sex therapy Archives - Page 2 of 8 - Dr Michael Aaron
Can Desire Be Rekindled?
One of the most common difficulties that bring couples into my practice is the extinguishment or disappearance of passion, lust, desire, or yes, even love itself. Often these couples have gone years (yes years) sinking ever further into a deeper rut of feeling like they are living with a platonic friend or roommate, but not a lover. They may have gone months or years without having sex. Indeed, research shows that about 1 in 7, or about 15% of long-term couples are sexless (meaning no sex in the last six months). When I ask these couples to describe their daily habits, they often describe lots of intimate behaviors such as holding hands, kissing, engaging in various activities together, and even sleeping together in the nude. But no sex. They describe loving each other, but not “being in love,” meaning no longer experiencing that lustful attraction that comes with passionate love.
In my experience, the success of turning things around and rekindling desire depends on a number of factors. First, how long has this relationship been passionless? The longer the couple has been alienated, the harder the task becomes. In addition, there are a number of contextual factors to consider. For example, how much resentment has piled up? Resentment, as I’ve written about before, is one of the most toxic and corrosive emotions within a relationship. It’s a combination of anger and entitlement, which leads to contempt. Indeed, contempt, along with criticism, defensiveness and stonewalling, is one of the four key factors that research has identified as predictive of negative outcomes in relationships. As a result, resentment […]
By Michael Aaron|January 7th, 2017|Couples Therapy, Sex Therapy, Sexuality and Psychology|0 Comments	
How I Help Partners Bridge Their Differences
Around 50% of my practice is working with couples (or other partnered systems), and I am often faced with the difficulty so many folks struggle with in understanding each other. Especially after our last election, I can’t help but see striking similarities between the ways that folks bunker down and become defensive and antagonistic in their relationship with the current state of affairs in our society post-election. Regardless of where someone stands politically (and in my clinical work, I try to stay out of politics), one thing is clear– if you find two folks who each voted for the two different candidates, you’ll find that they are living in two very different realities.
This is often the case, but on a more micro level, with the couples I see in my practice. Both individuals are so wrapped up in their own subjective reality, that they have no room left for understanding the subjective reality of their partner. As a result, their relationship is filled with frustrations, disappointments, and unnecessary conflicts over who is right or wrong. Instead of working together as allies, these folks are engaging in a battle over realities, sparring to see whose reality will come out on top and victorious. In the end, no one wins. A battle between realities is a zero sum game, in which one individual needs to win while the other loses. However, this only means that everyone loses, since a relationship filled with a ledger of wins and losses is a most unhappy relationship.
Some of the biggest signs of progress (and most rewarding times for me as a therapist) are when I finally start […]
By Michael Aaron|December 18th, 2016|Couples Therapy, Sex Therapy, Sexuality and Psychology|0 Comments	
Release of My New Book Modern Sexuality
It’s taken 3 long years and hours and hours of sometimes exhilarating, sometimes pain-staking work, but my book Modern Sexuality is set to be released on Oct 16. For my loyal blog readers, I’ve set up a number of ways to get this book for free, or at a deep discount, but only for a short period of time. You have a few options.
You have 3 ways of getting a major discount:
With each purchase of “Modern Sexuality” on Amazon (the hardcover edition, which retails for $36), you will get the entire price of the book taken off your purchase of AltSex NYC Conference 2017 tickets! Note: This deal only applies for book purchases made on Saturday October 15 or Sunday October 16. To get the discount, go to http://amzn.to/2cGARqL to buy the book, and forward your receipt or a screenshot of your receipt showing your name, the book title, and the date of purchase to [email protected], and you will receive a $36 discount code that can be applied toward purchase of your ticket. There is no limit on this discount, so you’ll get $36 off each AltSex ticket for each book purchased.
You can attend my Book Release on Tuesday November 15, where I present a 1.5 hr workshop based on “Modern Sexuality.” Everyone in attendance will receive a free signed copy of the book included with the ticket price ($40). So, you get a signed copy, admission to the talk, and CEUs—all for roughly the price of the book itself. We only have 20 tix available and some have already been sold, so purchase them sooner rather than later in order to not get shut out.
If you are not […]
By Michael Aaron|October 14th, 2016|Couples Therapy, Sex Addiction, Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|0 Comments	
Thoughts on Working With Adult Survivors of Childhood Sexual Trauma (CSA)
I was recently interviewed by an Australian production company about my work with adult men that have been victims of childhood sexual abuse (CSA). The focus was on the research concerning this subject as well as how I specifically work as a clinician with men who present to me with these difficulties in my therapy office. For those who don’t know, I’ve written the definitive meta-analysis of sexual outcomes of adults who have experienced CSA, and my research won an award for original scholarship and was published in a peer-reviewed academic journal. You can access it here.
