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Frequently Asked Questions

• What can I expect from a first visit?

An initial visit is first of all an opportunity for you to talk. What’s bothering you, or the two of you, about your sexual life? What would you like help with? For a couple, it’s very helpful to have each partner tell from their perspective what actually happens during lovemaking. Sometimes the two stories are very different.

Next, I’ll ask you more about yourself and your partner. Specific questions about your current sexual experience – for instance, about your experience of sexual desire (or the lack of it), and sexual arousal (see my blog for a discussion of the psychology of arousal). Given sufficient time, I’ll also want to hear about your sexual development growing up, as a child, teen, and adult. For couples, you’ll each have the option of some time with me alone, without your partner, if you prefer. I’ll also ask you questions about your general medical and emotional health. You’ll have time to ask me questions as well.

The consultation will end with my giving you direct feedback – explaining what I think the problem or problems are, and the best options for resolving them. We’ll usually formulate a plan of action in the first session.

• What exactly happens in sex therapy?

First of all, it’s strictly a talking therapy. Sex therapy is just psychotherapy, but with a focus on sexual concerns. Sex therapy began in the 1960’s as a set of behavioral techniques: Couples would be given home assignments – first relaxing together, then gradually becoming more comfortable with greater levels of sexual intimacy.

Things have changed since the 1960’s. Most sex therapists today, including myself, see our primary goal as helping people understand the activity of their minds with regard to sex and intimacy. Behavioral techniques and home assignments play a much smaller role. (Especially here in Manhattan, in the age of the Blackberry, where few people have much time or leisure for home relaxation exercises!)

Today there are other options as well. I have worked for more than 20 years of practice in NYC to develop effective alternatives to traditional sex therapy. For example, individuals who are not currently in a sexual relationship can nevertheless benefit from counseling focused on sexual concerns. Remember, modern sex therapy has more to do with understanding one’s own sexual mind, and no two sexual minds are alike. Busy Manhattan couples, and couples with kids, who lack the time or energy to do traditional relaxation exercises, can re-connect sexually using a technique called “simmering” that can be done in two minutes or less.

See my blog for a lesson in simmering.

Click HERE for an audio discussion of the hows and whys of simmering — from a radio spot I recorded on Sirius XM Doctor Radio with Dr Virginia Sadock at NYU Medical Center.

• What are the most common sexual and relationship problems that people are seeking your help for in Manhattan these days?

For men: erectile dysfunction (E.D.); premature ejaculation (P.E.); delayed ejaculation (R.E.); inability to ejaculate with a partner, especially inability to ejaculate during intercourse; lack of meaning or enjoyment from sex; hypersexuality; extreme need for sexual novelty; sexual compulsivity; sex addiction; love addiction; compulsive masturbation; compulsive use of internet pornography; loss of desire in long-term relationships; sexual aversion; sexual avoidance; pelvic pain; chronic prostatitis (many cases are related to pelvic muscle tension, and may have little to do with the prostate); sexual, emotional, and relationship problems stemming from sexual, emotional, or physical abuse; sexual effects of emotional or medical illness and/or medications.

For women: low sexual desire; problems with sexual arousal (such as a tendency to “lose” sexual arousal during lovemaking);trouble focusing during sex; inability to climax with a partner; inability ever to climax; lack of meaning or enjoyment from sex; sex addiction; love addiction; feeling undesired by one’s partner; pelvic pain problems; pain on intercourse; vaginismus (involuntary pelvic muscle contraction that interferes with intercourse); sexual aversion; sexual avoidance; negative body image; loss of desire in long-term relationships; sexual, emotional, and relationship problems stemming from sexual, emotional, or physical abuse; sexual effects of emotional or medical illness and/or medications.

For couples: all of the above, plus: disparity in level of sexual desire; sexual boredom; problems with intimate communication; unproductive fighting; infidelity; unconsummated marriage; religious concerns and conflicts regarding sexuality.

I also see many individuals and couples who’ve not had success with previous treatment for sexual and relationship problems.

• Additional resources:

National Institutes of Health — www.nlm.nih.gov/medlineplus

—search “sexual” to get a listing of sexuality topics

The Kinsey Institute www.kinseyinstitute.org
—click on “Related resources,” then on “Sexuality Information Links” for a selection of topics

Medical Center for Female Sexuality –  Manhattan women’s sexual health.

Howard Glazer Ph.D.  www.vulvodynia.com
– pelvic pain biofeedback specialist

Laura Muggli, Psy.D.  www.lauramuggli.com
– clinical psychology and neuropsych assessment


For the 3rd year in a row, Dr Snyder has been selected in 2014 as a Top Doctor by New York Magazine and Castle Connolly Medical Ltd. 

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