Sex Therapy in Indianapolis for Couples & Individuals
Sex can be wonderful.
It can also become complicated, awkward, painful, frustrating, anxiety-producing, emotionally loaded—or somehow disappear from a relationship entirely.
Sometimes the problem is desire. Sometimes it’s your body not cooperating the way you'd really prefer it would.
Sometimes two people love each other very much and want completely different things sexually.
And sometimes you aren't even sure what the problem is. You just know sex does not feel the way you want it to anymore.
I’m Jill Frame, LMFT, CST, an AASECT Certified Sex Therapist in Indianapolis, and I work with individuals and couples dealing with sexual concerns, intimacy problems, desire differences and the many ways our bodies, brains, histories and relationships manage to make sex considerably more complicated than health class led us to believe.
Jill is a Licensed Marriage & Family Therapist and AASECT Certified Sex Therapist with specialized training in relationships, sexuality, trauma and EMDR.
Talk therapy, fully clothed
No touching, no nudity, no exams. Conversations, in the office or on video.
Nobody's libido is the right one
Wanting more is not greedy. Wanting less is not broken.
No sex quota
You will never be asked to push through pain, dread or a no.
Alongside your doctor
Erections, pain and hormones get a medical look when they need one.
You may be thinking...
Or maybe the question underneath all of those questions is:
Here’s the good news:
Sexual concerns are incredibly common.
And...
It’s okay to talk about sex here.
One of the biggest sexual health problems I see isn't actually about sex.
It's that people are terrified, embarrassed or ashamed to talk about what is happening.
And that can make everything worse.
Because any human problem is made infinitely more painful by feeling alone in that problem.
You don't have to have the right terminology. You don't need a perfectly organized sexual history. And you certainly don't need to shock me.
"Nonjudgmental" is an easy word to put on a website. Here is what it looks like in my office: you tell me the thing you've never said out loud, and what you get back is a follow-up question. Not a face. Not a pause. I am more curious than I am surprised.
You can just tell me what’s happening.
We’ll figure out the rest together.
First: sex therapy is therapy.
Sex therapy is psychotherapy focused specifically on sexual health, sexual functioning, intimacy, relationships and sexuality.
Depending on why you're coming in, we may look at your sexual history, beliefs about sex, relationship patterns, communication, anxiety, trauma, medical issues, medications, body image, desire, arousal, orgasm, pain, expectations or the enormous pile of meaning we humans can attach to sex.
Sometimes education is useful. Sometimes communication work is useful. Sometimes the issue is primarily relational. Sometimes anxiety is hijacking your body. Sometimes there is trauma underneath the problem.
And sometimes we need to coordinate with another professional—such as your physician, gynecologist, urologist or pelvic-floor physical therapist—because sexual functioning is not purely psychological.
Your sex life exists inside a body, a nervous system, a relationship and an actual human life.
So we look at the whole thing.
Curious what a session feels like from the chair? I wrote the long version.
Nobody gets talked into a number.
This matters enough to say plainly. Sex therapy does not come with a quota, and I will never ask you to push through pain, dread or a no.
If you're the partner who wants less, that gets to be where we start. If you're the partner who wants more, you get to say so without being treated like the problem.
Both of those people are allowed in the room. Usually they arrive together.
Fifteen minutes with me
You talk to me, not an intake line. Tell me what's going on in whatever words you have. I'll tell you honestly whether I'm the right person, and if I'm not, who is.
Your first session
We start with a sexual history. That sounds more clinical than it is. I'll ask how you learned about sex, what has worked, what changed, what worries you and what you'd like to be different. If you're a couple, I want both versions.
You set the pace. If retelling your history feels like an impossible burden, say so in the first five minutes. Nothing painful has to be told in full on day one. Then we go from there.
Between sessions
Sometimes there's something to notice or try before we meet again. It's built around you, not pulled from a workbook, which is why I don't list examples here. Everything is optional, everything can be adjusted, and "that one didn't feel right" is useful information, not a failure.