Anyway, the interviewer asked me a number of very poignant and powerful questions, and I thought this blog would be a good venue for discussing some of the most salient points that came out of the interview. Even though the interview focused on men, my thoughts in this article are applicable to all individuals. Once the interview is live, I will post it on my media page, so be sure and be on the look out for it and keep checking this site.
The foremost question that the interviewer wanted to know, and that is also on the forefront of a number of my clients’ minds is to what extent does CSA effect adult sexuality? This is a very complex question because it incorporates a number of contextual factors. According to both the research and my clinical experience, people experience trauma very differently and a lot of it depends on a complex mix of environmental and psychological factors. First, not everyone experiences trauma from a childhood abusive event. Indeed the following external criteria are […]
By Michael Aaron|September 22nd, 2016|Sex Therapy, Sexuality and Psychology|0 Comments	
Why I Use a Harm Reduction Approach Instead of Sex Addiction
Over the years, I’ve worked with a number of individuals who have presented with out of control or compulsive sexual behaviors. In the past, these folks may have been designated as “sex addicts,” but the field is currently in transition and moving away from this perspective. A number of other models have sprung forth to fill in the void, and I have written about some of them previously. In this article, I will focus on what I feel is the most fundamental shift in the discussion around this issue, which is a move from abstinence only (the addiction model) to harm reduction.
Harm reduction? What is that? In essence, harm reduction is nothing new; it has been a staple of public policy and social programs for years. Indeed, I got my start in the field as a harm reduction outreach worker, going to local parks and other hangouts in and around NYC, exchanging clean needles for dirty ones with intravenous (IV) drug users or providing condoms and other necessities to transgender street sex workers. There are a number of harm reduction centers in many large urban areas around the country, funded both by charities and grants, as overwhelming evidence supports the efficacy of this kind of approach. It is only recently though that harm reduction has entered the psychotherapy office as a foundation for understanding human growth and psychological change. Indeed, I am proud to be at the forefront of this movement, hosting workshops on integrating harm reduction with sex therapy and speaking at major conferences on this issue.
At its root, harm reduction is both humanistic and culturally libertarian. No, […]
By Michael Aaron|August 24th, 2016|Sex Addiction, Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|2 Comments	
Working with Relationships in Transition
One of the key topics that I cover in my Common Issues in Partners’ Sex Therapy class is how to work with those relationships that are undergoing some sort of a transition. What I mean by a “transition” in this case, especially when it comes to sex therapy, is some new item of information that is introduced into the relationship which also serves to destabilize that relationship.
What are some examples of this kind of destabilizing information? Here are some common ones– one partner introduces a desire for a specific kind of sex (or fetish) that is found to be repulsive or offensive to the other partner; one partner shares a desire to open up the relationship and explore some form on non-monogamy; or, and this was more common in the past, but still happens frequently enough, one partner shares information about his or her orientation or preferred gender that is at odds with the other partner’s prior knowledge or understanding. Regarding the last item, these types of relationships are called “mixed orientation” relationships. In the recent past, with a lessening of homophobia in general society, this kind of disclosing was likely to be of a man opening up to be homosexual. These days, my observation is that, while that still does happen, mixed orientation couples tend to be more of a hetero/bi dynamic. But I digress.
Let’s now talk about some specifics of how I work with relationships that find themselves in transition. The first and most important step (as is the case in any type of psychotherapy) is to create a safe space for both […]
By Michael Aaron|July 27th, 2016|Couples Therapy, Sex Therapy, Sexual Minorities, Sexuality and Psychology|0 Comments	
Common Issues In Partners’ Sex Therapy
I am teaching a course this summer entitled “Common Issues in Partners’ Sex Therapy,” and as I’m in the midst of creating the outline and curriculum, I thought it appropriate to go through my old catalogue of articles and see what I’ve already written that provides further resources to the material I plan on covering. I’ve divided the class into six sections– 1) General considerations; 2) Communication issues; 3) Infidelity/sexual compulsivity; 4) Desire discrepancy; 5) Relationships in transition; and 6) Alternative relationships. I’ll go through each of these in turn.
Let’s start with “General considerations.” Typically when I work with a relational system, I want to get a sense of where each individual is developmentally. Are these folks in they honeymoon stage? Are they trying to differentiate from one another? Are they in different head spaces (one is trying to assert independence while the other is trying to maintain the status quo)? Are there any personality disorders that are preventing this relationship from moving forward? Here are some articles I’ve written in the past that provide further detail on these subjects:
Couples Therapy: What is Differentiation?
