All-assing your romantic and sexual relationships

LHC: Hey there, welcome to Let's make a health connection. In this podcast, we introduce the interview and showcase the many healthcare providers and resources that we feature on our website, I'm Jennifer Barber, and I'm a licensed clinical social worker in Washington and Oregon, and I'm happy to be part of the local health connect provider community. Today we're talking to Heather Brooks Rensmith. She's the owner of Switch On Sex Therapy, a private practice located in Portland where folks come to do the work of all-assing their romantic and sexual relationships. She's a licensed clinical social worker in Oregon and Washington and a certified sex therapist. Heather has built her business around authentic therapeutic connections with her clients, where she truly brings herself. Hi Heather.
HR: Hey, Jennifer
LHC: How are you doing today?
HR: I'm great. I sprang forward. Yes, I woke up on time. Yes, I'm looking forward to the day. I think I'll survive it.
LHC: I hope you do. I hope you survive it. I hope we all survive it. So what is all-assing one's romantic and sexual relationships?
HR: Yes.
LHC: What does that mean?
HR: Well, for me and what I try to do to bring awareness to the people that I'm working with. It is just this idea that relationships require tending if you want them to survive. It's not enough to just say "you are my person" and "I don't have to keep working for this" and really expect it to thrive. So when I tell people or talk to people about all-assing their relationships, it's a way of reminding them not to slide into the default settings. but to be really active and engaged in undoing the work that a relationship requires.
LHC: I'm not half-assing it.
HR: not half-assing any of it.
LHC: So tell us a little bit about what sex therapy is. If you could just clear it up, I think a lot of people have some preconceived notions when they hear that term, so if you could just clear it up. are our first certified sex therapist that I've interviewed on this podcast, and I think people are going to be really interested in hearing what you have to say today.
HR: Yes. Sex therapy looks a lot like mental health therapy. It is a therapeutic relationship that is based on talk only, so we follow the same ethics that licensed mental health professionals follow in terms of not touching clients. We do not have sexual relationships with clients. It's just like what you would expect when going to see a mental health therapist. The difference is that people may be coming for specific sexual concerns, and we might be just addressing that. so determining the source of the problem long have they been experiencing it? What their understanding of that concern is, What sorts of things have they tried to address and what do they hope for. This happens as a result of doing the work. So, rather than entering into a deep therapeutic relationship, we begin with lower levels of intervention in some cases.So that might be one difference. A deep therapeutic relationship is also possible, but we really start by addressing the concern that people come with. So I would say that that is the difference, and then also, as a sex therapist, I have a lot of comfort talking about sex and asking people about their sexual relationships. That's not something that generalists are often trained in, and so they may shy away from issues regarding sexuality and the nuances of sexual behavior. Should we lean into those sorts of questions?
LHC: Do you mainly see individuals or couples when you are focusing on actual sex therapy?
HR: Both I and I have a pretty equal mix of individuals and couples.
LHC: Gotcha. What brought you to the field of sex therapy?
HR: Well, that is a question I often get asked and I think it certainly started in graduate school with my hero, Sally Foley, who was the director of the University of Michigan Sexual Health Program. She was doing a lot of grief and loss work. I was working in oncology and was making this transition to opening the sexual health center at the University of Michigan. I was like, wow, grief and loss, cancer, and sex. I feel like it just sort of blew my mind that those things could exist in the same pot. Granted, she was transitioning, but I think what that did for me was come from a place of, especially around sexuality, where there can be lots of trauma, there can be losses. It can be really complicated and fraught. It seemed that I had been working more in domestic life and sexual violence. I wanted to really start addressing and talking about the things that might Instead of starting with the question, "How can we help people heal from sexual violence?" Seems like perhaps we should get ahead of it and help people figure out how to have healthy sexuality and healthy sexual relationships. How to eliminate culture and religion Sexual shame In a lot of ways, just talking about sex can, in a lot of ways, really change how people think about it and approach it. And that, to me, felt like where I wanted to be focused. More of my attention is just really coming at it from a perspective of health.
LHC: Great, thank you. Thank you so much. For what do people come to see you? What are their main concerns? I understand it's all over the map here because it doesn't just have to be regarding sex or sexual dysfunction or relationships, but that can seem to be such a big piece of somebody's lives. Some people, some people's lives, but if you could talk a little bit, Maybe it's just that someone is listening to this today and is having a difficult time in their relationship, and maybe it's, maybe there are sexuality concerns. they are having..Maybe they're even talking about opening up their relationship and maybe somebody has said to them, "Have you ever considered seeing a sex therapist?" If they find you or they listen to this, what could they expect to see when they come in and see you for the first time? What might that feel like for them?