How we know it's helping
We set goals early and I check back on them out loud, including whether we should change course. I won't quote you a number of sessions, because I'd be making it up. You will always know where we stand.
Sessions are 55 minutes, in person or by video. Fees, out-of-network details and superbills are on the Fees & FAQ page.
When you love each other but your sex life isn't working
One of the most common reasons couples come to sex therapy is desire discrepancy—one partner wants sex more frequently than the other.
And unfortunately, what starts as a difference in desire can slowly turn into something much bigger.
One person feels rejected.
The other feels pressured.
One reaches.
The other braces.
Then both people begin interpreting what happens sexually as evidence about the relationship.
You don't want me.
Sex is all you care about.
I'm never enough.
I'm only valuable if I have sex.
You aren't attracted to me.
I'm going to disappoint you again.
Pretty soon nobody is having much fun.
Couples sex therapy can help you understand what is happening underneath the sexual pattern and create a different way of talking about desire, rejection, initiation, pleasure, boundaries and connection.
The goal isn't to declare one person's libido correct.
It's to build a sexual relationship that makes room for two actual people.
More on this: mismatched sex drives and when a sexless marriage is actually a problem.
Couples come to sex therapy for concerns including:
Mismatched sex drives or desire discrepancy, low-sex or sexless relationships, loss of sexual desire, difficulty initiating sex, feeling rejected or pressured, differences in sexual interests, sexual communication, rebuilding intimacy after betrayal, changes in attraction and reconnecting after emotional distance.
“Why don't I want sex anymore?”
Low desire doesn't always mean something is wrong.
Desire can change with stress, hormones, medication, pregnancy, postpartum changes, menopause, illness, resentment, trauma, relationship dynamics, exhaustion, depression, anxiety and approximately twelve thousand other features of being human.
And people experience desire differently.
Spontaneous desire
The seemingly out-of-nowhere “Hey, sex sounds great” kind.
Responsive desire
Desire that tends to emerge after sexual or affectionate connection begins, rather than before it.
Neither one is inherently better. (Here's the longer explanation, because this one changes marriages.)
But if two partners experience desire differently and don't understand what is happening, it can create years of unnecessary hurt.
Sex therapy can help us figure out what is influencing desire, what belongs to your body, what belongs to the relationship, what belongs to your history—and what might actually be changeable.
When your brain turns sex into a performance review
Erection difficulties are common.
They are also particularly talented at creating anxiety.
Maybe you had difficulty getting or maintaining an erection once.
Then the next time you wondered whether it would happen again.
Then you started monitoring yourself.
Is it happening?
Is it going away?
Does my partner notice?
What if I can't perform?
Congratulations. Your brain has now invited itself into the bedroom with a clipboard.
Sex therapy can help with the psychological and relational components of erectile dysfunction, unpredictable erections and sexual performance anxiety.
Erections that work alone but disappear with a partner are a very familiar version of this. So is losing it right before penetration, and then watching for it the next time.
When appropriate, I also encourage medical evaluation because erection changes can have physical causes and deserve to be taken seriously. I will never tell you it's all in your head. Two things can be true at once.
This is not about telling yourself to “relax.”
It is about understanding the cycle and changing it.
Sometimes your body isn't following the script.
Orgasm and ejaculation concerns
Some people have difficulty reaching orgasm. Others orgasm much faster than they would like.
Some can orgasm alone but not with a partner. Some need a vibrator and have been told that's a problem. Some have never had an orgasm and are quietly wondering if something is wrong with them. Some suddenly notice that something that used to work doesn't anymore.
These experiences can become especially distressing when sex starts feeling like a test everyone is waiting for you to pass.
Sex therapy can address difficulty reaching orgasm, orgasm anxiety, early or premature ejaculation, delayed ejaculation, changes in sexual response and pressure around sexual performance.
Pleasure usually works better when it stops being graded.
Painful sex
Sex should not require you to grit your teeth and get through it.
Pain during sex deserves attention.
