Sexual Inhibition and Guilt

In previous articles, I discussed the connection between sexuality and emotions, particularly anger and shame. In this post, I want to focus more on the emotion of guilt. In my mind, one of the first things to understand about guilt is that it is very closely connected to anger. In fact, I believe that guilt is the flip side of anger. To illustrate this idea, let’s take a look at what someone may say to another person if he or she is provoked to anger. For example, someone who has become angered may state, “You messed up,” to the other individual. Now what may someone say to himself if he feels guilty about something he has done? How about, “I messed up.”

Anger– “You messed up.” Guilt– “I messed up.”

Just replace the “you” with “I” and anger becomes guilt. My point here is that what we call guilt is really anger directed at oneself. When we feel guilty, we are angry at ourselves.

The other crucial aspect of guilt is that it always entails punishment. Someone who is found guilty in a court of law is going to be handed down a punishment by the judge. In this way, criminals have been judged to be guilty by society and are deemed to be worthy of appropriate punishment. Sometimes the punishment may merely be a fine if the guilt is moderate. Other times, punishment entails a prison sentence for guilt that is more severe. And of course, the death penalty is the ultimate punishment for ultimate guilt.

Finally, guilt is always subjective. One jury may convict an individual for […]

What Does It Mean to Be “Sex Positive?”

Anyone surfing the net looking for sexual information will have probably encountered the term “sex-positive.” Individuals seeking therapists for sexual difficulties will also have inevitably read a therapist profile or bio which indicated that the clinician identified as sex positive. But what does this term mean, especially coming from a therapist?

I will offer a quote from sexologist Carol Queen to get the discussion going–
“Sex-positive, a term that’s coming into cultural awareness, isn’t a dippy love-child celebration of orgone – it’s a simple yet radical affirmation that we each grow our own passions on a different medium, that instead of having two or three or even half a dozen sexual orientations, we should be thinking in terms of millions. “Sex-positive” respects each of our unique sexual profiles, even as we acknowledge that some of us have been damaged by a culture that tries to eradicate sexual difference and possibility.
It’s the cultural philosophy that understands sexuality as a potentially positive force in one’s life, and it can, of course, be contrasted with sex-negativity, which sees sex as problematic, disruptive, dangerous. Sex-positivity allows for and in fact celebrates sexual diversity, differing desires and relationships structures, and individual choices based on consent.”
In my mind, being sex positive at its core means that one’s default position is that sex is natural, generally healthy in all its variations, and can be utilized positively in the service of personal growth and creativity. Now, that of course does not mean that sex can’t be used destructively, just that pathology is never the underlying assumption. For a distinction between the two, click here. (Cliffs Notes version– according to […]

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    Book Review: The Sober Truth and What It Means About Sex Addiction

Book Review: The Sober Truth and What It Means About Sex Addiction

I recently finished reading a fascinating book, The Sober Truth, by Lance Dodes, which focuses a critical look at the treatment of addictions, particularly inpatient rehab centers and 12-step groups. I’m sure this book will prove to be very controversial, especially in addiction circles, as its main premise is there is no evidence that 12-step groups, or inpatient rehabs (which are mostly modeled on the 12-steps) are more effective than no treatment at all in helping folks to overcome their addictions. In all, research shows that only 5% of those who regularly attend a 12-step fellowship are able to abstain fully from alcohol or drugs in the long-term, which is about the same percentage of those who quit on their own.

As a sexologist, my expertise is not in addictionology, but where my practice does intersect the addiction field is in the area of sex addiction and sexual compulsivity.  There is currently tremendous debate whether out-of-control sexuality is really an addiction or a compulsion. For more on this, check out this article which covers recent research in this area. Interestingly, in The Sober Truth, Dodes states that all addictions, yes ALL addictions, and this includes all manner of drug addictions and alcoholism are really compulsions, not addictions.  To illustrate his point, Dodes differentiates between physical addictions, where the human body has built up a tolerance and would go into withdrawal if the substance is removed, and the psychological or emotional aspect of the addiction, which looks very similar to a compulsion. Dodes states that it is quite possible to develop a physical addiction without emotional dependence, as well as emotional dependence without physical addiction. […]

Marat/Sade: Some Thoughts on Social Change and Sexuality

Over this past weekend, I was fortunate enough to see a new, more futuristic adaptation of the classic play Marat/Sade performed at the Players Theater in Greenwich Village. As I was watching, I was struck by the realization that many of the ideas as well as the main theme of the piece had much to do with my work as a sex therapist. And so I would like to put some of my thoughts down as a post on my blog, both as a means to clarify them and delve deeper in further exploration.

Marat/Sade originally premiered in West Berlin in 1964 and eventually won the Tony Award in 1966 for Best Play. It is set in the historical Charenton Asylum during the reign of Napoleon, and centers on a play staged within the asylum by the Marquis de Sade and using the asylum inmates as actors. The Marquis de Sade (from whom we have the term “sadism”) was held in the asylum after his arrest for the anonymous publication of Justine and other pornographic tracts. In real life, the director of the hospital did allow de Sade to stage plays within the asylum, often to a public audience. The particular play-within-a-play performed as Marat/Sade focuses on the life and assassination of Jean-Paul Marat, a radical journalist who goaded on the French Revolution, and was eventually assassinated by a member of a rival faction. As the play unfolds, the Marquis pops in now and then to add his commentary to the proceedings.

