Sex Therapy and Counseling
Some of the situations that I deal with
Sexual addiction
Sexual addiction is the term used to describe any sexual activity that feels "out of control". That might be sex with a partner, viewing pornography, masturbation, visiting prostitutes, or any number of other sexual activities. Although many of these activities don't cause a problem for most people, a sex addict feels compelled to engage in their chosen activity, in spite of the problems it may cause in their relationship.
Sex becomes addictive in a similar way to alcohol and illegal drugs. During sex, our bodies release a powerful cocktail of chemicals that make us feel good and some people get addicted to the high these chemicals produce. Like substance addictions, the body gets used to these chemicals and the sufferer soon finds that they need more and more sex in order to achieve the same buzz.
In between the highs of sexual fulfillment and the release of endorphins, come the inevitable lows. Most addicts feel an immense amount of shame about their behavior. They also feel regret, remorse, anxiety and isolation. Most feel powerless to change. Unfortunately these powerful feelings often cause the sufferer to seek out sex as a way to escape. Sex becomes a pain reliever, an escape from the very problem that it has created itself.
The majority of addicts find it very difficult to change their behavior on their own. You may be able to curtail the behavior for a while, but often a cycle develops that is extremely hard to break. A professional therapist can help you to understand what is happening and encourage you to take steps to change to a healthier sexual lifestyle.
Stuck in a rut
Sex in a long-term relationship does not have to become boring and monotonous, although at times you may feel as though your sex life is stuck in a rut. Whether or not you find sex boring is often more about attitude than the things you actually do. As your relationship continues to mature - sex matures as well, but like a fine wine, it can become richer and fruitier! As you get to know each other more and more, a deeper trust develops. You're less likely to feel inhibited and you can look forward to a new stage of sexual experimentation. Without the initial insecurities, you can take the time to learn to become great lovers together. Short-term sexual therapy can help you re-adjust your attitudes about yourself, your partner, and your sex life.
The internet affecting your relationship
Increasingly couples are citing the Internet as a problem in their relationship. The time spent on the Internet is time spent away from the primary relationship. Often, the intimacies that are shared with a virtual person don't get shared with a real partner and this leads to feelings of betrayal, rejection and worthlessness. It's not just partners that are neglected; children and friends may suffer too.
The person going online can feel they're escaping from real life problems, but retreating into cyberspace only exacerbates what's happening in real life. Online relationships carry the danger of detaching you from reality - the virtual partner can become idealized, and by comparison the real partner can look inferior. Unfortunately, Internet relationships can lead to break-ups and while some of these might have happened anyway, some are mistakes - leaving real partners for virtual partners whose online personas bear little relation to what they're really like.
It's not the Internet that's to blame for the rise in break-ups and relationship problems caused by online affairs. As human beings we have choices - to engage in what technology has to offer, or not. Just because technology is offering you access that is affordable and provides you with anonymity, it will not reduce the trauma of a partner who believes they have been betrayed – much like what happens when one partner has a real life affair.
Difficulty reaching orgasm
Research suggests that 1 in 4 women will have problem reaching orgasm at some stage in their life. A further 25-35% may never have experienced orgasm. Difficulty reaching orgasm during intercourse is the norm. In fact, an estimated 70% of women don't ever have penetrative orgasms.
Physical causes
There are very few medical reasons why a woman can't reach orgasm but if you have a diagnosed neurological, vascular or hormone problem, then the first step is to check with your primary physician. At times, the problem could be a side effect of medication and very occasionally, pelvic surgery can cause nerve damage and loss of sensation.
The most common physical cause is a lack of adequate stimulation. Most women need direct clitoral stimulation in order to achieve orgasm. The second most common factor is tiredness or general illness. Our bodies need to be in general good health in order to enjoy sex.
Psychological causes
Many women experience a range of psychological problems that makes orgasm illusive. The most common is known as "spectatoring". When an orgasm seems to be taking forever, many women detach from what's happening and become orgasm watchers. Anxiety increases and rather than enjoying the moment, they're getting increasingly impatient with themselves. Some women find they are easily distracted from what's going on, worrying about things to be done or worrying about how their body looks to their partner. Negative sexual messages from the past can leave a woman feeling uncomfortable about being sexually aroused or fearful of losing control. Relationship problems are also a major contributor to sexual dissatisfaction. If there is unresolved tension with your partner, then your physical relationship will inevitably suffer.
Problems getting an erection
Most men will experience erection problems at some stage during their life. In fact, erection problems will affect approximately 40% of men by the age of 40, and up to 70% of men by age 70. For most men, the occasional loss of erection shouldn't be seen as anything more than a minor inconvenience. It's most likely caused by stress, distraction, too much alcohol or just generally feeling run down or not really in the mood for sex. In these cases, the problem is nothing to worry about and is usually resolved on its own.
If you have problems getting an erection for masturbation as well as for partner sex and you infrequently or never get morning erections, then the problem may be physical. It is important you visit your physician as causes can include diabetes, poor circulation, kidney problems and high cholesterol among other things.
If your erection problems are quite sudden and you only experience difficulties in partner sex then the problem is more likely to be psychological. Performance anxiety is probably the most common cause of erection problems. And for many men, even when the initial cause of the erection problem has passed, whether psychological or physical, the anxiety of repeated failure creates anxiety and it is this anxiety that blocks erection.
