Sex Therapy

It might be repeated infidelity, seeing sex trade workers while you’re in a committed relationship, problematic porn use and/or masturbation, hooking up and cruising when you’d rather not, or unwanted and overwhelming sexual thoughts.

Problem sexual behaviours (PSB) is a non-diagnostic term for sexual thoughts, feelings, urges, and behaviours that people feel are out of their control or are causing them difficulties. Sometimes people refer to these experiences as sex addiction or porn addiction, compulsive sexual behaviour, sexual impulsivity, or hypersexuality.

These types of experiences are not uncommon. Many people struggle with sexual behaviours that they dislike or that feel out of their control.

At the West Coast Centre for Sex Therapy, we want to empower our clients to identify what healthy sexuality looks like for them. Our clients’ goals and values regarding sex and relationships become the blueprint for change.

We don’t use a one-size-fits-all approach. There are many reasons why people engage in sexual behaviours that feel out of their control or that they dislike.

Problematic sexual behaviours are almost always the symptom of some other problem that must be addressed for the behaviour to change (e.g., anxiety, loneliness, avoidance, resentment, sexual dissatisfaction, fear, etc.). That is why many people who go through other treatment programs often fall back into old bad habits – they may have learned skills to manage their behaviour in the short term, but without addressing and fixing the reasons for their behaviour, the problematic sexual behaviours return and become unmanageable again.

Unusual sexual interests (including fetishes, kinks, and paraphilias) are sexual interests that don’t fall within the bounds of what society and culture deem “normal”. But just as our brains are drawn to a variety of foods (from sushi to blue cheese) and a variety of activities (from exploring underwater caves to body piercing), so too are we sexually aroused by a variety of stimuli. In fact, scientists have discovered that the majority of people have some sexual preference that might be considered unusual.

Whether you’re sexually aroused by feet, being humiliated, wearing diapers, obese bellies, or the young or old, therapists at the West Coast Centre for Sex Therapy are here to provide a non-judgmental and open space to talk about what turns you on, and if and how you might integrate your interests into your sexual relationships in a consensual and fulfilling way.

We will talk through your greatest fears: “Am I normal?”, “Will anyone want to date me given what turns me on?”, “Did something in my upbringing make me this way?” and “Is something wrong with me that I’m turned on by this?”.

We will provide you with accurate and scientifically-based information on what we know about how our interests develop, and why there is nothing wrong with you if “vanilla” isn’t the flavor of sex you crave.

One of the most common issues that bring people to our offices are concerns around low libido or desire. Our clients often feel that their desire has decreased significantly over time and/or they are concerned that their desire is significantly lower than that of their partner, leading to distress and conflict in the relationship.

Some people are concerned because they no longer experience any desire – they don’t even have desire to masturbate, much less be sexual with a partner. Others still experience the desire to masturbate, or even experience desire towards other people, but no longer experience sexual desire towards their current partner despite still feeling very much in love. And still others don’t experience initial desire, but once they start being sexual, desire can be triggered.

Partners can often feel very hurt and rejected: “If you don’t feel sexual desire towards me anymore, does this mean you no longer love me or are no longer attracted to me?” Others assume that hormones are the problem. While hormones can play a role and are important to consider (especially in men), very often low desire is the result of a multitude of personal, relational, and situational factors that all come together to incrementally put the “brakes” on desire.

At the West Coast Centre for Sex Therapy, our approach is to understand all of the factors that may be shutting down desire (the “brakes”) and all of the factors that used to trigger desire (“the accelerator”). It’s often very helpful to meet with the couple and to hear each of their perspectives.

We will ensure that you have proper information on how desire works in men versus in women – information based on fascinating research conducted over the past 30 years that has changed our understanding of male and female sexuality. And we will come up with a treatment plan that will likely involve specific sex and relationship therapy techniques, recommendations, and exercises to help you create the right conditions that shift the dynamics from the brakes to the accelerator, and that put you back in the driver’s seat of your desire.

At some point in their lives, almost all men will have one or more experiences during which they struggle to get or keep an erection during a sexual experience with a partner.

Sometimes this is because of biological factors such as a medical condition, the side effects of a medication, very low testosterone, or normal aging.

However, problems with erectile function are often due to psychological factors such as performance anxiety or depression, or to situational factors such as inadequate stimulation, distraction, or relationship stress.

