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by: Dr. Sadie Sheafe, Ph.D., LCSW, ABSDip

For the patient, psychotherapy is the treatment of emotional or behavioral problems designed to encourage communication of conflicts and insight into their problems; the goal being relief of symptoms and changes in behavior leading to improved functioning.

Our expression, experience, and meaning of sexuality and intimacy are dynamic and fluctuate throughout the lifespan, changing over time as we age. At different ages the experience of sexual satisfaction changes. People that are 50 are not looking for the same things in their relationships of intimacy as they did when they were 25. Our sexuality changes as our experiences increase; according to Laumann, Paik, and Rosen, authors of Sexual Dysfunction in the United States: Prevalence and Predictors, satisfaction with sexual life, attitudes about sexuality, and self-rated sexual performance vary by age, gender, and partnership status. Other factors, such as generational effects, religiosity, and health also influence the quality of the individual’s sexual life. Sexual well-being has important implications for health. In an article, ‘Sexual Health: Counseling in Primary Care’ Diane Seibert, (2001) states, sexual intimacy can be a powerful, emotionally “connecting” event that is associated with positive physical benefits. The act of orgasm releases endorphins and dopamine, resulting in a deep sense of relaxation and feeling of well-being. However, sexual satisfaction eludes many people. Sexual dysfunctions are complex, having different meanings for individuals and cultures.

The DSM-IV-TR(5th edition) the diagnostic statistical manual of mental disorders, notes all of the different psychiatric problems listed in the United States; this manual lists all categories of mental disorders and the criteria for diagnosing them, this includes Sexual and Gender Identity disorders. Mental health professionals use this book to help communicate a patient's diagnosis after an evaluation. Our sexual function is an important component and indicator of overall health and well-being; sexual problems or dysfunction may result from, or even cause, physical or mental illness or deterioration in important social relationships.

Barring genetic and physiological causes, most mental conditions stem from abuse or trauma that occurred at some point in the patient life. Many patients bury these conditions as a defense apparatus or coping mechanism. In order to uncover and treat these conditions it is necessary for the trained therapist to begin treatment “where the patient is”. Many times the presenting problem may mask the real problem.

Sexual satisfaction is an important aspect of adult life. Sexual problems can cause individuals to suffer many adverse reactions that affect their sense of well being. Clinicians must ask the right questions in order to guide successful intervention in situations where sexual functioning is not optimal.

I welcome your comments or feedback

Dr Sadie Sheafe. Ph. D.,LCSW. ABSDip, is a Board Certified Clinical Sexologist, American Board of Sexology Diplomate, and Licensed Clinical Social Worker; Certified in Cognitive Behavioral Therapy and Dialectical Behavioral Therapy, she currently serves as the Chairman on the Virginia Legislative Committee for the National Association Social Work (NASW); and am Regional Representative for Hampton Roads, Virginia.  She is also Chairman of the Department of Veterans Affairs Social Work Professional Standards Board, for the South East Region of Virginia and an Adjunct Professor at Norfolk State University in the Doctoral and Masters Degree Programs for Social Work.  Dr Sheafe is a member of the American Board of Clinical Sexologists and the American Association of Sexuality Educators, Counselors and Therapists (AASECT).  Since 2008 she was appointed to the Mental Health Advisory Council Board for the city of Portsmouth, Virginia and also elected to the State Board of Directors for NASW. Main Areas of Therapy: Marriage Counseling, Family Therapy, Alcohol-Emotional-Verbal and Physical Abuse, Sex Therapy, Erectile Dysfunction, Substance Abuse, Military Sexual Trauma Dr Sheafe has over 24 years of clinical experience in marriage and couples counseling and family therapy.  She specializes in: substance abuse treatment, drug addiction, sex therapy and couples counseling.  She can assist with recovery from emotional, verbal, physical and drug abuse.   Dr Sheafe is considered an expert on domestic violence and issues related to childhood trauma and porn addiction.  She has worked with thousands of clients throughout the United States & Europe.  She states, “I offer solid, down-to-earth guidance!” Often Dr Sheafe is called upon by litigators as an ‘Expert Witness’ for issues related to sexual trauma.  For further information please visit: As part of this clinical practice she offers phone consultation: If you live in South East Virginia and would like to schedule an in-person visit contact Dr. Sheafe at or call 757-947-7913.

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