Sex Therapist’s Couch

Another Guy Who Isn’t A “Sex Addict”

When they came to me they were getting “sex addiction” treatment. As the spouse of an “addict,” she was in S-Anon, endlessly talking about her trauma and her “co-dependence.” He was going to Sexaholics Anonymous meetings and reading about the 12 Steps.

She wanted me treat his “sex addiction,” and he was willing to do almost anything to end their nightmare of mistrust and chronic conflict.

But in the very first session, I told them that I don’t use the category of “sex addiction.”

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No Orgasm? Lots of Good Reasons

Just about every week I see a new patient who complains that he has trouble having orgasms.

Of course, I ask lots of questions. Does this happen only with a partner, or with masturbation too? What medication is he taking? How much alcohol is generally involved before and during sex? How does his partner usually respond? How does he usually respond?

And if he’s been bothered about this for a while, why is he coming in now?

I want to eliminate medical issues first, so I always ask if he’s seen a physician. Since many of these guys are referred to me by a doc, let’s skip over the possible health issues (such as diabetes, auto-immune diseases, and possession by the devil) and…

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How Much Sex Do People Need?

Old therapy joke:
Q: What’s the difference between defense mechanisms and sex? A: You can go a whole day without sex.

Actually, we can go without sex for a lot longer than that. But you wouldn’t know it from listening to some of my patients. Or their partners.

It generally sounds like this: “So I just need a lot of sex. I can’t help it, that’s just how I am—I need a lot of sex, preferably every day.”

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