Sex therapy can be part of treatment for concerns such as painful intercourse, vaginismus, vulvodynia, fear of penetration and anxiety related to sexual pain.
Because pain can have multiple causes, I may recommend working alongside a gynecologist, physician or pelvic-floor physical therapist. "Your doctor says everything looks fine" does not mean nothing is happening, and "you're not broken" is not the same sentence as "there's nothing medically wrong." You deserve both taken seriously.
When your body has learned that sexual activity predicts pain, treatment often needs to address fear, anticipation, muscle tension, avoidance, communication, trust and the nervous system's very reasonable attempt to protect you.
Your body changed. That is not the same as your love changing.
These changes are normal. They are also almost never discussed, which is how one partner ends up hearing I don't love you when the other one means my body is different now and I don't have the words yet.
Sex therapy gives you the words.
We look at what has actually changed physically, what deserves a conversation with your doctor, what the two of you have been assuming about each other, and how to build a version of intimacy that fits the bodies you have now rather than the ones you had at thirty.
Different does not have to mean over.
Sometimes your mind knows you're safe before your body does.
Past sexual experiences, trauma, betrayal or other frightening experiences can change the way your nervous system responds to intimacy.
Or genuinely want intimacy and still notice your body saying, Absolutely not.
That doesn't mean you're incapable of having a fulfilling sex life.
It means we need to understand what your nervous system has learned.
Because I also work with trauma and EMDR, we can address traumatic experiences when they are part of the sexual concern—carefully, collaboratively and without forcing you through something before you're ready. EMDR can work with a memory without you narrating every detail of it.
Sex gets complicated when you're busy wondering whether you're doing it wrong.
Many people arrive in my office with an invisible rulebook about sex.
How often you're supposed to want it. How your body is supposed to respond. What you're supposed to enjoy. How long something is supposed to take. What a “normal” couple supposedly does.
What your body is supposed to look like.
And whether whatever is happening in your sex life means something terrible about you.
Sex therapy gives us room to examine those assumptions without judgment. You do not have to abandon your values, your faith or your history to have a sex life you enjoy. You just have to be willing to look at which rules are actually yours.
We can work on sexual confidence, body image, sexual shame, anxiety about sexual functioning, communication, boundaries and developing a sexual life that actually fits you rather than an imaginary standard.
“Am I doing this too much?”
Sometimes people come to therapy worried about pornography, masturbation or sexual behavior that feels difficult to control.
I don't begin with the assumption that sexual behavior automatically equals “addiction.”
I'm much more interested in what is actually happening.
- Does the behavior feel compulsive? Are you trying unsuccessfully to stop?
- Is it interfering with your relationship, work or daily life?
- Is it connected to anxiety, shame, loneliness, trauma or avoidance?
- Are you violating agreements in your relationship?
- Or are you distressed primarily because you've been taught that the behavior itself is wrong?
Those are very different problems.
We can figure out which problem you actually have before deciding what to do about it.
Why can it be so hard to talk about something so human?
Most of us were never given particularly useful tools for discussing intimacy, eroticism, fantasies, boundaries or sexual desire.
Instead, many of us received some combination of silence, embarrassment, jokes, misinformation and warnings.
And then somehow we're expected to become adults who communicate beautifully about sex.
Of course it can feel awkward.
In the beginning of therapy, many clients find talking about sex surprisingly uncomfortable.
I encourage you to think of it like learning a foreign language.
At first you're concentrating on every word.
Eventually, with practice, it gets easier.
Talking about sex and other intimate matters can be daunting, but I believe that with a little humor, depth, compassion and caring, sex therapy can even be fun.
Yes.
I said fun.
Years ago, the therapist turning bright red was me.
My clients started asking incredibly vulnerable questions about sexuality—and I realized my general therapy training had not prepared me to answer them nearly as well as I wanted to.
