couplestherapynyc

Sex Therapy with our practice is evidence-based talk therapy focused on helping you to create the sex life that you find most fulfilling, not based on religious propaganda or pseudo-science.  According to Abraham Maslow, sex is one of the most very basic of human drives (even more basic than love).  Therapists specializing in sex therapy use this as a guiding principal.  

In the 21st Century, people talk more and more openly about sex.  The thing is, there are lots of people who claim to be "sex experts" just by virtue of having a degree in journalism or by having read "Fifty Shades of Grey". Sex therapy is something more than just talking to an advice columnist for an hour.

Parts aren't working the way you think they should?  We can help you sort out fact from fiction. Feel like your sex life is out of control?  You might be surprised to find out "sex addiction" and/or "porn addiction" are not accepted terms or diagnoses among therapists. Let's work on time management, honesty and basic sex education.

Sex therapy is for individuals and couples to sort out issues with masturbation, fantasy life, porn, fetishes, dating, sexual identity, gender identity, relationship style, infidelity issues (and often the desire to be non-monogamous or non-sexually faithful).  

Our therapists, mental health counselors or marriage and family therapists in New York,  have all been selected because they have a special interest in working with relationships and sexuality of all sorts. By using an evidence-based, yet warm and non-judgmental approach, you can be sure you're getting effective, modern couples therapy and sex therapy for the 21st Century.  

You have to struggle enough with people telling you who you should be and how you should behave- your therapist doesn't have to add to that.  In therapy you might find out some ways of relating intimately that you didn't know were possible.

 

Whether starting individual therapy, couples therapy or sex therapy, the process we follow is the same. We will meet with you individually to get some preliminary information and make some recommendations on how to move forward with us or with other clinicians. We use rational emotive behavior therapy as our main modality to teach you and your partner(s) the same basic language to get you on track for getting the love and sex life that works best for you.

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In sex therapy, we want our clients to take back ownership of their sexual expression so they can take an active role in designing the type of sex lives they want, rather than the kind they think they SHOULD have based on parents, poor sex education, religious baggage, etc.

Let's define some terms:

Here is a short list of terms to consider (which is by no means an exhaustive list- people have been very creative in coming up with all sorts of more exact terms by which to identify and categorize themselves!!):

 

Drag Queen: Also known as female impersonators.  These are usually gay men who impersonate women for entertainment purposes, but drag queens do not usually identify as women outside of their performances.

Gender role: Behaviors that are judged by society to be masculine or feminine.  Someone may have a gender role considered feminine by society, for example, a stay-at-home dad.  This does not necessarily reflect one’s sexual identity (gay or lesbian) nor does it necessarily reflect one’s gender identity (someone who is transgendered).

Gender non-conforming (gender queer): Sometimes considered to be a political term, people who are gender non-conforming or gender queer may reject the notion of human beings being separated into male and female with females “acting” feminine and men “acting” masculine (those are difficult terms to define in and of themselves). People who are gender non-conforming sometimes choose adjectives, pronouns and names that best suit them, which are often gender neutral.

Intersexed: An individual born with one of a handful of conditions where it may be difficult to clearly label the anatomic genitalia as male or female at birth.  Many people who are intersexed are assigned a gender arbitrarily and raised as that gender.  Sometimes this works, but sometimes this does not work and the individual spends their life being forced to have a gender identity that does not match their external anatomy.

Kink: Also known as fetish (community) are people who desire something other than the usual penis and vagina sexual intercourse.  Kink may include role play, costumes, or certain types of sex acts.  Kink or fetishism may be a problem when it stops being safe, sane and consensual.  Kink communities range from leather to people who like to fantasize about being shrunken down to a miniature size or tickled.  Kink aware professionals are therapists and other clinicians who understand different types of sexual expression and are not going to talk you into vanilla style sex and the missionary position if that's not what you're into.

Masturbation: also known, in modern terms, as fapping (usually for guys) and schlicking (for gals).  Masturbation is on the front line of human sexuality, and has been controversial for ages.  Our take is this: knowing how to pleasure yourself is completely normal and healthy, and will help you master a great sex life with other people, if that's what you choose to do. We might even assign masturbation exercises to work on at home to get a handle on erectile difficulties and premature ejaculation as well as problems reaching orgasm for women. If you feel like your self-love is problematic, come and talk to us! 

Open Relationship: By this we mean any sort of emotional or sexual relationship that is outside of you and one partner relationship. Recent terms include monogamish, polyamorous, swingers, etc.  Though many consider this a non-traditional relationship style, there are many people around the world who feel that who they are in love with and who they want to have sex with may or may not be the same person or people.  Monogamy is one relationship style on the planet, but by no means the only one.  Our therapists are poly-friendly professionals who do not hold up any one relationship style as "normal", and want to help you design the relationship that works best for YOU based on consent and open, honest discussion. That being said, it is really important to know that many therapists (many people, for that matter) consider monogamy the gold standard of relationship models. It is one relationship model of many that exist on the planet. Designing a relationship that works for everyone involved is preferable to conforming to a relationship style that you think everyone else has.

