The Sexual History Technique: Where Do Your Desires Come From?

One of the most useful techniques I picked up when training in Sex Therapy with psychologist Suzanne Iasenza a few years back, is the Sexual History therapeutic technique. You might think that a Sexual History session involves sitting and chatting about your sexual past. While some of that is true, this technique is primarily a method used to connect the dots from your present sexual acts, behaviors, and wants to the time where it all began for you.

Some couples come into session thinking that what they do in their sexual lives somehow come from thin air. When I ask, “Why do you think you like that?” I might get a response along the lines of, “I don’t know. It feels good.” In the best of cases I might hear, “I watched porn and liked this or that.” The tricky part comes when I further ask, “And why do you think it feels good?”

No sexual act, behavior or want comes from thin air. Sure, culture and religion play a big role in all of our narratives about sexuality or the sexual act. Yet, when we really dig, or when sex has become “problematic,” that is when we must look a little further.

In my practice, couples often deem sex as “problematic” when sex has stopped or reduced. For individuals, sex often becomes “problematic” when it is shameful or seemingly unacceptable.

A Sexual History used as a therapeutic technique allows us to connect any sexual act to where it all began. Sometimes it traces back to innocent explorations of visuals, sounds, or smells introduced by a neighbor, or a playful game with a classmate. Other times, it traces back to more painful memories of abuse.

I encourage all couples and individuals to request a Sexual History with a clinician trained in Sex Therapy. For couples, this can lead to creating a closer and powerful alliance between the two. For individuals, this too can be a healing and empowering process of self knowledge.