The central idea of the play is the juxtaposition and contrast between the philosophies of Marat and de Sade. […]

Boundaries: The Most Important Part of a Relationship

Inevitably, when I work with couples that have long-standing problems in their relationship, I come across a litany of boundary issues strewn along the way starting from the very beginnings of the relationship. For more on why the beginnings of relationships are absolutely crucial, please click here. In this particular article, I want to focus on the very specific but essential topic of boundaries. Typically when people think of boundaries, they are actually thinking of cut-offs, or situations in which such a firm wall is put up that it literally cuts off all further communication or connection. For example, “Don’t call me after 9pm,” is a cutoff; the idea being that there will be absolutely no further phone contact after 9pm. Or “I’m so mad at you that I never want to speak to you again.” Again, I think it’s clear that statement is more of a cutoff than an example of appropriate boundary setting.

So what exactly are boundaries then? The way I see it, boundaries are guidelines that people put in place to allow them to enjoy their lives and relationships better. In this sense then, boundaries are built on internal values. So for example, if someone values his or her free time, then they will set boundaries on how many hours they are willing to work. If an individual values their time (and therefore promptness), they will place a boundary on people showing up on time to meetings and appointments. Again, boundaries are based on values. If we are not clear on our values, we will have absolutely no boundaries. If we don’t place […]

Narcissism and Sexuality

Note: The following article is meant to examine the ways in which powerful negative emotions can combine to form certain personality traits and how that can impact sexuality. It is not meant to pathologize or demonize anyone who struggles with any of these difficulties, but merely to illustrate how problematic emotions can create chronic relational and sexual disturbances. As a therapist, I always take a strengths-based approach, and focus on how the individual can resolve their difficult emotions, rather than what is wrong with them.

Previously, I wrote about borderline personality disorder and sexuality. In this post, I will focus on narcissism. In many ways, narcissism is the jigsaw puzzle piece that is the perfect fit for the borderline. There are many reasons for this. The narcissist is often self-preoccupied and unavailable, which does not set off the borderline’s abandonment fears because the relationship feels like it will never get close enough for the borderline to truly be hurt. While the borderline tends to be more anxious/ambivalent in her attachment style, the narcissist is more avoidant, and it is this avoidancy that feels safe to the borderline. For more on attachment styles take a look here.

As in the case of borderline, there are nine distinct criteria in the DSM for narcissistic personality disorder (NPD), including grandiosity, exploitativeness, envy, and lack of empathy towards others. Again, rather than focus on diagnostic criteria, I’m going to take a look at the core emotions that the narcissist struggles with. While the borderline is consumed with fear of abandonment, the narcissist is primarily motivated by a strong sense of internal […]

Borderline Personality and Sexuality

Note: The following article is meant to examine the ways in which powerful negative emotions can combine to form certain personality traits and how that can impact sexuality. It is not meant to pathologize or demonize anyone who struggles with any of these difficulties, but merely to illustrate how problematic emotions can create chronic relational and sexual disturbances. As a therapist, I always take a strengths-based approach, and focus on how the individual can resolve their difficult emotions, rather than what is wrong with them.

In previous articles, I described how emotions impact and wreak havoc on sexual expression. In the next series of articles, I will go into a little bit greater detail on how these various emotions can come together into very specific and defined characterological patterns and how these personality types can come through sexually. In this particular piece, I will focus on the borderline personality (BPD).

Borderline personality is marked by intense emotional swings, a distinct pattern of relational volatility, splitting behavior (which means seeing someone as either all good or all evil), and an absolute inability to take any responsibility for or have any insight into one’s behavior. The DSM lists nine distinct criteria, of which someone needs qualify for at least five in order to be diagnosed with BPD. I don’t adhere very closely to a purely medically diagnostic model, so rather than get lost in psychiatric diagnoses, I want to focus instead on what emotions someone who is borderline struggles with and how these get played out in the treatment room as well as in interpersonal relationship and sexual expression.

First and foremost, […]

Sexuality and Shame

In a previous post, I went over the important connection between sexuality and emotions. In this article, I am going to focus specifically on the core emotion of shame, since it wreaks so much havoc on all aspects of our lives, but in particular our sexuality.  Shame can be very nefarious, as it is one of those emotions that can become internalized as part of our identity. To understand why, let’s take a look at the difference between two words which are often used interchangeably, but are actually quite dissimilar– guilt and shame. Guilt is an emotion that we experience when we feel bad about something we did. Shame, in contrast, is an emotion that is experienced as feeling bad about who we are. This self-identity aspect of shame makes it into a potentially highly problematic emotion. This is because sexuality, whether we are speaking about gender, orientation, or specific interests or behavior, is often experienced as a central, core aspect of one’s personal identity. If we also experience a great deal of shame, since it touches upon our self-identity, it inevitably also affects the way we experience our sexuality. For this reason, folks struggling with any aspect of their sexuality also frequently struggle with the emotion of shame.

