Sex Therapy Pasadena | Intimacy & Sexual Issues Support

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Sex therapy for individuals, couples, and partners who want thoughtful support with desire, intimacy, sexual communication, pain, performance anxiety, shame, trauma, identity, or changes in their sexual lives.

Palomares Therapy offers in-person sex therapy in Pasadena and online therapy throughout California. Our work is relational, trauma-informed, sex-positive, LGBTQIA+ affirming and expertised, and welcoming of polyamorous, monogamous, open and consensually non-monogamous relationships.

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Meet the Danielle Palomares

When Sex & Eroticism Gets Difficult... And We Can't Talk About It

Sex and eroticism, in all its forms, can be one of the most connecting parts of a relationship and one of the more harrowing places to struggle. You may long to engage with more of your erotic energy, and find it difficult to activate. Alternatively, you may be in touch with a lot of erotic energy, but have contextual or biological realities that are getting in the way. And relationally, you may care deeply for a partner and still feel sexually distant or disconnected.

You may not understand why desire has changed, why your body no longer responds the way you wish it would, or why a conversation about intimacy so quickly becomes a conversation about rejection, pressure, shame, or inadequacy, but all of the not knowing usually leads to similar destinations: fear, anxiety, and sometimes, existential fears about your relationship/s.

Perhaps you have concerns less about specific symptoms and more about feeling disconnected from your own eroticism, uncertain about what you want, unable to say it aloud, or feeling lingering shame around your truth.

Many of the clients who arrive to our office have lived with these concerns for a long time before seeking support. Sex and peoples’ erotic worlds are often private, emotionally charged landscapes shaped by powerful, dominant (and frankly, domineering) messages about what it is “supposed” to look like.

Even people who are insightful, open, and comfortable discussing other parts of their lives may feel embarrassed, confused, defensive, or afraid when the conversation turns toward sex– and the stakes are even more heightened when we do so in front of our partner/s in couples therapy or relationship therapy.

Palomares Therapy offers a place to speak more honestly and understand what is happening with a non-pathologizing, embracing, and destigmatizing stance.

Couple sharing an intimate moment together in bed

Sex therapy may involve us exploring your emotional and relational worlds with depth, walking through practical sex and relationship education that you may not have been privileged to receive, shift attention to the body and nervous system, experiment with different tools, exercises, visualizations or somatic work. When we support clients who are working through sexual challenges, we may need to collaborate with fellow medical providers on your team– pelvic floor therapists, psychiatrists, couples therapists or individual therapists, or your physicians. Usually, sex therapy involves a combination of these depending on what you’re bringing forward.

I want to also state this plainly: the goal is never to force a particular kind or frequency of sex, but rather, to help you develop a sexual life that is more informed, consensual, connected, authentic, and genuinely responsive to who you are. To be frank, sometimes this work may lead to grief work as well, particularly when dealing with contexts or factors that are not changeable.

We are here to support you through it.

Who Sex Therapy Is For

Sex Therapy for Couples & Partners

Couples and partners often seek sex therapy when desire has become uneven, initiation feels loaded, a rupture has occurred, affection has diminished, or the subject of sex repeatedly ends in conflict or avoidance.

One person may feel lonely, unwanted, or frightened that the relationship is slipping away, while the other feels pressured, scrutinized, or as though their body has become a problem to solve. Over time, both people can become protective, and the pattern itself begins to make closeness harder.

In couples therapy with a sex therapy focal point, we slow that cycle down. We explore the meanings each person has come to attach to sex, desire, refusal, initiation, pleasure, and connection.

We also make room for the practical realities affecting your sexual relationship, including stress, parenting, health, medication, sensory needs, trauma, changing bodies, and the simple fact that two people rarely have identical rhythms throughout the life of a relationship.

The work is not about determining whose desire is “correct.” There is no such thing. Rather, it’s about helping both partners feel understood while building a more collaborative way of approaching intimacy.

Sex Therapy for Individuals

You do not need to be partnered to work with us. Individuals may come to us to explore sexual shame, body image, identity, desire, performance anxiety, difficulty with arousal or orgasm, the effects of trauma, questions about kink or relationship structure, or a sense of disconnection from their own body and preferences.

Some clients are dating or entering a new relationship and want to communicate more clearly. Others are grieving changes related to illness, medication, infertility, postpartum life, disability, menopause, aging, or the end of a relationship.

Individual sex therapy can provide space to understand your experience without having to manage a partner’s reaction at the same time.

