Sexual Self-Help Usually Works

I have tremendous respect for most sex therapists, but not all—and particularly not those who malign sexual self-help. Some years ago, at a meeting of the nation’s largest sexuality organization, I attended a panel discussion on the pros and cons of self-help. One panelist, a distinguished sex therapist, dismissed it as totally ineffective: “I have a steady parade of new clients who tell me self-help didn’t work for them.”

Well, duh. When self-help works, people have no reason to consult sex therapists. In addition to being myopic, this therapist had also failed to keep up with the research. Many studies show that self-help approaches—books (“bibliotherapy”) and/or videos—usually improve lovemaking and sexual satisfaction.

Self-Help Produces Real Benefits

Full disclosure: Over the past 43 years, yours truly has published three sexual self-help books. Curious about my latest? See my blogger profile. I’m a big believer in sexual self-help for two reasons. As a young man navigating then-new sexual relationships, I found one book quite valuable: Human Sexual Inadequacy (1970) by William Masters, M.D., and Virginia Johnson, the book that invented sex therapy. In addition, my three books have elicited hundreds of thank-you notes.

The research shares my opinion. It shows that for most people with a broad range of sex problems, self-help works almost as well as professional therapy.

Much of the research on sexual self-help has been conducted in the Netherlands by Jacques J. van Lankveld, a professor of psychology at Maastricht University:

• Van Lankveld and colleagues assigned 50 men with erectile dysfunction (ED) and 40 men with premature ejaculation (PE) to either a waiting list or to a website that outlined standard sex therapy approaches to dealing with these problems. After six months, the men on the wait list reported scant improvement. But among those who used the website, half reported significant benefit.
• Van Lankveld’s team recruited 117 women suffering vaginismus, vaginal muscle spasms that cause pelvic pain and make intercourse difficult or impossible. The women were randomized to a waiting list, a self-help book (with six brief phone consults with a therapist), or professional group therapy (10 two-hour sessions). After one year, no one on the wait list reported improvement. In the self-help group, 15 percent said they could have intercourse comfortably, among those in the group therapy, 21 percent. Self-help with minimal professional support produced almost the same benefit as 20 hours of group therapy.
• Van Lankveld offered other men with PE or ED 12 weeks of web-based sex information and brief e-mail Q&A. Months later, two-thirds reported significant improvement.

Other researchers have also found that self-help approaches offer real benefits for sex problems:

• One of women’s leading sexual complaints is little or no interest in sex. University of Florida researchers placed 22 low-libido women on a waitlist and gave 23 others a self-help book, A Tired Woman’s Guide to Passionate Sex by sexologist Laurie Mintz, Ph.D. It presents a self-help version of sex therapy for low libido. In the wait-list group, 5 percent reported increased desire, among the book users, 54 percent. Meanwhile, among low-desire women, sex therapy usually helps some 50 to 60 percent while, depending on the study, drug treatment (flibanserin) helps 15 to 50 percent. So the self-help book was approximately as effective as drug or professional therapy—but it was cheaper, easier, and caused no side effects.
• German researchers assigned 70 women with vaginismus to a waitlist or to a website that provided information and other recommendations. After six months, the self-help group reported significantly less discomfort and more enjoyable sex.
• Finally, researchers at Concordia University in Illinois analyzed 70 studies of do-it-yourself approaches to a variety of issues. Self-help showed little benefit for weight loss and drug addiction, but remarkable effectiveness for sex problems.

Why Self-Help Helps

It’s no surprise that sexual self-help usually works. A great deal of sexual misery stems from a lack of information or mistaken beliefs. With authoritative information, many people benefit quickly.

It’s also no surprise that professional therapy works somewhat better. Therapy can be tailored to individual needs, and many studies show that, independent of the therapy itself, a supportive, face-to-face relationship with a trusted professional is beneficial. But in a nation of 275 million adults, sex therapists and coaches number only a few thousand, and their services cost more than many can afford. Self-help resources are easily accessible and often work almost as well as professional therapy for the price of a pizza.

Self-help resources provide noticeable benefits to more than half of those who try them. For the other half, sex coaching or therapy help about two-thirds. This leaves around 30 percent of sexual issues largely untreatable—usually because of severe medical conditions or psychological challenges.

If You Have a Sex Problem

• Start with the internet, but beware. There’s a great deal of excellent sex information online—for example, the sexuality posts on Psychology Today. But there’s also a great deal of nonsense disguised as credible information. Sometimes it’s difficult to distinguish the good from the bad. Look for research citations—and not just one study, but several. Look for writers who have no agenda other than helping. Think twice before giving much credence to information provided by those who believe that pornography is evil and that “sex addiction” is rampant.
• Try a self-help book or two. Many provide practical, reasoned, research-based information. Unfortunately, some are wanting, especially books that claim to cure sex/porn addiction.
• Try some videos. By far the best source for authoritative sexuality videos is SexSmart Films. For one reasonable price, you obtain access to a library of 600 videos viewable on any device. SexSmart is the single best source of entertaining, enlightening sex information.
• If self-help doesn’t resolve things to your satisfaction, and you’re basically okay but have questions or want counseling, try a sex coach. Sex coaches are sexologically trained counselors who can help singles and couples with sexual issues uncomplicated by significant relationship issues.
• If your sexual issues also involve significant relationship strains, consult a sex therapist. Sex therapists are psychotherapists with extra training in sexual issues. They provide both relationship therapy and insights into sex problems. Sex therapists do not have sex with you and do not watch you have sex. They rely on face-to-face or Zoom conversations. They impart sex information and lovemaking insights, and often assign “homework.” For more, read the chapter on sex therapy in my book, Sizzling Sex for Life, and/or see the film, Hope Springs with Meryl Streep and Tommy Lee Jones.

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Every person is sexually unique. No single approach solves every problem for everyone. Sexuality professionals don’t have a monopoly on valuable insights. Many self-help resources provide real benefits. I suggest trying self-help first. If it works, problem solved. If not, consult a professional.

To find a therapist, please visit the Psychology Today Therapy Directory.