If you struggle with low desire, pain during sex, or difficulty with orgasm and don’t know where to go for help, this week’s Java with Juli is for you! Juli sits down with certified sex therapist Josh Spurlock to explore what Christian sex therapy really is—and what it isn’t.
Josh explains the difference between sex therapy and traditional counseling, the most common challenges he helps couples overcome, and why having a therapist who respects God’s design for sexuality matters.
From dispelling myths like “sex is supposed to hurt” to offering hope that orgasm is possible for nearly every woman, this conversation brings biblical wisdom and practical help to some of the most sensitive places in your marriage.
Prefer to listen? Listen to the full episode here.
Josh (00:03.15)
There’s a large percentage of women at one point or another in their life that experience pain with intercourse. And it’s tragic to me when I have a couple come in and they have been taught by somebody along the way that that’s just the way that sex is, that it’s going to hurt, that sex is really for the man and not for the woman. And so you just kind of grin and bear it. And it’s gotten to the place where their bodies just shut down and said, no, we’re not going to do this anymore.
Juli
Well, hey friend, welcome to Java with Juli. I am your host, Juli Slattery, and this podcast is an outreach of Authentic Intimacy, which is a ministry dedicated to helping you make sense of God and sexuality. Well, have you ever thought to yourself, I guess sex is just supposed to be this way? Or maybe you’ve thought, I guess it’s normal for my desire just to fade after a few years, right? Or perhaps you don’t know how to recover from a past sexual trauma.
Well, if you’ve ever felt embarrassed or stuck or maybe even hopeless in your sex life, you are not alone and you don’t have to just live with that. In today’s episode, we’re going to talk about Christian sex therapy, what that is, what happens in those kinds of sessions, and how it helps couples who feel like their sex lives are broken build kind of a new connection or framework that is pleasurable, intimate, and safe for both of them moving forward.
Juli
My guest to flesh out this conversation is Josh Spurlock. Josh has a lot of letters behind his name, but for this conversation, you need to know that he’s a certified sex therapist and he’s the founder of MyCounselor.Online. Josh is going to help answer some of the questions that you may be too embarrassed to ask. Questions like, should I just push through the pain of sex? Why can’t I climax? Or why can’t my husband stay aroused?
Now you might feel a little awkward about listening to this conversation or sharing it with a friend who may need it, but studies tell us that about 15 to 20 % of couples experience sexless marriages and about 63 % of women struggle to continually enjoy sex. So your friends probably aren’t talking to you about it, but this is a conversation that they need to hear.
Juli (02:25.134)
So how about you start that conversation by sharing this episode with a friend or maybe you have a group of friends and just say, Hey, I know we don’t talk about this much, but this was helpful for me. I care about you and God cares about our marriages. And you might be surprised how many of your friends would say, thank you. Like I really needed to hear that. Now, one quick caveat before we jump in. I recorded this conversation with Josh back in 2020 in the middle of COVID and we were just trying to figure out how to record with Zoom. So you might notice that Josh’s audio quality is not what you’re used to hearing on Java with Juli, but this is such an important conversation that we still wanted to bring it back. So let’s head to the virtual coffee shop for my conversation with Josh Spurlock.
Well, Josh, looking at your resume is really impressive for somebody like me. You’ve trained under, in our generation, some of the greatest thinkers and leaders in the space of Christianity and sexuality. So Dan Allender, right? And Mark Yarhouse.
Josh
Mark Yarhouse, Doug Rosenow, Michael Seitsma, Marnie Free. And yeah, I’ve had the opportunity to really set at the feet of some amazing folks and to really just sponge up from them. Cliff and Joyce Penner, just some amazing pioneers.
Juli
I gotta ask you, how did you accomplish that? I mean, I think most of us feel very blessed if we get to learn from one of those people.
