Category Archives: Couples Therapy

How to Visit Family & Have Vacation Sex this Holiday Season

Now that we are approaching the holiday season a lot of folks have planned to visit extended family to celebrate Thanksgiving, Mawlid-al-Nabi, Chanukah, Christmas, and New Year’s. As a couples and sex therapist, my associate therapists and I continually hear common themes and concerns among our CLS clients regarding upcoming plans and their sexual lives.

In a recent report by the US Bureau of Labor Statistics, in 48.3 percent of families with heterosexual couples, both husband and wife were employed.  While the remaining American families may have a parent that is child rearing or unemployed, most couples in our Center (including those couples without children, those that identify as LGBTQ, and those that have consensual non-monogamous relationships) report feeling exhausted by long hours, demanding bosses, and a lot less time for self-care than in that past few years.  Most workers have limits on the number of vacation days they’re allowed to take in a calendar year so saving these days for going home for the holidays with the fam can take a good bite out of that bank of person time off .

The essential questions my associate therapists and I often hear from couples in our offices at CLS is:

“How can we have a real vacation during a visit to our families for the holidays?” 

They are asking essentially: are the two terms literally an oxymoron when combined?
Here are a few common questions partners have posed in recent sessions leading up to anticipated Thanksgiving and Christmas visits to family on their valuable vacation days off work and my responses:

Why do we have to do what everyone else in your family does for every minute of the day? 

Set up a dinner with each other before your travel date to specifically discuss what kind of rhythm each day could have, what parents or relatives may expect of each of you, and what each partner is hoping to get out of the vacation/visit. Then brainstorm compromises around taking time away from the whole group at less peak events (going for a drive after post-Thanksgiving breakfast, scheduling a couples massage Christmas Day afternoon in lieu of watching a movie with everyone else).  Lastly once you come up with a plan, make sure the partner whose family is being visited tells their family what to expect a week or more before the holiday with specific details so that they have time to get used to it.

Credit: Deposit Photos

I don’t want to stay up late drinking since I want to use my vacation to exercise every morning but how can I do that without getting flack?

Many families have a tradition of heavy drinking during these holidays.  For relatives who are either less into partying or actually in sober recovery, family holidays can be really challenging.  Some people are trying to eat healthier by staying away from high caloric food and having lots of alcohol and high sugar foods around can be a high pressure situation.  For those whose ideal vacation is to maintain or catch up on an exercise regimen, the ongoing lounging on the couch and watching football or movies can prove to feel like pressure to join in.  Will you get a guilt trip from a parent or continual ribbing by siblings for going to bed earlier than the rest of the family or joining the breakfast crowd an hour later due to your morning run/yoga/cycling session?  Once you tell your family you’ll be following a particular rhythm over your break, let them know you’re looking forward to spending time with them and perhaps invite them to a class or run with you so that you have an ally in that domain and start a new tradition.

How do we prepare and protect our partner when it comes to touchy topics? 

Many partners feel like they either have full permission to express what they want with their in-laws while some feel like they have to walk around on eggshells for fear of stepping on a sensitive topic and blowing a landmine that explodes.  For example, a boyfriend expressed his openness about a friend’s decision not to have children during a family meal at his girlfriend’s parents’ home last Thanksgiving.  His girlfriend’s mother blanched and immediately excused herself from the table while his girlfriend shot him an accusatory look.

The mood turned into a frigid stone silence and the boyfriend was wondering what he had done wrong.  When they returned to their room, the girlfriend began blaming him for being so emotionally clueless regarding bringing up the topic of children since her mother had always expressed her desire for grandchildren and the idea of not having grandchildren depressed her.  He became defensive and argued that he was clueless because she hadn’t given him any clues!

I invite the partner whose relatives are being visited to act as an emissary and to prepare their partner by setting boundaries on subjects that might be hot topics and to be an ally to their partner when discussing issues and/or plans each day. This is the way partners can care for their mates and relationship while also keeping the peace with their family of origin culture.

How do we help our partners or spouses feel like this time is also made special for them? 

Credit: Deposit Photos

Plan to take some time as a couple away from the larger family unit to have some fun. This could include a visit to a local site, a hike at a nearby park or a grabbing a pint at a favorite pub.  One couple decided to go out dancing at a club they used to frequent as a teenager after their parents headed off to bed one night, another partner booked a couples massage Friday afternoon while the rest of the family went Black Friday shopping assuring their relatives they’d be back to help prepare a family dinner.