Problems with premature ejaculation
Premature ejaculation is one of the most common sexual complaints and is estimated to affect approximately 30-40% of men. Some men are able to overcome the problem quite easily by becoming more aware of the sensations in their penis as they become aroused and engaging different techniques to slow themselves down. However, for a small percentage of the population, premature ejaculation seems to be a physiological phenomenon that can't be overcome.
If you have a problem with premature ejaculation in every circumstance, i.e. on self masturbation as well as with a partner, then it may be that you are naturally a 'quick ejaculator'. From an evolutionary perspective it makes sense for man to ejaculate quickly and it seems that there is a percentage of men for whom this is the norm. It is part of the central nervous system response, and while it may be a bit more difficult to overcome, there are techniques to assist you in delaying ejaculation and prolonging your sexual experience.
If you only experience the problem during intercourse and/or with a partner, then it's more likely due to anxiety. Feeling anxious that you may ejaculate quickly sets you up to do exactly that. Once your body has developed a habit of reaching orgasm quickly it can take quite a lot of work to slow down the response.
Different levels of desire
Men and women are different. Over and over again, research tells us that men think about sex more often than women. Generally speaking, men have higher sex drives and enjoy more variety. There is a biological reason for this. The chemical responsible is testosterone and men have 20-40 times more of the stuff than women do. And, perhaps more importantly, men's testosterone levels stay at pretty much the same throughout their life. But for women, testosterone levels are dramatically affected by their monthly period and also by having children.
In the early days of a relationship both men and women tend to have much higher sex drives. Evolutionary psychologists believe this is important for 'pair bonding' - building the connection between the two of you. But over time, sex drive falls - particularly for women. This is often confusing for both men and women. Men can feel betrayed and rejected by their former “sexy” partner and fear that not wanting sex as often means there is a problem in the relationship. Women too can wonder if it means that they don't love their partner as much as they used to. But in reality, these changes in desire are just a natural course of events in any couple relationship.
There is no 'right' number of times that you should have sex in a relationship. If one of you would like sex every day and the other is happy with once a fortnight - you are both normal. If you have different desires, then compromise and negotiation are the solution. Many couples find they slip into a negative pattern where the partner with the higher libido is regularly asking for sex and being rejected. The person with the lower libido can also slip into the habit of avoiding physical contact unless they're in the mood for sex because they're frightened that it will give off the wrong signals.
Even if you're not going to have sex, it's really important that you continue to be affectionate and sensual. When you commit to creating a tender, loving environment, sex is more likely to happen naturally. Some couples agree to have a certain number of 'sex free' days so they know they can fully enjoy being close knowing it won't lead to sex.
Adult victims of childhood sexual abuse
A history of childhood sexual abuse leads to a lower health-related quality of life and a greater number of health problems, psychiatric symptoms and diagnoses. Research shows that survivors of childhood sexual abuse have "more medical problems, higher medical use, more physical symptoms, lower health status, and more medical procedures." High levels of anxiety and depression in survivors of childhood sexual abuse can lead to self-destructive behaviors, such as alcohol and drug abuse. Because of the association between sexual behavior and pain and violation, survivors of childhood sexual abuse often develop problems with intimate relationships in general, including difficulties during sexual contact and dysfunctions of desire and arousal.
In general, childhood sexual abuse is associated with a greater risk of: disturbances in sexual interest; difficulties during sexual contact; dysfunctions of desire, arousal or orgasm; seductive behaviors, compulsive activity and prostitution; precocious sexual behavior; confusion of sexuality and nurturing behavior; sexually transmitted diseases; unintended pregnancy; eating disorders; excessive weight gain; depression; anxiety; self-destructive behavior; alcoholism; drug abuse; panic attacks; insomnia and sleep problems; relationship problems; revictimization; suicide; self-mutilation; increased risk for sexually transmitted disease; identity disturbances; and involvement in physically abusive relationships as adults.
The good news is that many childhood victims become adult survivors and thrivers, learning to live symptom-free, healthy sexual lives.
Children with sexual behavioral problems
What makes a child sexually offend another child? Some children who molest other children are acting out their own sexual victimization. Many children who molest not only have a history of sexual abuse; they also have experienced physical and emotional abuse. When a child has been sexually used, abused, or overly exposed to adult sexuality, disruptions in multiple areas of the child's sexual development may occur.
Symptoms of sexualized behavioral problems in children:
- Sexual behaviors that are engaged in by children of different ages or developmental levels or who do not have an ongoing, mutual play relationship.
- Sexual behaviors that are out of balance with other aspects of the child's life and interests.
- Children who seem to have too much knowledge about sexuality and behave in ways more consistent with adult sexual expression.
- Sexual behaviors that are significantly different from those of other same-age children.
- Sexual behaviors that continue in spite of consistent requests to stop.
- Sexual behaviors that occur in public or in other places where the child has been told these behaviors are not acceptable.
- Sexual behaviors that are eliciting complaints from other children and/or adversely affecting them.
- Sexual behaviors that are directed at adults which are more akin to adult-adult sexual contact.
- Children (4 years and older) who do not understand their rights or the rights of others in relation to sexual contact.
- Sexual behaviors that progress in frequency, intensity, or intrusiveness over time.
- When fear, anxiety, deep shame, or intense guilt are associated with the sexual behaviors.
- Sexual behaviors that cause physical or emotional pain or discomfort to self or others.
- When anger precedes, follows or accompanies the sexual behavior.
- When verbal and/or physical aggression precedes, follows or accompanies the sexual behavior