anxiety Archives - Dr Michael Aaron

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Moving Past Sexual Regrets

Moving Past Sexual Regrets

Over the years, I have been interviewed by countless magazines, newspapers, and other media outlets, but the one article that has garnered the most response and feedback by far is an interview I did with Vice in late 2016 on the subject of individuals that have lost their virginity later in life. I have heard from people as far away as Germany and India for whom that article especially resonated. Indeed, the spotlight on communities of individuals who have experienced a crippling lack of sex has recently made headlines with the unfortunate car attack in Toronto by a self-described incel (involuntary celibate).

Going back to the Vice article (which you should definitely check out, it’s excellent), its main thesis is that individuals who missed out on the normal sexual experiences of early adulthood often feel like a tremendous part of their identity or self-esteem is missing, which then propels them to seek to soothe that hole by making up for a prior lack of sexual experiences. In this blog post, I will focus on those individuals who have regrets about missed sexual opportunities, but the same advice will hold true for anyone with any other kind of regrets.

I have often seen individuals who sought out sex workers as a means to catch up on their “numbers” and then opted for a self-diagnosed label of sex addiction when caught by a partner or spouse. Of course, this behavior is not a sign of addiction but rather an attempt to find validation, virility, and self-acceptance through sexual conquests. For this reason, a focus on sex as the main […]

By Michael Aaron|June 22nd, 2018|Sex Addiction, Sex Therapy, Sexuality and Psychology|3 Comments

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Dealing with Anxiety About One’s Sexual Interests

Dealing with Anxiety About One’s Sexual Interests

Despite a very striking shift in our culture over the last several years towards more acceptance of diversity, I hear from many individuals every month that continue to struggle with discomfort around their sexual interests. Often this anxiety stems from fantasies that these folks may find jarring, disturbing, or simply they are trying to make sense of. For previous articles on sexual fantasies, you can click here and here. As readers of this site well know, I always approach these situations from a nonjudgmental, collaborative, and humanistic perspective. While some fantasies or desires can be accounted for by some psychological need, many desires appear to be hard-wired and while we just don’t have enough strong scientific data to definitively assess whether kinks and fetishes are genetic, as I detailed in my book Modern Sexuality, new research appears to support that, in some people they may have an innate basis.

At any rate, etiology, while interesting, often provides little of value in the way of eliminating or suppressing that desire. This is because, regardless of etiology, much of our sexual desires have become hard-wired, either through a genetic component, or through endless repetition, or a mixture of both. Even if the content of the fantasies or desires seems to shift over time, the overarching theme stays omnipresent while the specifics may change. For example, someone who craves an experience of humiliation may imagine being verbally thrashed, but then those fantasies can shift towards elements containing bondage or physical impact. While the content seems to shift, the underlying motivation fueling the fantasy remains the same. (Note: there […]

By Michael Aaron|March 28th, 2018|Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|0 Comments

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OCD and Sexuality

OCD and Sexuality

Sexual addiction/compulsivity is a trendy diagnosis these days and I have written much on this topic here and here . However, some studies have indicated a cormobid diagnosis of OCD for many individuals struggling with compulsive sexual behavior. Indeed one of the most common situations I have seen in my practice, which in my opinion has often been self-diagnosed by clients as sex addiction, could more readily be called homosexual OCD or HOCD, in which case the entire established paradigm is completely wrong. I will go into this in more detail further down in this post, for the moment, the most important point is that OCD type symptoms can create a tremendous amount of sexual distress and are very poorly understood and as a result, diagnosed.

I’m going to assume that everyone reading this has a basic notion of what OCD means, but I think few people understand some of the underlying mechanisms fueling this disturbance. First and foremost, OCD sufferers experience a tremendous amount of fear, which might seem obvious as OCD has been historically categorized as an anxiety disorder (although in the DSM 5, the two are split into adjacent categories). But there’s a big difference between a general feeling of anxiety and a very deep and pointed fear. In the case of OCD, the sufferer fears something very specific, which the symptom itself only touches on superficially. In therapy, the client and therapist work together to dig deeper and figure this out. Often times the fear has less to do with sexuality itself and more to do with the underlying worry of being exposed, […]

By Michael Aaron|August 8th, 2017|Sex Addiction, Sex Therapy, Sexuality and Psychology|0 Comments

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The Intersection Between Personality and Sexuality

The Intersection Between Personality and Sexuality

This article originally appeared on my blog on Psychology Today and discusses ways in which personality traits manifest in sexual tastes, preferences, and behaviors. It’s a bit more scientific than articles I typically publish on this site, which mainly focuses on my clinical work as a therapist; however, I thought a number of my readers would benefit from and enjoy reading it.

