Can you find love advice online? Yes, if you could trust it.
April 10, 2000 (Reno, Nev.) -- Shari Dawson (not her real name) was having
difficulty with physical intimacy and pain during sex, but was too embarrassed
to bring it up with her doctor.
Instead, Dawson found a free Internet site where the doctor posted her
question and, in his answer, suggested she get in-person therapy. "The
Internet got me on the right path," she says. "I wasn't scared to talk
about it anymore. I went to my doctor and found out I had a bladder infection.
She also put me on a long-term therapy program with my partner to become more
comfortable with physical intimacy."
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While the cast of television's "Sex and the City" discuss a myriad
of sexual quandaries with ease, in real life, most people -- like Dawson --
will stammer through questions about such topics as pain during sex or
masturbation. In fact, embarrassment can be the biggest obstacle between a
sexual problem and help. That's where online sex experts can help, says Deborah
Fox, MSW, a Washington, D.C., sex therapist with her own web site. "The
Internet is useful for addressing sexual problems because people are able to
ask questions that [otherwise] make them feel uncomfortable."
Online Roles and Limitations
Fox and other sex therapists offer their expertise online, providing
educated responses to a variety of questions. They're quick to point out that
this does not, however, qualify as therapy. At "Ask the Sex Doc," for
example, William Fitzgerald, PhD, a sex therapist in Santa Clara, Calif., posts
his answers to hundreds of questions, choosing the ones he feels are most
Common questions easily answered online, according to Fitzgerald, include
the effect of masturbation on sexual performance, the regaining of sex drive
after the death of a spouse, and the way to approach a spouse about acting out
a sexual fantasy. Some sites answer questions free of charge and post the
answers for other users to see, while they may require a fee for answering
Sandor Gardos, PhD, an online sex expert, also responds to questions on many
sexual topics. But when a question is beyond the scope of what can be or should
be answered online, Gardos is quick to suggest face-to-face professional help.
He and other online sex therapists often recommend traditional therapy for
issues that involve more complex problems, such as childhood sexual abuse. Fox
adds that current technology simply doesn't allow for the equivalent of
ongoing, in-person meetings necessary to resolve many sexual issues.
The Marriage of Therapy and Technology
Online sex therapy falls under the umbrella of "telemedicine," which
also includes videoconferencing and telephone therapy. Because telemedicine is
in its infancy, the American Psychiatric Association and the American
Psychological Association are still grappling with guidelines. Even so, both
organizations emphasize that therapists who are online must adhere to ethics
standards already in place.
William Stone, MD, who is on the American Psychiatric Association's
Committee on Telemedicine, says the new technology is a mixed blessing.
Although it is starting to bring therapy to people in remote locations, it also
has limitations and potential dangers. For instance, doctors can usually
prescribe drugs only in states where they are licensed to practice medicine,
making it difficult to treat patients signing on from other states. And the
images transmitted during videoconferences don't always allow detection of
subtle changes in body language or expression that are often helpful in making
a diagnosis during face-to-face meetings.