Changes in erectile function can be very upsetting, not only for the men experiencing these changes, but also for their partners. Partners may wonder: “Does losing your erection mean you aren’t attracted to me?” This, in turn, can put even more pressure on men to get an erection.

At the West Coast Centre for Sex Therapy, we will work with you to help understand what is leading to your erection problems. Depending on what the underlying cause is, we will come up with a treatment plan that may involve specific sex therapy techniques and exercises to help you to reclaim a feeling of control over your body, lower the anxieties that you (and your partner) are feeling about sex, and help you get back to stress-free and, most importantly, pleasurable sex.

Some people reach orgasm with ease. For others, orgasms are extremely effortful or unpredictable. Some people only have difficulty reaching orgasm when in the presence of a (new) partner or during specific sexual activities. Others struggle to reach orgasm no matter what they are doing and who they are doing it with.

The problem is that many people think that orgasm is what determines if an experience was “good”; in other words, the thinking goes: “If my partner had an orgasm, they must have enjoyed themselves; if they didn’t have an orgasm, then something must have been wrong.” This puts immense pressure on people to have an orgasm as a way to reassure oneself or one’s partner that the experience was enjoyable. But the sad reality is that when people feel pressure to have an orgasm, the experience is less enjoyable and people are less likely to have an orgasm!

At the West Coast Centre for Sex Therapy, we will help you understand why you have difficulties reaching orgasm. Depending on what the underlying causes are, we will then come up with a treatment plan that may involve specific sex therapy techniques and exercises. We will also ask you what having an orgasm means to you, and why it’s important. In many cases, we will help you shift focus from having an orgasm to having great sexual experiences. Because we know that the more pressure there is to orgasm, the harder they are to come by (no pun intended!). Instead, the more we work to enhance your sexual pleasure and remove any pressure (including pressure to orgasm), the easier and faster your orgasms will come.

Sexual performance anxiety can take many forms. For men, it can involve anxiety about the ability to get or keep an erection, anxiety about ejaculating too quickly or taking too long to reach orgasm, anxiety about the size of one’s penis or other body parts, anxiety about pregnancy and contraception (including anxiety about putting on a condom), and anxiety about being a “good lover”.

Similarly, for women, performance anxiety includes fears about the ability to get turned on, to have orgasms (or multiple orgasms, or orgasms from intercourse versus other forms of sexual stimulation), fears about one’s body (including look, taste, and smell), anxieties about getting pregnant, anxieties about urinating or squirting during orgasm, and anxiety about being not “good in bed.”

Apart from the distress this anxiety causes, it can also become a self-fulfilling prophecy: for example, fears about not getting an erection can lead to not getting an erection, and fears about not being able to orgasm can lead to not being able to orgasm! This, in turn, only further reinforces and increases worry and distress.

People may turn to alcohol, drugs (including prescription drugs like Viagra and Cialis), “faking”, and avoidance as ways to cope with their performance anxiety. But sadly, none of these approaches help in the long term – the anxiety will persist.

At the West Coast Centre for Sex Therapy, we will help you understand what is leading to and maintaining your performance anxiety. We will then come up with a treatment plan that may involve specific sex therapy and anxiety-reduction techniques and exercises to help you to reclaim a feeling of control over your body, lower the anxieties that you are feeling about sex, and help you get back to stress-free and enjoyable sexual experiences.

Also called premature ejaculation, early or rapid ejaculation involves reaching orgasm sooner than you or your partner would like. For many men, early/rapid ejaculation occurs only during intercourse; it doesn’t happen during masturbation or during “foreplay” activities. For others, it happens in all situations.

If you look up early/rapid ejaculation on the Internet, you will find lots of tips to address this, from reducing stimulation through numbing creams or the use of condoms, to squeezing the heck out of your penis to stop you from ejaculating (the “squeeze-technique”), to thinking about your grandmother or something else that’s a major turn-off. Unfortunately, none of these techniques are about getting to the underlying cause, and none of these are about maintaining or enhancing pleasure.

At the West Coast Centre for Sex Therapy, we will help you to understand what might be leading you to reach orgasm sooner than you would like. We also will ensure that you have realistic expectations about what’s “normal” when it comes to orgasms.

