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The Self of the Christian TherapistDoing Sex Therapy: A Model forTraining Christian Sex TherapistsBrie Ann Turns a , Sarah J. Morris a & Nicole Ann Lentz aa Marriage and Family Therapy Program, Purdue UniversityCalumet, Hammond, USAVersion of record first published: 12 Feb 2013.

To cite this article: Brie Ann Turns , Sarah J. Morris & Nicole Ann Lentz (2013): The Self of theChristian Therapist Doing Sex Therapy: A Model for Training Christian Sex Therapists, Sexual andRelationship Therapy, DOI:10.1080/14681994.2013.765557

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The self of the Christian therapist doing sex therapy: a model for

training Christian sex therapists

Brie Ann Turns*, Sarah J. Morris and Nicole Ann Lentz

Marriage and Family Therapy Program, Purdue University Calumet, Hammond, USA

(Received 9 October 2012; final version received 7 January 2013)

Upon a thorough review of the literature, the authors failed to find sufficient informa-tion and resources for Christian therapists conducting sex therapy. Our intent is to pro-vide a model for self-of-the-therapist work for both therapists and their supervisors.The model includes various worksheets for self-reflection and different considerationsfor the Christian therapist to review. The model is rooted in the theoretical tenets ofNarrative and Bowen Family Systems theories. The authors use the ideas of under-standing our dominant story and lenses from Narrative theory and differentiation andtaking an I-position from Bowen Family Systems theory. We begin by giving a briefhistory of the relationship between Christianity and sexuality, highlight the importanceof self-of-the-therapist work, and explain the rationale for use of Narrative and Bowentheories. Finally, we present our model, which includes several worksheets for use insupervision or independently by the therapist.

Keywords: sex therapy; Christian therapist; therapist self-care

Introduction

Therapists have a responsibility to explore and define their own personal beliefs and values.

Without a process of self-of-the-therapist work, therapists have the potential to engage in

transference or counter-transference with their clients (Epstein & Feiner, 1979). Religion or

lack of religion tends to shape people’s general beliefs and values. About 78% of the US pop-

ulation identifies themselves as Christian, 5% of another religion and 16% with no religion

(Pew Research Center, 2007). Based on these statistics, the chances that therapists will have

a client who is Christian during their career are extremely high. The chances that therapists

themselves also identify as Christian are also high. As such, it is important that therapists ex-

plore their own beliefs and values so that they may identify areas that may be sensitive or

difficult for them to discuss. In order to avoid a therapist’s own issues getting in the way of

sex therapy with clients, it is important for therapists to consider their own views and beliefs

about sexuality and therapy. Virtually nothing is written in scholarly journals that addresses

self-of-the-therapist work for Christians doing sex therapy. The model proposed in this paper

will serve as a beginning discussion and a tool for therapists and supervisors alike as they

engage in self-of-the-therapist work for a Christian therapist doing sex therapy.

Sexuality and Christianity

The relationship between Christianity and sexuality is long and complicated and there is

no one accurate account. It is beyond the scope of this paper to cover all the issues of

*Corresponding author. Email: baturns@yahoo.com

� 2013 College of Sexual and Relationship Therapists

Sexual and Relationship Therapy, 2013

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looking at sexuality through a Christian lens, but in order to provide some context for the

subject a brief overview is necessary. The history of Christianity addressing issues of sex-

uality has been characterized by a sense of shame and oppression. In some teachings and

writings of Christianity, Christians have been made to feel shame if their sexuality is

expressed outside of the context of marriage (Jones, 1996). Some teachings encourage

Christians to only engage in sexual acts for the purpose of procreation and to only per-

form sexual intercourse (Curan, 1987). There are many ways to read and interpret the Bi-

ble, which is the main source that Christians use as a guide for life. These ideas have left

current church leaders to grapple with questions of how unmarried Christians should han-

dle their sexuality or how married couples should view sex and intimacy. Even after

many discussions, writings, and teachings about the topic of Christianity and sexuality,

there is still not a consensus for the way Christians should view sexuality, which can vary

from culture to culture (McGoldrick, Loonan, & Wohlsifer, 2007). We will now briefly

take a look at how sexuality has been viewed in Christianity historically, starting with the

Bible as the original source. We will then highlight the main ways different denomina-

tions within Christianity view sexuality in present day.

Historical context

In order to understand one way many Christians are approaching their views of sexuality,

we will first consider the Bible. Even the way we are discussing how the Bible views sex-

uality comes from lenses of the teachings we have received, but it is the basis for our

work in examining our own beliefs and how it may affect our work as sex therapists. In

the Bible, sex is talked about as a positive and wonderful, God-given gift (Piper, 2009).

