What Terms Should I Use When Talking About Sex In Therapy?

When you’re talking about sex with your clients, how do you know what kind of language to use?

Lots of therapists have told me that they worry about using the wrong words and end up making their clients feel uncomfortable. How do you strike that balance between “too clinical” and “too casual”? It’s a tricky question, and there’s no one-size-fits-all answer because every client has their own particular sweet spot where the language feels comfortable and natural.

I have a very easy strategy to deal with this. I simply mirror the language that my clients use. I listen to the terms that they use to refer to their own anatomy and the sexual activities that they engage in, and, because I assume that those terms feel comfortable to them, I make an effort to use the same terms myself. That helps me meet my client in their comfort zone between clinical and casual language.

There are a few exceptions to this, of course. If the client is using terms that I don’t feel comfortable saying, then I will usually use slightly more formal language. If I use language that’s clearly awkward and unnatural for me, I think my awkwardness will impede the process of building a connection. My primary goal is to communicate and model comfort with the topic, so I try to get as close as I can to their language while remaining relaxed and comfortable.

The other exception is if I have a client who is not comfortable describing their situation using any specific language at all. Have you had any clients who say something like “when he touched me down there…” or “when we were doing that stuff…”  or even “when…you know…” In those cases, I ask clarifying questions using simple and specific language, because I need to know exactly what we’re talking about in order to help at all. In those moments, I explain why I need to understand better, and together we then work through the interactional sequence that is causing distress. Usually within just a few minutes, my clients become more comfortable as they see how many entry-points we have to work with when I have more information.

How do you think this strategy would work for you? Would you be able to use specific language about sexual anatomy and sexual encounters if it made you a more effective therapist? I promise you, it gets easier with practice. The first time I brought up sex in the therapy room, I thought, “Oh my gosh, am I really allowed to ask that?” I’ll bet that, like me, by the fiftieth time it will feel so natural that you won’t even be able to remember why you were so nervous in the first place. Go ahead, start counting, and let me know how you feel by #50. And here’s to your courage!