Psychosexual & Relationship Therapy is Psychotherapy!

Whilst we all understand PRT is an area of specialism which requires dedicated and high quality training it is, at its core psychotherapy.

How do the clients understand this and how do practitioners position it?

When seen as a specialist area of psychotherapy, assessment goes beyond the specific information gatheringof their sexual history, organic and non-organic issues, sexual trauma issues, queries about orientation/identity, sexual desires, or lack of, and faith and culture rules around sexuality and intimacy.We also aim to familiarise ourselves generally with them as individuals in the broadest sense, knowing as Walt Whitman said

“I am large, I contain multitudes.”

We need to know whatever may be relevant. This will depend on our own view of people and life. If we see things through the lens of Attachment, we will be interested in the extent to which and the ways in which they are secure or insecure and how that might impact on their relationship or sexuality. If we see things in a Person-Centred way, perhaps we might be curious about how congruent they are, and so on and so forth.

What is the mandate offered by the client(s)? How do we look beyond the ‘presenting issue’? Perhaps they are offering a sexual difficulty as a mere example or symptom of a deeper malaise. How often do clients bring a sexual difficulty, resolve that with us but stay on because they want to deal with something else more general that now feels approachable?

Are general psychotherapists sometimes uncomfortable in asking about sexuality, intimacy, and performance? Do they have the knowledge within their skill base to do this, have they been taught to do so withing generic psychotherapy training?

PRT therapists need to be able to investigate the microcosm of a sexual presentation, understanding the minutiae of the particular, using the specialist knowledge acquired, as well as the macrocosm of psychotherapeuticcuriosity and awareness.

As COSRT states:

Psychosexual and Relationship Therapy (PRT) is an advanced, integrated therapy using several components – psychosexual therapy, relationship therapy, and broader psychotherapy.

As such students who come from a generic background are required to embrace ‘studentship’ – this is not always easy, nor for those who come primarily from a medical or alternative health background.

Gretchen Blyke remphasized, quoted in a zencare blog:

“…due to the additional education about sexual health and functioning…” the importance of seeking a therapist with specialist knowledge. Whilst also saying ‘comfort with dialogue focusing on sex, sexual behaviors, and gender related topics.”

So, in a nutshell, this is what we do, we sit in our psychotherapy seat, which needs to become larger to accommodate all aspects of psychosexual and relationship work – both with individuals, couples, and the host of other intimate systems we may be presented with, and to have enough comfort to do so.

Our psychotherapy ‘home’ will inform us, however our PRT training and experience will guide us.

As such to elect to become a PRT psychotherapist requires a level of robustness, flexibility, passion for knowledge, the ability to be confused/puzzled and a sense of humour!

As with clients, it also requires some bravery to undertake the work.

Judi Keshet-Orr & Jean Miller, LDPRT Directorate.

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