When Sex Gets Complicated: Porn, Affairs, Kink, & Cybersex

The number of patients involved in pornography, non-monogamy, sadomasochism, and sex toys has dramatically increased. Are we prepared to provide them quality therapy?

Every therapist deals with sexual issues-­loss of desire, lack of orgasm, unreliable erections. And, of course, shame, anxiety, and confusion often accompany common sexual issues. But some sexual issues are more difficult than others. They challenge our clinical beliefs or personal values. Perhaps they highlight our lack of knowledge or vocabulary.

As society becomes more psychologically sophisticated, the sexual problems people bring to us are more complicated. Where is our increasing sophistication about sexuality coming from? If our information about alternative sexualities is limited primarily to the mass media and personal experience (or inexperience), we will be unprepared to deal with many clinical situations.

This seminar will explore:

  • Common alternative sexualities patients may wish to discuss
  • How alternative sexualities are similar to traditional sexual expression–and how they differ
  • Common vocabulary patients use in discussing alternative sexualities
  • Learning about alternative sexualities from patients
  • What is most pornography actually like?
  • What we know about the impact of pornography use on relationships
  • How porn consumers describe their experience­-and why clinicians describe it so differently
  • When is infidelity about sex, and when is it about other things?
  • What if couples don’t agree on whether or not there has been infidelity?
  • Is there such a thing as “emotional infidelity?” “Cyber-infidelity?”
  • When should we focus on the sex, and when on something else?
  • Evaluating patients’ sexual practices; where do we draw the lines? How? Why?
  • How do we distinguish clinical judgment from personal queasiness?
  • When to refer these cases out

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