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Sexuality and Unresolved Grief

Sexuality and Unresolved Grief

In previous posts, I addressed the relationship between sexual difficulties and such powerful negative emotions as guilt, shame, and rage. I briefly addressed the emotion of grief in this article, but I also wanted to take the opportunity to expand on the ways in which grief affects sexual functioning, particularly because it is such a prevalent experience for so many people.

When we experience grief, inevitably we are dealing with some kind of a loss. Grief is the emotional response to loss. Typically, we may think of the loss of a loved one, but loss doesn’t just have to be about the death of a person– it could be about the death of an idea, a hope, a dream, an identity, and so on. In many ways, grief is a normative process in human development. We’ve all had to (or will have to) grieve the loss of childhood dreams and opportunities; we have to accept that we will never be an astronaut or professional ball player. And we also have to grieve the natural effects of the aging process– we cannot stay young and keep our looks and health forever. So grief is an inevitable experience for all of us in one way or another. We cannot escape it. But there is also a large gap between this kind of normative grief and the unresolved, perhaps pathological, grief that causes long-term difficulties.

When grief becomes unresolved it is typically because an individual is stricken with grief but does not allow him or herself to fully experience it. Essentially, the person is afraid to experience the grief, and develops something resembling […]

By Michael Aaron|October 22nd, 2014|Sex Therapy, Sexuality and Psychology|1 Comment

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Why Sex is Just the Tip of the Iceberg

Why Sex is Just the Tip of the Iceberg

When people ask me what is sex therapy, my answer often comes as a surprise– sex therapy is simply regular talk therapy, which also includes a frank discussion of sexual issues and/or difficulties. In other words, the skills necessary to be a good sex therapist cannot be separated from the skills of more general psychotherapy. And there is a specific reason for this– more often than not, the sex is just the tip of the iceberg.

Let me explain. An individual may come in to my office, complaining of a sexual difficulty, let’s say inability to enjoy sex, for example, but as we start working together it becomes apparent that this individual’s entire body is numb because he has shut himself off from ever having to feel intense, painful emotions again. So, in this instance, a deeper emotional issue has now begun to affect the individual’s sexual functioning, but the core issue isn’t the sex, it’s these nagging underlying painful emotions. The sex is merely the fire under someone’s butt to get him or her into the office, but the sexual issue will not and cannot be resolved unless the individual is willing to take a committed look at the deeper underlying issues.

This is just an example, and yes, sometimes sexual difficulties can be resolved without any of this deeper work. Often, because we live in a culture that is so confused about sex, just providing accurate sex education to dispel toxic and inaccurate beliefs is enough to send someone in the right direction. Or some behavioral interventions are sufficient when we are working with more […]

By Michael Aaron|October 6th, 2014|Sex Therapy, Sexuality and Psychology|0 Comments

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Some Additional Thoughts on Anger: The Three-Headed Monster

Some Additional Thoughts on Anger: The Three-Headed Monster

In numerous previous posts, I have gone into extensive length in discussing anger. For most of us, anger is such an uncomfortable emotion, that we have found elegant solutions to manage it, tolerate it, and push it away from our awareness. Unfortunately these defensive maneuvers, although at one time may have worked, often create more pain and suffering than benefit for us. Let’s take a look at the three most common strategies that people typically have found to manage anger along with the negative consequences that result from these strategies.

The first and most common strategy is called deflection. This is the typical “kick the dog” when you’re angry strategy. In other words, this is when we focus our anger on someone else, rather than the actual source of the anger, because this other entity is either more vulnerable in some way or just plainly a more easy target. So, for example, if a boss or supervisor has enraged the individual, it is far easier to take out the anger at home with one’s family, which is usually a captive audience, rather than deal with direct conflict at work, which may have unknown and terrifying consequences. When we are angry at someone and we have no idea why, it may be helpful to take a look at deflection as a potential culprit.

Second is projection. If it is too uncomfortable for us to tolerate the anger, we may project it unto another person, which means that instead of being aware of our anger, we instead believe that someone is angry at us. In essence, the end result of […]

By Michael Aaron|September 25th, 2014|Sex Therapy, Sexuality and Psychology|0 Comments

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Sexuality and Self Destructive Behavior

Sexuality and Self Destructive Behavior

I’ve written many times before about all of the wonderfully positive aspects of sexuality, but I cannot examine the totality of sexual experience without acknowledging that some individuals can and do use sexuality for destructive purposes. Often as clinicians, we will see these destructive acts in the form of self-destruction– risky sexual behaviors in which the individual can end up badly hurt, dead, or in jail. Often these destructive behaviors are compulsively performed in the face of, and even due to the threat, of these dangers. In other words, the danger itself is what makes the behavior so arousing. I don’t think it’s enough though to simply understand that self-destruction is arousing. That makes it seem like any other kind of fetish or sexual proclivity. Rather, I think the other salient point to understand about this behavior, is that the individual believes that they are worthy of self-destruction. In other words, the individual may be aroused by destruction (or the “death drive” as Freud called it), but for him to continue seeking self-destruction, he must believe that this is what he deserves. So, fundamentally, if we are to try and change this individual’s self-destructive behavior, we must seek to change his relationship to himself.