Depending on what the underlying causes are, we will then come up with a treatment plan that may involve specific sex therapy techniques and exercises to help you to (re)claim a feeling of control over your body, lower the anxieties that you (and your partner) are feeling about sex, and help you get back to stress-free and enjoyable sex.

Despite it rarely being talked about, genital/sexual pain is not uncommon. In fact, most men and women will experience pain in their genitals – just like most of us will experience pain in our necks, knees, and backs – at some point in their lives. Fortunately, for many, the pain is short-lived and has an identifiable and easily treatable cause (for example, yeast or urinary tract infections, certain skin conditions, and bacterial infections). However, for others, genital/sexual pain can be chronic (i.e., lasting more than three months) and have no identifiable cause.

This sometimes leads people to mistakenly conclude that the pain is not real. But just because no observable cause can be identified does not mean that the pain is not real. The pain is very real and very distressing. And it can lead to difficulties engaging in penetrative and non-penetrative sexual activities, thus impacting relationships and quality of life.

At the West Coast Centre for Sex Therapy, we are very familiar with genital/sexual pain conditions and the impact they have on sexual intimacy and relationships. We also understand the physiology underlying chronic pain, and the treatments that research has shown to be most effective. Based on the research literature, we believe a multidisciplinary approach is most effective in treating chronic sexual/genital pain, and we regularly refer our clients to (and work closely with) physicians, gynaecologists, urologists, and pelvic floor physiotherapists to ensure our clients are receiving the best support and are applying the most effective treatments to address their pain. We will work with you (and your partner) to not only apply evidence-based psychological treatments to manage pain, but also to help you get back to having a happy and healthy sex life. If you are struggling with genital/sexual pain, you are not alone, the pain is not in your head, and there are treatments that can help.

Most of us have grown up in cultures and in families where talking openly about sex rarely or never happened. In fact, many people have been raised in families where talking – or even thinking – about sex was considered wrong and shameful. No wonder so many of us have confusion and anxiety when it comes to sex.

We may have anxiety about our bodies, our sexual interests, what our bodies do (or don’t do) in sexual situations, and whether we are “good” in bed.

At the heart of many of these fears is the question: Am I normal?

At the West Coast Centre for Sex Therapy, we have heard pretty much everything there is to hear when it comes to sex. And we know the science and research, so we know what’s “normal” (quick answer: you are!). We know why our bodies do what they do, and how our cultures, upbringings, and experiences (or lack thereof) have shaped us when it comes to our sexual confidence. We’ll explore your fears and anxieties with you. And we will provide you with accurate and up-to-date information on what you can expect from your body and from sex. Most importantly, our goal is to help you to overcome confusion, fear, and shame so that you can approach sexuality with curiosity, confidence, and excitement, and have great sex.

Most of us have grown up in cultures and in families where talking openly about sex was not the norm. In fact, many people have been raised in families where talking – or even thinking – about sex was considered wrong and shameful. It’s no wonder so many people have confusion and guilt when it comes to sex!

We may feel guilt and shame about our bodies, our sexual interests, our sexual behaviours, what feels good or doesn’t feel good, and what our bodies do or don’t do. Our sexuality may be in conflict with our religion, our upbringing, society’s messages about what’s “ok”, or even our own values.

At the West Coast Centre for Sex Therapy, we have heard pretty much everything there is to hear when it comes to sex. And we know the science and research on sex, so we know what’s “normal” (quick answer: you are!). We know why our bodies do what we do, and how our cultures and upbringings have shaped us when it comes to our sexual confidence (or lack thereof).

We’ll explore your guilt and shame with you. We will help you figure out the degree to which your sexuality is in true conflict with your values. If your sexual behaviours go against your values, we will work with you to get your behaviours back in line with who you want to be. And if your sexual behaviours aren’t actually in conflict with your values, then we will encourage you to work on acceptance of who you are. Most importantly, our goal is to help you to overcome confusion, guilt, and shame about sex so that you can approach sex with curiosity, confidence, and excitement.

As our society has become more open and accepting about sexuality, increasing numbers of people are questioning the assumption that monogamy is the “gold standard” and “right” approach for their relationships.

At the West Coast Centre for Sex Therapy, we want to empower our clients to identify what a healthy and satisfying relationship looks like for them. Our clients’ goals and values regarding sex and relationships are the blueprint.

