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Kinky Sex or Paraphilia?

Kinky Sex or Paraphilia?

Kinky Sex or Paraphilia? This was the title of a one-day conference sponsored by the New State Psychological Association which I attended about a week ago. The main presenters were Richard Krueger, a psychiatrist who was on the DSM 5 sexual and gender identity disorders workgroup, and Peggy Kleinplatz, a sex-positive activist psychologist from Canada. Dr. Krueger basically went over the main changes in the DSM 5– gender identity disorder is now gender dysphoria, premature ejaculation now is quantified as a male orgasm occurring 59 seconds or less once sex has begun– and so on. Dr. Kleinplatz gave her objections.

The main topic though was the changes in the DSM 5 regarding paraphlias. Paraphilia is a term created by psychoanalyst Wilhelm Stekel in the 1920s and consists of the latin roots “para”– above or beyond– and “philia”– love. So literally, paraphilia stands for love that is above or beyond the norm. We’re talking about stuff like sadomasochism, transvestism, fetishes. Stuff like that. Kinky stuff. This term was largely unknown for decades until it was popularized by sexologist John Money, who made a career of categorizing various paraphilias. Paraphilias made their official establishment debut in the DSM III in 1980. Even though paraphilias are not the same as fetishes, for all intents and purposes these terms are often used interchangeably.

For years, the psychiatric establishment viewed all of this kinky behavior as pathological. The DSM III basically stated that anyone who was into all this kink was mentally ill. The DSM IV in 1994 softened this stance a bit and stated that kinky sex was a mental illness […]

By Michael Aaron|October 15th, 2013|Sex Therapy, Sexual Minorities, Sexuality and Psychology|2 Comments

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Sexual Selfishness is a Necessary Turn-On

Sexual Selfishness is a Necessary Turn-On

A lot of sexual advice out there urges us to be very mindful of the needs of our lovers, to be empathic, selfless and attuned. If we can only satisfy all of partner’s needs, good sex will take care of itself. It’s all nonsense. Sexuality actually requires a high degree of selfishness and ruthlessness to make it work. This is an issue that confuses many because it so goes against the grain of what we are taught about human relationships.

Yes, making a relationship work requires attunement. It requires selflessness. If we want to make our partner feel special, we may wake up early in the morning before them to make breakfast. To make them feel understood, we will listen with an empathic ear, ask questions, provide comfort. We make them feel valued when we remember important dates and anniversaries. We make sure to compromise in some ways and give in in other areas that are more important to the other person.

All of that needs to disappear in the bedroom.

People who struggle with sexual difficulties often find themselves preoccupied with the needs and thoughts of others. That is wonderful in most relationships. It’s a killer in the bedroom. There is probably nothing less arousing than having a partner who is constantly wondering if they are “doing things right.” There is equally nothing less arousing than a partner who is too afraid of asserting his or her sexual needs for fear of offending or hurting the other person. Sex is not for the timid.

Good sex occurs when both partners are focused on getting their needs met. […]

By Michael Aaron|October 1st, 2013|Couples Therapy, Sex Therapy|0 Comments

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Social Anxiety and Sexual Dysfunction

Social Anxiety and Sexual Dysfunction

When clients complain about sexual anxiety, whether it is the inability to achieve erection or rapid ejaculation, they often find themselves dwelling on everything that could possibly go wrong in a future sexual encounter. That kind of anxiety starts building up much earlier than the actual event itself and can feel crippling and paralyzing in other aspects of daily life. We call this anxiety “performance anxiety” because it reflects the fears of being unable to perform adequately in front of other people.

In this case, “other people” refers to a sexual partner, but performance anxiety rears its ugly head in other areas, ranging from public speaking to interviews. In all of these situations, the person struggling with performance anxiety is preoccupied with the thoughts and judgments of others. “What will these people in the audience think of me if I mess up?” “If I don’t perform well, my interviewer won’t like me, and I won’t get the job.” These are common thoughts that go through someone’s head when they are stressed about an upcoming performance. You see, the most important aspect of the anxiety is the fear of social disapproval. Someone who can practice their speech alone in the privacy of their room can suddenly start shaking uncontrollably in front of an audience. Same speech. The difference is other people.

Sexual anxiety works the same way. Someone may have absolutely no anxiety masturbating alone in a room, but bring in a sexual partner, and all of a sudden Mr. Happy goes to sleep and can’t wake up. This is why so many people who struggle with […]

By Michael Aaron|September 22nd, 2013|Couples Therapy, Sex Therapy, Sexuality and Psychology|0 Comments

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Study: People happier when they have lots of sex

Study: People happier when they have lots of sex

It’s conclusive: sex makes people happy. Or so a recent study finds about the relationship between the amount of people sex have and how happy they are. The findings basically state the following: 1) people are happier when they have sex, and 2) they are even happier, like really over the top happy, if they think they are having more sex than their friends.

Even having sex at least once a week boosted people’s happiness scores (however that was calculated) by 44 percent over those who had not had sex in a while. But if those same people thought that their friends were having sex more than them, their happiness plummeted by 14 percent.

