Interview - Sexuality and Relationship Therapy
My interview with David Khalili, LMFT, an open-minded and compassionate therapist who counsels clients with diverse sexualities, relationship styles, orientations, and genders.
Recently, I interviewed David Khalili, LMFT, a therapist with Rouse Relational Wellness. Rouse offers in-person or online psychotherapy, sex therapy, couples therapy, and group therapy operating under a tagline I love, “shame less, love more.” They’re based in the Castro neighborhood of San Francisco and also provide online services to clients in California and Florida.
I wanted to interview David because the practice of which he’s a part specifically mentions polyamory, kink, and sex generally as among their specialties. I also know they are LGBTQ and gender savvy. Having mental health providers who are culturally competent in these areas is vitally important to effective therapy and counseling. That’s one of the reasons I founded, along with Guy Baldwin, the Kink Aware Professionals referral service, which is now overseen by the National Coalition for Sexual Freedom. Fostering therapeutic professionals who understand the needs of much of my reading audience is important to me.
I hope this interview continues to encourage psychotherapeutic professionals to learn about the entire range of orientation, sexual, and relationship options because there is still far too much judgment and negativity about such topics among mental health professionals. I hope my readers glean some useful information and insights from the interview.
You offer sex-positive mental health support and couples therapy to gender and sexually diverse communities. Give me an example of some of the kinds of clients you have.
At Rouse Relational Wellness, we have the privilege of working with a wide array of individuals, couples, and polycules. For example, we might see a queer couple navigating opening up their relationship while also dealing with long-standing communication patterns. Or we could be supporting an individual who is exploring their kink identity and wants to integrate it more fully and healthily into their life, while also processing past (unrelated or related) trauma that impacts their intimacy. We also work with relationships of all sexual identities and relationship structures who are finding difficulty in having different levels of sex drive or interests.
Regarding gender, we work with couples where one partner is transitioning, and they need support navigating the shifts in their sexual and emotional landscape, or an individual desiring a safe space to openly discuss their relationship with their gender and find a definition that truly matches them. Our clients truly reflect the rich tapestry of gender and sexually diverse communities in San Francisco and across California.
What part does shame play in the minds of some of your clients?
Shame often plays a significant, though sometimes hidden, role in our clients' minds. It can stem from societal norms, past negative experiences, or internalized judgments about their desires, identities, or past sexual behaviors. Shame often manifests as anxiety around sexual expression, difficulty articulating needs, or even avoidance of intimacy. It can make people feel fundamentally flawed or "weird," preventing them from exploring their true selves or connecting authentically with partners. A core part of our work is creating a space where clients can unpack and release this shame, leading to greater self-compassion and empowerment.
You help clients talk more comfortably and their turn-ons and turn-offs. Got a few tips to share with my readers?
We truly love helping our clients gain more comfort talking more openly and honestly about their turn-ons, turn-offs, and any other desires and boundaries they hold. We’re raised in a double-bind where we are naturally sexual people, but are told or pressured to only talk about sex in particularly shame-based ways. So, we want to offer support and guidance to find their true sexual and romantic selves. Here are a few tips we often share:
Start Small and Low Stakes: You don't have to jump into your deepest fantasies right away. Begin with simple, easy conversations to build up comfort and vulnerability. What was a recent pleasant physical sensation for you? What kind of touch do you enjoy outside of sex?
Use "I" Statements: Talk about your own experience without making assumptions or demands of your partner. For example, "I feel really turned on when we..." or "I find it a turn-off when..."
Embrace Curiosity, Not Judgment: Approach the conversation with a genuine desire to learn about your partner, and ask them to do the same for you. Remember, there's no "right" or "wrong" turn-on or turn-off.
Non-Sexual Context: Sometimes, discussing sexual preferences in a non-sexual setting (like over coffee or during a walk) can feel less pressured and more relaxed than in the bedroom.
In one of your pamphlets, you suggest eight steps to promote an open dialogue between partners about their turn-ons and turn-offs. Can you tell me about that?
In our work, we try to adapt and simplify these steps to fit a client's needs, but the core idea of a structured, open dialogue is vital. While we have various tools, a common approach for promoting open dialogue about turn-ons and turn-offs often involves steps like:
Setting the Stage: Choose a relaxed, low-pressure time and place.
Mutual Agreement: Both partners agree to the conversation, understanding it's about exploration, not immediate action.
Define Terms: Clarify what "turn-on" and "turn-off" mean to each of you.
Individual Exploration (Preparation): Each person privately brainstorms a few things they know are turn-ons and turn-offs for themselves.
Share One at a Time: Each partner shares one turn-on or turn-off, allowing the other to listen without interruption.
Curious Inquiry: The listener asks open-ended questions to understand more deeply, as well as using active listening and repeating back what they heard. "Tell me more about that?" or "What about that feels good/uncomfortable for you?"
Acknowledge & Validate: Express understanding for what you've heard, even if it's different from your own experience. "I hear that X is really a turn-on for you."
Repeat & Revisit: This isn't a one-time conversation. Make it an ongoing part of your relationship, revisiting topics as you both grow and change.
What do you think are some of the biggest challenges people face when discussing their sexualities with current or potential partners?
The biggest challenges people face when discussing their sexualities with current or potential partners often boil down to fear and lack of language. There's fear of:
Rejection or Judgment: "Will they still love/like me if they know this about me?"
Shame and Embarrassment: Feeling that certain desires or experiences are "wrong" or "weird."
Lack of Knowledge: Not having the vocabulary or understanding to articulate complex sexual feelings or identities.
Past Trauma: Previous negative experiences around sex or vulnerability can shut down open communication.
Mismatched Desires: The anxiety that discovering different turn-ons/offs might signal incompatibility. Keep in mind that the key to this is deciphering if this is an ongoing incompatibility, or an incompatibility of where you’re at in your “seasons of life.” Meaning, there are natural ebbs and flows to our sexual energy throughout our lives, which is influenced by so many factors, so figuring out if this is a short-term issue or a long-term mismatch can be one of the challenges.
In your experience, how comfortable are people discussing their sexualities?
It’s definitely a varied mix. On the one hand, there's a growing movement towards sexual liberation and openness, especially among younger generations and in queer spaces. More people are exposed to diverse sexualities through media and advocacy. On the other hand, many individuals still carry significant shame and discomfort from their upbringing, societal messaging, or previous negative experiences. It's often easier for people to discuss general "relationship issues" than to delve specifically into sexual mechanics, desires, or fantasies. The comfort level is often directly proportional to the perceived safety and non-judgment they feel with their partner or therapist.
Anything else you'd like to add?
I know I’m preaching to the choir here, but I'd like to really drive home that sexual health is an integral part of overall well-being and relational health. Often, sexual concerns are symptoms of deeper underlying issues, whether they are relational, emotional, or even physical. Approaching these concerns with curiosity, compassion, and an open mind — whether individually or with a partner — is an incredibly powerful step towards a more integrated and fulfilling life. It can be a tall order, but begin by trying to treat most sexual or relational concerns as a shared problem, not a battle between the two (or more) of you. It's about empowering individuals to embrace their authentic selves and build relationships that truly honor all their parts.
How can people find you and Rouse Relational Wellness?
You can find out more about us and connect with Rouse Relational Wellness through our website, rousetherapy.com. There, you'll find information about our services, our team of therapists, and how to schedule a consultation. We look forward to hearing from some of your readers!
You can use this link to access all my writings and social media and ways to support my work. My content is usually open and free to view, but for those who are able your paid subscription (click the Subscribe button) or patron support are always appreciated.