Sexual healing is a return to safety and congruency. All healing is a return to balance. So often we think of healing as trying to fix what is wrong with us, with someone else, with the world, and with our sex life but it is exhausting to run around fixing because the world is in constant flux. We can’t fix anything; healing comes from source. Still the word “fix” is a misnomer because even our wounds are perfect expressions of the divine. There ultimately is nothing to fix because chaos reigns supreme and there will be a new problem tomorrow. Nowhere is this truer than in romantic and sexual relationships which is why I always ere on the side of couples staying together instead of trying to “fix” things by calling it quits in order to find a better sexual partner. When we switch sexual partners, we usually get similar lessons in different packaging. Obviously, some relationships and some marriages need to end, still it is important for people to understand that without addressing the core symptomatology in a failed relationship they will very likely find themselves in a similar hole.

I remember reading that part of learning to walk is learning to fall; this is a fantastic analogy for our need to continually seek balance in our relationships. Balance is a relative of volition and movement; how we go about the day-to-day. We all get out of balance; yesterday, I was tired but today I am energized. Balancing acts in sexual and romantic relationships are tricky because we choose people that habituate the familiar for us. If we had a mother that was critical, being criticized will be normalized and feel like love.

Part of healing the sexual is learning how to “fall” in our relationships. We cannot just continually try and stay upright so to speak, if things are not working in our primary relationship: we need more, more sex, less sex, no sex, whatever the need is, needs to be discussed, even at the risk of disfavor, i.e. “falling”; drop expectations and stick with “I” statements.    When it comes to sexual healing “fixing” is a noose to intimacy. Only through surrender and honesty with self, is it possible to name the familiar that has grown stale sexually and emotionally; give voice to what no longer serves the relationship’s highest interests; those systemic, habituated patterns which can make communication feel like riding a bike in sand.  If your partner can’t hear it or doesn’t want to receive it, share your feelings with a mental health professional, sex therapist, or friend. Voice has the potential to move energy and if we change, invariably all of our relationships, including the sexual, will change and shift as well.

Wasting time trying to get others to change or see our point is, a waste time. Using voice to understand the skin we have in the game is place to start when frustrations get amped up with an unresponsive lover.

As a therapist I often hear from clients that they have done talk therapy and found it wanting, a subpar dead-end to lasting change. Unfortunately, like stitching a seam with a needle that weaves, under and over to form a stitch, sexual healing can be slow work and may require a host of interventions. This does not mean that talk therapy does not work.  When clients share from their heart of hearts with a trained healer, speak their truths, they often stumble upon a real emotional find like discovering the perfect bauble from a vintage store or a trying new restaurant that turns out to be insatiably memorable. Sharing can lead to surprise insights and sexual acting out, sexual arousal, and sexual dysfunctions show up in our lives as human beings, not to break us, but to light a new sense of what might be possible when it comes to sexual. Don’t doubt the power of your voice when it comes to sex, stand by what you know you know, even when what you know is not being reflected back to you with magnanimous gratitude or at all for that matter. Talk therapy is not just about sharing but repairing attachment wounds, soothing the central nervous system, making the unknown know, releasing secrets, and pain. When the wound is relational the healing must be relational as well.

When treating erectile dysfunction the first course of action is a physical rule-out. It is important to meet with a doctor to determine that the erectile dysfunction is not flagging a physical or hormonal imbalance. Usually, patients have checked this box before they call a therapist. It is difficult to see a therapist when everything in life works but your sex life.

We, both patient and therapist, must be careful listeners to the voice of the erectile dysfunction. Not all erectile dysfunction is created equal and therefore there is not a one-size-fits-all treatment model. Sometimes erectile dysfunction is a more generalized anxiety response. Erectile dysfunction can also be an expression of unrealistic sexual expectations: all men are ready to go sexually at any time with anyone. Erectile dysfunction may have to do with the aging process. Sometimes what gets labeled erectile dysfunction is a reflection of not being in the mood and erectile dysfunction is a misnomer. Perhaps you just had a big meal, are tired after work, or just don’t feel it.

Successful treatment of erectile dysfunction involves anxiety reduction, a lessening or cessation of viewing porn, and a close look at sexual details. I offer my clients techniques to stay body focused so they do not shift to disassociation, people pleasing, and negative thought. Ask any of our ancestors as far back as the caveman, worry, sexual anxiety, and pressure our unique bi-products of our age.  The penis knows how to have sex. It really is that simple once the psychological blocks give way.

 Sex addiction can be confusing. On one hand sex is fun, feels good, and is a natural part of being human and on the other hand when sexual behavior turns addictive, the fun stops cold and gels quickly to shame and pain. Even more confusing and contradictory, sex addiction is not ultimately about sex. Sexual acting out is almost always about self-regulation, attachment trauma, chasing a high, wanting validation, and relief from internal or external pain. When a client or couple comes to my office post-discovery I often hear the addict say, “I just have a high sex drive.” Usually, a partner, spouse, or girlfriend has done some snooping on a cell phone, an email account, and/or bank statements and found evidence of sexual betrayal; compounded research has perhaps led the couple to suspect sex addiction. For the addict, admitting to sex addiction is a step towards authenticity and recovery. For the betrayed partner naming the infidelity as sex addiction provides a container to help hold the pain and trauma that has just side swiped the coupleship. Here are some signs of active sex addiction:

-Escalation in unwanted sexual behaviors

-Secret keeping

-Lying to self and others — rationalizations

-A desire to stop or cut down on sexual acting out and an inability to do so

-Transactional sex

-Loss of money on webcams, sites, etc.

-Health and safety risks

-Increasing fears about getting caught

-Shame.

Whether it is sexual addiction, sexual compulsion, or sexual acting out the treatment model is the same.  Boundaries must be placed around destructive behaviors and trust restored with self and others. Sex addiction is an intimacy disorder involving a divided well-defended self. Process addiction like sex and food are usually older developmentally than substance addictions and therefore more pernicious. Abstinence does not work; the goal is healthy sex not stopping all together. Sex addiction tends to germinate long before we are sexually active and grows like a vine around a tree as the structure of self forms.

Healing begins with accountability and asking for help. The wounding is relational and therefore the healing must be relational as well. My office is a shame free zone which allows us to explore the painful experiences of the past that have become sexualized.  Sex addiction is not just about the lust hit, it also involves the dopamine reward system of the brain which means we have to look at the complete picture of self. My approach is confidential, discrete, and compassionate. There is a way out. Life can be sweet when you don’t have to manage secrets and cover your tracks.