God created human beings with the ability to engage in sexual acts and He called it some-

thing “good” (Genesis 1:31, New International Version [NIV]). He commands humans to

engage in sexual relationships with each other in order to procreate and to be naked and

intimate with one another without experiencing shame (Genesis 1:28; Genesis 2:25,

NIV). After the “fall of man,” or when sin entered the world, humans fell from the grace

and perfection of God and held a different view of sexuality. It was now seen as an act to

be completed between husband and wife (Piper, 2009). With the restoration of men to the

grace of God, humans were given the view of sexuality that God intended where sexuality

and religion were not separate (I Corinthians 6:16–17, NIV). The resurrection of Jesus

Christ can now be seen as a new covenant between God and man and now men and wom-

en are seen as equals (Harris, 2007), and humans are encouraged to celebrate sexuality in

marriage including, but not limited to procreation (Piper, 2009; Proverbs 5:18-19, NIV).

Although this is the journey that the view of sexuality has taken from the perspective of

the Bible, there is no guarantee this is the way all Christians view sexuality. It can be

beneficial for therapists who identify as Christian to consider the Biblical context for

sexuality and also the influence of the various interpretations of what the Bible says about

sexuality (Fowler, 1999).

There has been a lack of a balance in the view of sexuality within Christian teachings

and practices that have developed from interpreting the Bible. Some Christians advocate

for a very restrictive sexuality where only married couples can engage in sexual inter-

course and that sex should not be talked about at all because that will only encourage peo-

ple to engage in sex outside of marriage (Jones, 1996). On the other hand, some Christians

believe there should be a rather open approach to sexuality and that it is something to be

talked about and understood. Until the last 30 years, sex in the majority of Christian tradi-

tions was viewed as sinful and unclean (Jones, 1996). Regardless of what the actual

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instructions of the Bible say about sexuality, it is more important to look at the way it has

been interpreted and how people have understood what is being said about sexuality.

This is an important distinction between actual original text and interpretation because

the Bible has historically been used to oppress different races and women and to encour-

age a patriarchal society and female submission (McGoldrick, 2005). All of these views

are important to consider while attempting to understand what views Christian clients

may be coming in with and even perspectives that therapists who identify as Christian

may have without even realizing the historical context of their beliefs.

In some historical references, Christianity holds the viewpoint that humans have to

overcome their sinful human urges (including sexual ones) and aim for a higher spirituali-

ty that transcends the desires of the flesh (McGoldrick, 2005). In this viewpoint, sex and

spirituality are seen separately. It can lead to Christians believing all sexual acts are

wrong or there is an obligation to have sex in marriage in order to obey the Biblical com-

mandment to procreate.

Current status

Popular media sources for Christians have begun addressing questions of sexuality in a

modern way that still aligns with Christian teachings and beliefs. Christian writers have

decided that it is a topic worth writing about. One recent article entitled “The Secret

Sexual Revolution” discusses how the majority of Christian singles report having sex or

engaging in various sexual acts outside of marriage (Tyler, 2012), despite the fact that

the traditional standard has been for Christians to wait until they get married. In the arti-

cle, authors speculate about why this new trend is happening. One of the hypotheses is

the fact that Christian churches are not discussing sex in a manner that is conducive to

people thinking critically about their sexuality and that people are wondering whether

or not the Bible is outdated for life in the twenty-first century (Tyler, 2012). Again, al-

though the starting place for considering sexuality is the Bible, people have moved on

to consider an interpretation that fits with their current lifestyle. It is a reality that peo-

ple who come from a religious background must consider how religion affects their

beliefs and actions. Although the pendulum swings back and forth between conservative

and liberal Christian viewpoints of sexuality, it seems that the current trend is to be

open to discussing Christianity and sexuality and helping people to create fulfilling sex-

ual relationships within marriage.

Even within different denominations of Christianity, there are discrepancies with how

Christians view sexuality. While some more orthodox denominations may have strict

views on sexuality, such as Irish Catholic or Greek Orthodox, other more liberal denomi-

nations, such as non-denominational, Evangelical or Italian Roman Catholic, will typical-

ly be more willing to engage in discussions about sexuality and have an open view

(McGoldrick, Loonan, & Wohlsifer, 2007; Petry, 2010). A therapist’s religious denomi-

nation can thus influence how comfortable he or she is with the topic of sexuality and

how willing the therapist is to explore one’s own viewpoints. From our perspective, we

tend to be from more liberal Christian denominations and believe that it is important to

discuss sexuality, and we believe that God intended us to enjoy and explore our sexuality.

As previously stated, beginning to address the topic of Christianity and sexuality is

daunting at best, impossible at worst. It is difficult to encompass over a thousand years of

ideas that influence beliefs that people hold about their spirituality, view of self, and view

of the world. Even in our construction of this paper, we enter it with our own biases.

