Sex & Sexuality Articles

Out of Control Sexual Behavior: Addiction or Offending?

Thursday, September 25th, 2014

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 sexual addicts and sexual offenders. Sex addicts are people who engage compulsively in one or more consensual sexual behaviors, continuing those behaviors despite directly related negative consequences – relationship woes, problems at work or in school, loss of interest in previously enjoyable activities, lack of self-care, declining physical and/or emotional health, financial issues, and more. Sex offenders often have similar symptoms, but their sexual activities are nonconsensual, violating the rights of others, breaking the law, or both.


The Truth about Gay Conversion Therapy

Thursday, August 21st, 2014

The Truth about Gay Conversion TherapyTherapists 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:

  1. Is homosexuality a psychological disorder (or the result of a psychological disorder)?
  2. 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.


Discussing Casual Sex: An Interview with Dr. Zhana Vrangalova

Friday, August 1st, 2014

Discussing Casual Sex: An Interview with Dr. Zhana VrangalovaZhana Vrangalova is a human sexuality researcher with a PhD in Developmental Psychology from Cornell University. Currently she teaches in the Psychology Department at NYU. Her research focuses on sexual orientation, consensual non-monogamy, and the effects of casual sex on emotional wellbeing. She is the originator of The Casual Sex Project, a forum for real stories from real people detailing their experiences with hookups, one-night stands, friends with benefits, and the like. Her recently published study, Who Benefits from Casual Sex: The Moderating Role of Sociosexuality, is generating a great deal of discussion among not just sexologists, but the general public, primarily because the research finds that casual sex, for people who are emotionally and socially “into it,” may actually benefit emotional and psychological wellbeing. (Previous studies looking into the effects of casual sex on wellbeing have been largely inconclusive.) I recently had the opportunity to speak with Zhana about her groundbreaking work, and I wanted to share the transcript of our conversation here.


The Reality of Bisexuality

Wednesday, June 26th, 2013

Sex is Not a One-Way Street

The Reality of BisexualityI 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.


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

Wednesday, March 27th, 2013

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.


Holiday Sex Tips

Wednesday, December 19th, 2012

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.


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

Thursday, August 30th, 2012

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.


Crystal Methamphetamine: The Other Sexual Addiction

Wednesday, July 25th, 2012

addictionCross 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:


The 12 Steps as Therapeutic Tasks for Sexual Addiction Recovery (Continued): Steps 4 through 9

Wednesday, June 13th, 2012

Stepping It Up in Treatment

Sex addicts, like many in early addiction recovery, are often highly resistant to the idea of attending 12-step recovery meetings. Their reasons are myriad and usually without merit, though they sure can sound convincing on first listen.

Basically, it boils down to this: individuals who hang out in adult bookstores, cruise local red light districts looking for prostitutes, download hard-core pornography on work computers and masturbate in their office during business hours, post hi-definition photographs of their exposed genitalia on dating websites, and openly announce their extramarital availability on Ashley Madison (with a face photo but without a second thought) are the same folks who become very concerned about being “spotted” at one of “those” meetings.

“What if someone sees me there and thinks I’m a pervert?” they fret. Never mind the fact that these meetings usually take place in churches, school classrooms and local businesses after hours with no neon signs announcing what’s going on. Resistance to change is what it is, and even though sex addicts invite risk when acting out, they are risk averse in terms of being seen in 12-step sexual recovery meetings like SAA, SLAA, SCA, SA, and SRA.

It is therefore up to the addiction therapist, when working with a 12-step-averse client, to bring the themes, neurobiological rewiring, and experience of 12-step recovery into the treatment arena—especially in a group therapy setting. Once the sexual behavior problem has been clearly assessed and client/treatment goals and expectations aligned, sex addiction treatment is well served by the therapist initiating discussions on themes like surrender, feeling out-of-control/powerlessness, developing personal integrity, asking for help, accepting responsibility, turning it over, establishing accountability, etc., all within the framework of cognitive behavioral treatment.


Sexual Freedom vs. Sexual Addiction: The Gay Male Conundrum

Wednesday, June 6th, 2012

Pride and Problems

June is unofficially “Gay Pride Month,” when major cities around the world host gay and lesbian focused celebrations and events featuring parades, parties, festivals and forums. In Los Angeles (home of The Sexual Recovery Institute), Pride takes place this weekend, June 8th – 10th, in the form of a huge parade and a weekend-long outdoor festival.

And there is much to celebrate. Without doubt, the GLBT (Gay, Lesbian, Bisexual, and Transgender) community has come an incredibly long way since the American Psychiatric Association was labeling homosexuality as a diagnosable and treatable pathology in the 1960s and early 1970s.

In most American urban areas, gay people now can adopt children and openly build lives together without fear of repression or overt discrimination. Gay marriage is now legal in many countries (Canada, England, and Spain, to name just a few), and the topic is being addressed in the US.

Most notably, last month, for the first time, a US President spoke out in favor of marriage equality. But for every step forward, we slide a half-step back, and gay and lesbian people remain in many ways marginalized, stereotyped, and highly susceptible to prejudice, negative bias and oppression.


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