Why The Beginning of a Relationship Determines It’s Success
Boundaries: The Most Important Part of a Relationship
Moving on now to “Communication issues,” my work as a therapist requires me to dissect the communication difficulties that relationship systems struggle with and then model new, more productive forms of relating. I am informed by numerous thinkers in this area including John Gottman and Daniel Wile and here are some articles that highlight some of these […]
By Michael Aaron|June 28th, 2016|Couples Therapy, Sex Therapy, Sexuality and Psychology|0 Comments	
When It Comes to Change, Nothing Beats Experience
Despite the era in which we live, where any information (right or wrong) can be found instantaneously at your finger tips via a Google search, one of the most common problems I hear in my office is the struggle of my clients to overcome sexual shame and accept their sexuality. You might wonder, how could one still be ashamed of being gay when positive messaging about homosexuality can be found all over the internet and mainstream media? How could one still be afraid to admit their fetish to a partner when Fifty Shades of Grey was a runaway best seller? These are important questions to ask since I believe they directly address the mechanism through which the change process occurs.
You see, it’s not enough to cognitively understand something. It’s not enough to have facts and figures in front of you. And it’s not enough to have other people around you convincing you to dispel your opinions. That’s because there’s a huge gap between knowing and believing. Knowing is having disposal to certain information. But believing is when that knowledge becomes internalized. And true change only happens when our beliefs become internally congruent with the things we know. And it is this process of changing beliefs that requires lived experience in order to take hold.
We’ve all heard the phrase “walk a mile in someone’s shoes”, or some other version, which basically means that you can’t truly understand another person’s experience without having lived it yourself. We are all familiar with these ideas because on some level, as we’ve all had the experience of having that “light bulb” moment when […]
By Michael Aaron|May 25th, 2016|Sex Therapy, Sexuality and Psychology|0 Comments	
Research Shows When It Comes To Sex, It’s Quality Over Quantity
Moving along with my review of key talks from the most recent Society for Sex Therapy and Research (SSTAR) conference, I will focus this particular article on the fascinating research on peak sexual experiences by Dr. Peggy Kleinplatz, from the University of Ottawa. In my previous review, I summarized the groundbreaking work of Doug Braun-Harvey and Michael Vigorito in creating a competing model to the sex addiction model in treating out of control sexual behaviors.
But before diving in, let’s first take care of some housekeeping. As many of you know, we just wrapped up the 1st Annual AltSex NYC Conference, which I created and co-produced with my colleague, Dulcinea Pitagora. It was a smashing success, in which over 150 attendees participated in a day long conversation around sexuality topics that are rarely discussed anywhere else. We had numerous media in attendance. New York Magazine just posted a nice summation, and additional reviews will be forthcoming in other media outlets. Feel free to continuously check the media page for additional updates.
Also, I am proud to announce that I am now blogging for Psychology Today, with my new blog entitled Standard Deviations. There is no content up there yet, as I am just getting started, and have been busy finishing up other matters, but feel free to subscribe there as well, as I will be posting a few articles to that blog in the next few weeks. I will still be blogging here, but my articles here will be more focused on clinical issues relevant to clients, while my writing for Psychology Today will be more big picture […]
By Michael Aaron|April 29th, 2016|Couples Therapy, Sex Therapy, Sexuality and Psychology|0 Comments	
A Different Perspective on Out of Control Sexual Behavior
I have just come back from Chicago, where I presented my latest research at the Society for Sex Therapy and Research (SSTAR) Annual Conference. In the next few posts, I will point out a few key ideas that I took away from some of the other presentations, which were uniformly excellent. In particular, and that which is the subject of this particular article, I am going to focus on what I consider to be the groundbreaking work of clinicians Doug Braun-Harvey and Michael Vigorito and their approach to “out of control sexual behavior” or (OCSB). OCSB? What is that? Well, you may recognize this concept as “sex addiction,” which in my view is a problematic term that I’ve critiqued both here and here. So, the first thing to understand about these two guys is that they are working with the same sets of behaviors as sex addiction counselors, but without the addiction lens. Why is this so significant? Let’s take a look.
One of the most salient concepts from their talk is the central importance of therapist self-awareness. In other words, especially in the field of sexuality, it is very easy for any clinician to get carried away with one’s own prejudices and biases, which of course will inevitably interfere with treatment, often likely even causing great harm. This kind of bias may lead to a “premature evaluation”, in which a pre-established label (such as sex addict) is automatically assumed and foisted onto the client, stigmatizing him (and it’s often a “him”) for life. Braun-Harvey and Vigorito urge us to never assume etiology, instead approaching each client as […]
By Michael Aaron|April 20th, 2016|Couples Therapy, Sex Addiction, Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|0 Comments	