Josh (03:56.674)
Yeah, so I studied at the Institute for Sexual Wholeness, which is the world’s only Christian sex therapy program, and Doug Rosenau pioneered that, and he’s put together an incredible team of folks to teach the courses that go with it.
Juli
Yeah, that’s fantastic. And you have gone out and been charged by Doug Rosenau and really by the Lord, you said, to be a sexual evangelist, proclaim God’s design, to help individuals and couples walk in the fullness of that design. But your title is sex therapist.
Josh
Certified sex therapist and an ordained minister.
Juli
Wow, both together.
Josh
Which weirds folks out sometimes. When I was at the, when I was doing my sex therapy training program, I was sitting at Starbucks reading one of the textbooks, which happened to be the Science of Orgasm. And I’m sitting there and I have my Bible open and I have the Science of Orgasm sitting there and had a gentleman walk by and go, now there’s a couple of books you don’t see very often side by side. I’m kind of chuckled and laughed, but that’s what God’s called us to do, really go in and speak his truth and those things.
Juli
Yeah, that’s amazing. That’s wonderful. And I know that our audience won’t be surprised by that because we talk a lot about the integration of our love for the Lord and the fullness and wholeness of sexual design. So, but I know that for most people that’s a real paradigm shift. Let’s talk about the title, sex therapist. People often say that I’m a sex therapist. I’m not.
I teach a lot on sexuality. I’m a therapist, I’m a psychologist, but this is a very specific training that allows you to have the title of certified sex therapist. you work with people in a different way than a psychologist might. And I know you integrate the spiritual aspect and the emotional and relational aspect, but you also do a lot more work with the physical piece of sexuality.
Josh
Yeah, absolutely. You know, I always like to start defining what a sex therapist is– Christian sex therapist– by kind of seeing what it’s not. You can pretty well forget anything that you’ve seen on TV or in a movie or in a Netflix series on what sex therapy is. There’s some weird stuff out there and it really paints a different picture than what actual sex therapy is about.
Sex therapy is about helping folks overcome the challenges that they run into in the sexual arena of life. So we hone in very specifically on that aspect of life and how it differentiates from say marriage therapy or work that a psychologist would do is really in its directive approach and troubleshooting and putting together treatment plans for overcoming specific sexual barriers and challenges.
Josh (07:07.34)
And so while there can be some overlap, a lot of times sex therapists are also psychologists or marriage and family therapists and so on. That specific set of protocols and approaches that we’re using are a little bit different than our kind of standard training for marriage and family therapists or psychologists.
Juli
Okay, so what kind of individual would you say needs to see a sex therapist, not just a marriage and family therapist or not just a general counselor?
Josh
Yeah, so a lot of times psychologists or marriage and family therapists will refer to sex therapists for specific kinds of sex therapy work. To begin doing sex therapy, there’s some assumptions about the relational health of a couple, if we’re working with a couple and overcoming challenges that they’re in a good place communication-wise, they’re able to have tough discussions, they’re able to work through kind of intimacy, or to have intimate conversation with each other and that that’s not the kind of the basis for the sexual difficulties that have. Sometimes couples will come straight to a sex therapist and when we assess the situation we go, actually need to do some marital work first before we can do sex therapy because our relationship is in a place where we can navigate through the sexual challenges.
When we’re working with individuals, similar dynamic is there that if there’s some extreme anxiety or depression that the individual is dealing with, those things have to be worked through before we can really address the sex therapy pieces. Or trauma. Sometimes we have folks that come in, have sexual trauma, which is getting in the way of their sexual relationship, but there’s actually trauma work that needs to be done before we can actually do the sex therapy part of the trauma work. a little bit.
Juli (09:05.486)
Okay. And usually you’re not going to refer out for those pieces, but you’ll just do them before getting to the actual sex therapy.
