When I started my studies of sexology and sex therapy in 1973, I was already a practicing Gestalt therapist. At the time, the Masters and Johnson approach primarily defined the field of sex therapy and essentially promoted a cognitive-behavioral method for relieving sexual dysfunction. Though I learned a great deal, especially about what could go wrong, my own focus on growth and on the phenomenology of sexual distress and pleasure cast me in a lonesome position in the world of sex therapy.

It also seemed to me that the split between mind and body that dominated the larger culture was alive and well in the whole of the clinical field. Psychotherapists were supposed to deal with the mind and emotions. The more holistically-inclined included the body. But sexual issues required a separate kind of therapy.

Much has changed in these thirty years, and the unity of mind and body is now widely acknowledged. Yet among clinicians, psychotherapy, bodywork, couples counseling, and sex therapy are often seen as requiring separate therapists and different modalities. As O'Shea (2000) has pointed out, the failure to deal with sexuality in psychotherapy likely has more to do with “fear and uncertainty” among psychotherapists than it does with sexual issues being irrelevant to the clients and trainees with whom we work. She goes on to suggest that “...the struggles and contradictions of our culture reflect a yearning for a sexuality that is more fully integrated, more connected to our sense of self, that touches people at their deepest level of need....”

This paper explores the possibilities for greater attention to sexual issues as growth issues, and for more integration among these various therapeutic disciplines. In particular, it describes a comprehensive approach to personal growth and satisfaction in relationships that is based in Gestalt theory and practice and includes attention to the body and the sexual self.

The paper begins by identifying several models for approaching sexual concerns in psychotherapy. It continues with an exploration of how a body-oriented Gestalt model—a somatic-experiential approach—differs theoretically and methodologically from more traditional methods. It concludes with a case history demonstrating applications of this approach, and a summary of essential features.

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