In many ways these findings echo previous research on wealth and happiness. If I recall, a really good book I read a long time ago called Stumbling On Happiness discussed research that found that people who had enough money to cover basic needs were much happier than those who were just struggling to get by. But the amount of happiness associated with wealth faded away the more money the person had beyond basic needs. At that point, the most important factor in happiness was the size of wealth compared with the person’s friends and neighbors. So if the person had the smallest house in the neighborhood, he would be miserable even if he was a millionaire. The best solution was to move into a cheaper neighborhood where that person could then afford the biggest house.

Apparently sex works the same way. Start having sex a few times a week and you’ll suddenly feel […]

By Michael Aaron|September 7th, 2013|Sexuality and Psychology|0 Comments

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Required Reading: The Authoritarians

Required Reading: The Authoritarians

Every once in a while I’ll stumble upon an amazing resource online that makes me want to recommend it to anyone who will listen. With that in mind, probably the best thing I’ve read all year is a free ebook written by psychologist Bob Altemeyer called The Authoritarians. The amazing book discusses political ideology from a psychological perspective. Basically, people who vote Republican or are Evangelical can be described as authoritarians– they crave authority in order to feel safe and secure in the world. It doesn’t matter if the authority is deeply flawed, if it takes the form of a president who sends us to useless and meaningless wars, or in the form of literal readings of a religious text which has so many holes in consistency that it could be swiss cheese. All that matters is that there is an authority ready to tell them what to do.

Based on extensive psychological research, Altemeyer argues that certain people (about half the population) are wired to crave authority above all and everything else. To them, secular relativism is just way too anxiety provoking. It’s just way too difficult for them to get on in the world if there are no absolute laws or morality. The authority doesn’t have to make sense, doesn’t have to have any kind of internal consistency or logic, and definitely doesn’t have to give a crap about the welfare of those “others” (and those who seek authority all know who those others are). Above and beyond all else, the right authority must be very strict, very harsh, and extremely punitive. Seems […]

By Michael Aaron|August 24th, 2013|Sex and Culture, Sexuality and Psychology|0 Comments

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Couples Therapy- The three main reasons behind loss of sexual desire in couples

Couples Therapy- The three main reasons behind loss of sexual desire in couples

As a sex therapist, I often work with long-term, committed couples struggling with a variety of sexual difficulties. The most common issue is the problem of mismatched sexual desires. The partner who wants sex more often usually ends up feeling rejected, wondering whether their partner still finds them sexually attractive or whether their partner is cheating on the sly. If one partner suddenly seems to have lost interest in sex or is pulling away after years of closeness, the real reasons often have very little to do with attraction or infidelity. Sometimes the problem is blamed on porn, especially if the one pulling back is a male who is caught watching porn instead of being physically intimate with his partner. However, increased porn viewing is often the symptom rather than the cause of lack of desire.

Usually, emotional and power dynamics lie at the heart of these situations. One partner uses sex as a way to convey strong emotions that they normally are not comfortable expressing directly. Or they may use it as a weapon to reassert a sense of power and control. By withholding sex, a partner may find a source of leverage that they may otherwise feel they do not possess. Below are the three main causes behind desire discordance in relationships.

1) Anger- Often, individuals never learned healthy expressions of anger in their families of origin. Anger may either have been taboo or only seen when built up to the point of rage. As a result, many people experience anger as dangerous, something that leads to negative consequences, and so must be avoided […]

By Michael Aaron|June 28th, 2013|Couples Therapy|2 Comments

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How does sex therapy work?

How does sex therapy work?

I often get asked both from prospective clients and colleagues in the field how seeing a specialist in sex therapy can assist in resolving sexual difficulties. This is a very important question and cuts right to the heart of the psychotherapeutic process. In order to give a more complete, yet concise answer, it’s important to briefly trace the history of psychotherapeutic practice in general, and sex therapy in particular.

The practice of psychotherapy as we know it can be traced to the late 19th century and Sigmund Freud, the founder of psychoanalysis. Even though Freud had his own influences and some professionals were speaking of concepts related to the unconscious at that time, he was the first to really propose a comprehensive theory of the workings of the unconscious process, identifying such structures as the ego, id and superego. As psychoanalysis developed the focus was on interpretation and insight; however, since Freud was basing his theories on a very limited subset of the population of turn of the century Vienna, the problem was that these techniques proved to be unsuccessful with many clients that he did not account for. In the mid 20th century, Aaron Beck and his cohorts started looking at the role of cognition (thoughts) in human misery and, combining this research with techniques developed by behaviorists, introduced cognitive-behavioral therapy (CBT).

It is at this time, with the pioneering work of Masters and Johnson, that sex therapy as a separate discipline was born. Masters and Johnson saw the act of sex as a purely behavioral process and incorporated behavioral techniques of graduated exposure to sexual arousal. […]

By Michael Aaron|May 10th, 2013|Sex Therapy|0 Comments