HR: So this is the first time. I mean, hopefully the first time we're meeting is in consultation, really just to make a decision about whether or not we want to work together. So that's something that's really important to me. Also, to have the opportunity to set the stage for what to expect. In our first session, what we are trying to do is name the primary concern, and there can be many primary concerns. But usually, you know, somebody's taking, for instance, wanting to open up their relationship. When do we get to talk about when did you start thinking about this? Was there anything that happened in your relationship or even within yourself that made you think that this might be a way of being in a relationship that works for you? And then we would go into their understanding of that. For some people who want to open up their relationship, they may have thought for years, you know, "I don't know if I'm a monogamous person or if this actually works for me." but may not have shared this with their partner or may not have even realized it themselves. So we're trying to help them unwind their understanding of what this is about for them. And then I really want to see what sorts of things people have tried or how they have tried to talk about this. What kinds of conversations have they had? So I have a really good understanding of where to start and not recreate the wheel or suggest something that they've tried that hasn't really worked for them. Then I want to help people get really clear on what their goals are or their vision of perhaps what their relationship would look like if it felt more in line with what they wanted or what they think they wanted. So that's what we do in the first session and you can apply that frame to people who are struggling with obtaining or maintaining e********s, people who are struggling with o*****s, or people who aren't really feeling the attraction or the desire for their partner. Yeah, so we have a really helpful little container that we get to get really curious about.
LHC: What are the concerns and issues, and how do you get clarity about how to work through them? I can even think of it very simply. If someone or if a couple is uncomfortable talking about sex. If it's just something they've never even talked about, they don't even know how to talk about it, or it's so uncomfortable that they shy away from it. I just think about how difficult that can be for a relationship, and talking to you and just listening to the way in which you bring, you know, warmth and even humor into the room or even into this conversation, allowing a space to give some vocabulary.
HR: Okay, yes, yes, make it ex****!
LHC: That is fantastic. Thank you. you so much. How long do you work with people who come to see you? If someone says, "Yeah, we're going to see a sex therapist," they may believe you'll only see them once and everything will be fine and dandy. I don't know if that's realistic, but I do know how long it might take to work through some stuff.
HR: right? I never know. I never knew that answer, and people still ask it. When I attempt to answer it, I really like to frame it in terms of if you are here for a really specific problem, like you're struggling with obtaining and maintaining e******* and we are really getting down to the work of that. People come in and, if they're pretty committed to the work, can really get to a different place where they feel much better in a relatively short period of time. if they're pretty engaged. Which I think is true. Many parts of therapy and it's not a race by any stretch. But people do want relief, so. I often tell them that the length of time that you are here is really dependent upon you. How long have you been seeing value or experiencing value in our work? How are you finding it to be helpful? If you, of course, are seeing gains or benefits if you resolve it, you're going to want to move on. If you do not want to do the work outside of therapy, then you might notice that you're here longer. I welcome that as well, because sometimes we do have to sift through the resistance or the avoidance or the challenges that have really helped build this problem that people are coming for help with. Sometimes I see people come for sex therapy, but sometimes we really have to start in a different place. I'll know that when we get through assessment and get clear on what it is that's actually going on, right?
LHC: I mean, I might even just give an example of potentially a couple who's having difficulty sexually, but maybe it's because there's been a recent infidelity...
HR: Yes, right.
LHC: And that might not always present itself right up front. I'm thinking in your therapy sessions, but this is definitely a piece of why there's difficulty with sex right now, and so I can see how you would have to go back and unravel and peel back some layers.
HR: Yeah, right, and maybe do some healing work or …
LHC:... absolutely...
HR: … before a couple can really examine what's happening in their sexual relationship.
LHC: Right. What kinds of clients do you enjoy working with the most? If you could have a perfect client or client couple, who would that be?
HR: I don't even know. There's no formula. I know that the things that the people that I love to work with are excited about doing the work. And not even necessarily thrilled, right? Because it's kind of hard work, right? It's hard to show up for it. But I really love it when people just bring. You know, it's that too. This is really hard work, or I don't want to be here today, or I do not want to talk about this, or don't say those words. It is really thrilling to me to be with people in all of the parts. It's not just the excitement but also sort of the pain of it. But I definitely know the people who I really enjoy working with are there because they are making a commitment to it. I think that's probably the number one part that I enjoy the most. In whatever form people take, if they are making a commitment and they are showing up, They are doing the difficult work of building this therapeutic relationship as well as dealing with whatever's going on in their own relationship or with themselves. That's what makes my work really exciting.