We can work with the beliefs, emotions, protective responses, relationship history, and physical or contextual factors shaping your sexual life while helping you develop language for your needs, boundaries, curiosities, and choices.

Couple sharing a warm and affectionate moment together

Concerns We Can Explore in Sex Therapy

Desire Differences & Sexual Disconnection

Differences in sexual desire are among the most common reasons partners seek sex therapy. These differences can become painful when one person experiences sex as an important path to connection and reassurance while the other experiences growing pressure, anxiety, or a need for more space.

Therapy helps us move beyond a simple “high desire” and “low desire” story to understand the emotional, relational, physiological, and contextual factors shaping each person’s experience.

Performance Anxiety & Sexual Functioning

Erectile concerns, difficulty becoming or remaining aroused, challenges reaching orgasm, rapid ejaculation, and other changes in sexual functioning can carry an enormous amount of shame. Worry about what will happen can make it harder to remain present, creating a self-reinforcing cycle of vigilance, disappointment, and avoidance.

We can work on reducing pressure, broadening the definition of satisfying sexual connection, and addressing the emotional meanings that have gathered around the concern.

Sexual Pain, Health & Bodily Changes

Pain during sexual activity is real and deserves to be taken seriously. So do the effects of chronic illness, disability, medication, hormonal changes, pregnancy, postpartum recovery, infertility, medical trauma, and aging. Psychotherapy does not replace appropriate medical assessment.

When helpful and with your consent, I can work collaboratively alongside physicians, pelvic-floor physical therapists, and other healthcare professionals while we address anxiety, grief, relationship strain, communication, and the loss of trust that can develop when the body no longer feels predictable.

Sexual Shame, Body Image & Self-Insight

Many people were taught to fear, hide, judge, or disconnect from parts of their sexuality. Messages from family, religion, culture, gender roles, past relationships, or limited sex education can remain powerful even when your adult values have changed.

Therapy can help you examine these narratives with compassion, make sense of the parts of you that still anticipate judgment, and develop a relationship with sexuality that feels more congruent with your values and identity.

Trauma, Consent & Felt Safety

Sexual assault, coercion, relational betrayal, attachment trauma, and other experiences of harm can affect trust, boundaries, arousal, touch, dissociation, and the body’s ability to remain present. Trauma-informed sex therapy moves carefully.

You will not be pushed to disclose details or move toward sexual activity before there is enough safety and readiness. Depending on your needs, we may focus on stabilization, nervous-system regulation, parts work, attachment-focused therapy, or EMDR while preserving your autonomy throughout the process.

Neurodivergence, Sensory Needs & Sexuality

ADHD, autism, AuDHD, sensory-processing differences, chronic overwhelm, and executive-functioning differences can all shape sexual experience. A person may seek novelty and intensity while also becoming easily distracted or overstimulated. Transitions into intimacy may be difficult after a demanding day.

Differences in sensory preferences, communication style, interoception, demand sensitivity, or emotional processing may be misread as rejection or lack of care. Neurodivergent-affirming sex therapy helps partners understand how each person’s brain and body work without treating neurotypical expectations as the standard everyone must meet.

Kink & BDSM

Therapy can be a place to discuss kink, BDSM, fantasy, power, consent, and boundaries without assuming that these interests are inherently pathological. We work from a kink-affirming perspective, creating space to explore what these experiences mean to you and how they intersect with identity, intimacy, communication, pleasure, trauma, and relationships.

When conflict or distress arises, we attend to the actual concern rather than treating consensual sexual interests— or the people who engage in them— as the problem.

Expansive Relationship Structures

We work affirmatively with people in polyamorous, consensually non-monogamous, open, monogamish, and other expansive relationship structures, as well as with LGBTQIA+ clients whose relationships may not fit conventional expectations.

Therapy may include exploring jealousy, boundaries, agreements, attachment needs, communication, relationship transitions, or differences in what each partner wants. When there is conflict or distress, we focus on the actual concern rather than assuming that your relationship structure is the source of the problem.

Life Transitions & Evolving Sexuality

Sexuality often evolves across a lifetime. Parenthood, infertility, grief, aging, menopause, illness, disability, career stress, caregiving, relationship transitions, and changes in identity can alter desire, availability, embodiment, and the meaning of sex.

Therapy can help you grieve what has changed, understand what is emerging, and develop a sexual relationship that fits your present life rather than measuring it against an earlier version of yourself or an outside ideal.