Open relationships can take many different forms. We are non-judgemental and don’t use a one-size-fits-all approach. There are many reasons why people may want to open up their relationships. And there are just as many reasons why, for others, this may be anxiety-provoking or not a good fit.

We will work with you to explore your reasons for having an open relationship, as well as your fears and anxieties about this. We will help you to have open and honest discussions, and set appropriate limits. And we will help you to approach open relationships in a respectful and consenting way that hopefully not only maintains, but also ultimately strengthens, trust and intimacy.

Gender identity refers to our sense of being a man, a woman, both, or neither. Our gender identity may correspond with what’s between our legs, or it may be different. When our gender identity does not correspond with the sex we were assigned at birth, it can be very confusing and upsetting – something made all the more difficult in societies and cultures that view people as only either men or women, and that are neither understanding nor supportive of the wide range in gender identity and gender expression that exists.

Whether you are unsure of your gender identity and are looking for a safe place to explore this, or already feel confident with who you are but are looking for support in navigating social stigma, relationships (including family, platonic, romantic, and sexual relationships), health care, and other aspects of your life that can have added complexities when not meeting the traditional and stereotypical ideas of masculinity and femininity, we’d be happy to provide you the support that you need. Our goal is to get to know you as a person while also understanding aspects of your life and gender identity that may be confusing or distressing for you. We promise to provide a safe, non-judgmental, and supportive space where any topic is open for discussion.

Traditionally, sexual orientation has been defined by who we are sexually and/or romantically attracted to: the opposite sex, same sex/gender, or both one’s sex/gender and others’ sex/gender (bisexuality). Nowadays, we also recognize asexuality (a lack of sexual attraction to others) as another sexual orientation. And many other terms have also come into common usage to describe the nuances of our attractions: for example, pansexuality (being sexually and romantically attracted to certain people without regard to their biological sex or gender identity); omnisexuality (being attracted to all genders); and demisexuality (not experiencing sexual attraction until an emotional connection has formed).

Our sexual orientation is often an important part of our identity. But for many people, sexual orientation can also be a source of distress. Some may be confused about their sexual orientation because it seems to shift and evolve over time. Others are ashamed and anxious about their sexual orientation because it doesn’t fit the standards or rules set by society, culture, religion, or family upbringing. Some wonder if they are “normal” if they don’t experience sexual attraction toward others or only experience it under very specific circumstances.

At the West Coast Centre for Sex Therapy, we celebrate the diverse ways our brains are configured when it comes to sex and attraction. Whether you are unsure of your sexual orientation and are looking for a safe place to explore this, or already feel confident with who you are but are looking for support in navigating social stigma and relationships, we are here to assist you. Our goal is to get to know you as a person while also understanding aspects of your life and sexual orientation that may be confusing or distressing for you. We promise to provide a safe, non-judgmental, and supportive space where our therapeutic approach is based on evidence-based practice that prioritizes your goals and concerns.

While sex can result in great joy, excitement and pleasure, for some people, their sexual experiences have been anything but positive. Unwanted and coercive sexual experiences can be extremely traumatic, resulting in confusion, hurt, anger, fear, shame, and avoidance of anything that reminds a person of what occurred. Some people experience nightmares and flashbacks, and can be triggered by sights, sounds, smells, touch or specific words. Sexual desire, arousal, and orgasmic function can be impacted.

Many people experience intense guilt and shame about unwanted sexual experiences. There are several reasons for this. It’s not uncommon for people to report that their bodies became aroused and even orgasmed during these types of experiences. Additionally, many people feel that they bear some responsibility for what happened to them.

Unwanted or coercive sexual experiences can make sexual and even non-sexual relationships very difficult and highly anxiety-provoking.

At the West Coast Centre for Sex Therapy, we have therapists trained specifically to help people who have experienced unwanted and traumatic sexual experiences. In a warm and supportive environment, we use evidence-based approaches to help you move on to have a fulfilling life, including sexual and romantic intimacy, despite what happened to you. We use evidence-based approaches to help you to overcome the re-experiencing, hypervigilance, and avoidance that usually accompany traumatic experiences. We will go at a gradual and tolerable pace, and empower you to reclaim your sexual self in whatever ways feel appropriate and desirable to you.

