Archives for Sex & Sexuality


Recovery from Cybersex Addiction: Part One – Initial Action Steps

For the last five years (at least), Jerry, a handsome 36-year-old office manager, has put the search for sex ahead of all else – even though he’s not having any in-person sexual encounters. Instead, he looks at and masturbates to hardcore pornography for several hours each weeknight and all day on the weekends, and occasionally he engages in mutual masturbation with strangers via webcam. Until a few years ago he tried to also date in real life, usually going out with nice women who were interested in a long-term relationship. He says that he really liked one of them, but that he was never really present with her and she eventually broke things off. He admits that on their dates he was usually more focused on going home and going online than on her. As it turns out, she broke up with him because she thought he was cheating on her (and in a way he was). That was three years ago, and Jerry has not been on a date since. He has tried several times to quit using porn, and sometimes he manages to do so for a day or two. But before long he feels depressed and lonely and he goes back online as a way to escape the pain. Recently, he’s started using his office computer to access porn during work hours – a situation that he knows will not end well. And yet he continues.

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Sex & Sexuality

The Viagra Conundrum

I’m of a certain age – if you don’t know what “certain age” means, then you’re not there yet – and I tend to watch television programs geared toward my demographic. With these shows I am inevitably treated to a barrage of commercials featuring impossibly attractive middle-aged and older couples looking unusually romantic in some wonderfully bucolic setting. Most often they’re either cuddling by a lake at sunset or sipping Chardonnay on the veranda of a remote mountain cabin. Whatever the locale, these doe-eyed twosomes are very clearly in the process of kindling and/or rekindling the flames of their relationship. Suddenly, before I can start to feel too badly about the fact that neither of these people has even an ounce of extra belly fat, they look into one another’s eyes and they experience “the moment” – the instantaneous realization that a bed is nearby and they both want to use it for a purpose other than sleeping. Then the ad’s voiceover screams: “Hey old guy! Yeah, you with the aching back! If you take one of these pills, you can become the sexual dude that you were 30 years ago!”

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Sex & Sexuality

Out of Control Sexual Behavior: Addiction or Offending?

When It Comes to Sex, Confusion Reigns

After more than two decades spent treating both sexual addicts and the occasional offender, I’ve watched the field of sexual disorders assessment and treatment come very far in its understanding of both sexual addiction and sexual offending. Nevertheless, the general public is often wildly misinformed on both topics, as are at least a few clinicians. One of the most common misperceptions is that sex addicts and sex offenders are one and the same. This is most definitely not the case.

In reality, there are significant differences between
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Sex & Sexuality

The Truth about Gay Conversion Therapy

Therapists are Trained, Governors are Not

A few weeks ago Texas Governor Rick Perry, speaking in San Francisco, defended his state’s Republican Party Platform endorsing gay conversion therapy (also called reparative therapy), essentially stating that homosexuality is a choice. So once again this topic is in the news and in need of intelligent discussion. Somewhat amazingly, the basic questions being asked about homosexuality and conversion therapy haven’t changed much in the last 50-plus years, despite the almost incalculable progress we’ve made in our scientific understanding of human sexuality and romantic attraction. The two primary questions seem to be:

Is homosexuality a psychological disorder (or the result of a psychological disorder)?
Can homosexuals be repaired (i.e., converted into heterosexuals) via psychoanalytic treatment or any other methodology?

The answer to both of these questions is a resounding NO. Yet here we are again, fighting off painfully misguided, highly moralistic efforts to judge healthy forms of sexuality.
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Sex & Sexuality

The Reality of Bisexuality

Sex is Not a One-Way Street

I had thought that in writing this long-overdue blog on bisexuality I could offer a straightforward, readily understandable overview of some issues that are very basic to human sexuality. I was wrong. Research, literature, and societal attitudes about bisexuality are all over the board. Part of the issue is that there’s not even a universally agreed upon definition. After doing a lot of reading and thinking, I’ll propose - for purposes of this blog - the following:

To be a bisexual man or woman means having a personally significant and meaningful romantic and/or sexual attraction to both males and females.