 

How can we have sex when we’re sleeping in a guest room near the family room? 

Use this vacation/visit to add creativity to your sexual repertoire:

  • Create playful rules about noise and use blindfolds and tape to limit sight and sound to enhance sex play.
  • Plan to give one another sensual massages with oil from a warm wax candle as a fun way to create outercourse or foreplay while the rest of the family go to sleep, then you have options for what comes next.
  • Stay home while the rest of the family go out for a pickup football game and have a quickie in the shower.

Wishing you a restful, emotionally and sexually satisfying holiday season with your lover and your families.  Happy Holidays!

How to Get/Give Comfort from Your Partner After a Mass Shooting (Post Pittsburgh)

When Bad Things Happen to Good People, the world seems more fragile

When Robert Bowers, the gunman who ran into The Tree of Life Synagogue in Pittsburgh this past Saturday he murdered 11 innocent people and wounded 6 more.  The event also tore into the fabric of the American community’s sense of safety, respect and collective faith in the country.

Each time there’s been a traumatic event in the US whether it’s a terrorist threat (the bomb packages allegedly sent by Cesar Soyac last week),  the Las Vegas shooting one year ago at the Harvest Music Festival and the riot allegedly incited by white supremacists RAM members in Charlottesville, Virginia last year, clients come in to sessions and are palpably frightened.  They are seeking a place to express their feelings of rage,  fear and vulnerability (many of the bomb packages were mailed to locations all around Manhattan).  The rabbi of the Tree of Life Synagogue described receiving letters of condolence and support from people all over the world.  The media shows communities spontaneously gathering to hold candlelight vigils in cities around the USA.  What does a therapist who specializes in sex therapy advise after a traumatic event that shakes a nation like this?  How does this even connect with one’s sex life?

Vulnerability and Sex 

One of the main challenges for clients in my group practice Center for Love and Sex, is the longing they have for more meaningful sex.  This can come in the form of wanting more frequent sex with their partner or spouse.  It can also present as the desire to express a long-held fantasy to a partner in order to feel more whole in their sexual expression. It also can be described as the wish to lower one’s anxiety so as to feel more present and freer in partnered sex.  For many of these presenting problems, anxiety is a large contributor to the challenge.  According to the Anxiety and Depression Association of American,  anxiety disorders affect approximately 40 million US adults aged 18 and older.

One might not be surprised that folks who already suffer from anxiety will feel a spike in their anxiety levels when a mass shooting or terrorist attack occurs.  According to a Gallup Poll taken soon after the Las Vegas mass shooting 39% of Americans are either very worried or somewhat worried that they or someone they love will become a victim of a mass shooter.  These levels were similar to a poll taken right after the San Bernadino mass shooting.  So how do people with anxiety seek out comfort?  What is interesting to me is that while most of my female clients (whatever their sexual orientation) feel comfortable in seeking out comfort verbally from their partner or friends, most of my male clients are reluctant to ask their partner/spouse directly.  However, they may ask indirectly by initiating some type of physical touch,  whether a cuddle, a hug or some sort of more direct sexual signal.  Why might that be?

Men and Comfort, an oxymoron?

Most men are acculturated to repress their fear outwardly. They’re taught that to be “real” men they need to be tough and indifferent because that is the way you win and get ahead.  Never show your hand when it comes to cards, in business and at times in romantic relationships.  Thus there’s a small menu of emotions that are socially sanctioned in American life (although there’s some variance depending on your cultural background).  Some of these common emotional expressions include: anger, rage, disdain, belittling others (either in humor or with aggression), frustration, disgust and physical extensions of these emotions.

American men (this includes those that identify as gay, bisexual and queer) are  taught that they have to be the ones that their partners can lean on.  But in the years I have worked with men from diverse ethnic, cultural, religious and orientations, I have witnessed there’s one place they can experience a wider menu of emotions. This is in the sexual and erotic realm.  Through a sexual scenario a more vulnerable side (even if most men aren’t even conscious of it) emerges, and sex isn’t just something he is performing or doing. It becomes the place he goes to be held, rocked, whispered to allowing him to feel accepted, loved and yes comforted.

Meaning of Sex and Death Anxiety

When I work with men I help them become more aware of their own fears and how they might learn how to express their worries and concerns to their partners in other ways beside being  withdrawn, belligerent, complaining or in some cases angry when their partners turn them down for sex.  I help them uncover what sexual activity with their partner means to them in the larger significance of their lives.  For some it is a return to connection that is beyond having to prove themselves, for others it’s a space they can be gentle givers of pleasure, for others it’s where they’re given free reign to lead which quiets their fear of lack of control in the outside world. And for others it’s a haven from death. 