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Sex Does Not Exist in a Vacuum

Sexuality is shaped by far more than attraction. It is affected by stress, sleep, medication, pain, hormones, disability, parenting, grief, sensory experience, body image, identity, relationship safety, cultural and religious messages, and the meanings we learned to attach to closeness.

A sexual concern may be connected to the nervous system, a relationship pattern, a medical issue, a lack of accurate information, an old protective response, or several factors operating at once.

At the same time, not every sexual difficulty is evidence of trauma or a failing relationship. Sometimes people need better information, more precise language, permission to let go of a narrow sexual script, or practical ways to communicate and experiment differently.

My approach makes room for complexity without searching for pathology where it does not belong. We can be curious about what lies underneath a pattern while also addressing what might help in the present

Our Approach to Sex Therapy

I am a Licensed Marriage & Family Therapist and a Certified Emotionally Focused Couples Therapist with advanced and ongoing training in sexology, desire and intimacy, trauma, consensual non-monogamy, EMDR, and attachment-focused work. My approach is active, collaborative, and integrative. I will not sit at a distance while you struggle to find the right words, and I will not impose a template for what a healthy sexual life is supposed to look like.

Begin With Context, Not Assumptions

We begin by understanding the concern within the context of your actual life. Depending on what brings you in, we may explore relationship patterns, sexual and relational history, health, medication, stress, culture, faith, gender, identity, trauma, neurodivergence, body image, and the messages you received about sex.

You choose the pace and level of detail. The purpose of this history is not to scrutinize you, but to build a thoughtful picture of what may be contributing and what kind of support is likely to fit.

Understand the Pattern Without Assigning Blame

In work with couples and partners, I draw heavily from Emotionally Focused Therapy to understand the cycle that develops around sex. Pursuit, refusal, disappointment, pressure, shutdown, reassurance-seeking, and avoidance can all become ways of protecting against deeper fears.

When we can see the pattern as the shared problem, rather than locating the problem in one person’s body or level of desire, partners often become more able to hear each other and respond with care.

Combine Emotional Depth With Practical Support

Insight matters, but insight alone may not change what happens between partners or inside the body. Sex therapy may include accurate sexual-health information, communication practice, work with boundaries and consent, broadening sexual scripts, identifying conditions that support desire, and optional exercises to explore between sessions.

When trauma, shame, attachment wounds, or protective parts are central, we can integrate EMDR, parts-informed work, somatic awareness, Narrative Therapy, and attachment-focused approaches. We decide together what the work needs rather than forcing every concern into the same modality.

Work Collaboratively With Medical Providers

Sexual concerns can have psychological, relational, and physical contributors. Pain, sudden changes in functioning, hormonal shifts, medication effects, and other health concerns may warrant evaluation by an appropriate medical provider.

With your permission and when needed, therapy can complement the work of physicians, pelvic-floor physical therapists, and other specialists so that the emotional, relational, and physiological parts of the concern are not treated as though they exist separately.

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What Sex Therapy May Look Like

The first sessions are usually devoted to understanding what brings you in, what has already been tried, how the concern affects you or your relationship, and what you hope will feel different.

For couples or partners, I want to understand each person’s experience and the cycle that has developed between you.

For individuals, we may spend more time exploring personal history, beliefs, identity, embodiment, relationship experiences, and current goals. You do not need to arrive with a polished explanation.

Finding language together is part of the work.

Sex therapy is talk-based psychotherapy. There is no sexual touch, nudity, or sexual activity in session.

Depending on your goals, sessions may include reflective conversation, psychoeducation, nervous-system and somatic awareness, communication practice, trauma-focused work, or optional exercises completed privately between sessions.

Every intervention is discussed collaboratively, and consent can be revisited at any time.

Therapy may be exploratory and emotionally deep, direct and skills-focused, or move between both. Some clients want to repair a painful sexual pattern in a long-term relationship.

Others want to understand themselves with more freedom and less shame. We will shape the work around the life and relationships you actually have, not around an idealized picture of sexuality.

Couple sitting apart during a therapy session

Specialized, Affirming Care for the Whole of Your Experience

Sexual concerns often overlap with other parts of a person’s life. Clients may benefit from the attachment and communication focus of couples therapy, the pacing and nervous-system awareness of trauma therapy, or specialized support for survivors of sexual assault and relational violence. For clients whose concerns involve attention, sensory processing, masking, or mixed-neurotype dynamics, our neurodivergent couples therapy and neurodivergent adult therapy specialties may also be relevant.