So I went back for extensive specialized training in sexuality and sexual health and became an AASECT Certified Sex Therapist. In plain English, that means specialized education in human sexuality, supervised clinical hours doing sex therapy specifically, and ongoing training, all sitting on top of the license. Here's what the credential means and how to check it.
Today, sex therapy is one of the central parts of my practice.
I'm also a Licensed Marriage and Family Therapist, couples therapist and EMDR therapist.
That combination matters because sexual concerns rarely arrive neatly separated from everything else.
Sex gets tangled up with relationships. Relationships get tangled up with attachment. Bodies get tangled up with anxiety. Trauma gets tangled up with sex.
And sometimes the argument that appears to be about sex hasn't actually been about sex for approximately seven years.
We can talk about all of it.
Jill Frame, LMFT, CST · AASECT Certified Sex Therapist · Broad Ripple, Indianapolis
Sex therapist. Couples therapist. Human being who is very hard to embarrass.
I'm Jill Frame, a Licensed Marriage and Family Therapist and AASECT Certified Sex Therapist at High Thrive Counseling in Indianapolis.
My style is warm, direct, curious and collaborative.
I am not particularly interested in spending months carefully circling around the thing you came here to discuss.
If sex is the issue, we can talk about sex.
If your relationship is the issue, we'll talk about your relationship.
If trauma is sitting underneath both, we'll talk about that too.
I work with people of every orientation and gender identity. LGBTQ+ clients are welcome here, and you will not spend your sessions educating me.
You are allowed to laugh. You're allowed to be embarrassed. You're allowed to say, “I cannot believe I am telling you this.”
You probably won't be the first.
Sex therapy in Indianapolis, and online throughout Indiana and Florida
High Thrive Counseling is located in Broad Ripple, Indianapolis and serves adults and couples throughout Indianapolis and surrounding communities, including Carmel, Fishers, Zionsville and Brownsburg.
Online sex therapy is also available by video anywhere in Indiana and Florida. Same 55-minute sessions, same therapist.
Questions people ask before they call
What happens at the first appointment?
We start with a sexual history. I'll ask how you learned about sex, what has worked, what changed, what worries you and what you'd like to be different. For couples, I want both versions. You set the pace, and nothing painful has to be told in full on day one. From there we decide together what the work looks like: individual sessions, couples sessions or a mix, and whether a doctor or pelvic-floor physical therapist should be part of the picture.
Will you expect me to have more sex?
No. Sex therapy does not set a quota, and I will never ask you to push through pain, discomfort or a no. If you're the partner who wants less, that is allowed to be the starting point. If you're the partner who wants more, you're allowed to say that without being made the problem. The goal is a sex life that works for both of you, not one person's preferred frequency with a therapist's stamp on it.
What is sex therapy?
Sex therapy is psychotherapy focused on sexuality, sexual functioning, sexual health and intimacy. Sessions may address desire, arousal, orgasm, sexual pain, erectile concerns, performance anxiety, relationship dynamics, sexual communication, shame, trauma and other factors affecting your sexual life.
What happens during a sex therapy session?
We talk. Depending on your goals, we might discuss your sexual history, relationship, sexual functioning, beliefs about sex, anxiety, communication, body image, trauma, desire or specific situations causing distress.
Does sex therapy involve touching or sexual activity?
No. Sex therapy is talk therapy, fully clothed, in a regular office or on video. There is never sexual contact or a physical examination. A Certified Sex Therapist does not engage in sexual activity with clients during therapy—ever. Anything physical that comes up in treatment happens privately, between partners, on your own terms.
Do you provide sex therapy for couples?
Yes. I work extensively with couples around mismatched desire, different sex drives, low-sex relationships, sexual dissatisfaction, difficulty initiating sex, rejection and pressure cycles, sexual communication and rebuilding intimacy.
Can sex therapy help with low libido or mismatched desire?
Yes. Desire discrepancy is one of the most common concerns I see. We look at relationship dynamics, stress, hormones, medications, mental health, life stage, trauma, sexual scripts and differences between spontaneous and responsive desire.
