PH&PTC

Sex Therapy and Relationship Counseling

Sex Therapy is a subspecialty of psychotherapy, focusing on the specific concerns related to human sexuality. People of all ages, creeds, health status, ethnic backgrounds, whether partnered or single, may benefit from working with a psychotherapist who specializes in this area. Certified Sex Therapists use specialized clinical skills and theoretical knowledge to help people solve their sexual concerns (aasect.org).

Sex Therapy typically focuses on the following areas: desire, arousal, orgasm, and pain. Emily, our sex therapist, also counsels on sexual addiction and compulsivity.

Below, you will find information on Emily’s credentials and her treatment philosophy, as well as the services that she offers at the Pelvic Health and Physical Therapy Center. Please feel free to contact us for more information, or to schedule an appointment.

About Emily deAyala Credentials

Emily deAyala completed her undergraduate work at the University of Texas at Austin, where she graduated with honors, receiving her BA in Psychology and minor in Educational Psychology. She then completed my Master of Arts in Counseling from St. Edward’s University, with a dual emphasis in marriage and family therapy and licensed professional counseling. Emily is a professional member of the American Association of Marriage and Family Therapists, the Texas Association of Marriage and Family Therapists, and the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). She currently serves as the Texas Section leader for AASECT.

Emily is accepting new patients and off-site referrals.

Emily has given many guest lectures at Baylor College of Medicine, Rice University, and at various support groups and meetings in the Houston area. Please feel free to contact us if you are interested in hosting Emily at a speaking engagement.

Treatment Philosophy

Emily discovered her passion working as a psychotherapist who specializes in sex therapy. She takes careful consideration with each case that comes through her door. Her dedication is to working collaboratively with you and your partner toward the goal of living a more fulfilling life. She believes she has a natural ability to make working through and talking about sexual concerns as comfortable as possible. One size doesn’t fit all. Emily takes time to conceptualize each case and tailor her treatment to meet unique needs, and she strongly believes in the utilization of a multidisciplinary, team approach when necessary. Her dedication, compassion, and enthusiasm drive her to work with you till the end, and her integrity ensures you will receive quality care.

Relationship/Couples Counseling

Whether you and your partner are having a sexual issue, or just having trouble in your relationship, Emily is happy to work with you. As a marriage and family therapist, Emily thinks systemically about most problems. This means taking a close look at all factors, and people, that may come into play. Couples counseling is best for people who suffer from communication difficulties, life adjustment issues (for example kids, a new job, moving), sexual concerns, and for those who find themselves in repeated, unhealthy patterns of functioning. Sessions usually consist of a combination of individual and couple counseling.

Low Sexual Desire/ Discrepancy in Sexual Desire

Rarely does Emily see a partnership in which both individuals equally initiate sex, or in which one is always willing to be sexual when the other initiates. Instead, most couples consist of a “high desire” and a “low desire” partner. This is normal! Often the “lower desire” partner is the one blamed for problems related to sex and is the one who “needs to be fixed.” The messages we get from TV and movies don’t do much to debunk the myths about what is normal for sexual desire. Unless there is a purely physiologic reason for low sexual desire, our therapist usually finds that both individuals have patterns that contribute to the discrepancy. Of all the sexual dysfunctions, this is the one that requires the most extensive assessment because there are so many factors that may be to blame. Sexual desire is one of the most complex – and one of the most common – concerns that Emily sees.

Sex Therapy Areas of Practice

Difficulty with Orgasm

Of all the sexual dysfunctions, orgasm is the one most shrouded in myth. “I should be able to orgasm every time I am sexual.” “Sex won’t be enjoyable if I don’t orgasm.” “I should be able to have simultaneous orgasms with my partner.” These are common, but incorrect, beliefs that people hold about the female orgasm. In fact, only about 25-30% of women are able to have an orgasm from intercourse alone. If you are only able to have an orgasm when you masturbate, if you are unable to have an orgasm at all, or if you are dissatisfied with the quality or frequency of your orgasm, sex therapy may be able to help.

Erectile Dysfunction

This is the most common complaint our therapist encounters from her male patients. ED is a very troubling concern. Many men attach much of their sexual self esteem to the quality of their erections. Erectile dysfunction is defined as the inability to attain or maintain an erection during sexual activity. While medications may be useful for some men with ED, they usually do not help when the problem has a psychological cause. Talking to your therapist can help weed out what may be the psychogenic origins for your inability to develop and/or maintain an erection.

Premature/Rapid Ejaculation

Men tend to think they should be able to “last and last” during sex. As a matter of fact, most men last between 2-10 minutes on average once rapid thrusting begins. If you last less than 2 minutes or if you last less than you think is satisfactory for you and your partner, there are techniques which may help elongate the time you maintain an erection before ejaculating. And remember, sex doesn’t have to end with ejaculation! You have heard of foreplay, but how much do you know about afterplay? There are many things you and your partner can enjoy sexually after you have had an orgasm.

Sexual Pain

Sexual pain, or dyspareunia, is an umbrella term that refers to any pain one experiences during sexual activity. Both women and men may suffer from pain during sex. With women, the pain is usually due to vaginismus (an involuntary spasm of the pelvic floor muscle) or vestibulodynia (inflammation of the vestibule, the tissue that surrounds the vaginal and urethral openings). There are many other causes of sexual pain, but these are the most common. Vaginismus usually has a psychological component and is best treated using a combination of psychological and physiological treatment. Regardless of the type of pain you are having, therapy will help deal with any underlying anxiety or depression that causes or comes as a result of the pain. It will also help uncover any psychogenic cause of the pain. Sexual pain is less common among men, but it does happen. It is most often physiologic in origin, but may have a psychological component as well. Your therapist will help you differentiate the causes and outline the best course of treatment for your pain.