We also provide affirming therapy for LGBTQIA+ clients and for people practicing or considering polyamory and consensual non-monogamy. Your identity, consensual sexual interests, neurotype, culture, body, or relationship structure will not be treated as a problem to correct.

Comfortable therapy office at Palomares Therapy in Pasadena, California, featuring a welcoming space for individual, couples, and family counseling.

Sex Therapy in Pasadena and Online Across California

Palomares Therapy offers in-person sex therapy by appointment at 210 S. Orange Grove Boulevard in Pasadena, California. We work with clients from Pasadena, South Pasadena, San Marino, Altadena, Eagle Rock, Glendale, Monrovia, the broader San Gabriel Valley, and greater Los Angeles. Online sex therapy is also available to individuals and partners located throughout California.

Some clients prefer the privacy and convenience of telehealth, while others feel more grounded meeting in person. Local clients may also move between the two depending on scheduling and clinical needs.

Common Questions About Sex Therapy

What is sex therapy?

Sex therapy is a form of psychotherapy focused on sexual concerns, intimacy, desire, communication, identity, functioning, shame, trauma, and the ways sexuality intersects with relationships and emotional well-being. It is talk-based and may include psychoeducation, relational work, trauma-informed interventions, and optional exercises outside of sessions.

**Can I work with you on other issues and sexual issues?**

Absolutely. Part of the reason we specialize in several intersecting areas—including trauma, sexual concerns, neurodivergence, gender and sexuality, attachment, and relationships— is that we know these parts of our lives rarely exist in isolation.

Too many of our clients arrive in our office after being referred elsewhere (and often many times) whenever something arises that falls outside their therapist’s comfort or experience. We understand that therapists have an ethical responsibility to practice within their areas of competence. At the same time, we know how disruptive it can be to interrupt an established therapeutic relationship, particularly when the concerns you are bringing are deeply intertwined.

Rather than expecting you to divide yourself into separate parts for separate providers, we are committed to continually expanding our knowledge and skills through consultation, training, and ongoing study. If something emerges that stretches the limits of our current expertise, we will be transparent with you and thoughtfully assess what is needed. Whenever it is clinically appropriate, we will do the work necessary to continue supporting you, while also being honest if specialized or additional care would better serve you.

What happens in the first sex therapy session?

The first session is a chance to discuss what brings you in, how the concern is affecting you or your relationship, and what you hope will change. We may explore relevant relational, emotional, medical, cultural, or sexual context, but you will not be expected to share every detail before you feel ready. It is also an opportunity to ask questions and decide whether the therapeutic fit feels right.

Can I come to sex therapy without my partner?

Yes. Sex therapy can be helpful for individuals as well as couples and partners. Individual work may focus on desire, shame, body image, sexual identity, trauma, performance anxiety, boundaries, pleasure, dating, or understanding your own sexual patterns. If a partner later joins, we will discuss the clinical and confidentiality implications first.

Does sex therapy involve touch or sexual activity in session?

No. Sex therapy is professional, talk-based psychotherapy. It never includes sexual contact, nudity, sexual activity, or physical demonstrations between a therapist and client. Some clients choose to complete therapeutic exercises privately outside of session, but these are discussed in advance and are always optional.

Can sex therapy help when there may be a medical or physical issue?

Yes, as one part of a coordinated approach. Therapy can address anxiety, shame, grief, avoidance, communication, relationship strain, and the emotional effects of pain or changes in functioning. It does not replace medical care. When appropriate and with your consent, I may recommend or collaborate with a physician, pelvic-floor physical therapist, or another qualified provider.

Is your practice affirming of LGBTQIA+, kink, and non-monogamous clients?

Yes. Palomares Therapy welcomes LGBTQIA+ clients, kink and BDSM communities, and people in polyamorous, open, consensually non-monogamous, monogamish, and other expansive relationships. Therapy focuses on the concern you bring rather than treating identity, consensual interests, or relationship structure as pathology.

Beginning the Conversation

You do not need to know exactly what is wrong, have the perfect language for what you are experiencing, or decide in advance what a satisfying sexual life should look like.

A consultation is simply a place to share a little about what brings you in, ask questions, and get a sense of whether working together feels like the right fit.

If you are looking for sex therapy in Pasadena or online anywhere in California, you are welcome to reach out.

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