Sexual Desire and Libido – Individual Therapy


Individual Therapy

You’re here because you’re struggling with how to enjoy intimacy, and you want to experience more emotional and physical pleasure.
You may have a pretty consistent pattern of when your sexual libido takes a turn that feels out of your control. Or something unexpected changed along the way about sex and you’re not sure what to do. You could be in a place where you want to explore parts of your sexuality, such as certain fantasies and/or with other genders, which may feel overwhelming. It’s probably gotten to the point you notice yourself avoiding or withdrawing from sex altogether. It might be hard for you to talk about these issues with a partner and it’s reached a crisis point. You worry about burdening them, or the topic has gotten so fraught it is causing problems.

Some folks feel in the dark about how all their problems came about. For others, there’s an intuition that old relational or sexual trauma wounds are affecting their ability to have a fulfilling sex life. Wherever you are, it can feel like you’re out of ideas on how to change things.

Desire can run on a spectrum of very low or very high. There is no right way to be. But when people feel like they’re “different” from others, they often assume that something might be wrong with them. The truth is that sex rarely follows a standard script. We’re all unique individuals with changing sexual needs and preferences.

You’re ready to focus on this part of your life more than ever.
Deva Segal has worked with many clients of different races and cultures in California.
Sex Therapy Vs Regular Individual Therapy

Most therapists only receive a very limited education about sex in therapy. A certified sex therapist is a licensed mental health professional with in-depth training in sexuality-related issues. While sex therapists treat sexual dysfunction, they also treat various emotional and psychological issues related to sex.

Clients come to me after thinking about what’s “wrong” with them sexually. They may have spent extensive time researching, trying various remedies for their sexual issues. Often they have been in therapy in the past, but it didn’t improve things or they decided not to talk about sex in therapy at all.

It’s not unusual for clients to feel frustrated about what is going on, but also kinda intimidated. They feel insecure about what to do next. They want reassurance, and they want concrete tools for improving their sexual problems.

Individual sex therapy can help you with:

  • Unexpected shifts about your sexuality or fantasies
  • Sexual frustration in your relationship
  • Embarrassment about how to talk about sex
  • Recovering sexuality after trauma
  • Adjusting to sex after childbirth and during early parenting
  • Redefining your sexuality after hormonal changes, such as menopause or cancer
  • Sexual dysfunctions impacting your emotional or physical well-being
  • Confusion, guilt, or shame about what turns you on
  • Lack of desire to have sex or curiosity about asexuality
  • Uncertainty about your sexual orientation or just struggles with being “out”
  • Cultural factors affecting how you perceive sex and sexuality
  • Problematic sex behaviors (sometimes known as sex addiction or sexual compulsion)
Man with his hands together looking worried
How Sex Therapy Works
Human sexuality is such a nuanced and complex concept. Sex therapists recognize how numerous psychological, physical, societal, and relational factors intersect with a person’s sexual life. This speaks to the first step of our therapy – building a relationship together. It’s important that you feel comfortable talking about your needs and feelings. My overarching goal is to offer an accepting space where it feels truly safe to share your difficulties. Some of the topics we might cover are:

What turns you on: Not knowing what makes you feel good or interested in sex to begin with can feel daunting, like you’re frozen about what to do next. There’s a feeling of hopelessness that can take over. My interest is not in getting you “just to have more sex”, but to start having the sex worth having. Wanting no sex is also a perfectly acceptable option.

Who turns you on: There could be curiosities about what intimate experiences with other kinds of people could be like. Could be different genders or just different types of partners. It’s hard to challenge your own ideas about yourself and figure out if you’re supposed to have new ones. Alternatively, if you’re not able to disclose your sexuality or desires with others, it may lead to secretiveness or isolation.

Fear: You could be wondering if you’ll ever get what you want or if you’re somehow inadequate. This fear can be even more pronounced if you’ve always had sexual issues or if you have ever felt rejected by past partners or healthcare providers.

Shame: Shame is the emotion that tells you, Something is really wrong with me. I think I’m broken. When we feel high levels of shame, we tend to struggle with low self-esteem and isolate ourselves from others. Even if you’re in a loving relationship, you might notice yourself avoiding vulnerability or feeling immense embarrassment during sexual activity.

Cultural and religious beliefs: Sex myths are reinforced in our relationships, media, and our cultures and religions of origin. Because there is so little support to help you understand sexual health, it can be challenging to find your own values about sex. Together, we think about how gendered and cultural beliefs inform where you are now.

Ruminating about your past sex life: If you’ve thought more you may notice yourself continuously comparing your current situation to what you had in the past. People experiencing sex problems often fear that things will be this way forever. There is a longing to have things go

Problems with too much sex: Sometimes folks can become over-focused on the excitement of sex and what they hope it will provide them. That could be partnered sex or solo sex with erotic imagery. In some cases it has impacted relationships or jobs. There are cycles to these behaviors that need some attention in order to unpack.
In therapy, we will work together to further solidify your therapy goals and identify what needs to change, and create a plan for you to achieve them. Over the course of your therapy treatment, I will provide ongoing feedback and offer various solutions intended to help you improve your well-being. Based on your specific goals, therapy may be either short-term or long-term.
What If I Have other Problems Besides Sex?
It’s common for clients with sexual concerns to have anxiety and depression attached to it.  Sex may be an apparent stressor in your life, but there can also be old wounds and trouble in other areas that have gone unresolved. I will always bring in relevant discussions of where else you are getting stuck. After we put your story together, we’ll both have better insight into your current challenges. We’ll start to focus on addressing immediate concerns, such as managing difficult emotions or problematic life situations.

If you have an existing individual therapist and would like to explore working with me for sex-related issues, I address this more in depth in my FAQ.
Working With a Certified Sex Therapist in San Francisco, CA
Your sexual health is part of both your physical and emotional health. Whether you’re experiencing performance anxiety, libido changes, confusion about your sexuality, or you simply feel uncomfortable talking about sex with your partner, therapy can help. My depth training in sexuality helps in bringing in the full picture.

In my practice, I welcome all genders, sexual identities, and different relational and monogamy agreements. I am a sex work ally and have advanced competency in kink practices. Many of my couple therapy clients or couple partners are LGBTQIA+ identified. Matching my own background, I often work with people of mixed ethnic and cultural identities, first and second-generation immigrants, and BIPOC clients. Come as you are.
If you have a sense something needs to shift, now is the moment to take a risk. You don’t have to figure it all out on your own. Contact me to book a free consultation.
Deva’s clients may be hurt & outraged at the system of racism recently & seeking professional help.
“It is a joy to be hidden and a disaster not to be found.” – D.W. Winnicott
Deva is a licensed psychotherapist (LMFT CA #103816 / ME #MF7207 / SC #TLC 825 MFT) and AASECT Certified Sex Therapist practicing in the downtown Financial District of San Francisco, CA. She has worked with clients aged 6 to 88 in different settings since 2011. These days, she helps individuals and couples get more in tune with their wants and needs. She has a special focus on sexuality and folks of mixed ethnic or racial backgrounds.

She slightly prefers pie over cake, but loves dogs and cats equally.

© Deva Segal, Marriage and Family Therapy and Consulting, Inc. SF Therapist. All rights reserved. 2018-2024