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One of the most fascinating aspects of sexuality is in understanding where it comes from. Specifically, from where do differences in sexual orientation and preference arise? Mountains of research have been conducted on orientation, focused on understanding distinctions in brain size and anatomy, prenatal hormone surges, genetic variations, and even disparities in finger length. However, especially when it comes to preference (not orientation), physiology is just one part of the equation. Indeed, as I will argue here, personality is a key missing ingredient in understanding individual sexual proclivities.

Up until recently, not much has been written about sexuality and personality. What has been published has mostly come from a very psychoanalytic perspective, often equating deviations in sexuality (from a vanilla norm) to pathologies in personality. Only in the last few years has research emerged, studying specific sexual interests and corresponding personality traits from a rigorous, empirical framework. Let’s take a look at a few of these research studies and their implications. But before digging in, I think it’s important to take a deeper dive into understanding what personality is and how it is measured.

The most standard way of measuring personality is using a test called the Big Five Inventory (BFI). Decades of research have shown […]

By Michael Aaron|June 19th, 2017|Sex Therapy, Sexual Minorities, Sexuality and Psychology|1 Comment

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Using Crisis as an Opportunity for Growth

Using Crisis as an Opportunity for Growth

As many might know, I write for many online properties such as PsychologyToday.com and Quillette. I usually don’t mix the content of these different venues, as they often have a different focus. For example, on this site, I write about specific clinical issues that may be of interest to my clients; on other sites, I write about broader cultural and sociological issues. However, I thought this piece, which originally appeared in Psychology Today in January would be appreciated by the audience reading this blog, especially as I reference many of the ideas regularly within my practice with my clients. Its original title was “Why Growth Most Often Occurs When We Fall Apart.” I hope you enjoy.

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In many ways, our current society is set up to avoid as much pain as possible. Whether it is new technology, new medical or pharmaceutical advancements, or the self-help industry, everything is set up to make our lives easier, simpler, and more uniquely tailored to our every individual need. Even the names of products such as the iPhone and iPad nod to the symbiotic merger of products and people.

But the question remains, does all of this avoidance of pain and seeking of pleasure really make us any happier or more resilient? Obviously, new technological and medical advancements have helped millions of people rise out of poverty or overcome disease, but overall our social levels of happiness haven’t risen. Indeed, studies have shown that use of social media such as Facebook is correlated with depression and unhappiness. Other studies have shown that there is some increase in levels of happiness when […]

By Michael Aaron|May 8th, 2017|Sex and Culture, Sex Therapy, Sexuality and Psychology|0 Comments

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How I Help Partners Bridge Their Differences

How I Help Partners Bridge Their Differences

Around 50% of my practice is working with couples (or other partnered systems), and I am often faced with the difficulty so many folks struggle with in understanding each other. Especially after our last election, I can’t help but see striking similarities between the ways that folks bunker down and become defensive and antagonistic in their relationship with the current state of affairs in our society post-election. Regardless of where someone stands politically (and in my clinical work, I try to stay out of politics), one thing is clear– if you find two folks who each voted for the two different candidates, you’ll find that they are living in two very different realities.

This is often the case, but on a more micro level, with the couples I see in my practice. Both individuals are so wrapped up in their own subjective reality, that they have no room left for understanding the subjective reality of their partner. As a result, their relationship is filled with frustrations, disappointments, and unnecessary conflicts over who is right or wrong. Instead of working together as allies, these folks are engaging in a battle over realities, sparring to see whose reality will come out on top and victorious. In the end, no one wins. A battle between realities is a zero sum game, in which one individual needs to win while the other loses. However, this only means that everyone loses, since a relationship filled with a ledger of wins and losses is a most unhappy relationship.

Some of the biggest signs of progress (and most rewarding times for me as a therapist) are when I finally start […]

By Michael Aaron|December 18th, 2016|Couples Therapy, Sex Therapy, Sexuality and Psychology|0 Comments

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Cultivating Gratitude as a Means of Healing

Cultivating Gratitude as a Means of Healing

As we enter the holiday season, I experience an unmistakable pattern in my practice that usually becomes most prominent at this time of year when people start taking stock of the year and (on a larger scale) of their entire life. One of the most corrosive thought patterns and emotions that people fall into is remorse and regret about lost opportunities or poor decisions from the past. These feelings may have something to do with sex or not, but the common theme is one of loss, particularly the loss of youth. I mention youth because we are most likely to feel regretful when we feel we don’t have a second chance or do-over, and second chances are abundant in youth. Therefore, remorse and regret are often as much to do with the mourning of youth as it is with the concrete details of missed opportunities.

Everyone has regrets at times, but it becomes problematic when they become obsessive, devolving into unhelpful rumination, bitterness, possibly vindictiveness, and at worst, destructive “acting out” behaviors. In some ways, and counterintuitively, bitterness and disappointment can sometimes feel “addictive” in the sense that they can provide a sense of pleasure and power from being a martyr or victim. Yes, victimhood can be and sometimes is used as currency. (Note, I am not invalidating victimization, but simply stating that dwelling on such can provide secondary benefits for some people). And cultivating anger feels both more defensive and empowering than truly facing sadness and vulnerability.

