Sex Therapist’s Couch

Erections, Car Wrecks, and “Manliness”

Every week, I deal with men terribly anxious about losing or strengthening their “manliness.” A lot of women are concerned about their mate’s “manliness,” too. They all measure it by referring to an erection—a small bit of flesh which comes and goes as it pleases. I think it’s rather pointless for people to be measuring their own or others’ manliness–especially if measure it by something that’s outside the man’s control.

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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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