Premature Ejaculation: Theravive describes P.E. as follows- "Premature (Early) Ejaculation is classified as a sexual disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition), diagnosis assigned to men who ejaculate prematurely during vaginal intercourse. Although premature ejaculation can occur during other sexual activity, it is only defined as a disorder in the case of vaginal intercourse, as a time duration for oral or manual stimulation has not been established. Premature or early ejaculation is defined as the man feels unable to control their orgasm, and climaxes in less than one minute after vaginal penetration; generally, this is not sufficient time for a woman to reach orgasm (American Psychiatric Association, 2013). This can result in sexual dissatisfaction or frustration for one or both partners, (Graziottin, & Althof, 2011), and self-esteem and self-image problems in the man. Many sources describe causality in terms of psychodynamic reasons such as anxiety or culturally or religiously rooted guilt about sex. Less frequently cited are causes that are more apparent: eagerness, inexperience (Lording, 2011). and penile hypersensitivity. Premature (Early) Ejaculation can become a conditioned response. Anxiety about climaxing too quickly and over focusing on the woman’s orgasm as the objective can perpetuate the sexual dysfunction. The definition of Premature (Early) ejaculation can be difficult to operationalize, as couples will have a range of preferences as to what constitutes adequate time at sexual intercourse (Hatzimouratidis, Amar, Eardley, Giuliano, Hatzichristou, Montorsi, Vardi, & Wespes, 2010). One way to define Premature (Early Ejaculation) is if sexual intercourse is unsatisfying to one partner, or “any ejaculation that happens before you both want it to” (Comfort, 1987). Unrealistic expectations regarding sexual endurance can be fueled by exposure to pornography. It is noted that three minutes is the average time from vaginal penetration to ejaculation (Brown University, n.d.)." Read more about diagnosing premature ejaculation.

Sex addiction: Not easily defined, this controversial and ham-fisted explanation of human sexual behavior is not an actual psychological diagnosis, but something invented by people who would presume to define for others what a healthy level of sexual activity is, and what type of sexual is acceptable.  This is a concept that traces it's roots to 12 step program models that are not evidence based (think anything that ends with Anon or Anonymous). Can your sexual expression and behavior be unhealthy? Absolutely. But identifying as a sex addict because you don't fit into the model of husband and wife monogamy circa 1950 is more harmful than actually learning about and accepting the safe, sane and consensual sex life you are entitled to. The American Association of Sex Educators, Counselors and Therapists (AASECT) released an official position on "sex addiction" and "porn addiction" in late 2016. Read it here.

Sexual Identity: Sexual identity as it is understood currently is something different than gender identity, yet the two are often confused.

  • Gay men might be sexually and/or emotionally attracted to men.  Whether they behave in ways that are perceived to be masculine or feminine is irrelevant and nothing more than a social construct.  Gay men do not want to be women.
  • Lesbians might be sexually and/or emotionally attracted to women.  This doesn't mean they want to be men.
  • Bisexuals are not usually confused, sex addicted, greedy, etc. Bisexual people might be sexually and/or emotionally attracted to men and women.

It is reasonable that some people who at first identify as gay or lesbian are trying to figure out their gender identity at the same time, and may eventually realize that though they may be attracted to one or both sexes, the label they use may still depend on their internal gender identity. A broader view of sexual identity is that we are on a spectrum so nuanced that these labels are too constricting and might just serve as a shorthand.  Conversion therapy (also known as reparative therapy) has been banned in many states and most professional psychological and psychiatric associations across the world have denounced any sort of therapy that aims to "cure" queer people and/or that heterosexuality is more healthy than any other sexual identity.

Slut Shaming: A term that has really caught on within the last few years, slut shaming is associating any sort of negativity with safe, sane, consensual sexual expression. Dossie Easton says it best in her book "The Ethical Slut" - An ethical slut is someone who has the courage to "lead life according to the radical proposition that sex is nice and pleasure is good for you".

Transgender/Transsexual: Someone who feels like their core gender identity, who they are on the inside, ie their soul, their mind, etc, does not match with their anatomic genitalia on the outside (gender dysphoria).  Both terms are generally used, although transsexual is sometimes used more often to describe people who have had sexual reassignment surgery. The process leading up to possible sexual reassignment surgery is called “transition”, where the individual is sometimes diagnosed by a mental health specialist with “gender identity disorder”, a controversial diagnosis that is still included in the DSM (the book psychiatrists use to diagnose mental illness).  This is not meant to imply that transgendered individuals are mentally ill, but the conflict of the inside and outside identity not matching can cause much internal and external conflicts.

Transvestite: Mostly heterosexual men who feel sexually aroused when dressing in women’s clothing.  These men don’t usually have a sense that they ARE women.  They have attached sexual arousal to women’s clothing as a kink or fetish.

 

Again - these are just a few terms to get you thinking about relationships and sexuality, and these terms might be defined differently by different people. That's the beautiful thing about sex, relationships and love- it means many different things to many different people. 

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