While some readers will find the definition above to be too broad, others will feel it is lacking. Please note that I fully understand this. This language is posited merely as a starting point for the discussion that follows, and not as the be-all, end-all of what it means to be bisexual.
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Sex & Sexuality

One Bed or Two? What is Healthy Sex for Long-Term Couples?

Doing It Until We Need Glasses (Or Not)

There are a great many statistics - not all of them obtained scientifically - regarding the frequency of sex among long-term committed/married couples. A quick Internet search will yield a surprisingly wide variation in what is thought to be a “normal” or “healthy” amount of sex for married people. So much for Internet searches. That said, the most scientifically reliable data comes from the General Social Survey, which has tracked American sexual behaviors since the early 1970s. According to the GSS, married couples of all ages have sex an average of 58 times per year. But this number lumps 29-year-old newlyweds into the same survey sample as 70-year-olds who’ve been married half a century, and I’m guessing that those in the first blush of love tend to get it on a wee bit more than couples who’ve been together for twenty-plus years with two or three kids and maybe even some grandkids to show for it. Recent GSS studies support this, finding that couples in their twenties have sex 111 times per year on average, with that frequency dropping steadily as couples age - perhaps as much as 20 percent per decade. Basically, younger married couples have sex twice per week, give or take, slowing over time to once or twice a month with the occasional extra session thrown in to acknowledge birthdays, anniversaries, and major holidays. That said, the frequency of sex varies widely depending on health, available time, and external circumstances (new kids, caring for a senior parent, etc.), not to mention each individual’s very specific sex drive.
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Sex & Sexuality

Holiday Sex Tips

For most of us, the holidays are a time of stress, anxiety, depression, loneliness, and a whole bunch of other uncomfortable feelings. Sure, even the most curmudgeonly among us is bound to experience the occasional, fleeting flash of peace, joy, love, and good will toward man. In these ephemeral moments we'll pick up a few toys and drop them off at a donation center, write a check to our favorite charity, and send our mother a card - hoping she'll assume we've sent everyone a card and will therefore stop bugging us about the "need" to remember friends and loved ones at the holidays, even if they're no longer friendly or loved.
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Sex & Sexuality

What’s In A Fetish? Maybe Not What You Think

Fetish, fe•tish noun: an object or bodily part whose real or fantasized presence is psychologically necessary for sexual gratification and that is an object of fixation to the extent that it may or may not be required for complete sexual expression

—Merriam Webster, 2012

Sexual fetishes* are defined as recurrent and intensely arousing sexual fantasies, urges, and behaviors that incorporate specific roles and/or physical objects. Theses objects and roles are brought into one’s sexual life because they feel compelling to the individual and because they are a primary source of sexual arousal.

Involvement in and fascination with fetishistic sexual behavior lies on a continuum. Some individuals or couples may occasionally incorporate a fetish object or act to add a little spice into their sexual lives, while others are solely aroused by fetishistic behavior, finding sex to be neither interesting nor arousing without that element.

In other words, for some people fetishes are nonexclusive, meaning the fetish is only one element of a wider arousal pattern, whereas for others the fetish is exclusive, meaning the individual can’t become aroused without it.

While the majority of sexual fetishes are playful and harmless means of sexual arousal, some are also illegal, pathological and dangerous. This blog will focus on the less pathologic, better-known fetish behaviors. In future blogs we will discuss more profound fetish related sexual pathology.
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Crystal Methamphetamine: The Other Sexual Addiction

Cross and Co-Occurring Addictions

Individuals who are cross-addicted are people who switch from one addiction to another—for instance, Suzanne stops drinking alcohol, then gains 40 pounds in three months, replacing booze with compulsive eating. People with co-occurring addictions struggle with multiple addictions at the same time—for instance, Eric smokes pot morning, noon, and night, and also plays video games for eight to ten hours each day.

Cross and co-occurring disorders are especially common with sex addicts. In one survey of male sex addicts, 87 percent of respondents reported that they regularly abused either addictive substances or other addictive behaviors. Considerable anecdotal evidence suggests that for a majority of sex addicts with a co-occurring addiction the secondary drug of choice is crystal methamphetamine. Sex addicts also use cocaine, crack cocaine, and almost any other stimulant—but crystal meth is usually cheaper and more readily available.

Consider Brad, a married, 38-year-old lawyer:
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