We acknowledge that this is an incomplete background on Christianity and sexuality, but

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also feel it important in this paper to at least start the conversation about sex therapy and

Christianity.

Self-of-the-therapist

Timm and Blow (1999) wrote: “Self-of-the-therapist work is the willingness of a therapist

or supervisor to participate in a process that requires introspective work on issues in his or

her own life, that has an impact on the process of therapy in both positive and negative

ways” (p. 333). Some of the leading pioneers of the marriage and family therapy field

(Aponte, 1982; Bowen, 1978; Napier & Whitaker, 1978) believe that self-of-the-therapist

work is vital to the therapeutic process and believe that therapists are better equipped to

focus on their clients’ needs when they are more secure with their own issues and belief

system. We believe that if a therapist does not acknowledge his or her beliefs and issues,

the therapist can encounter severe consequences such as burn-out, transference and uneth-

ical therapy.

“The personal growth of therapists should always be a goal for all therapists in an ef-

fort to free themselves of old hang-ups that impede good therapy, and to grow in personal

insight and emotional maturity to bring a more complete self to the therapeutic encoun-

ter” (Aponte & Carlsen, 2009, p. 404). As therapists, we have the wonderful privilege of

assisting clients through very difficult times in their lives. With this privilege comes the

challenge of caring for others while trying to continue to care for ourselves. We believe

that it is vital for Christian therapists to have various self-of-the-therapist activities that

they may partake in to help alleviate the trials that come with helping others who hold

beliefs that may or may not coincide with their own. If therapists are unable to grow per-

sonally and strive for emotional maturity, therapists may not be providing a complete

form of themselves when working with clients (Aponte & Carlsen, 2009).

Yet despite the importance of self-of-the-therapist work, we were unable to find any

material that was designed specifically for Christian therapists. Sori, Biank and Helmeke

(2006) identified activities designed for therapist spiritual “self-care,” such as the follow-

ing: meditation, prayer, conducting a personal moral inventory, exploring one’s attach-

ment to God, identifying our spiritual coping styles and speaking with clergy.

Unfortunately, before one can begin these self-care activities, one must first discover

what topics and notions one is having a difficult time with and why.

Therapist’s self-disclosure

In addition to the idea of exploring self, we postulate that self-disclosure may arise and be

a sensitive topic to address. Approximately 90% of therapists self-disclose information to

their clients (Edwards & Murdock, 1994; Pope, Tabachnick, & Keith-Spiegel, 1987).

However the repercussions of disclosing information are unknown due to the wide variety

of results from one study to the next. Unfortunately, the authors have not been able to find

material specifically discussing Christian therapists’ self-disclosure towards their clients.

When discussing spirituality with clients, there are many different opinions in the

field. Tan (1996) supports the notion that therapists should include their beliefs on reli-

gious and spiritual issues during the informed consent process. Rizzuto (1996) believes

that a therapist should not disclose his or her religious affiliation, belief or any other per-

sonal information. Debates regarding the appropriateness of disclosing one’s religion are

far from being over. Whether we, as therapists, chose to self-disclose our religious back-

ground, Jones (1996) states that it is impossible for a therapist to separate his or her

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religious values and beliefs while conducting therapy. However, when considering self-

disclosing to clients, Stricker (2003) states that therapists need to consider whether the

self-disclosure is occurring for the needs of the client or the needs of the therapist. Having

this patient-centered approach can influence whether the therapy being conducted is ethi-

cal or not.

Lindgren and Coursey (1995) found that only half of clients surveyed who wanted to

discuss their spiritual beliefs felt comfortable to do so. We, as therapists, need to make

note that not discussing our or our client’s spiritual beliefs could harm clients and the

therapeutic relationship. Therapists may be more unlikely to discuss religious or spiritual

issues due to their own beliefs. This may be especially true if the therapist has had a nega-

tive religious experience (Helmeke & Bischof, 2002). Acknowledging this possibility fur-

thers the importance of therapists discussing and exploring their religious and spiritual

beliefs by utilizing the model provided.

Our lenses and our life: applying Narrative and Bowen Theory

As previously discussed, the purpose of this paper is to begin a discussion of the various

personal and professional issues that a Christian therapist may face while providing sex

therapy to clients. Sex is a topic that until relatively recently was typically considered pri-

vate by our culture. This sense of privacy is only amplified in the context of the Christian

community. We believe that although this topic is complex and controversial, the insight

that may be gained by broaching this topic is worth the effort.