Destructive behaviors of any kind, whether they are sexual or not, usually if not always involve underlying aggression. And as I’ve discussed in numerous other posts, aggression is fueled by anger and rage. So, destruction of any kind is fueled by anger, which is a simple enough observation. But it becomes an important consideration to keep in mind when understanding destructive […]

By Michael Aaron|September 19th, 2014|Sex Addiction, Sex Therapy, Sexuality and Psychology|3 Comments

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Is Couples Therapy Right For You?

Is Couples Therapy Right For You?

Deciding to see a couple’s therapist is never easy. It can bring up many painful and scary questions. For example, is going to see a therapist an admission that both I and my relationship are failures? What if couples therapy doesn’t work, will that mean the end of my relationship? And what if it does work, will that too push my relationship to the brink? Will I discover things that I am not ready to deal with? These are all normal and typical questions that folks may find themselves dealing with when pondering whether or not they should seek out the services of a couples therapist.

So, let’s talk about what someone can expect in couples therapy, when couples therapy makes sense, and when it can prove to be less than effective.

First, I think that any good couples therapist will help the couple to realize and understand dynamics within the relationship that can be undermining it. A couples therapist can act as a neutral facilitator to help couples overcome disagreements and impasses, embark on life transitions, and make important relationship decisions. Here are some specific instances where couples therapy can do a whole lot of good for a couple:

Resolving ineffective communication strategies
Resolving differences in expectations of and attitudes about the relationship
Resolving discrepancies in sexual desire and/or sexual interests
Deciding whether to make important life decisions, including whether or not to stay in the relationship
Overcoming infidelity and deceit

The common denominator in these situations is that a couple is so lost in the weeds, that they cannot step outside of the conflict or disagreement to see the bigger picture. This is why it can […]

By Michael Aaron|September 8th, 2014|Couples Therapy|0 Comments

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Mindfulness and Sexuality

Mindfulness and Sexuality

One of the most important topics that I address with clients is the subject of mindfulness. To understand the importance of mindfulness, particularly when it comes to sexuality, let’s first take a look at what it is and what it isn’t. Many people confuse mindfulness with some sort of meditation practice, such as Zen or Vipassana. While it is true that meditation builds and fosters mindfulness, one can practice mindfulness without engaging in any of the meditative traditions. So what is mindfulness? It is defined as “the intentional, accepting and non-judgmental focus of one’s attention on the emotions, thoughts and sensations occurring in the present moment.” This can occur within a meditative practice, or just throughout the day, as one observes oneself while at work, sitting on the train, eating, or engaging in interactions with others. The most important aspect of this kind of self-observation is acceptance and non-judgmentalness. I’ll say this once more, because it bears repeating. Acceptance. Non-judgmentalness.

What does this have to do with sexuality? Everything. Often when we find ourselves struggling with some aspect of our sexuality, what is actually going on is that we are fighting ourselves. What I mean is that sexual performance, sexual desire, sexual arousal, and so on, come naturally. We don’t have to think about it. It just happens. But when we are experiencing sexual difficulties, we may be pressing too hard, putting undue pressure and stress on results, tensing our pelvis and surrounding muscles, or just fighting off the natural emotions that arise. In other words, we are going against the current, and not allowing ourselves the experience […]

By Michael Aaron|August 23rd, 2014|Sex Addiction, Sex Therapy, Sexuality and Psychology|2 Comments

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Sexual Inhibition and Guilt

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 […]

By Michael Aaron|July 11th, 2014|Sex Therapy, Sexuality and Psychology|0 Comments

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Narcissism and Sexuality

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 […]

By Michael Aaron|June 2nd, 2014|Sex Therapy, Sexuality and Psychology|6 Comments

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Borderline Personality and Sexuality

Borderline Personality and Sexuality

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, […]

By Michael Aaron|May 23rd, 2014|Sex Therapy, Sexuality and Psychology|6 Comments

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Sexuality and Shame

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 […]

By Michael Aaron|May 16th, 2014|Sex Therapy, Sexuality and Psychology|2 Comments