Therapy Group of DC
Sex is the thing people decide not to bring up. Not with a partner, not with a friend, and — often for years — not with a therapist.
It might be desire that faded, or never arrived the way you expected. It might be something in your history that still shapes what happens now. It might be that you and a partner have built a careful arrangement around not discussing it. By the time people call us, the difficulty itself is often smaller than the silence that grew up around it.
Sex and intimacy therapy at our Washington DC therapy practice is exactly what it sounds like: talk therapy — about sex, desire, and closeness, for individuals and for couples. Not a technique. Not homework handed down from an expert. A room where the subject is finally on the table, with someone whose job is to keep it there when it gets uncomfortable.
Two versions of this walk through our door. One is a couple who says “we just don’t have sex anymore,” and who is usually describing something else — a resentment nobody named, a season of stress that never quite ended. The other is a person who has never said any of this out loud to anyone, and who has been carrying it alone since long before their current relationship. The work goes differently. The first move is the same.
What Sex and Intimacy Therapy Involves
Sessions are conversations. You talk about what’s happening, what it means, and what sits underneath it.
In individual therapy, that often means going back before the current situation — to what you absorbed about sex growing up, to a history that still has a say in the present, to the anxiety or shame that shows up before anything else does. Plenty of people do this work with no partner in the picture at all, and plenty do it while in a relationship without ever bringing their partner in.
In couples work, it means a therapist helping two people say things to each other that have been unsayable — slowing a conversation down enough that neither of you can retreat into the usual roles, naming a pattern out loud for the first time.
Progress tends to look less like a technique that works and more like a change in what’s possible to discuss — the difference between managing around a subject and being able to approach it.
Kevin
Keith
Kevin
Dominique
Robert
Ela
Michael
Is Sex Therapy Right for You?
People come to us with some version of the following, on their own and together. You don’t need all of them, and you don’t need a diagnosis.
Why Sex Gets Hard to Talk About
Between two people, desire discrepancies are among the most common reasons sex comes up in therapy — and among the most misread. The partner who wants more feels rejected. The partner who wants less feels pursued, then guilty, then further from wanting anything. Both experiences are real, and each makes the other worse.
Research on sexual conflict found that when couples fall into a demand-and-withdraw pattern — one pressing, one retreating — it predicted lower relationship satisfaction, lower sexual satisfaction, and higher sexual distress a full year later. The pattern does the damage, not the mismatch.
For the person carrying it alone, the story is usually older. Many people absorbed something about sex early — that it was dangerous, or dirty, or not theirs to want — and never revisited it as an adult. Add a history of trauma, or a sexuality that didn’t match what was expected, and the result is often someone who has been managing this privately for decades. None of that requires a partner to work on, and for a lot of people it’s better addressed before a partner is in the room.
Anxiety runs through both. When your mind is going — on performance, on how you look, on tomorrow’s meeting — it interferes directly with arousal and satisfaction. That’s not a character problem. It’s cognitive distraction, and it responds to the same work that treats anxiety generally.
In Washington DC that matters more than it might elsewhere. This is a city of people working long hours in high-stakes jobs who treat exhaustion as the baseline. Sex is often the first thing deprioritized and the last thing anyone admits is missing.
How We Approach Sex and Intimacy
Individual therapy
Shame, trauma history, anxiety, and questions about your own sexuality are often better approached on your own first — sometimes only on your own. You don’t need a partner, and you don’t need your partner’s participation, to do this work.
Emotionally Focused Therapy
Attachment-based couples work. A 2025 randomized trial found EFT significantly reduced shame and increased intimacy — shame being the thing that makes vulnerability feel impossible and self-disclosure feel dangerous.
Learn More →Integrative
Most of our therapists draw on several approaches rather than one. What you’re carrying determines the method, not the other way around.
We don’t make assumptions about who you are or what good sex looks like. Our therapists work with LGBTQ+ individuals and couples and with every orientation and identity — the work is defining a sexual life on your own terms, not measuring it against someone else’s. If identity or orientation is closer to the center of what you’re carrying, our LGBTQ+ therapy page goes deeper.
You've Already Done the Hard Part
Deciding to talk about this at all is the step many people never take.
What to Expect
Getting oriented
The first sessions are about understanding what’s happening and how you experience it. Nobody is put on the spot, and nothing is required of you in the first hour beyond showing up. If you’re coming as a couple, your therapist will usually want some time with each of you separately.
Building understanding
The pattern usually becomes visible before it changes — the sequence that leads to withdrawal, the belief underneath the shame, what the pursuit is actually asking for. Naming it is most of the work.
Active change
This is where things get tried differently. Saying what you want without bracing for a reaction. Noticing the old story start up and not following it. Being turned down without it meaning something catastrophic.
Integration
Sessions space out. The aim is that you can hold these conversations without a therapist in the room — because the ability to raise it at all is what protects you long after therapy ends.
Sessions are 45 minutes and available in our Dupont Circle office or by secure video anywhere in DC, Maryland, and Virginia. For couples work, we generally recommend meeting in person when you can; individual sessions translate well to either format.
Our Sexuality & Intimacy Therapists
The therapists below do this work — some with couples, some individually, several in both. Sex, desire, and intimacy are a regular part of their caseloads, not an occasional exception.