In beginning to explore the self-of-the-therapist issues that may arise in conducting sex

therapy, we are approaching it from the viewpoint that we, as therapists, will be viewing

our clients through our lenses if we are not sensitive to ourselves and sensitive to our cli-

ents. We utilize the term “lenses” throughout this paper to correlate with the narrative per-

spective and emphasize the importance that individuals do not observe or think about a

situation in one universal way, but rather several fluid modes. We believe we must engage

in intensive self-exploration, supervision and differentiation in order to avoid misunder-

standing or labeling our clients, while at the same time following our personal spiritual

beliefs and convictions. We believe that if we are not willing to begin exploring our per-

sonal viewpoints as Christian therapists, we are doing a tremendous disservice to our cli-

ents, who are already in a vulnerable position as they seek sex therapy. Additionally, we

could be doing a disservice to ourselves if we refuse to begin exploring the sensitive sub-

jects that repeatedly arise in therapy – such as sex – that are undoubtedly affecting us as

therapists. As Langberg (2006) put it, “Therapists are profoundly impacted by the suffering

and evil with which they sit. We become like that which we habitually reflect”

(p. 258). Because therapists are in a problem-saturated environment that can be draining, it

is important to engage in self-of-the-therapist work as a therapist, a Christian and a person.

Therefore, we will be referring to the major tenets of Narrative theory (White & Epston,

1990) and Bowen Family Systems theory (Bowen, 1978; Kerr & Bowen, 1988) to suggest

conversations and activities that may aide therapists in personal and professional explora-

tion of the subjects of Christianity and sex in the context of therapeutic work.

Explanation for use of Narrative Theory with self-of-the-therapist work

Carlson and Erickson (2001) stated, “Some self-of-the-therapist traditions in train-

ing/supervision tend to be deficit or pathology based by centering training around encour-

aging the new therapist to ‘deal with’ their personal ‘issues’” (p. 201). While this in

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essence is important, we do not believe it is necessarily the most comprehensive approach

to self-of-the-therapist work. Considering the aforementioned definition of “self-of-the-

therapist traditions” used in training and supervision, we are hesitant to label a therapist’s

Christian belief system as a personal “issue” that they need to “deal with.” Nevertheless,

these lenses are something we as therapists need to be aware of within ourselves and our

clients in order to reduce the risk of doing harm. So what is a Christian therapist to do?

Surely, we are not expected to just “deal with” this “issue.” After all, our Christian duties

would at one level convict us to remain steadfast in our faith and, at another level, expect

us to stay true to those convictions while accepting the varying positions of others. The

following will begin our exploration of applying Narrative Theory to the topic of self-of-

the-therapist work for the Christian therapist.

The core tenet of Narrative Theory is that people organize reality into stories, which

inform them of the meaning of their lived experiences (White & Epston, 1990; White,

2007). This tenet points to the fact that people, including therapists, view other people

and the world around them through their own lenses. These lenses are formed from a

history of dominant stories and a combination of many lived experiences. We as thera-

pists enter into the therapy room with our own lenses. During the beginning of our train-

ing and careers as therapists, we may still lack the awareness of the power of these lenses

in the therapy room. Each person’s lenses incorporate biases, past experiences, present

and past relationships, personal values and, in many cases, spiritual or religious back-

grounds. As the focus of this paper is Christianity and sex therapy, we will focus on the

latter of this list. Our model will apply the basic tenets of Narrative Theory to aide and en-

courage fellow Christian therapists in hearing and grappling with their client’s story as

they live their own.

Explanation for use of Bowen Theory with self-of-the-therapist work

When discussing Murray Bowen’s family systems theory, and specifically the core con-

cept of differentiation, Wright (2009) stated:

This [differentiation] involves the ability to remain emotionally present, engaged and nonreac-tive, in emotionally charged situations, while simultaneously expressing one’s own goals, val-ues and principles. This must be attempted without insisting or expecting that others change,and without being thrown off track by others’ disapproving or anxious reactions. (p. 29)

We, as therapists, found this to be both a thorough, precise explanation, as well as a

daunting expectation. The above is even harder to achieve when applied to the “hot top-

ics” that clients bring to therapy. Specifically applied to the situation of doing sex therapy

as a Christian therapist, this definition would involve the balance of being present and

nonreactive, while being comfortable with his or her own values and principles. Although

we know this is important to our personal and professional development, we think thera-

pists could use more specific guidelines on how to deal with the topic of sex in therapy

without damaging or compromising their own value system.

David Schnarch (1991, 1998) bridged sex therapy and Bowen Family Systems theory.

One of Schnarch’s (1998) definitions of differentiation is: “balancing two basic life

forces: the drive for individuality and the drive for togetherness. Individuality propels us

to follow our own directives, to be on our own, to create a unique identity. Togetherness

pushes us to follow the directives of others, to be part of the group” (p. 55). If a therapist

has a “lower level” of differentiation, they will be more likely to engage in

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highly dependent relationships. A higher differentiated therapist will function more

autonomously while still being in meaningful contact with others (Schnarch, 1991).