There is a large range of behaviours that people may consider infidelity or cheating. For some, cheating means having sex with another person. For others, cheating includes behaviours that don’t involve physical sexual contact – for example, flirting, communicating sexually on line, masturbating to pornography or to fantasies of another person, or having an emotionally intimate but non-sexual relationship with another.

This means that within a relationship, what one partner considers cheating, the other partner may not. And quite often, couples have not discussed and agreed upon what constitutes infidelity.

When a partner chooses to be unfaithful, the impact on relationships is typically very similar: broken trust, intense hurt, humiliation, confusion, anger, the desire to punish the unfaithful partner, and difficulties moving forward (or even knowing how to move forward).

For the partner who was unfaithful, there are often conflicting feelings about their behaviour – anxiety, confusion, and shame, but also difficulties letting go of the behaviour or seeing the behaviour as having been “all-bad”.

For the partner who has been betrayed, there is often a huge amount of distress in trying to come to terms with what has happened: How did this happen? Why did my partner cheat? Is there more that I don’t know about? Am I not enough for my partner? How can I ever trust my partner again? Can my partner change? Am I an idiot for even considering staying in this relationship? How can we get past this? 

If you are struggling with infidelity, we at the West Coast Centre for Sex Therapy have a good sense of what you may be going through. We’ve worked with many individuals and couples dealing with the aftermath of an affair or a series of transgressions. Using a non-judgmental and supportive approach, we will meet with you to find out what you are going through, your biggest fears and sources of distress, and explore with you the best path forward based on your own unique set of circumstances. Unlike your friends, we don’t take a one-size-fits-all approach of either “you should stay” or “you should end it”. We recognize that many factors go into making that decision, and we will help you to identify the factors that matter the most. Most of all, you can count on us for a safe space to fully explore and work through what led to the infidelity and its consequences, and what can be done to minimize the likelihood that it will ever happen again.

The fact is that bodies – including those parts of our bodies most commonly associated with sexuality – change as we age. And as we go through life, most of us will, at various points, experience medical and/or mental health conditions that either directly or indirectly affect our sex lives.

Many people find it difficult to obtain accurate information about what to expect from our bodies as we age. Many times, we feel too embarrassed to talk to our doctors, friends, family, or even our sexual partners about these changes. Instead, we may withdraw from, and start to avoid, sexual intimacy. But this is a great loss for many people and for many relationships because sexuality is often the way that people connect, play, relax, and/or explore themselves and each other.

At the West Coast Centre for Sex Therapy, we aspire to help people to maintain their sexual selves and their sexual connections for as long as it feels personally important and desirable.

We work with individuals and with couples to help them understand the changes happening to their bodies, whether as a result of normal aging or as a result of injuries (including spinal cord injuries and head injuries), medical conditions (including cancer, multiple sclerosis, diabetes, and heart disease), mental health concerns (including depression and anxiety), and medications or surgical treatments.

We will help you understand what is leading to the changes in your sexual function. With your consent, we are happy to work closely with your medical providers (physicians, gynaecologists, oncologists, urologists, endocrinologists, etc.) to ensure you receive a collaborative, team approach to care. Depending on what is affecting you, we will come up with a treatment plan that may involve specific sex therapy techniques and exercises to help you to reclaim a feeling of control over your body wherever possible, to lower the anxieties that you (and your partner) are feeling about sex, and help you get back to stress-free and enjoyable sexual experiences.

At the West Coast Centre for Sex Therapy, we work with adults of all ages and at many different phases of their lives. However, a common time that people come to see us is after having children. Sometimes it’s within the first year of having a baby, and sometimes it’s 5, 10, or even 20 years later. But the usual story is that once kids were in the picture, sex wasn’t (or at least not to the same degree or in the same way as before children).

Having children changes everything (sex lives included). It changes couples’ energy levels, priorities, time available to be intimate, their needs for physical touch, their roles and relationships with one another, and their feelings about sex. But sexual intimacy is important for many couples: for connection; for physical pleasure; to prevent feeling like roommates or just co-parents; to feel desired and wanted; etc.

At the West Coast Centre for Sex Therapy, we get what it’s like to have families and young children. And we know how important it can be to find ways to adapt to family life while also maintaining quality sexual intimacy. We’re here to help. We’ll work with you to find the right approach and resources to result in a hot, healthy, and happy sex life that leaves you and your partner feeling satisfied.