June 2014 - Dr Michael Aaron

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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. […]

By Michael Aaron|June 22nd, 2014|Sex Addiction, Sexuality and Psychology|0 Comments

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Marat/Sade: Some Thoughts on Social Change and Sexuality

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. […]

By Michael Aaron|June 16th, 2014|Sex and Culture, Sexuality and Psychology|0 Comments

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Boundaries: The Most Important Part of a Relationship

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 […]

By Michael Aaron|June 9th, 2014|Couples Therapy|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