While conducting sex therapy, it is best if the therapist has a higher level of differenti-

ation. Conducting self-of-the therapist work that is proposed in this model will allow a

therapist to reflect on self, which will likely lower their anxiety while discussing difficult

issues. Therapists will also be able to model higher differentiation. The emergence of a

new level of differentiation in one person will have an impact on the development of both

individuals and enhance intimacy (Schnarch, 1991). The same impact is likely to occur

while participating in supervision. If a supervisor has a higher level of differentiation,

supervisees are likely to be impacted and both will grow in their ability to listen to others

views and beliefs and remain calm and clear-headed.

The model we are proposing will also apply the basic tenets of Bowen family systems

theory as a guide for supervisors and/or Christian therapists. The model will be useful to

both in the journey of exploring their own experiences with their family of origin, their

process of differentiation as they learn to be sensitive to themselves and their clients in

the context of sex therapy. Even though this model is geared towards Christian therapists,

one does not necessarily need to be Christian to use any of the worksheets we have pro-

vided. Discovering one’s own beliefs, values and goals while finding their dominant story

is an asset that a therapist from any religious standpoint can benefit from.

Model

Supervision discussion starters “let’s talk about sex”

Supervision is a process that has the ability to benefit many therapists. It provides a safe

environment for therapists to wrestle with notions that may coincide with their personal

beliefs, particularly topics of sex therapy. However, in many graduate programs, supervi-

sors do not discuss their or their supervisees’ religious beliefs. Martinez and Baker (2000)

discovered that if supervisees did not know what their supervisor’s religious beliefs were,

they assumed that their supervisor had an unhelpful and antireligious attitude. If supervi-

sees are uncomfortable with talking to their supervisor, this could inhibit the personal

growth of the therapist and the relationship between the supervisee and supervisor and

ethical therapy. Several authors (Haug, 1998; Helmeke & Bischof, 2002) have stated that

the lack of training regarding beliefs and practices of various religions contribute to thera-

pists viewing themselves as not capable of discussing the issues in therapy. To prevent

these ramifications, we recommend that supervisors discuss religious topics with their

supervisees, especially when sexual matters are on the table.

Before we are sitting in front of a client who has very different beliefs than our own, it

is wise that we begin the process of locating our dominant story and identify potential

anxiety. Using the information that we have presented on Narrative theory, Appendix A

provides several questions that assist with a therapist’s journey in finding his or her domi-

nant story. Other questions found on this worksheet guide a therapist in identifying topics

that could come up in therapy that have the ability to increase the therapist’s anxiety.

Follow-up questions on this worksheet are geared toward the therapist discovering ways

to self-soothe in case he or she feels anxiety is increasing. By discussing these questions,

a supervisee is able to receive help from his or her supervisor and is also forced to face

difficult topics before speaking with a client.

The worksheet found in Appendix A, “Supervision discussion starters: ‘let’s talk

about sex’,” was created to help supervisors discuss sexual topics with their supervisees.

We have found that supervisors can use this worksheet with not only Christian therapists,

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but also any supervisee struggling with client’s sexual activity. Supervisors can ask these

questions during individual or group supervision. The supervisor should give the supervi-

see as much time as necessary to answer each question effectively. The supervisor should

also take the “curious” stand-point and ask subsequent questions that they may find use-

ful. The supervisor is also able to provide the supervisee with some of the questions if he

or she would like additional time to think about the topics.

Understanding your lenses: a tool for use in supervision or

self-of-the-therapist work

As previously discussed, Narrative theory provides a great framework to approach the

task of helping Christian therapists both personally and professionally. One way to look

at how narrative theory can be applied is to think about the Christian therapist as having

“lenses” through which he or she currently view sexuality. Our lenses are made up of all

our past experiences. This includes the covert and overt messages we have received

through conversations, relationships and media exposure and the information we learned

at home, church and school. It is important that we as therapists are aware of the things

we have learned in our past about sex. It is also important that we are able to differentiate

what we have learned/been told from what we actually currently believe.

The worksheet found in Appendix B, “Understanding your lenses: what I’ve learned

and what I believe about sex”, aims to help therapists begin to sort through what they

have learned and what they currently believe to be true about sexuality. It is important

that therapists know what they believe, because being at this level of development

reduces the likelihood that they will feel threatened by clients’ opposing belief systems.

After all, in general a person who feels secure in his or her beliefs can more easily listen

to the beliefs of others without seeing it as a personal threat. This person grows from each

opportunity to wrestle with people of different beliefs and backgrounds. Similarly, this

applies to Christian therapists. It is also important that therapists know what they believe

about sex because we need to fully understand how our lenses affects our viewpoints of

and interactions with our clients.

