Behind the doors of a sex therapist, clients seek understanding, acceptance, and answers.  But how can mental health professionals help their clients achieve these goals?  Dr. Stephanie Buehler, a licensed psychologist, sex therapist and a recognized author, invites you to “Step Into My Office” with monthly sidebars taken from her own experience.

Clients' sexual complaints vary greatly, from those that arise from the simple need for information to those that may require weekly visits for 6 months to a year or more. One's culture can greatly influence these complaints. The culture includes influences such as socioeconomic status, ethnicity, heritage, and values. A man who grows up in a culture that values a man’s right to sexual expression may take a “boys will be boys” view of extramarital affairs, for example. Individuals within the same culture may also vary, so that a woman growing up in the same culture but who is highly educated may have a more democratic view of the sexes.

Other cultures, both Western and Eastern, vary in their outlook on sex. European countries may seem more liberal or permissive because of more relaxed attitudes toward the body and sex, but in countries where the majority of the population is Catholic (e.g., Spain and Portugal) there are still traditional expectations about refraining from intercourse before marriage. In countries where Islamic religion dominates, sexuality is largely repressed, though there exists an accepted double standard that men will be sexual before marriage, while women stay chaste. Asian cultures vary widely depending on how Westernized the area where the client or the client’s family immigrated from.

Step Into My Office

Lawrence, a 32-year-old heterosexual, second-generation Chinese-American man who grew up in a small farming town in central California, met his 23-year-old Chineseborn future wife, Mei Ying, on an extended business trip to Hong Kong. They fell in love and maintained a long distance relationship, but Mei Ying complained, “We had very little sex.” Thinking that sex would improve if they married, Mei Ying agreed to come to the United States to marry Lawrence. Mei Ying was soon disappointed, while Lawrence was overwhelmed with Mei Ying’s high sex drive.

I needed to put aside my preconceptions about members of Chinese culture and conduct an ecosystemic assessment. Lawrence reported that he never saw his parents touch, nor did they ever speak to him about sex. In fact, Lawrence thought that marrying a Chinese woman from what he believed was a more traditional culture would be perfect, since he didn’t understand the “big deal” about sex. However, Mei Ying was from cosmopolitan Hong Kong and not very traditional at all. Her parents had divorced after her father had an affair, and both parents then openly dated new partners. This was clearly a case where family of origin issues superseded cultural issues, but all factors needed to be accounted for in the assessment in order to understand the systemic influences.


For a full list of activities to help overcome a situation like this, check out Stephanie Buehler’s book What Every Mental Health Professional Needs to Know About Sex.