Can sex therapy help with erectile dysfunction?
Sex therapy can be particularly helpful when anxiety, pressure, relationship dynamics or psychological factors contribute to erection difficulties, which they very often do even when a medical cause is also present. Because erectile dysfunction can also have medical causes, medical evaluation may be an important part of treatment. More on performance anxiety here.
Can sex therapy help with painful sex or vaginismus?
It can be one part of treatment. Painful sex can involve physical, psychological and relational factors, so treatment may also include collaboration with a physician, gynecologist or pelvic-floor physical therapist.
Can sex therapy help after sexual trauma?
Yes. Sexual trauma can affect desire, arousal, touch, trust, safety, body awareness and intimacy. When trauma is contributing to a sexual concern, therapy can address both the trauma and the sexual or relationship patterns connected to it.
What if I'm embarrassed to talk about sex?
That would make you extremely normal. You don't have to walk into your first appointment enthusiastically announcing your sexual history. We'll get there, at a speed you can tolerate. And if you tell me something you've never said out loud, what you'll get back is a follow-up question, not a face.
Do I have to come with my partner?
No. I provide sex therapy to both individuals and couples. Sometimes the concern is primarily individual. Sometimes it is relational. Sometimes a combination makes the most sense. Plenty of people start alone and bring a partner in later.
What if my partner doesn't think there's a problem?
You can still come. We'll work on your side of it: what you want, what you're carrying, how you talk about it at home. Therapy can't change a person who isn't in the room, and I won't pretend otherwise, but it very often changes the conversation enough that the reluctant partner gets curious. If the real question is whether to stay in the relationship at all, discernment counseling is built for exactly that.
Do I have to explain everything right away?
No. If you've already done trauma work and the idea of retelling your whole history feels like an impossible burden, tell me that in the first five minutes. We'll work with what you choose to share, when you choose to share it. I'm trained in EMDR, which can address a traumatic memory without narrating every detail of it.
Is there homework?
Sometimes there are things to notice or try between sessions. They're built around you, not pulled from a workbook, which is why I don't list examples here. Everything is optional, everything can be adjusted, and "that one didn't feel right" is useful information, not a failure.
Should I see a doctor too?
Often, yes, and I'll tell you when. Erection changes, pain with sex, and shifts around menopause or medication deserve a medical look, and "your doctor says everything looks fine" doesn't mean nothing is happening. I regularly coordinate with physicians, gynecologists, urologists and pelvic-floor physical therapists. Therapy works alongside that care, not instead of it.
How much does it cost, and how do we know if it's helping?
Current fees, out-of-network details and how superbills work are on the Fees & FAQ page. On progress: we set goals early and I check back on them openly, including whether what we're doing is working. I don't promise a fixed number of sessions, because I'd be making it up. I do promise you won't be left wondering whether we're getting anywhere.
Is what I tell you private?
Yes, with the legal limits every therapist has, which I'll walk you through at the start. In couples work we'll agree up front on how I handle things one of you tells me individually, so nobody is surprised later. One practical note: a superbill submitted to insurance carries a diagnosis code. If you'd rather keep this entirely off your insurance record, say so and we'll talk it through.
Is this a good fit for LGBTQ+ clients?
Yes. I work with people of every orientation and gender identity, and you won't spend sessions educating me. Sex therapy is about your sex life and your relationship as they actually are.
Do you offer online sex therapy?
Yes. I see clients by video anywhere in Indiana and Florida; sessions are 55 minutes either way. You need to be physically in one of those states during the session and somewhere you won't be overheard. For couples, same room or two screens both work.
How do I get started?
Start with a free 15-minute phone consultation with me, Jill, not an intake line. You don't have to tell me your entire sexual history in fifteen minutes. Just give me the basic version of what is happening, and we'll figure out whether I'm the right person to help. If I'm not, I'll tell you who is.
You don't need to have the right words before you start.
Tell me the basic version of what is happening. You can bring the concern and your uncertainty about changing it; both belong in the room.