Sex therapy and intimacy
Sex, desire, and closeness: talked about plainly and without embarrassment. Whether that's something in your own history or something between you and a partner, it's an ordinary thing to bring here.
Not to a partner, not to a doctor, and often not to themselves in so many words. Sex is the thing people are most likely to decide is not worth bringing up, either because it feels too small to take up an hour with, or because it feels too much. None of it is unusual, and none of it needs to be a crisis before it is worth an hour. Maybe you're experiencing:
Desire that has gone, or never arrived, or does not match a partner's.
Pain, or anything else that makes sex something to avoid rather than want.
A body that doesn't feel like yours anymore, after kids, illness, aging, or just time.
Something in the past that shows up in the present.
Shame that came from a family, or a church, or a first relationship, and never left.
Feeling disconnected from your partner, emotionally or sexually.
You set the pace here. The first few sessions are about understanding your story: your history, what's going on now, and what you're hoping is different. Nothing is off-limits, and nothing needs to be said a certain way or in a certain order. There's no reaction to brace for and nothing that will surprise or embarrass your therapist. This is familiar territory for us, even if it doesn't feel that way for you. Your therapist will ask direct questions, because vague conversations don't actually help, but you're always in control of how much detail you share and when. From there, you and your therapist will build a plan that fits what's actually going on for you.
The consultation: Twenty free minutes. You describe as much or as little as you want to, and we work out whether this is the right place and who fits. It ends in a recommendation, not an assignment.
The first sessions: Taking a history and understanding your experience. It will start to feel easier, talking about a subject that may have been difficult to talk about before.
After that: You and your therapist will build a plan that actually fits what's going on: whether that's working through something from your past, addressing a physical or medical piece alongside your doctor, or working on connection with a partner.
Ellen Johnson
MA, LPC | Clinical Director
We work with sex and intimacy the same way we work with anything else: directly, without judgment, and at your pace. That might mean individual sessions to work through something from your history, couples sessions to rebuild connection, or both together. We draw from approaches like EFT and Gottman for the relational side, and trauma-informed and somatic approaches when the past is part of what's showing up now. Whatever's brought you here, you don't have to have the words figured out before you start. That's part of what we'll work on together.
Not every therapist is comfortable talking about sex and intimacy directly, and that discomfort has a way of showing up in the room. Ours are. We have therapists who specifically train in this work, so you're not the one teaching your therapist how to talk about it. That means fewer vague questions, less circling around the actual issue, and more of the direct, practical conversation that actually helps. If faith is part of this for you, we have a separate page for that work.
Only as much as actually helps. Your therapist may ask direct questions (vague conversations don't move things forward) but you're always the one deciding how much detail to share and when. There's no version of this where you're expected to perform comfort you don't feel, or explain something before you're ready to.
Yes, and plenty of people do. Sometimes a partner joins later and sometimes the work stays individual. Either is a legitimate way to do this.
Either. Some of this work is one person on their own, some is a couple together, and some starts as one and becomes the other. If what is going on is mostly about the relationship as a whole rather than about intimacy specifically, couples counseling might be the best place to start.
That's common, and it's worth naming early. Pain, low desire, and other physical symptoms often have a medical component alongside the emotional one, so we'll ask about that as part of understanding your experience, and coordinate with your doctor or a specialist when it makes sense. Therapy isn't a substitute for medical care, but the two often work best together.
Appointments Monday to Friday, 8am to 8pm, in person in Central Austin (across from Pease Park) or virtually across Texas. Weekends are sometimes available, so please ask if that works better for you.
No. The practice does not bill insurance directly. We can check your out-of-network benefits for you, by hand, before you commit to anything.
Say so on the consultation. Some of the team are working under supervision toward full licensure and see clients at a reduced fee, and there is no awkwardness in asking.
Twenty free minutes with someone who knows the team. You describe what's going on, and we tell you honestly whether this is the right place. Rates, insurance, and timing are all part of that conversation, not a surprise later.
Book a free consultationPick a time that suits you, sometimes as early as today.
We talk through what would help, and answer any questions that you have.
You leave with a recommendation to work with someone on our team, or a referral to another resource in the area. Either way, you won't be back at square one.
We are also gathering interest in a workshop on this. If that is something you would want, say so on the consultation or email hello@decadescounseling.com.
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