Sexual Addiction/Compulsivity

Sexual addiction is defined as any sexually-related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one’s work environment. Sexual addiction has been called sexual dependency and sexual compulsivity. Sexual addicts make sex a priority more important than family, friends, and work. No single behavior pattern defines sexual addiction. These behaviors, when they have taken control of addicts’ lives and become unmanageable, include: compulsive masturbation, compulsive heterosexual and homosexual relationships, pornography, prostitution, exhibitionism, voyeurism, and indecent phone calls, to name a few. Even the healthiest forms of human sexual expression can turn into self-defeating behaviors (sexhelp.com).

Sexual Abuse/Trauma

Any history of sexual abuse or trauma may impact your current sexual functioning. Trauma may be more obvious, such as rape, or may seem less evident, as in the case of an unhealthy relationship with someone in a position of power. Trauma has many faces and can present itself in many ways. You may not even be aware of the impact your trauma history has on your sexual functioning or in your current relationship. Regardless of the level of your sexual trauma, therapy may help alleviate some of the residual effects.

Sexual Paraphilias

A sexual paraphilia is defined as having an arousal to an object, person, or situation that is out of the norm. Usually this causes significant interpersonal distress and impairment in functioning. The types of paraphilias vary greatly, but some of the more common ones include voyeurism, exhibitionism, and transvestic fetishism.

Gender Identity

This is perhaps one of the most difficult inner struggles people face. Feeling like you were born in the wrong body, struggling with issues around masculinity and femininity, living in two different worlds – one public and one private – has the potential to cause significant depression and anxiety. It is very important that you receive therapeutic support as you embark on this journey of self exploration and change.

Sexual Orientation

Whether you are just beginning the process of questioning your sexual orientation or are starting to come out to friends and family, therapy can help alleviate the fear and anxiety of this process. While the world is moving toward more acceptance of the gay population, many people still hold on to faulty beliefs about homosexuality. Our therapist is happy to work with you individually, you and your partner, or you and your family as you go through this process.

Pricing

*While our therapist, Emily deAyala, MA, LPC, LMFT-A, is not currently in network with any insurance companies, she is happy to provide you a superbill should you desire to file for out of network benefits with your insurance company. Please note that reimbursement is between you and your insurance company, and full payment for your session is still required at the time of the service rendered.

FAQ’s

How long will I be in therapy?

• While many problems can be resolved in 12 to 16 sessions, the amount of time spent in therapy varies from case to case. After a thorough assessment, our therapist will be able to provide you with a general idea. Emily has seen some clients for just a couple of sessions and has seen some for over a year.
• Factors that influence how long therapy lasts include the complexity of the problem, the length of time you’ve experienced the problem, and the amount of time you devote to working on the problem in between sessions.
• It is usually best to meet on a once weekly basis. Aside from the first session, which is typically scheduled for 80 minutes, sessions are usually 50 minutes unless you specifically request otherwise.

What should I expect in the first session?

• The first session will focus on the presenting problem. Our therapist prefers to see both you and your partner together the first time. This allows her to understand each of your perspectives on the cause and influence of the problem and also to see how you interact as a couple. Emily will take a thorough assessment of the specific concern.
• Our therapist will then ask (unless you specifically request otherwise) to see each of you individually. This allows for a more in depth individual assessment. It is not uncommon for couples to identify one person in the relationship as “the one with the problem.” However, Emily often finds that both parties contribute to the identified problem. Individual assessments allow her to take a closer look at potential individual contributions.

Is therapy confidential?

• Therapy is always confidential with a few exceptions:
• If you indicate an intent to hurt yourself or someone else;
• If you indicate having participated in or having knowledge of any child or dependent abuse or neglect.
• Emily often consults with other therapists about cases, however no identifying information is ever disclosed.

How do I know if my therapist is a good fit for me?

• How comfortable you feel with your therapist is very important. Emily strongly encourages you to give her (or any other therapist) feedback on how you feel about the therapeutic relationship and the progress of therapy. This alone will greatly influence the therapeutic outcome.
• It is important to note that the word “therapist” is not a legally protected term. Make sure that you are seeing someone who holds a professional license that is authorized by the state in which you reside. While anyone may claim to practice sex therapy, it is important that you check the specific qualifications and certifications the individual holds in this area of practice.

Do you prescribe medication?

• No. Only a medical doctor may prescribe medication. If our therapist believes you need medication, whether psychotropic or otherwise, she is happy to make a referral to a physician she believes may best meet your needs.

What is the best way to prepare for therapy?

• Overlap between medical/physiologic issues and sexual concerns is not uncommon. Our therapist will always ask when your last complete physical or gynecological/urological exam was. If you have not had a physical exam in over a year, it is best to schedule one with your doctor prior to coming to therapy. This will help her to quickly rule out any physiological issues that may be contributing to the problem.
• Other than that, just bring yourself and a willingness to grow!

How do I become a sex therapist?

• Becoming a Certified Sex Therapist involves extensive training in sex education and therapy. For a complete list of requirements, visit http://www.aasect.org/therapist.asp.

Contact the Pelvic Health and Physical Therapy Center to Schedule an Appointment

Please contact the Pelvic Health and Physical Therapy Center for more information, or to schedule an appointment for sex therapy, couples and relationship counseling, and other needs. We offer discreet, confidential counseling for a variety of issues.