Electronic Journal of Human Sexuality, Volume 17, April 7, 2014


Book Review

Expanding the Practice of Sex Therapy:
An Integrative Model for Exploring Desire and Intimacy

Gina Ogen, PhD
Routledge: New York and London, 2013, 204 pages.
Paper back, £21.11 or $32.25, Kindle, £17.94 or $18.33

Click on cover to buy this book from Amazon.com

Reviewed by Samantha Anne Banbury. Cpsychol, PhD, Cert Couns and Alena Silvester-Szabó: BSc (Hons) Psychology. London Metropolitan University.


This book provided a unique and integrative means of discussing sexual issues in a creative and insightful manner.  The book’s focus is upon the ISIS Wheel of Sexual Experience, a template which recognises the full range of sexual needs, behaviours and issues via a physical, emotional, mental and spiritual perspective. This understanding was based upon the analysis of an ISIS survey consisting of 3,810 respondents, aged between 18 to 86 years, throughout the United States. As noted by Ogden, “No such model existed in sexology” (p. 16).

Gina Ogden is a sex therapist and researcher who provides supervision for professionals specialised in human sexuality and conducts ISIS retreats and training in the United States and Mexico.

The text is applicable to any individual or couple who wish to expand their sexual awareness irrespective of culture, ethnicity and sexuality. Importantly, the book encourages clinicians to shift their clinical understanding from an arguably quantitative mind set towards a qualitative modus operandi. Indeed, it provides a comprehensive understanding of the clients’ concerns, needs and wishes from a multidimensional perspective.

The book provides an insightful means of aiding clinicians work more efficiently and intuitively with their clients, potentially enhancing the clinicians’ own personal awareness and skills. For the more theoretical minded, understanding some of the recommended imagery and reference to spirituality may prove challenging. However, the book offers a foundation, a guide for individuals to utilise their own examples and means of understanding their own sexuality.

The book is clearly outlined and well structured. It is comprised of four sections: part 1, “The Research”; part 2, “The ISIS Wheel: A Guide to the Quadrants”; part 3, “The ISIS Practise: A Guide to Clinical Use” and part 4, “Training and Integration”. The latter is followed by concluding comments, the author’s appreciations and references. The overall text has been complimented by case vignettes, clear illustrations and examples of the ISIS wheel.

In part one, details of the survey are provided whereby the author introduces the reader to the ISIS wheel of Sexual Experience. The acronym, ISIS, derived from “integrating sexuality and spirituality” (pp. 1) highlights the relationship which exists between spirituality and sex. Rather than the survey asking questions directly about orgasm, intercourse, sexual performance or pharmacological interventions, it establishes an in-depth understanding of sexual behaviour from a holistic perspective. This is established by open-ended questions centring on sexual feelings and sexual meanings.  This may ultimately affect treatment modality and intervention strategies. Indeed, the author argues that, “Sexuality and spirituality are seemingly irreconcilable concepts in most of mainstream American culture. Perhaps they are especially irreconcilable in current sex research and therapy, where sexual norms are based on what can be counted and measured in random controlled trials and evidence-based treatments” (p. 8).

The overwhelming and multidimensional responses to sexual experiences, obtained from the survey, included a very powerful means of highlighting the importance of questioning and in the understanding that sex is more than just physical exchanges. Further, “… that erotic satisfaction was embedded in [the] relationship with a partner or partners, and most importantly with themselves--- not only as masturbation but also as a sense of extraordinary awareness, self-esteem and connection” (p. 13).  Refreshingly, the author emphasises that age, or more specifically, old age does not imply sexual abstinence. Whilst aging can be associated with sexual dysfunction owing to aetiological physical changes, this only reinforces that sex is intercourse and orgasm rather than employing a more sexually diverse perspective. Further, not everyone who goes through the process of physical aging loses their sexual interest or prowess. This is a critical inclusion as it encourages clinicians to avoid being pre-assumptive regarding the relationship between age and sexual behaviour. Arguably such a dogmatic assumption may negatively affect treatment modality.  Indeed, “The ISIS Wheel acts as a kind of generator for therapists who are hungry for healing modalities beyond performance-orientated and evidence-based approaches to sexual dysfunction” (p. 23).  Ultimately, this may liberate the clinician from the constrictions of formal sex therapy training which is arguably the true essence of an integrative approach. 

Part two of the book, commences with exploring and understanding the quadrants of sexual experience; namely, the embodiment of mind, body, heart and spirit along with their confluence. A diagrammatic representation of the ISIS wheel of sexual experience clearly presents the organizing principle for exploring the sexual stories and whether these are predominately physical, emotional, mental and/or spiritual. Each quadrant is excellently described and detailed providing a skills-based approach to addressing the ISIS wheel in an illustrative fashion. This is followed by the importance of skills training for validating integration and transformative work throughout the therapeutic process.

Part three is an essential read for clinicians and provides a step by step and easy to follow guide to ISIS practise. The author commences by detailing the four components  of the ISIS approach including creating and holding space, directing movement, creating ritual and concretizing abstract concepts. Importantly, reference to creating a group ISIS wheel has been included along with personal growth incentives. Indeed, such group processes can be carried over into sessions with individuals and couples. Compared to previous sections of the book, part three, provides empirically supported comparisons with cognitive behavioural and medical approaches. The author highlights the application of the ISIS model to existing therapeutic practises including “your own practise of psychotherapy, family therapy, Gestalt, sensorimotor work, meditation, energy healing, recovery groups, and more...” (p. 2). This section provides both a fascinating and varied number of case examples, including sexual dysfunctions and sexual abuse along with their clinical application to the ISIS model.

Part four centres on some of the challenges which may present clinicians during the therapeutic process. Since the book is aimed at those already practising in the field, it succinctly acknowledges and addresses some of the main issues, for example, countertransference and other presenting ethical considerations. From a common sense perspective, the author encourages clinicians to try the ISIS approach on themselves prior to working with clients and kindly offers additional support to those who require it.

In summary, this book provides an in-depth, interesting  and alternate means of addressing sex therapy from a physical, emotional, mental and spiritual perspective.   It is a highly captivating read and as the author highlights, “This book is not intended to be the last word on ISIS practise. It is my hope that future practitioners will expand ISIS practise...” (pp. 2-3). I found the book to be a contemporary, thought-provoking and up-to-date account of sex therapy. It is an essential read for clinicians working in the areas of sexology, counselling, psychology and psychiatry. Finally, one hopes this book will encourage a better understanding of sex therapy via the utilisation of ISIS, so that best practise may be instigated and future clinical contributions may be made.

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