Death Anxiety and The Lack of Living Fully

Irving Yalom, the famous existential therapist and writer has written about his theory of death anxiety can keep people from truly living deeply, including shutting off their sexual desires.   He wrote: ““…the more unlived your life, the greater your death anxiety. The more you fail to experience your life fully, the more you will fear death.”  But when faced with death either through a terminal illness or at the top of the World Trade Center, a man urgently calls their partner and/or family to tell them in an emotionally authentic voice how much they love them, finally freed of society’s chains of decorum.

Ask for Comfort without Shame

When a massively violent event occurs like the Tree of Life Shooting last weekend, it tears into our day to day lives and threatens our own sense of safety. It is the human condition to want to reach out, to hold a partner close and to give and get comfort through touch. It’s our primal urge when we’re born and it’s a haven against our own fears regarding our own eventual deaths. I always let clients know that inside all of us are the children we used to be; playful, eager to learn, and longing to be comforted when we’re frightened.  This need is not something to be ashamed of.  The increase in mass shootings are fear-inducing for all Americans and for all humans.  If you have a partner, let your guard down, tell them of your fears and invite them to comfort you and offer yours to them.  If you don’t have a partner, reach out to friends, your community, attend one of the hundreds of interfaith vigils that are still occurring across the country and offer to give and receive a hug.  The only way through this is to confront pure hate with pure love and authentic comfort.

“Prurience” Exposes 3 Controversial Topics in America: Sex, Porn Addiction & Recovery

While I’m not sure in what order they should be listed, I have spent years helping people say the unsayable, articulate what turns them on, and supporting their journeys in coming to terms with the particular consensual erotic interests they find most compelling. At CLS, we also help those who tell us they have a porn addiction or who find that their porn gazing has become out-of-control.  In a recent performance called “Prurience” created and performed by Christopher Green at the Guggenheim’s Works & Process Series, Green created a space in The Wright restaurant that while not a safe therapeutic environment, still encouraged some participants/audience members/performers to communicate what they are erotically drawn to when watching porn or how their porn watching became what they deemed to be an addiction.

Christopher Green in “Prurience”

Green invited participants into an unusual immersion/theater which was a combination of a 12-step sex addiction meeting, a confessional, a one-way-mirror-interrogation, and a-funhouse-mirror-maze. I was lucky enough to interview Mr. Green during his show’s run in NYC given how it reflects on some of the issues our clients are confronting given their porn use whether as an out-of-control behavior on their own or wanting to incorporate the fantasies they enjoy with a partner or spouse

I wondered if the impetus to create the piece coincided with the changes in UK laws regarding pornography. Green stated: “Funnily enough no, it happened all at the same time. Suddenly when I was writing it, David Cameron became obsessed with it and started legislating and talking about porn all the time.” In 2013 Prime Minister Cameron proposed having all porn blocked by internet providers in the UK, where Green grew up.

The audience is invited by the person we think of as the leader of the Prurience group, an American artsy-man with an effeminate inflection in his speech played by Green, to make a circle with the chairs as usual before the “meeting” begins. He is apologizing for being late and haphazardly setting up the product table in the corner, offering up swag printed with the Prurience logo. Once settled, he begins the group by asking participants to share their first memory of seeing porn for the first time. This question aligns with many of the questions we ask at CLS when conducting a Sexual History as part of a full bio-psychosocial assessment to learn about our clients, their families of origin, their education regarding sex (formal and otherwise) both through self-pleasuring and/or partner sexuality.

In this immersive theater experience, several participants shared the discovery of their father’s Playboy, or a friend’s older brother’s stash of videos, or searching online at sites like Pornhub. In our practice, clients express how they watched their parents hold hands, or kissed a “crush” for the first time in 5th grade at a friend’s house party or happened upon porn online at age 14. The firsts of our lives leave an imprint, and at times it is so strong that it becomes a go-to fantasy that one seeks to recreate again and again whether in one’s imagination, online, or with a partner.

In “Prurience” we are led to believe that the members of this so-called self-help group are struggling with so called porn addiction. While the term sex addiction was not accepted as a formal DSM5 diagnosis, nor has it been accepted by the American Association of Sexual Educators, Counselors and Therapists (AASECT), the terms sex or porn addiction has been popularized enough by people like Patrick Carnes, the unscientific YourBrainonPorn site and the many rehabs that continue to charge thousands of dollars to help people with sexual behavior they may find out of control, sinful, shameful and unfaithful.