This worksheet can be used in supervision by any therapist hoping to better under-

stand his or her beliefs about sex. The supervisor can give supervisees a copy of the work-

sheet and ask them to first fill out the things they have learned about sex and sexuality.

The supervisor can then ask the supervisees to fill out the next column with things they

currently believe about sex and sexuality. After the supervisees have completed the work-

sheet, the supervisor can begin a discussion about what this experience was like and what

was learned. This worksheet can also be used independently by therapists doing self-of-

the-therapist work. It can be used to explore the topic of sexuality in general or be used

with specific issues that may arise in sex therapy.

“Hot topics” in sex therapy

In order to understand and manage potential anxiety that a therapist may develop in the

therapy room, it is important to first understand the source of the anxiety. Within sex ther-

apy, several topics will arise that need to be discussed in order to provide best care for cli-

ents that are related to their sexual behavior and practices. Some of those topics may

cause the therapist to feel anxious or nervous about the ideas because they do not align

with the therapist’s Christian beliefs. Bowen (1978) believed that part of being differenti-

ated was being able to deal with other’s anxiety without it overwhelming us. This skill is

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an important one to have as a therapist dealing with many stressful and anxiety-provoking

situations. It is also not unusual for a therapist to experience discomfort in the therapy

room and become reactive without knowing or acknowledging what it is that is causing

him or her discomfort or anxiety.

The worksheet found in Appendix C, “Hot topics in sex therapy,” aims to help thera-

pists identify potential areas in sex therapy that may make them uncomfortable. Thera-

pists should place a checkmark next to the items that they believe do not agree with their

personal belief system or that they believe will be difficult for them to discuss in therapy

with clients. Once therapists are able to identify which areas they may struggle with, they

are better prepared to deal with anxiety they experience in the therapy room. It will also

help therapists decide which ones they will benefit from discussing with a supervisor or

other therapists. This worksheet is something that a therapist can do on their own or in

the context of individual or group supervision. Therapists can complete it on their own

when they have time to carefully consider what topics will cause them anxiety.

Once the therapist completes the checklist, it would be beneficial to discuss with a su-

pervisor or another therapist who could help him or her identify ways to continue to pro-

vide helpful therapy when these topics come up. There is a list of questions for the

therapist to consider once he or she has identified issues that he or she may struggle with

to identify the origin of why the issue is a “hot topic” and ways to work with the issue in

therapy. This worksheet helps create awareness for the therapist, and hopefully reduce his

or her anxiety as well.

My lenses, your sex life

Continuing with Bowen’s (1978) differentiation of self, a therapist who is well-differenti-

ated can stay calm and clear headed in the face of conflict to be able to distinguish his or

her thoughts, beliefs and emotions from client’s. The less differentiated a therapist is, the

more of an impact others have on the therapist’s functioning. Being able to clearly sepa-

rate their thoughts from the thoughts of client will allow a therapist to stay calm and clear

headed while conducting therapy with an individual who is engaging in sexual activities

that the therapist does not agree with.

The worksheet found in Appendix D, “My lenses, your sex life,” allows for the clini-

cian to write out the thoughts, beliefs and opinions that he or she and the client hold. The

therapist is also able to write out the views that he or she may share with the client. The

first component of the diagram allows the therapist to write out and visually see the differ-

ence in his or her views versus the client’s. Realizing that you and your client can hold

different beliefs will allow the therapist to not feel that his or her views are being threat-

ened by the client or vice versa. This activity will also allow the therapist to remain true

to his or herself, while providing effective therapy that is best for the client’s views and

not the therapist’s. Recognizing the difference of beliefs, views and opinions will also as-

sist the therapist in not consciously or subconsciously pushing his or her beliefs upon the

client. This activity also assists to further show the therapist that the client’s views are not

a threat to his or her personal views.

The second component of the diagram allows the therapist to write out the views,

beliefs and notions that the therapist and client share. If the therapist is only listing the dif-

ferences between his or her views and the client’s views, the therapist will neglect to see

the similarities that they share. Recognizing the similarities will also give the therapist an

opportunity to build the therapeutic relationship. For the therapist to see similar beliefs

that he or she share with the client will also help the therapist to relate better to the clients.

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Conclusion and limitations

Christian therapists experience a unique opportunity and challenge while engaging clients in

sex therapy. They have the opportunity to understand how their beliefs and faith can remain

intact while dealing with challenging issues that arise in sex therapy. Christian therapists

must be able to reconcile their beliefs about sex with the information that they are learning,

in order to provide the best treatment in sex therapy. Issues that arise in sex therapy should

not be ignored by Christian therapists and it would be most beneficial for therapists to ex-

plore their beliefs, seek supervision and engage in self-of-the-therapist work. Doing these ac-

tivities, will help therapists to reduce their anxiety, increase their level of differentiation and

understand their own lenses when it comes to sex and sex therapy.