When faced with such “existential challenges,” I find it helpful to envision the dual control model that I have discussed […]

By Michael Aaron|November 24th, 2016|Sex Therapy, Sexuality and Psychology|0 Comments

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Release of My New Book Modern Sexuality

Release of My New Book Modern Sexuality

It’s taken 3 long years and hours and hours of sometimes exhilarating, sometimes pain-staking work, but my book Modern Sexuality is set to be released on Oct 16. For my loyal blog readers, I’ve set up a number of ways to get this book for free, or at a deep discount, but only for a short period of time. You have a few options.

You have 3 ways of getting a major discount:

With each purchase of “Modern Sexuality” on Amazon (the hardcover edition, which retails for $36), you will get the entire price of the book taken off your purchase of AltSex NYC Conference 2017 tickets! Note: This deal only applies for book purchases made on Saturday October 15 or Sunday October 16. To get the discount, go to http://amzn.to/2cGARqL to buy the book, and forward your receipt or a screenshot of your receipt showing your name, the book title, and the date of purchase to [email protected], and you will receive a $36 discount code that can be applied toward purchase of your ticket. There is no limit on this discount, so you’ll get $36 off each AltSex ticket for each book purchased.
You can attend my Book Release on Tuesday November 15, where I present a 1.5 hr workshop based on “Modern Sexuality.” Everyone in attendance will receive a free signed copy of the book included with the ticket price ($40). So, you get a signed copy, admission to the talk, and CEUs—all for roughly the price of the book itself. We only have 20 tix available and some have already been sold, so purchase them sooner rather than later in order to not get shut out.
If you are not […]

By Michael Aaron|October 14th, 2016|Couples Therapy, Sex Addiction, Sex and Culture, Sex Therapy, Sexual Minorities, Sexuality and Psychology|0 Comments

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Thoughts on Working With Adult Survivors of Childhood Sexual Trauma (CSA)

Thoughts on Working With Adult Survivors of Childhood Sexual Trauma (CSA)

I was recently interviewed by an Australian production company about my work with adult men that have been victims of childhood sexual abuse (CSA). The focus was on the research concerning this subject as well as how I specifically work as a clinician with men who present to me with these difficulties in my therapy office. For those who don’t know, I’ve written the definitive meta-analysis of sexual outcomes of adults who have experienced CSA, and my research won an award for original scholarship and was published in a peer-reviewed academic journal. You can access it here.

Anyway, the interviewer asked me a number of very poignant and powerful questions, and I thought this blog would be a good venue for discussing some of the most salient points that came out of the interview. Even though the interview focused on men, my thoughts in this article are applicable to all individuals. Once the interview is live, I will post it on my media page, so be sure and be on the look out for it and keep checking this site.

The foremost question that the interviewer wanted to know, and that is also on the forefront of a number of my clients’ minds is to what extent does CSA effect adult sexuality? This is a very complex question because it incorporates a number of contextual factors. According to both the research and my clinical experience, people experience trauma very differently and a lot of it depends on a complex mix of environmental and psychological factors. First, not everyone experiences trauma from a childhood abusive event. Indeed the following external criteria are […]

By Michael Aaron|September 22nd, 2016|Sex Therapy, Sexuality and Psychology|0 Comments

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What the Buddha Had to Say About Love (and What That Means for Sexuality)

What the Buddha Had to Say About Love (and What That Means for Sexuality)

In a previous article, I brought up a broad overview of Buddhist psychology and its implications for understanding sexuality. In this article, I want to expand on that a little bit more and talk about some more specific ideas that the Buddha taught. Specifically, I’ll be drilling down to focus on four key concepts (what the Buddha called the “four qualities of love”) which lay at the heart of the Buddha’s teachings, and that also hold specific implications to modern sexuality.

Let’s begin. The first quality is called metta- translated as loving kindness. And by this we mean actions, not just thoughts and feelings. The thought that comes to my mind about acting towards others in a manner of loving kindness, specifically when it comes to sexuality, is the importance of consent. Indeed, as I’ve written about before, what often separates sexual “deviance” from just simply kinky non-normative sexuality is consent, or lack thereof. This is a very trick and thorny issue because consent is often quite complex. Unfortunately, in most relationships, the issue of consent is never adequately addressed or discussed in matters of sex, or otherwise. Great sex, however, requires the trust that comes from a direct discussion of defining what is consensual and what is not. Terrible sex, on the other hand, often involves no discussion, no negotiation, and just either carrying one’s desires in secrecy or acting out on them non-consensually.
Next is karuna- translated as compassion. And not just compassion for others, but also compassion for oneself. As I’ve written about here and here, self-compassion is one of the hardest lessons to learn when it […]

By Michael Aaron|February 10th, 2016|Couples Therapy, Sex Therapy, Sexuality and Psychology|0 Comments