Josh
Yeah, depending on what it is and depending on the therapist, some therapists will refer out and we’ll just do the sex therapy piece and say, here’s someone at our practice or someone here in the community that can do this work. And then when you are ready, they can refer you back and we’ll get started in the sex therapy piece. For me in our practice, we tend to do that work internally and with the therapist that originally the couple or individual places with. For us, we feel like the relationship that’s built by doing the other parts of the work help us do the sex therapy work easier and better.
Juli
Sure, yeah. I mean, that’s kind of awkward just to start with a therapist and to get into such intimate details. I would imagine that even the intake interview has to be specific. And I’m sure that’s very difficult. I’m sure there are couples that need this work, but they’re afraid. So first of all, if you could just tell me what specific problems would people come to see you or a Christian sex therapist for?
I have things in my mind, but just kind of run down what are the top five things that you would see couples coming in for?
Josh (10:25.774)
So there’s different categories of work that folks come into for. One category is what we’ll call desire disorders. That is where one or both spouses have a loss, a desire to pursue connecting sexually with their spouse. They just don’t have any interest in sex. They’re trying to figure out why is that? What’s happened? Sometimes there’s been some relational difficulties. Sometimes there hasn’t been that their relationships, really good friends and they really enjoy the friendship aspect of the relationship, but that for whatever reason doesn’t translate into a sexual connection. And so they’re coming in trying to figure out what’s happened, why am I experiencing this and what can I do about it to rekindle the passion in a relationship. So that would be kind of the desire disorder group of services or reasons why folks would seek out sex therapy.
And there’s a group that we call arousal disorders. That’s where something physiologically in the body isn’t working. Either if it’s a male that there’s erectile dysfunction or premature ejaculation, or maybe if it’s female, there’s not a physiological arousal that’s taking place that can cause sex and intercourse to be uncomfortable for them, and they’re trying to figure out why is my body not arousing, kind of physiologically going through that arousal process, or why is it shutting down at some point in the process? And so we’ll troubleshoot arousal disorders and figure out what’s happening there and put together a game plan for addressing those things.
Then there are pain disorders. This is when a person experiences pain of some sort while connecting. There’s a variety of different kinds of pain disorders, but dyspareunia or pain disorders are kind of a broad umbrella. Those that experience more than just a discomfort with connecting, that there’s something painful that makes sex not fun, not enjoyable to pursue, but is really painful and uncomfortable. And so we’ll troubleshoot that, figure out how to address whatever’s happening there.
Josh (12:48.47)
And sometimes we have folks come in with same sex attractions or gender dysphoria that’s causing distress for them that they’re wanting to try to sort through and figure out. We’ll have sexual addiction or pornography addiction clients that come in. Sometimes that comes in as a part of infidelity work with a couple. Sometimes that comes in just as an individual. So you have a problem here. I have a relationship with this that I don’t feel good about and want to figure out how to be different. Those are the main broad categories of different sexual issues that folks would come to a sex therapist for.
Juli
That’s a lot. Those are a lot of specialties within your specialty. So I’m glad you have the extensive training that you have. We’ve talked a lot at our ministry about several of those categories. I think one that I’d really like you to speak into that there aren’t a lot of experts on are some of the issues involving the body, involving sexual pain, like you said, no desire.
We work with a lot of women and hear from a lot of women who just say, I’m trying, but I just can’t, I can’t get there. I’ve never had an orgasm. I don’t know how to, I don’t know if something’s wrong with my body. So that’s, think a category that I really appreciate your specialty on. And we actually have a lot of people that email and say, “Where do I go? Because I don’t know how to find somebody who is going to share my worldview and not recommend watching pornography”.
So as we jump into that, I’d love for you to talk first about why you think it’s important to have a Christian sex therapist and maybe what might happen if you just kind of Google somebody near you and what to be aware of.