At CLS we work with people who struggle with Out of Control Sexual Behavior or hyper-sexual behavior that have put their relationships, family and livelihoods at risk. In a structured, thorough assessment process we discover what other overlapping challenges, potential diagnoses, past trauma and/or relationship dynamics are contributing to the behavior and collaborate with the client on the treatment goals and individualized plans we recommend.

In the Prurience porn addiction meeting one soon hears from people who are revealing ever more detailed descriptions of what they like to watch, what they desire and the level to which these desires haunt their waking and sleeping hours. The comments are sharp, humorous, disturbing, self-flagellating, erotic, disgusted and intriguing.

SC: How important was it for you to create an Uber-reality of a 12-step meeting?

CG: “Yeah, I wanted to unsettle people because one of the effects of porn as we know one of the effects of porn is it’s deeply troubling, or arousing in the fundamental sense of the word. It alerts us and wakes us up…I wanted to try and replicate that in a theatrical setting”.

SC: “Like in a parallel process kind of experience?”

CG: “Yeah, absolutely.”

The term I used in this last question, “parallel process” is a psychotherapeutic term to express the feelings or dynamics that crop up in the relationship between a supervisor and a therapist who is telling the supervisor about a particular client. While relaying the issues, the dynamic may well unconsciously mirror the dynamic that is occurring between the therapist and their client.

In his run on the West End in London, Green told me that some audience members got up at the break and walked out, never to return. They were too disturbed, or embarrassed or uncomfortable to stay through the 2nd part. The topic of porn is still rarely brought up in general therapy but in sex therapy, we try to help clients describe what turns them on so that they can articulate it to their partner(s). If a person is into porn, or erotic novels or other fantasy-type trigger, describing a scene or exchange can help them formulate what it is that fires up their erotic ignition.

Green wondered how I felt at witnessing his role as group leader who didn’t really “hold” the members of the porn addiction recovery group in a safe space by setting clear boundaries on the length of people’s contributions or the intensity of what was shared even when someone seemed to be in a high risk situation.  I thought it was an astute question since in fact I was quite aware that the experience was theater and that his playing the role in a passive manner was intentionally done.  It certainly unnerved some folks who felt unsure of what was to come. Much like getting on a roller coaster that might make you nauseous, many audience members were rattled by the tea break. 

This lack of structure and support that one sees in the group is NOT like a professional therapeutic experience where a therapist lets a client know what comes next in the process, allows the client to ask questions, holds their fears so that they don’t become overwhelmed and may stop someone who becomes hurtful to another.  The therapist closely monitors the clients’ experience, and checks in to ensure that the sessions are going at an emotional pace that they can handle.

I asked Green about the fact that the group didn’t seem to have a performer playing a partner who has suddenly discovered their partner/spouse’s compulsive sexual habits and come to the group to express their shocked, hurt and angry reactions. He let me know that in fact in the original version of the piece there had been a female character who had discovered her husband’s porn use and ostensibly came to the meeting as almost one would go to AlAnon to get more education and support but that in the final edits made by the dramaturge, he lost this character which saddens him at times.

In our work with a client wanting help with their compulsive sexual behavior at Center for Love and Sex we at times work with the individual and refer the couple to another therapist for couple/marital counseling. in other cases we’ll work with both the couple and each partner individually if it seems like a better plan. Like any secret kept hidden for years, the ripple effect after the discovery of an out-of-control porn problem has tremendous impact on both the partner with the issue and the relationship. For many of our clients the recovery of Out-Of-Control sexual behavior includes the opportunity to speak about all sorts of issues (including their sex life) which had been swept under the carpet for years.

We help them understand the behavior, treat the underlying or coinciding disorders that might have contributed to the behavior and then help them and their partners begin the long road to rebuilding trust, expressing hurt, articulate anxiety, and describe erotic desires. The split-off part of their self that was continually numbed out through the compulsive behavior can now emerge and be known not only to the individual but to their partner. And the therapist helps them stay grounded through the at times painful,  anxiety-ridden process.

I’ll quote Chris Green with his perceptive reflection on therapy and theater to end this blog:

“I think a lot of therapy is sitting with discomfort isn’t it? It’s being able to turn your face towards the thing you normally turn away from. And it’s.. to put that into theater you have to sit with discomfort, you have to encourage people to sit with discomfort. And it’s only through that that we make any breakthroughs in life” .