Shame is a very quirky emotion in that different people react to it in different ways. Some folks, for example, will avoid anything that may even remotely evoke feelings of shame. Others, however, react in the opposite, or counterphobic way, in that they are compelled towards situations that feel shameful. For example, exhibitionists, and here I’m referring to the sex offender […]

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    Why the Beginning of a Relationship Determines It’s Success

Why the Beginning of a Relationship Determines It’s Success

This is an article I originally wrote for Singles Warehouse….


If you are just getting back into the dating scene, you may find the process to be both exhilarating and frightening at the same. Exploring the possibilities of love with new people can be very exciting, but can also be frustrating and disappointing when things don’t work out. What most people don’t realize though, is that the dating process is the MOST important part of any relationship. Of course, once you are settled in a relationship, you have to know how to keep it going strong, but if you don’t set the tone the right way at the very beginning, your relationship may unfortunately just be doomed.
Planting the Seeds
As an example, have you ever gone through a long-term relationship that eventually ended and just as it started going downhill, things that were said or done from the very start of the relationship, maybe that happened even years ago, were drudged up and used as ammunition during the breakup process?

If so, if you ever look back at that failed relationship, chances are you’ll be able to see that the seeds of the downfall were planted at the very beginning of the relationship.  Girlfriend was overly insecure? Perhaps something you did at the beginning of the relationship exacerbated and stirred up the insecurity. Boyfriend feels unappreciated? Maybe you stoked those fires in the first month.

The First Few Months

The first few months of the relationship are absolutely crucial in determining the eventual direction that the relationship goes. Just as the first few minutes of meeting someone new are crucial in determining attraction, and the […]

The Connection Between Attachment and Sexuality

One of the subjects that I have spoken on extensively on over the last few years is the topic of attachment. By attachment, I am referring to the style of interpersonal relating that we have learned and internalized from childhood experiences. According to decades of research, started by psychoanalyst John Bowlby and extended by Mary Ainsworth, among many others, psychologists have identified four main types of attachment styles- secure, anxious/ambivalent, avoidant, and disorganized. The secure attachment style, prevalent in 65% of the population is marked by emotional stability and a childhood featuring stable and nurturing caregiving. Anxious/ambivalent attachment is characterized by obsessive preoccupations about the object of the intimate relationship and intense fear of abandonment. People with this attachment style typically have experienced inconsistent caregiving, and so have grown to feel unsafe in the stability of close relationships. Avoidant attachment is marked by the avoidance of intimacy, as well as of experiencing feeling and emotions. These folks have typically experienced more neglectful caregiving as kids. I will put aside the disorganized attachment for the moment, as it is not very common, and is typically a byproduct of more severe abuse.

At this point, I want to make an important note about what I mean by “intimacy.” I think sometimes folks get caught up in some kind of a rigid idea about what intimacy means, one that is cooked up in harlequin romance books, soap operas, and Hollywood Happy Endings. This involves the kind of romantic closeness, actually known as partner engagement, which involves the typical aspects of what we would all consider as deep and meaningful love making– the pillow talk, […]

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Upscale Magazine- May 2014 Issue

SwingersGo check out a great, and I mean GREAT, absolutely fascinating article in the May issue of Upscale Magazine, entitled "Secret Lovers," in which I am interviewed regarding the hush hush world of the swinger subculture.  The writer does a really good job of trying to understand the psychology of folks who practice consensual non-monogamy and I think the piece is very even-handed, with some practical tips for couples who are curious about dipping their toes in the lifestyle. I'll leave you with a quote from one of the swingers profiled in the piece, which I think gives a good feel for the tone and depth of the article-- "I love to see her with two guys and two girls at once. I enjoy submissive women, and there is no sexier submission than to watch my wife please me by pleasing others."  If that sounds interesting, then I suggest you head out and grab a copy. It's well worth the read.

Cosmo- April 2014

cosmoI am featured in the Sex Q&A section of Cosmo's April 2014 issue, in which I get asked about BJs, Plan B, sex in hot tubs, and all kinds of other tittilating reader questions. They did a good job of adding all kinds of humor, including a silly picture of tea bags-- need I say more? It's a can't- miss hoot. Go and check it out at news stands now!

Sex For Smart People Podcast

sex for smart peopleI just recently did an interview for a cool podcast called Sex For Smart People. Here is their description of the show: Sex therapist/psychoanalyst Dr. Michael Aaron is our guest of honor this time. Hear his and our perspectives on things like: What to do when you feel less ravenous about sex than your partner feels? Is it really honestly possible to feel coziness/familiarity and also sexiness/mystery/excitement in a long term partnership? How do you begin to talk to your partner about your interest in power play? (Trigger warning, around the half hour mark, we talk explicitly about rape fantasies.) And did you know that *just this past year*, kinky behavior was officially de-pathologized in clinical psychology terms (we think it is about f*****g time)? Plus, Dave is super silly and time)? Plus, Dave is super silly and loopy on NyQuil, and he and Stephanie share their favorite pick-up lines. [audio mp3=""][/audio]