So Where Do We Go from Here?

Abstract

Binik and Meana’s (2009) article criticizes sex therapy as an institution and as a psychotherapy specialty, but these criticisms are not new. Many of us in the field have lamented about these problems (as well as few others that they did not mention) for years. There are serious problems with the field of sex therapy, including poor insurance reimbursement, essentially no money for research, difficulty with standardization, lack of an agreed-upon knowledge base, ‘‘media stars’’ diagnosing a ‘‘caller’’ after a few minutes on the air for the amusement of the audience, plus all the other problems that Binik and Meana identified. So far, the field and its practitioners do not have a remedial plan or even the collective will to create such a plan, which is quite unfortunate. I am going to let other sex therapists valiantly defend their turf and I will make a different point. What response did the authors expect? Did they think sex therapists would agree that sex therapy is a fraud, voluntarily disband their organizations, meekly offer abject apologies for misleading the public, or some other mea culpa? Is it possible they had another purpose? Why would Binik and Meana preach to sex therapists? Sex therapists really cannot change the situation; it is up to the general psychotherapists to take up Binik and Meana’s challenge. Sex therapists will continue to sit in their offices until those who need (or think they need) sex therapy stop making appointments. If general psychotherapists would just assume the care of these sexually troubled souls, sex therapy would wither and die. Why publish this article in a sexology journal and speak at sex therapy conferences? Binik and Meana should publish in general psychotherapy journals and speak at general psychotherapy conferences. A few papers in mainstream psychotherapy journals explaining how easily cognitivebehavior therapy, psychodynamic, or other therapeutic approaches can treat sexual concerns will set the stage. The authors can demystify sex therapy, expose all our tricks (maybe even the secret handshake), and nip those referrals in the bud. If there is nothing special about sex therapy, all the well-trained psychotherapist needs to do is read a couple of articles or attend a lecture or two. Once the sex therapist is unmasked as a fake, the general therapist will have a new source of clients and the sex therapy institutions will crumble as all unused relics do. Those papers and presentations will give Binik and Meana the needed platform to urge the professors at psychotherapy training programs to demand all basic psychotherapy textbooks cover sex therapy. The faculties of these programs decide which textbooks to use and the publishers want to please them; if they demanded that the textbooks cover sex therapy, they would. Binik and Meana are excellent writers and respected scholars; they can even write the needed chapters. I hope they have more success than the rest of us who have tried to interest these editors in sex therapy chapters previously. It has been the editors—not the sex therapists— who have refused to consider these chapters in the past. Binik and Meana should not bemoan the lack of a Sex Therapy Division at the American Psychological Association—they should start one. I am sure that many sex therapists, some of whom are also card-carrying psychologists, would be interested. It also would generate increased interest among general psychologists about sex therapy and its practice. Or could it be that the psychologists just have not been interested? C. Moser (&) Department of Sexual Medicine, Institute for Advanced Study of Human Sexuality, 45 Castro Street, #125, San Francisco, CA 94114, USA e-mail: Docx2@ix.netcom.com