Josh (14:44.204)
Yeah, for sure. as you mentioned, know, that understanding God’s design and having a respect for God’s design for sexuality in addition to the clinical treatment is why folks seek out and prefer to work with a Christian sex therapist. This Christian sex therapist is never going to disrespect your convictions around God’s design for sexuality and is always going to look to, if there’s challenging to be done in terms of ideas or thoughts around sexuality, the challenging is going to come from a vantage point of the scriptures and with an assumption that the client is committed to the scriptures and that that’s what they’re looking to try to, as a framework for understanding their sexual experience. And that’s not always the case in working with a secular sex therapist.
I have had clients that have had good work that they’ve been able to do with secular sex therapists. And so it’s not to say that all secular sex therapists are dangerous and bad and that there can’t be any benefit from them. Depending on the framework that they’re coming from, some are very much disrespectful of and see Christian faith and spirituality as being a weakness or crutch or something that’s clinically needs to be treated as opposed to being something to be valued and respected. And so that’s really why folks look to work with a Christian sex therapist. And they used to be incredibly rare. They’re still hard to come by and find, but thanks to Doug and the work of the Institute for Sexual Wholeness, there’s been about 10 years, 12 years now, of course, working through and getting certified. So there’s a growing body of resources out there, thankfully.
Juli (16:42.988)
Yeah, I’m so grateful for that. Even some of the issues you might not even think about that could be a problem become a problem. For example, our fantasy life. if you have even a moral therapist who doesn’t necessarily know or respect God’s design, they may encourage a fantasy life that isn’t in line with God’s design and actually separates you from your spouse because your mind is going down a whole different road.
Josh
Yeah, whether that’s like you mentioned, and it’s not uncommon for a secular sex therapist to prescribe pornography as part of a treatment protocol or even encourage fantasy that doesn’t involve one spouse. Those kinds of things that we would see as being spiritually harmful and not helpful to the individual.
Juli
Yeah. Well, thank you for what you’re doing. I’m so appreciative of that and I’m thankful for Doug’s work as well.
Juli (17:48.526)
Hey friend, it’s Juli. I’m jumping in here just for a quick minute to remind you to register now for an Online Book Study this fall. Now these groups are an opportunity for you to dive into God’s design for sexuality along with other men and women just like you. In fact, we know OBS members who have really become lifelong friends through these groups. So grab your spot today in one of our groups for men, for women, or for couples. We’ve got groups that are going through my new book called “Surrender Sexuality”, plus “God, Sex. and Your Marriage”, “Finding the Hero and Your Husband”, “Rethinking Sexuality”, Linda Dillow’s new book, “Hope for My Hurting Heart”, and “Beyond the Battle” by Noah Filipiak. Now in these studies, you’ll take part in weekly Zoom meetings, you’ll have online discussions, and at the end, you’ll have a live Q&A with me. The deadline to register is September 12th, and these groups will be starting on September 15th. So what are you waiting for? Head to Authenticintimacy.com/online-book-studies and grab your spot today.
Juli (18:54.104)
So let’s go into some of these issues. We talk a lot with women and so we’re getting their questions and issues and problems. One of them we’ve talked about or mentioned already is just pain during intercourse. How common is that?
Josh
It’s pretty common. it’s, I don’t have the statistical data in front of me at the moment, but you know, there’s a large percentage of women at one point or another in life that experienced pain within a course. Sometimes that is a developmental piece and, you know, maybe when they’re going through menopause and their body’s changing or around pregnancies, either during pregnancy or postpartum that they experienced pain. And some from the very beginning of their sexual experiences, experience pain. And there’s a ton of bad information out there. And it’s tragic to me when I have a couple come in and they have been taught by somebody along the way that that’s just the way that sex is, that it’s going to hurt, that sex is really for the man and not for the woman. And so you just kind of grin and bear it. And that’s kind of the way it goes.
