Introducing Alexandra Sutherland! She is our newest therapist at Sex Life Therapy.

Alex has worked in community mental health and wellness for over seven years. Through her work, she provides an empathetic and holistic approach to many. We (including Alex’s dog) sat down over Zoom to chat. During, we spoke about how mental health affects sexual health, what it’s like being a big sex nerd and her favourite parts of working at Sex Life Therapy.

How did you get your start in psychosexual and relationship therapy?

I did my placement with Sex Life Therapy as part of my postgraduate degree in Counselling. Following that a Master of Science in Medicine (STIs, HIV and Sexual Health) at Sydney University. After I completed my master’s I went overseas to Manchester. While there I worked in HIV prevention and support for marginalised groups. When I returned to Australia I worked in complex case management at RhED. This is a Victoria-wide program supporting anyone who is currently working or has worked in any form of the sex industry. I worked with them for four years, and I coordinated the program for a year. Now I’m working with couples and individuals again in community health.

What drew you to your placement and specialisation in psychosexual and relationship therapy during your post-grad?

I knew as soon as I could pick up and read a Dolly magazine. It’s funny, even in high school, I’ve always gravitated towards open-minded people. Even now, some of my closest friends are sex workers. I think it starts with just having a strong interest and passion. I feel like a lot of us in this area are just big sex nerds!

Aside from Dolly Dr was there much out there that supported that interest?

I feel like that wasn’t a lot, and when you don’t have much else you find yourself searching for more. As a young person, I was into fan fiction and erotica – even online dating – before it was popularised on Tinder. There’s no shame around it now but back then, it would have been a bit embarrassing to admit. Then in university, I was interested in historical erotica, like Tropic of Cancer and I liked collecting erotic art for a while. So while there’s always been stuff out there, it’s about accessibility. There wasn’t as much then as there is now.

I’m in terms of what’s out there now, I’m a bit obsessed with Emily Nagoski, who writes ‘Come As You Are’ and Esther Perel.

How have you found working at Sex Life Therapy?

I really liked it, there’s a reason I’ve kept in touch since my placement. Everyone I’ve met so far contributes to such a caring and cultivating environment. But, the biggest thing that’s stuck with me is how much the practitioners at Sex Life Therapy care for their clients. They are all invested in a person’s journey and life. Another reason is diversity. I’ve been lucky to work in a lot of workplaces that allow you to be open about your identity and experience. I think that openness makes for better practitioners and at Sex Life Therapy I can tell everyone brings their own experience to the way they work.

Being in a comfortable space where you can talk about sex is such a privilege, it shouldn’t be but it is.

So what can I come to see you for?

Come see me for any discussion you want to have around sex or relationships. Areas I’m confident in are; working with the queer community, gender-based violence and sexual assault, working with sex workers and providing non-judgemental approaches to anyone under the marginalised umbrella. When it comes to sexual difficulties, I can help with mixed libido and intimacy issues, trauma-related sexual difficulties and concerns around sexual functioning such as erectile dysfunction, vaginismus and other vulva owners’ pain conditions. I can also help with general relationship difficulties not necessarily related to sex.

I’m also trained to work with neurodivergent folk as well and it’s something that I like to do because I think mental health and sexual health are so related. Not only does sex come up with mental health a lot, but I also see it as a spectrum. Looking at it this way allows me to adapt to a client’s needs depending on where they are at and use different formats to teach. Teaching or psychosexual education is also what I see people for.

Can you speak more on this connection between mental health and sexual health?

Speaking from lived experience, mental health conditions have different needs and patterns based on the day-to-day. Sex can be very dependent on that. Not to mention the added complexity of the medical intervention and other challenges. As well as when partners experience a mental health condition causing the dynamics of that relationship to change. Partners may take on more of a carer role and that’s another factor impacting the relationship.

Mental health conditions can sometimes become an extra person, one that you haven’t invited, but has crashed the party and joined the relationship.

What is the difference between couples and individual therapy?

It feels quite different to me. From my experience, an individual session is fully directed by the client. I then use feedback to see what’s working with them. However, I would describe couples therapy as the couple is the client. I still prevent any biases and work to understand you as individuals but all my suggestions and inventions will be for the relationship.

With two people in the room, there is obviously a lot more going on. I’m very protective of individuals and relationships. Even if the relationship has deteriorated, and we’re looking at friendship or separation that’s still a relationship to preserve – safe and respectful.

What would a first session with you be like?

I think a lot of clients are really nervous when they go to any health professional for the first time. So for me, it’s about making a person feel very comfortable in the space and meeting them where they’re at. I like to be guided by the patient and take a gentle approach. If a client wants to go into the deep stuff immediately then that’s fine. But if a client isn’t there yet, I’m here for that too. What’s challenging is when people have poor experiences with other practitioners. I want to let them know that I’m an ear. I’m here to ask questions, be curious and understand what they’re like and what their experiences are. But for any client, it’s important to me to get a whole picture of what’s going on for them.

Oh and humour, I like to use humour to defuse stressful situations for people. I can’t help it. I think I’m funnier than I am.

So what’s the whole picture to you? How do you see the whole person?

So the idea of a “whole person” touches on the Gestalt concept – that the whole is greater than the sum of its parts. Based on my past, I’ve worked with so many people and you’re never just one thing. I might identify as a bi, cis female but beyond that, I am my experiences. I truly believe that the intersectionality of our life experiences and identities is what makes us who we are. To understand a person is to acknowledge all their experiences and consider how it’s strengthened or challenged them. This belief informs how I like to operate which is from a strength-based space.

A lot of people will come to you with their flaws, and it’s so easy to see the deficits in ourselves rather than consider the alternative, that from certain experiences and challenges we’ve gotten stronger. Contextualising the current issue, challenge or experience in everything we’ve been through can show us how resilient we really are.

And how do we believe that we can improve if we can’t believe we’ve improved in the past?

We’ve touched a little on sexual health, but given your experience, I wanted to ask where a psychosexual therapist fits in when it comes to general well-being.

I see sex and intimacy as two separate and important parts of any healthy life. So when we have chronic health conditions, sexual health-related diagnoses, or a pain condition affecting sex or intimacy people need support from a team. So you’ve got your good GP, your good specialist, and a good mate to talk to. If you don’t have that mate or you need another person there, we can offer a space that the medicalised system isn’t always able to hold. Our role is to be there for you and work out how we can support things through a psychosocial holistic lens. I think honestly with any health-related sexual issue, even an STI there’s always a way that sex therapy can support it.

Are there any misconceptions about sex or sex therapy that you would like to clear up?

I mean I could probably write a list about this – especially when it comes to sex work. I think I’d like to spotlight the lifelong battle between feelings of shame and sex. Everyone can experience shame around sex, but just because it’s normal doesn’t mean it’s right. 

To finish up what do you do when you’re not in the office?

I like going to the gym and exercising, eating good food, and drinking good wine. I really like reading books and I should relate this to sex therapy but… I’m reading a Dark Matter and Stolen Focus that I’m enjoying. When it comes to books I like to have three on the go – normally one fiction, and one non-fiction and then I just rotate them

Read more about Alexandra Sutherland here.