LHC: When people are ready to show up and do the work. I want to circle back around and just talk about your education and your certification. You are first and foremost a licensed clinical social worker in Oregon and Washington, and then you have this certification that is very specialized. I mean, we do not have a lot of sex therapists in the Vancouver and Portland areas. I haven't heard of very many, and so I'm wondering if you could talk a little bit about your certification. How long did it take? What did it involve? What do people need to know?
HR: Sure, sure. So I am a certified sex therapist through the American Association of Sexuality Educators, Counselors and Therapists. It's a pretty old association that has been operating primarily in the U.S. but also internationally and has worked to support the training. And they're consultants. They're very interested in continuing education for people in the field of sexuality, whether it be sexual medicine, sex therapy, or education. So with this training, you can go about it in many different ways. First of all, in many states, anybody can call themselves a sex therapist. I think when you have sex behind you, what you're really demonstrating is that you've met the educational requirements, which are pretty intense. It took about a year for me to go back to the University of Michigan Sexual Health Program every other month or so and then do distance learning as well to complete the educational requirements. Then, once I fulfilled the educational requirements, I had to engage in supervision with another certified sex therapist. I did group supervision and individual supervision where we would review cases, much like what happens when you are choosing licensure as a mental health therapist. So the certification requires supervision engaged in that whole process. Once I completed my hours of supervision, I could then officially apply for the certification. Which is then again reviewed by a board, and they want to make sure that you've done all of the things and done your due diligence to actually earn this credential. which I did, and I'm very proud of it. In addition, there weren't very many certified sex therapists but that is changing and growing. Now, I think that there are many options in the area if people are seeking a sex therapist who's been they are well-trained and have the education and the supervision to back that up.
LHC: So, you were mentioning that anybody could call themselves a sex therapist. If someone is listening and thinking, "Well, I just want to see the people who have gone through the kind of certification process that Heather's gone through,” is there a place for them to find that information so that they know that they're seeking someone who's got the education?"
HR: Yes, there is. I would encourage people to go to There is a directory there where you can locate professionals. This actually extends beyond therapists to include counselors who might be pelvic floor physical therapists, or OB-GYNs, or urologists. They are medical professionals who have actually gone through training to become certified sexuality counselors and then also educators, the people who may be hosting workshops for adults or even sex education groups for kids and families or going to schools. You can also look for professionals who have that certification who are educators as well.
LHC: Great, that's so good to know. Will you tell people where you're practicing?
HR: Yes, I've maintained my physical space in the very beautiful, very quirky Ford building in Portland, Oregon. I am also continuing to see people virtually. I expect that I will continue doing both of those things for the foreseeable future, which I think will be forever. It's opened up therapy for people, especially those who live in more rural parts of the states of Washington and Oregon. It's harder to get a sex therapist in Spokane, Washington, but by meeting virtually, we have that option. So it's been really wonderful.
LHC: Great, and before we wrap things up today, is there anything else you want people to know? I know people who are listening to this. What do you want them to know about you?
HR: Well, I really want people to know that I see all sorts of people. All sorts of people need help with their romantic and sexual relationships or with their sexual health and functioning. So I really just encourage people of all sorts to think about how they might make those improvements or, if they know that they are struggling with something, to know that they can get help. I really welcome people of all different sorts of relationship configurations. I work with not only monogamous people or married heterosexual people, but also queer people, kinky people, and people who exist within and outside of the binaries of gender. I have made it sort of, I mean, that's really where I started in my practice. I was making sure that the people who may not have had support. That was really important to me. And so that's what I want you to know.
LHC: great. Thank you, Heather. Thank you so much for your time today. If people were trying to find you, obviously, they could find you through local health connect, but I believe you also have a website and I believe you also have an instagram account. Can you let people know where that might be?
HR: I do if you are looking for my website. You can find me at If you are looking for me on Instagram, you can find me at @switchontherapy. If there is no sex in that, the censoring bots will get you.
LHC: That's so true! Those darn censoring robots. Thank you so much for your time, Heather. We'll talk again soon.
HR: Okay Bye-bye
LHC: Thanks again for listening to "Let's make a health connection." Find us online at as well as on Facebook, Instagram, and Twitter. The links and show notes for this interview are available on our podcast page. These interviews are really fun, and I hope you made a health connection today. We'll talk again next time.
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By Jennifer Barber, LICSW 3-22-2022