And so out of that advice. They’ve been playing through the pain for years and it’s gotten to the place where their bodies just shut down and said, no, we’re not going to do this anymore. And they have no desire to connect intimately. And the bleed over from that sometimes causes just a real emotional relational disconnect is that pain gets associated with the spouse and causes us disconnect between them and their spouse in areas outside of the bedroom as well. And so I want to implore your audience and anybody listening to this, don’t play through the pain. Yeah. That that’s, not the way it’s supposed to be and it’s treatable. We can figure out what’s going on there and have it be different. The more you engage sexually and when it’s painful, there’s this pairing that takes place in our brain. And we form these things we call sexual aversions. That is the best way I know how to explain it is if you’ve ever eaten enough food that you enjoy and love but then got sick afterwards. Yeah. for a time you couldn’t eat that food anymore.
Juli (21:20.078)
Turkey burgers.
Josh
Yeah, right? I had a particular brand of pizza that I used to love and then I got sick and something about pushing it through my nose kind of made it like not something I could do anymore. Even though I knew that it had probably nothing to do with the pizza, nobody else got sick that ate the pizza. It wasn’t related to that. I knew that here, but the protective mechanisms in my body caused there to be this aversive response to that and said, no, that’s associated with pain and sickness and you don’t want to have any part in that. So what happens when we experience pain around sex is our body forms sexual aversion to that, associates everything related to sex with the pain of sex and we get this kind of our body does this, know, winces and pulls back away from anything that suggests to us that it’s going to lead to sex.
And so couples get to the place where even a hug causes a wince.
Juli
Yeah.
Josh
Or even a smile from across the room causes a scowl back because I don’t want him to get the wrong idea that I’m open for connecting I’ve just gets it gets really shut down Because of those aversions, so please Please don’t play through the pain. There’s help we can figure it out.
Juli
Wow, thank you for saying that. Honestly, I wish I had you about 20 years ago. because a lot of what you’re describing has been our story in marriage. And I think like a lot of women, you go to the OBGYN and they’re like, no, everything looks good. You’re fine. There’s no help.
Josh
Yeah.
Juli (23:02.734)
Here’s a cream.
Josh (23:06.742)
If you go to, OBGYNs are not sex therapy.
Juli
Right.
Josh
I had some OBs in our sex therapy training that had decided to come to ISW and to get training in sex therapy and had them kind of share about what their training consists of in medical school around this. so they get zero training on sex therapy. They’re trained on the physiology of the body and that’s it. And so their treatment protocols that they recommend sometimes are actually devastating to a person’s sex life. I get angry sometimes. I have couples come into my office and they talk about going to their OBGYN and they prescribe them numbing cream for their vulva. Here’s their solution. Let’s numb your genitals and then you can get through it without pain. I’m like, what? How can we be training doctors to…
Juli
Yeah.
Josh (24:08.824)
…for sexual health of women, the answer is to numb their genitals and that so that they can get through, they can bear and survive kind of getting through intercourse. What does that do to the connection between a couple and how does that fit with God’s design for sex? That’s information.
Juli
Yeah, that’s sad. There sure is. Let me ask you about one other issue that, again, we hear a lot about is the issue of orgasm for women. Yeah, some women will just say, I don’t think it’s ever possible for me. There must be something wrong with my body. And I’ve also read, I don’t know if this is true, that every woman like physically is capable of an orgasm. It’s about a lot more than the body. Would you agree with that?
Josh
I would totally agree with that. I’ve been practicing sex therapy for about 10 years and it, I have maybe one case in 10 years where we, the discontinued therapy before we were able to be orgasmic. And so, an orgasm really is treatable that God’s designed women to be able to enjoy orgasms part of the relationship with their spouse and for them to be able to anticipate that and look forward to that as much as their spouse enjoys that and looks forward to that. And so, yeah, I would very much want to dispel that myth and say that we can, the treatment protocols for anorgasmia are highly successful. Like they’re easily 80, 90 % orgasmic with a spouse, with a partner, and even higher, just period in terms of being able to physiologically experience orgasm. And so it’s a treatable condition. There’s lots of different things that are components to it and can be contributing to that, but we can figure it out.
