By Erin A. Alexander, LPC-S, Clinical Sexologist
As a relationship coach and clinical sexologist, I’ve had the privilege of guiding hundreds of couples and individuals toward deeper intimacy, healing, and connection. It’s rewarding work that I genuinely love. But like any profession, there are certain client behaviors that can make even the most patient therapist want to scream into a pillow.
Today, I’m pulling back the curtain on the five most common (and frustrating) things clients do in sex therapy and relationship coaching sessions—and more importantly, how you can avoid them to get the most out of your therapeutic journey.
1. The Last-Minute Cancellation: Respecting Your Commitment to Change
The Scenario: It’s 8:58 a.m., your session starts at 9:00 a.m., and my phone buzzes with a text: “So sorry! Can’t make it today. My cat looked at me funny and I need to process that alone.”
Why It Matters: While life genuinely happens, chronic last-minute cancellations send a clear message: the therapeutic work isn’t a priority. Not only does this impact your therapist’s schedule and income, but it also sabotages your own progress.
How to Do Better: Treat your therapy appointments with the same respect you’d give a doctor’s appointment or important work meeting. If something comes up, provide at least 24 hours’ notice. Remember, punctuality and consistency are the first forms of relational respect—both to your therapist and to yourself.
The Therapeutic Truth: Progress in sex therapy and relationship coaching requires consistency. Sporadic attendance creates sporadic results. When you show up regularly, you signal to yourself and your partner that this work matters.
2. Self-Diagnosis: Leave the Clinical Labels to the Professionals
The Scenario: “Based on my late-night Google search, I’m pretty sure I have Hypoactive Sexual Desire Disorder, and my partner definitely has Compulsive Sexual Behavior Disorder. Can you just confirm this so we can get to the cure?”
Why It Matters: While the internet is an excellent resource for understanding sexual health topics, it’s not a substitute for professional assessment. When you arrive with a pre-determined diagnosis, you skip the crucial step of understanding root causes.
How to Do Better: Come prepared with observations about your sexual relationship and intimacy patterns, not diagnoses. Instead of “I have HSDD,” try “I’ve noticed my desire has decreased over the past six months, especially during stressful work periods.”
The Therapeutic Truth: Sometimes “low libido” doesn’t indicate a disorder—it means you’re exhausted, stressed, disconnected from your body, or need to intentionally schedule intimate time. As a certified clinical sexologist, I use research-backed assessments (like Gottman methods) to understand your unique story, not one-size-fits-all labels.
3. Skipping Your Homework: Why Therapeutic Assignments Matter
The Scenario:
- Last week’s assignment: Spend 10 minutes, three times this week, holding eye contact with your partner without discussing logistics.
- This week’s update: “We were really busy. I did organize my sock drawer though—very therapeutic!”
Why It Matters: Therapeutic assignments aren’t busywork; they’re the bridge between awareness and action. They represent the single most important factor in your progress toward deeper intimacy and sexual satisfaction.
How to Do Better: Think of assignments as investments in your relationship. If time is genuinely tight, communicate that during the session so we can modify the exercise. Start small but commit to consistency.
The Therapeutic Truth: Healing from infidelity, rebuilding trust, or overcoming sexual difficulties doesn’t happen through conversation alone. You have to practice new patterns of connection. Skipping homework means paying for the same conversation week after week with zero forward momentum.
4. The Avoidance Dance: Staying Focused on What Matters
The Scenario: You schedule a session to address why you haven’t been intimate in six months. Twenty minutes in, we’re discussing your neighbor’s leaf blower etiquette and whether to buy organic kale.
Why It Matters: With only 50 minutes per session, tangents about peripheral frustrations eat into time we could spend addressing the emotional distance, sexual concerns, or trust issues that brought you here.
How to Do Better: Notice when you’re deflecting. Vulnerability is uncomfortable—that’s why we avoid it with stories about leaf blowers. When you catch yourself wandering, pause and ask: “Am I avoiding something scary right now?”
The Therapeutic Truth: Those tangents aren’t random; they’re protective mechanisms. As your therapist, I’ll gently redirect us back to the core issue, but your awareness of the pattern accelerates the healing process. The scary, vulnerable thing you’re avoiding is exactly what we need to talk about.
5. Hidden Agendas: Honoring Therapeutic Transparency
The Scenario: “I need you to write a letter confirming my diagnosis of sexual aversion disorder. It’s for… work benefits.”
Why It Matters: I’m here to serve your relationship health and sexual wellness, not to provide legal documentation for non-therapeutic purposes. When the real agenda involves insurance claims, custody battles, or proving your partner is “the problem,” it compromises the entire therapeutic process.
How to Do Better: Be transparent about your needs and motivations from the start. If you have legitimate concerns about disability benefits or legal matters, discuss them openly so we can determine the appropriate professional support.
The Therapeutic Truth: Therapy works best when both parties are honest. I work with couples navigating infidelity recovery, out-of-control sexual behaviors, consensual non-monogamy, trauma, and PTSD—all topics requiring deep trust and transparency. Without honesty, healing cannot happen.
What Great Clients Do: Your Roadmap to Therapeutic Success
Despite these frustrations, the majority of my clients are wonderful humans doing brave, vulnerable work. Here’s what the most successful clients have in common:
- They show up consistently, even when it’s uncomfortable
- They complete their assignments, viewing them as relationship investments
- They bring curiosity instead of rigid self-diagnoses
- They stay focused on the core intimacy and sexual issues
- They communicate honestly about their needs, fears, and goals
Why This Work Matters
Whether you’re recovering from infidelity, addressing low libido, navigating consensual non-monogamy, healing from sexual trauma, or simply wanting to deepen your intimate connection, the therapeutic journey requires partnership between client and therapist.
My approach combines compassionate, research-based methods with practical exercises designed to create lasting change. I specialize in working with couples, individuals, and military populations facing challenges including:
- Infidelity recovery and rebuilding trust
- Sexual desire discrepancies and low libido
- Sex addiction and out-of-control sexual behaviors
- Trauma and PTSD affecting intimacy
- Consensual non-monogamy and kink exploration
- Same-sex relationship challenges
- Low sexual confidence
- Intrusive sexual thoughts
The goal isn’t perfection, it’s progress. It’s about becoming whole, healthy people cognitively, spiritually, emotionally, physically, socially, and sexually.
Ready to Invest in Your Relationship?
If you’re ready to rebuild trust, restore passion, and navigate intimacy challenges with a compassionate professional guide, I invite you to schedule a consultation.
My virtual practice ensures privacy, convenience, and accessibility for clients nationwide. Together, we’ll use evidence-based tools to understand your unique story, take meaningful action, and create sustainable progress toward the healthy, fulfilling relationship you deserve.
Schedule a Consultation:
- Phone: (425) 666-9152
- Email: [email protected]
- Website: Love and Intimacy by Erin
Erin A. Alexander, LPC-S, Certified Clinical Sexologist (#18193), specializes in helping couples and individuals overcome sexual concerns, intimacy struggles, and relationship transitions. Her compassionate, research-based approach focuses on creating lasting change so you can build the connection and intimacy you deserve.