We were unable to address issues specifically within sexuality that may be particular-

ly problematic for Christian therapists. We did not want to address any of the politics or

different thoughts regarding these topics. Our aim was to begin the dialogue and self-of-

the-therapist work for Christian therapists about the broad topic of spirituality and sex

therapy. Future research should look at the way sexuality is discussed in Christian

counseling programs and students’ level of comfort in discussing their faith beliefs while

attending secular programs with their supervisors and other students.

Starting the conversation for Christian therapists (along with other therapists) about

sex therapy and self-of-the-therapist work will be beneficial for therapists as well as their

clients. Beginning to explore our own beliefs as therapists will help reduce our anxiety

about doing sex therapy and better accept the lenses and viewpoints of our clients.

Acknowledgements

The authors would first like to thank their Lord and Savior, Jesus Christ. The authors would also liketo thank Dr. Joseph Wetchler for his continued guidance and encouragement.

Notes on contributors

Brie Turns graduated from the University of Nevada-Las Vegas with her bachelor’s in Human Serv-ices Counseling and minor in Family Studies. She will graduate from the Marriage and FamilyTherapy Program at Purdue University Calumet in the spring of 2014 with intent to pursue her PhDin Marriage and Family Therapy.

Sarah J. Morris has a bachelor’s degree from Xavier University in Psychology and Gender and Diversi-ty Studies. She will graduate from the Marriage and Family Therapy program at Purdue University Cal-umet in the spring of 2013 and plans to focus on clinical work with low-income couples and families.

Nicole Ann Lentz will soon complete her Master’s Degree in Marriage and Family Therapy from Pur-due University Calumet. She is passionate about her work and believes in the advantages of workingfrom a systemic perspective. Nicole plans to eventually open a private practice in her community.

References

Aponte, H. (1982). The person of the therapist: The cornerstone of therapy. Family TherapyNetworker, 46, 19–21.

Aponte, H., & Carlsen, J. (2009). An instrument for person-of-the-therapist supervision. Journal ofMarital and Family Therapy, 35(4), 395–405.

Bowen, M. (1978). Family therapist in clinical practice. New York: Jason Aronson.Carlson, T., & Erickson, M. (2001). Honoring and privileging personal experience and knowledge:

Ideas for a narrative therapist approach to the training and supervision of new therapists.Contemporary Family Therapy, 23(2), 199–220.

10 B.A. Turns et al.

Dow

nloa

ded

by [

69.2

08.1

04.1

39]

at 0

6:27

12

Febr

uary

201

3

Curan, C.E. (1987). Roman catholic sexual ethics: A dissenting view. The Christian Century.Retrieved March 3, 2012, from http://www.religion-online.org/showarticle.asp?title=113

Edwards, C., & Murdock, N. (1994). Characteristics of therapist self-disclosure in the counselingprocess. Journal of Counseling & Development, 72(4), 384–389.

Epstein, L., & Feiner, A.H. (Eds.). (1979). Countertransference. New York: Aronson.Fowler, J.A. (1999). Sex, sexuality and sexual acts. Retrieved March 12, 2012, from http://www.

christinyou.net/pages/sexuality.htmlHarris, S. (2007). Understanding the Bible (7th ed.). New York: McGraw-Hill.Haug, I. (1998). Including a spiritual dimension in family therapy: Ethical considerations. Contem-

porary Family Therapy, 20, 181–194.Helmeke, K., & Bischof, G. (2002). Recognizing and raising spiritual and religious issues in thera-

py: Guidelines for the timid. Journal of Family Psychotherapy, 13, 195–214.Jones, S. (1996). A constructive relationship for religion with the science and profession of psychol-

ogy: Perhaps the boldest model yet. In E. Shafranske (Ed.), Religion and the clinical practice ofpsychology (pp. 113–147). Washington, DC: American Psychological Association.

Kerr, M., & Bowen, M. (1988). Family evaluation. Ontario: Penguin.Langberg, D. (2006). The spiritual life of the therapist: We become what we habitually reflect. Jour-

nal of Psychology and Christianity, 25(3), 258–266.Lindgren, K., & Coursey, R. (1995) Spirituality and serious mental illness: A two-part study. Psy-

chosocial Rehabilitation Journal, 18, 93–111.Martinez, S., & Baker, M. (2000) “Psychodynamic and religious?” Religiously committed psycho-

dynamic counselors, in training and practice. Counseling Psychology Quarterly, 13, 259–264.McGoldrick, M. (2005). Irish Americans. In M. McGoldrick, J. Giordano, & N. Gatcia Preto (Eds.),

Ethnicity and family therapy (3rd ed., pp. 595–615). New York: Guilford Press.McGoldrick, M., Loonan, R., & Wohlsifer, D. (2007). Sexuality and culture. In S. Leiblum (Ed.),

Principles and practices of sex therapy (pp. 416–441). New York: Guilford Press.Napier, A.Y., & Whitaker, C. (1978). The family crucible: The intense experience of family therapy.