Juli (26:08.238)
Boy, that’s good to know. A lot of people are saying, I need that. Let me ask you some questions I think people may be little leery about. What are the boundaries of how you work with couples? You do a physical exam? How do you keep it respectful? What does it look like?
Juli
Yeah, so physical touch isn’t a part of any recognized therapy in a professional realm, whether it’s sex therapy or other kinds of clinical therapy and counseling. And so you’re not going to experience that. All the work that we do is via talk and communication. Sometimes physicals are needed, and we recommend to a physician for a physical to rule out some possible physiological things that could be getting in the way, whether that’s cardiovascular-related or pelvic floor structure-related. But a sex therapist will always refer to a physician or a physical therapist, pelvic floor physical therapist for that sort of work to be done. It’s not voyeuristic. We don’t do tape or watch any kind of engagement. We’re not gonna be in your bedroom at all.
So what it looks like is a couple coming into an office or coming to a therapist’s office by way of video and answering a series of awkward and invasive questions that are none of our business, but are the information that we need in order to be able to be helpful to you. Based on the information that you share with us, we gain a hypothesis as to what’s going on, which we share. It’s a collaborative effort we’re doing here, and go, okay, based on what you’ve told me around these questions and the questions that I followed up with around that, here’s what I think might be going on. Here’s how we start going about treating that. Sometimes that’s just some protocols that the sex therapist will initially spell out to the client to help them recognize or help them diagnose further what’s going on.
Josh (28:28.558)
Other times that involves some book resources, some self-help guides. that we’ll them pick up and give them exercises to follow out of those guides, get back together and ask questions about how did that go? What did we experience? What did we notice? And use that information and then shape the further treatment that we do.
Juli
Okay, that’s good. And you did mention that you do online counseling. So that can be from really anywhere in the world.
Josh
Yeah, it’s such a blessing that increased access to care that the internet and video therapy has made possible. Then many, many of the folks that we work with at our practice are in areas where they can’t find a sex therapist in their state, Christian sex therapists in their state, and would have to drive or fly in order to try to find and connect with someone, which is, is prohibitive, just keeps them from being able to access care. Now, them being able to come to our office by way of video can really enable folks wherever they’re at to be able to get the care that they need.
Juli
That’s wonderful. Well, I’m so thankful for what you and your colleagues are doing. There’s a great need and I’m glad to know that you exist as a resource. We’ll be sending a lot of people your way. So grateful for you.
Josh (29:53.548)
Yeah, we’re thankful to be able to be here. Now that one of the most tragic things that I experience is when I have a couple that comes into my office and it really says what you said earlier in this interview. It says, wish we could have connected with you 20 years ago or five years ago. last five, 10, 20 years could have been a lot different. And it’s just really heartbreaking because it doesn’t have to be that way. These things can be understood and can be treated. And for folks to be in a place where they’re suffering and they’re feeling disconnected and they’re feeling ashamed, they’re feeling broken, and they’re embarrassed about it and nobody in their life knows what’s going on. It’s just very isolated. And it doesn’t have to be like that.
Juli
Friends, the world has really taken sexuality and twisted it and even made it seem dirty. But there’s really so much hope when we go back to God’s design to understanding sexuality in our bodies and what He intended marriage to be in this area of our lives. I’m really grateful for Christian professionals like Josh who are able to integrate what the Bible says about sexuality with what the science is telling us about how our bodies work.
If you’re struggling, really hope you’ll consider finding out more about sex therapy, finding a Christian sex therapist near you, or maybe checking out mycounselor.online. As Josh mentioned, these problems can feel very isolating because we don’t know who to talk to or where to go, but you don’t have to live with them. Look for a link for mycounselor.online in our show notes as well as a blog that I wrote about how to choose a wise counselor.
And please stop by authenticintimacy.com to check out our fall online book studies. The spots are filling up fast, so don’t wait. Thanks for listening. I look forward to having coffee with you next time on Java with Juli.