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What Role Does Sociology Play in Psychotherapy?

What Role Does Sociology Play in Psychotherapy?

As a sexologist, my approach to my work is multi-disciplinary. In other words, I cull from numerous fields, including psychology, human reproductive biology, anthropology, as well as sociology to inform my world view and the way I approach my clients. These days, as part of my writing and research activities, I find myself drawn much more to the sociological side of things, rather than the psychological. There are various reasons for this that I think are important to clarify, not only because it may help prospective or existing clients to better understand how I think, but also to contrast what in essence are very different ways of viewing and understanding human behavior. And when it comes down to it, my overarching point in this article is that any psychotherapist’s training is inadequate without a thorough grounding in sociological theories and principles.

Let’s begin. Sociology is the study of social behavior. Psychology is the study of the individual mind and resulting individual behavior. There is some overlap, for example with social psychology. But the main difference being that sociology focuses on the external forces within society that influence behavior, while psychology’s intent is to keep its focus within the individual. So, sociologists might take a look at how group dynamics shape human interactions, while social psychologists would be more interested in understanding how the individual relates to and processes these groups. This is just a brief and superficial explanation, and I’m sure some PhD student somewhere will want to argue some of the finer points stated here, but my purpose here is just to provide a rough outline of how […]

By Michael Aaron|April 23rd, 2015|Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|0 Comments

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An End to Conversion Therapy?

An End to Conversion Therapy?

President Obama made news this week when he made a statement, posted on the whitehouse.gov website, calling for the end of conversion therapies aimed at gay and trans* youth. Numerous news sites reported that, in making the statement, he had been moved by the December suicide of a 17-year old trans* youth named Leelah Alcorn, who had been subjected to conversion efforts by religious therapists. A petition to ban conversion therapy, begun in her honor, has already received over 120,000 signatures.

Those are some of the bare facts, but as is usually the case, by the time someone high up like the president gets around to an issue, it’s already been building steam for a while. States such as California and New Jersey, as well as Washington DC have already banned conversion therapy aimed at youth, and I believe this is just the beginning of further state legislation. In making these decisions, the courts have pointed to the complete lack of empirical, scientific evidence for the efficacy of these so-called therapies as well as the catastrophic potential harm that they can cause.

In my mind, therapies such as conversion therapy and it’s close cousin, reparative therapy are nothing more than formalized ways of exploiting shame, under the cloak of professionalism and authority. They reach out to potential clients (victims?) by appealing to their pain points of shame that is based around their sexuality and then proceed to intensify the shame by trying to eradicate the sexual thoughts, fantasies or behaviors. So what you have here is an individual who is already scarred by shame, and then retraumatized over and […]

By Michael Aaron|April 9th, 2015|Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|0 Comments

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Generalized Anxiety and Sexuality

Generalized Anxiety and Sexuality

One of the most common issues I see in my practice is the negative effect of anxiety on sexual performance and satisfaction. I’ve written about performance anxiety before, particularly in the context of social anxiety, but in this particular post I want to focus more on a different kind of anxiety– generalized anxiety. The first thing to understand about anxiety is that it comes in many different forms and flavors. Social anxiety, panic disorders, hypochondria, and obsessive-compulsive disorder (OCD) are all classified as different types of anxieties. The most common anxiety, as it relates to sexual functioning is generalized anxiety.

Now, based on the name alone, most people probably don’t place enough importance to an anxiety that is considered to be generalized in nature. After all, everyone has experienced some sort of “generalized anxiety” before, right? I mean, the commute to work, the looming deadlines, the financial obligations can all make someone feel very, very anxious. So, it’s not really a big psychological problem, right? Not true at all.

At the core, folks with generalized anxiety experience a prevailing, sometimes even debilitating worry that something really bad is going to go wrong, that things are about to fall apart any moment. Often they feel that the anxiety alone is what keeps things glued together. If they stopped worrying, all hell would break loose. Often times this worrying is focused on things that, if they did fall apart, then all hell would indeed literally break loose. These things include pivotal life arenas such as finances, health, and relationships.

The main reason that sexuality often becomes the focus of generalized anxiety is […]

By Michael Aaron|March 20th, 2015|Couples Therapy, Sex Therapy, Sexuality and Psychology|0 Comments

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BDSM or Abuse?

