Common Topics in my Therapy Practice

Some still believe that going to therapy is only for diagnosed mental health issues found in the Diagnostic and Statistical Manual of Mental Illnesses or the DSM-5/DSM-5-TR. This isn't true. Therapy also serves anyone going through everyday common struggles. This is a quick glance at two of the most common topics in my therapy practice:

The Number One Most Common Therapy Topic is Sex

Sex and sex-related issues. It amazes me how sexual conversations and have evolved. Although many can feel embarrassed to talk about sex, almost everyone has questions and feelings about it. As much as we are relational beings, we are also sexual. Denying it or casting shame or taboo on the topic is harmful. Plain and simple.

I have so many angles from which I can come at this, but I want to keep your attention, so I'll keep it to a thesis statement or two.

First, there's so much, in fact too much, choice out there for sexual partners and gratification. I'm going to park gratification aside for now because that's a post of its own.

In terms of partners, previous generations could and would meet someone, and dedicating themselves to each other was not a struggle like it is now. Sure there were extramarital affairs, but that initial choice was simplified. It was also a time of building lives, families, businesses and homes that is very different than today.

Now, the increase of sexual FOMO if you will, skyrocketed as the internet and smart phones came into our lives. We were no longer dating the boy from school, the girl from down the street, the person we keep encountering in the elevator, or our grandmother's best friend's nephew. Now it's a buffet of who catches our eyes on dating apps and the endless list of social media platforms. Sliding into DMs, and the ease of having sex instantly, having several partners in one week, or in one day, is common.

How can anyone keep up?

No pun intended.

So when it comes to having a committed relationship, all these ideas of what sex could be or, even worse, "should* be," lingers in our heads.

Second, the idealized version of sex is creating too much pressure. No matter how old you are, from the moment we are introduced to the concept of sex, we start to develop a fantasy of what sex should look like. Most of us know sex isn't like what it is in the movies. It isn't always instant, perfectly choreographed, animalistic, nor is it always making love. It can be all of those things and it can be none.

Sex can be painful. It can be awkward. It can be messy. There can be noises. Sometimes it can be quick and sometimes it can be a marathon. Sex drives change. The point is, the version of sex developed in our minds can often lead to disappointment in ourselves or in our partners when reality doesn't match the fantasy.

My questions to my clients are, did you have fun? Did you feel safe? Did your partner?

Did you enjoy yourself? Did it make you feel good in any way? If the answer is yes, then we're cooking. If the answer is no, then we have to take a step back and try to find out what's happening. What is your history with sex? Is there trauma? How were you introduced to sex? Point is, I ask a lot of questions and we look for the answers.

There's a lot more to this but for now I'll simply say, I have so much admiration for those who come to therapy with sexual-related problems because it takes a lot of courage to be that vulnerable.

The Second Most Common Therapy Topic is Relationships

Human beings live in relationship. Whether it's friendships, family, pet, work, peer or romantic relationships - we're in them. A lot of the time (maybe except for the pet ones), things can go sideways.

Love can be lost, found or change so profoundly that we aren't sure how to make sense of it. No matter what age and life stage we are in. We change and not always in tandem with those around us. We can have expectations that come from our models of relationship and they may not work with the partner we've chosen. We have different needs and don't always know how to express them well or at all.

Relationships like two atoms coming together. Each has their own set of electrons moving around the centre nucleus. The electrons are our history - our family dynamics and our attachment styles, our pain, our past relationships - everything we have internalized over our lifetime. The nucleus is our core self, which includes our inner child. That core needs to feel seen and understood and cared for. Expecting two atoms magically match without friction, is impossible. What do we need to know about these two individual atoms as we put them together so they can work well? Often we struggle to navigate all of this.

That's where therapy comes in. We need to understand ourselves so we can help our partners, friends and loves ones do the same. Therapy helps us understand our patterns of attachment, helps cultivate a stronger self of self, stronger self-confidence, self-worth and self-esteem. It also allows us develop empathy within any of our relationships.

At the end of the day, we are all more the same than we are different. I think anyone from anywhere can take something away from the topics here, especially around relationships.

There's More

Obviously there are many more topics that come into a therapy session but these are the most popular ones I see. I'm going to make the assumption that there's an increase in individuals out there, in general, struggling similarly and this is to let them know they aren't alone.

Stay Tuned...

Please be patient and hang in there with me as I find my footing with this blog.

In the next post, I'm going to talk about some common issues when dating. Even TRYING to start a relationship has its troubles, let alone staying in one.

*I take issue with the word should. We'll get to that.