Pre-Orgasm Condition - No Orgasm or difficulty to orgasm
  • Dyspareunia - Painful Sex
  • Sexual Desire Discrepancy

Other reasons to see a sex therapist would be:

  • You are dealing with trust issues
  • Infidelity...one of you are or did have an affair
  • You or your partner are dissatisfied with the sexual part of your relationship
  • You want to improve your communication with your partner; sexual or otherwise
  • Jealousy is an issue
  • You are not sure the relationship is working for you
  • You wonder what normal sex is
  • Porn is an issue for you or your partner
  • You or your partner are concerned about sex addiction
  • You are faking orgasms
  • You are having conflicts about sexual frequency
  • You are having relationship difficulties, i.e. communication and anger problems, lack of intimacy or commitment
  • You are avoiding sex or are too busy for sex
  • You have different sexual likes or dislikes
  • You have questions about gender,  gender orientation, or gender roles

Emotional Insecurity and chronic stress patterns can affect sexual expression and create desire difficulties that limit capacity for sexual pleasure. Sex is not simple!

There are many reasons people have sex:

  • feel powerful
  • nurture other
  • feel close
  • prove they're ok
  • pleasure
  • self-expression
  • relieve tension
  • express love
  • money
  • feel nurtured
  • control other

So why not talk with you doctor about a sexual issue?

A survey of 125 United States and 16 Canadian medical schools revealed that the majority of undergraduate medical programs provide less than 10 hours of education on human sexuality. (Solursh, Ernst an Lewis, 2003)

A survey of adults 25 years of age and older showed that 85% would like to discuss a sexual problem with their physician, but 68% were reluctant to ask and 71% thought their concerns would be dismissed. (JAMA, 1999) Times are changing, though it is clear that both physicians and patients still feel awkward at initiating or admitting to sexual questions or concerns.

In addition, most physicians do not have the time to address sexual problems and since many do not have the expertise in this area, they are not prepared to address sexuality concerns. More often it is not a physical or organic problem that can be seen visually or through a lab test. However, at times it may be necessary for certain lab tests to determine hormonal or physical cause of a particular sexual dysfunction. In this case, the physician and therapist can consult with each other for a comprehensive approach. For example, low thyroid function can cause diminished or no desire for sex, therefore a referral to your doctor for a thyroid test would be appropriate.  In fact, chances are the doctor would not have thought to ask about your low sexual functioning during an office visit. In this way the doctor and therapist work collaboratively to improve your physical and sexual health.

As for couples, the bottom line is Communication with a capital C.  According to “Sex: A Man’s Guide,” in a Redbook magazine survey of 100,000 married women, the strongest indication of sexual and marital satisfaction among them was the ability to express sexual feelings to their husbands. The more they talked the better they rated their sex lives, their relationships and their overall happiness.”

The truth is, it is difficult to be open and communicative when we are not sure if we are “normal” and especially if we think something is wrong with us sexually or otherwise. Thanks to the marriage manuals of the 1950’s that stated the ideal for both partners was to achieve “simultaneous orgasms” during intercourse, most women and men expected the impossible while ignoring the possibility of amazing sex without simultaneous orgasms and not only during intercourse.

For generations, the movies and the media help to continue this conspiracy by having actors demonstrate wild, simultaneous orgasms after 5 minutes of hard thrusting on a floor, or table or standing almost fully clothed in a closet. It might look hot and sexy, but indeed it is acting at its finest.

The reality is that 70% or more women do not have orgasms during intercourse and it turns out 85% of those that do, now report that they are stimulating their clitoris with their hand or a vibrator or his pubic bone. Please re-read that sentence.  This is one reason why many women, 25% - 80% depending on the survey, say they have faked their orgasms.  Women fake orgasms for other reasons as well though some of those reasons stem from a lack of knowing her own body and an inability to communicate their desires clearly.

In 1993, President Clinton appointed Joycelyn Elders, the first African American, and the second woman to the position of United States Surgeon General She had a strong background in public health and was quite outspoken on many topics including sexual health. At a United Nations conference on AIDS, she was asked whether it would be appropriate to promote masturbation as a means of preventing young people from engaging in riskier forms of sexual activity and she replied, “I think that it is part of human sexuality, and perhaps it should be taught.” She did not mean masturbation should be taught in schools, though this remark caused great controversy especially among conservative Christian groups and right wing interests in the US giving Clinton little choice but to ask for her resignation, though it is said that he apologized to her.

I hold the philosophy that sexual health is not merely the absence of disease, dysfunction and infirmity, but also the presence of pleasurable and safe sexual enjoyment and satisfaction, free of coercion, discrimination and violence. How does this match with your reality?

 

  • placate partner
  • reinforce gender identity
  • avoid intimacy or conflict
  • because they have to/should
  • prove they're normal
  • prevent partner from straying
  • create dependence in partner
  • to have a baby
  • make someone jealous
  • move on after a break up

 

Psychotherapy

In addition to sex therapy, I also provide psychotherapy for concerns that do not involve sexuality, such as:

  • a general feeling of dissatisfaction with life
  • problems with communication with kids, or spouse or anyone for that matter
  • need a neutral person to process something
  • issues involving in-laws
  • low self-esteem
  • money
  • depression
  • anxiety
  • issues about work
  • life coaching

 

 

 

Please note.

You do not have to be in this condition to reach out to a therapist.

My approach is flexible, because every client and couple is unique, requiring different interventions and needs.

If you are interested in making an appointment or have questions, please give me a call.

Frantic woman with "I have Issues" tee shirt

"Its a shame there isn't a pill to stimulate conversation."

"To you it was fast

KELLEY AIYANA, MSW, LCSW  Licensed Clinical Social Worker ·  2511 S Kihei Rd.  Kihei, Maui, Hawaii  96753 ·  (808) 281-8948