BDSM or Abuse?

Recently a new article by sex columnist Dan Savage trigged a lot of discussion and debate online, and I thought that the subject matter was important enough to also add another piece of commentary to the already crowded field. Basically, Savage answers a concerned mother whose 15 yr old son has been “watching sadistic porn- and ONLY sadistic porn- for a couple of years” and that “he thinks about this porn all the time-all day, every day- and fantasizes about doing sadistic things to the girls he dates.”

Savage then checks in with a bunch of experts including Canadian sex researcher Dr. James Cantor, who suggests that the woman’s son is a budding kinkster and any concerns that he could be the next Ted Bundy should be put to rest. Some other folks add their opinion, including a professional dominatrix who brings up the importance of “ethical sadism.”

I’ll leave the description of the column at that for the moment, and merely suggest that anyone who is interested in reading more go directly to the column here: http://www.thestranger.com/seattle/SavageLove?oid=21679058 . I think it’s well worth the read.

So what should we make of this mother’s concerns about her son’s use of violent porn? First, let me get some basics out of the way. As I’ve written in this blog before, there is absolutely no evidence that violent porn leads to acts of sexual violence. In fact, in the aggregate those countries that have legalized porn use have experienced an inversely correlated drop in sex crimes. Second, fantasies involving themes of seemingly sexual violence are not uncommon as I’ve written about here and here. […]

By Michael Aaron|February 23rd, 2015|Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|1 Comment

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What is Harm Reduction?

What is Harm Reduction?

Last post I discussed some ideas around self exploration and peak experiences that strongly resonate with me. In this post, I’m going to address another issue which is just as equally important to me– harm reduction. What is harm reduction and what application does it have for sexuality in general and sex therapy in particular?
First, let me say that my introduction to the field of sex therapy was in harm reduction, so all of my work is firmly rooted through this lens. Initially I volunteered and then worked in several harm reduction facilities in the city conducting outreach to homeless intravenous (IV) drug users, street prostitutes, and transgendered individuals. For example, I would go into Tomkins Square Park in the village and trade clean needles for old, dirty ones. I always wore an ID badge to make sure I wasn’t arrested. I would go into known prostitution areas and hand out fresh condoms to mitigate the chances of them contacting STDs. If they were ready for help, I’d bring them back to the facility and connect them with a benefits counselor who would assist them with getting sober and finding housing and any other necessities they needed.
According to psychologist Andrew Tatarsky at the Center for Optimal Living, harm reduction is “a philosophy and set of interventions that seek to reduce harmful consequences of substance use and other risky behaviors without requiring abstinence.” Without requiring abstinence? What is that about? I think an important point here, and one that many harm reduction theorists and practitioners would argue, is that abstinence doesn’t work for everyone. Or […]

By Michael Aaron|February 9th, 2015|Sex Addiction, Sex and Culture, Sex Therapy, Sexuality and Psychology|0 Comments

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More on Working with Fetishes: Important Considerations

More on Working with Fetishes: Important Considerations

My earlier post about whether it is possible to eradicate fetishes appears to have struck a nerve, as I have heard from folks all over the world with their comments, questions, and requests for further information. I want to thank everyone for writing in– everyone’s communications have been very thoughtful and respectful, and it is really heartening to be able to reach so many in constructive dialogue.

As I read over the article however, I realize that, while pointing out what I believe to be inappropriate and unethical treatment, I do not go into any detail about what I do believe to be appropriate treatment protocols when someone is seeking help with a fetish. So, to address that gap, I’m going to go into some treatment protocols here in this particular post. It’s a lengthy and very broad topic, so I think this may very well turn into a series of postings, but I’ll see how it goes. For this article though, I’m just going to focus on initial steps (edit: as you’ll see, I found that laying down some groundwork of important initial considerations took up a lot of writing, so in this post, I am focusing on the groundwork, and I’ll talk about specific interventions in subsequent posts).

First, in the interest of disclosure, let me put it out there that I hold a sex-positive perspective. For more on what this means, you can take a look at my article about sex positivity here. Basically, I start out with the assumption that sexual behavior is neither inherently negative nor pathological unless shown to be otherwise. In other words, the meaning […]

By Michael Aaron|January 8th, 2015|Couples Therapy, Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|0 Comments

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Is it Possible to Eradicate a Fetish?