New York: Harper.Petry, S. (2010). Spirituality and the family life cycle. In M. McGoldrick, B. Carter, & N. GarciaPreto

(Eds.), The expanded family life cycle (4th ed.). Boston, MA: Allyn & Bacon.Pew Research Center. (2007). Key findings and statistics on religion in America. The Pew Forum on

Religion and Public Life. Retrieved March 20, 2012, from http://religions.pewforum.org/reportsPiper, J. (2009). This momentary marriage. Wheaton, IL: Crossway Books.Pope, K.S., Tabachnick, B.G., & Keith-Spiegel, P. (1987). Ethics of practice: The beliefs and

behaviors of psychologists as therapists. American Psychologist, 42, 993–1006.Rizzuto, A. (1996). Psychoanalytic treatment and the religious person. In E.P. Shafranske (Ed.),

Religion and the clinical practice of psychology (pp. 409–431). Washington, DC: AmericanPsychology Association.

Schnarch, D. (1991). Constructing the sexual crucible. New York: WW Norton.Schnarch, D. (1998). Passionate marriage: Love, sex and intimacy in emotionally committed

relationships. New York: Norton.Sori, C., Biank, N., & Helmeke, K. (2006). Spiritual self-care of the therapist. In K. Helmeke & C. Sori

(Eds.), The therapist’s notebook for integrating spirituality in counseling: Homework, handoutsand activities for use in psychotherapy (pp. 89–112). Binghamton, NY: Hawthorn Press.

Stricker, G. (2003). The many faces of self-disclosure. Journal of Clinical Psychology, 59(9), 623–630.Tan, S. (1996). Religion in clinical practice implicit and explicit integration. In E.P. Shafranske

(Ed.), Religion and the clinical practice of psychology (pp. 365–387). Washington, DC:American Psychological Association.

Timm, T., & Blow, A. (1999) Self-of-the-therapist work: A balance between removing restraintsand identifying resources. Contemporary Family Therapy, 21(3), 331–351.

Tyler, C. (2012). The secret sexual revolution. Relevant Magazine. Retrieved: March 5, 2012, fromhttp://www.relevantmagazine.com/life/relationship/features/28337-the-secret-sexual-revolution

White, M. (2007).Maps of narrative practice. New York: WW Norton.White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: WW Norton.Wright, J. (2009). Self-soothing: A recursive intrapsychic and relational process: The contribution

of the Bowen theory to the process of self-soothing. Australian and New Zealand Journal ofFamily Therapy, 30(1), 29–41.

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Appendix A. Supervision discussion starters “let’s talk about sex”

1. Thinking about doing sex therapy with clients, where do you foresee potential roadblocks?2. What about these roadblocks are bothersome to you?3. What did you learn from your family about these topics?4. How do you believe your faith could benefit you as a therapist? How could it benefit your

clients?5. How do you believe your faith could be a detriment or liability to you as a therapist? How

could it benefit your clients?6. What are your fears or concerns in working with people who have a different faith

background?7. What do you believe about self-disclosure of personal views about sex in therapy (e.g. mas-

turbating, pornography)?8. What are some things you could do to make sure you aren’t negatively impacted by work-

ing with clients who have different views than yours?9. What resources do you have when you feel challenged or anxious about doing sex therapy

(who can you talk to?)10. What is your experience like as a Christian in a secular setting, when discussing sex or sex

therapy?11. What would you like me to know as your supervisor as a Christian doing sex therapy?

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Appendix B. Understanding your lenses: what I’ve learned and what I believe

about sex

Things I’ve learned from church, parents, spiritualadvisors, friends, the Bible, books, etc. about sex Things I currently believe about sex

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Appendix C. “Hot topics” in sex therapy

Questions to consider:

� Take time to define and discuss the meaning for you behind the terms you checked.

� What bothers you about these items?

� What emotions arise for you as you think about the items that you checked?

� What would be your initial reaction if one of these items was brought up in the therapy room?

& Abortion & Pedophilia& Anal Sex & Polyamorous relationships& Atheism & Pornography& Birth control & Premarital sex& Bisexuality & Recreational sex (sex outside of procreating)& Cohabitation & Sadomasochism& Divorce & Same-sex relationships& Fetishes & Sex positions& Infidelity & Sex toys& Incest & Strip clubs& Lust & Swinging&Masturbation &Transgender/sexual& Oral sex &Other/________

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Appendix D. My lenses, your sex life

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