Is it Possible to Eradicate a Fetish?

In a recent post, I wrote about how the field of sexology is uneven in its application and rife with regional and individual biases, largely due to general sex phobia and a subsequent lack of empirical research within the field. Recently, a debate on the mailing list of one of the sexological organizations to which I belong touched again upon discrepancies within the field. The discussion in question concerned whether or not it is possible to eradicate a fetish. Most respondents were in agreement that, like a sexual orientation, eradicating a sexual fetish is not only not possible, but particularly in fetishes that cause no harm, even unethical.

One clinician, however, stated not only that eradicating a fetish is possible, but then went on to describe exactly how (he/she believes) it is done. The methodology described was so disturbing, however, that I felt it necessary to challenge the ideas presented and to present both his/her perspective as well as my response here on my blog as a cautionary tale to individuals who may have questions regarding their own sexuality so that the know what to avoid in therapy. I have eliminated any details that could reveal the identify of the other clinician.

Below is what the clinician wrote in support of fetish eradication. I am highlighting and italicizing the most objectionable aspects:
I don’t see a fetish as similar to sexual orientation – it is something that does reflect “something wrong”, and in my own experience, DOES respond to therapy! One issue is that sexual fetishes – paraphilias – typically involve sexual activity with something that does not provide the […]

By Michael Aaron|December 8th, 2014|Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|2 Comments

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Another Word on Loss of Sexual Desire

Another Word on Loss of Sexual Desire

Recently, I was interviewed in a Huffington Post article about the most common sexual issues that sex therapists see in their office. To see more on this article, you can click here. Anyway, since the interview response that they posted was a bit abridged, I wanted to spend a little more time exploring this difficulty since it is so prevalent.

When I work with individuals struggling with low libido, I first want to understand the context in which they are having this experience. For example, I would want to know answers to the following questions. What is the relationship status of the person– are they single, dating, in a committed relationship? If in a committed relationship, for how long? When did this problem begin? I would also want to rule out medical issues, so I will refer the individual to a physician for blood work to determine levels of testosterone and other hormones. Sometimes testosterone is a major player, but more often not. In my experience, with individuals low libido tends to be more emotional, rather than physical in nature, while with couples it is more often than not it stems from relational problems. For more info on the relational aspects of low libido difficulties within couples, you can check out my article “Three Main Reasons Behind Loss of Sexual Desire in Couples”, which was picked up and syndicated by numerous other websites.

As I indicated in my response to the HuffPost journalist, relational issues include stuff like resentment (which is basically a euphemism for anger) and lack of trust, along with other elements I didn’t mention such as inequitable power […]

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

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New Documentary about Mind/Body Connection

New Documentary about Mind/Body Connection

I don’t often endorse projects that come to my attention, but I feel so strongly about the subject matter of this upcoming documentary film, that I felt a strong desire to share it on my site with my readers. The film, All the Rage sheds light on one of the pioneers of mind/body medicine, Dr. John Sarno. Dr. Sarno, who worked for many years in the rehabilitation center of NYU Medical Hospital treating individuals who had various structural and back injuries due to vehicular collisions, slips and falls, and various other accidents. At some point, he started noticing very interesting phenomena– some people who injured their back would get well rather quickly, while others never moved on past their back pain. In addition the severity of the pain had no correlation to the severity of the injury. And finally, there was absolutely no connection whatsoever between back pain and structural abnormalities discovered through x-ray imaging and MRIs. In other words, individuals with severe back pain would have nothing show up on an x-ray, while those with no pain at all would show multiple ruptured disks, and so on.

Dr. Sarno began to realize that most, if not all, of the chronic back pain that he was treating was not caused by structural abnormalities, but by other factors. Specifically, he noted that most of the chronic pain sufferers he treated shared many similar psychological commonalities. For example, they were more likely to be Type-A people, you know the type who are very perfectionistic and successful, but also very hard on themselves. He started realizing that perhaps the […]

By Michael Aaron|November 18th, 2014|Sex Therapy, Sexuality and Psychology|0 Comments

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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