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Who I am and what I think

Robyn Cirillo

I have been a psychotherapist in private practice for over 40 years with a specialty in trauma.  Learning from clients led me to recognize that addiction is so often a by-product of trauma and that sex addiction, in particular, can be a deeply held and insidious secret that often emerges from trauma with a devastating impact on life. 

It is important to differentiate addiction from compulsivity and compulsivity from life style.  There are many people who have very active sex lives with multiple partners. What makes this a life style and not compulsivity or addiction is the lack of shame and negative impact on life.  Shame is an Important point here in that therapy for sex addiction must include a focus on shame reduction. That shame is often compounded by previous trauma where clients so often blame themselves for deeply painful experiences in their lives.  Thus, shame reduction is multi-faceted.

Therapy for sex addiction is often positively complimented by client attendance at 12 step meetings.  It’s not surprising, however, that 12 step meetings don’t speak to everyone.  Group therapy can sometimes be a replacement for 12 step meetings but certainly also helpful in any case.

Recovery is possible from substance addiction, process addiction, including sex addiction, gambling, eating disorder. Hard work, willingness diligence are going to be keys in recovery…and an independent life.

Working with out-of-control sexual behavior and sexual health

Gilbert McCurdy

While we might long for changes in life, making change can be painful and scary. Therapy is a collaborative process, and I will partner with you on this journey. My practice focuses on treating intimacy/relationship problems, out-of-control sexual behavior (OCSB), alcohol/substance abuse, codependency/co-addiction, personality issues, childhood traumas, anxiety/depression and career/workplace concerns. In addition, I have a speciality working with the LGBT community.

I began my career with an MBA working on Wall Street. It was during that time I became interested in the human experience. And, in my training as a therapist learned how it’s possible to expand our ability to live with discomfort while working through problems and heal from traumatic symptoms holding someone back. By helping people work on building resources needed in the present, we can uncover or get reacquainted with our own best selves. Since 1995 I’ve been practicing psychotherapy as a licensed clinical social worker (LCSW) and received my MSW from Columbia University.

I am a Somatic Experiencing Practitioner (SEP), and I’m also trained in all 3 levels of EMDR. Both approaches focus on trauma resolution but can also be effective with many issues people face in life. In addition, I’m certified in Emotionally Focused Couples Therapy (EFT), which is based on attachment theory. And, I’m also a Certified Sex Addiction Therapist (CSAT). The treatment modalities I utilize include individual, couples & group psychotherapy.

I lead a weekly Gay Men’s Psychotherapy group which focuses on members practicing having new experiences relating to one another on a weekly basis in the here and now.

I also run a weekly group for Gay Men in recovery from OCSB or OCSB fused with alcohol and/or drug use. This group offers members an opportunity to practice relating to one another on a weekly basis in the here and now while defining and working towards sexual health in their lives.

Jerry Katz – My Blog

Jerry Katz

As the years go on, I’ve realized that I have become a good deal more ‘myself’ as a therapist – meaning I present more of who I am, though only when appropriate to benefit the particular individual I’m working with.  So I might talk about something that happened in my own past if it relates to what the client is discussing; I will generally answer questions about my own life; and generally I much more prize and focus on the actual relationship between me and my client. This has gone along with my own growth, as a person and as a therapist, in which I’ve realized clearly that what matters in the therapy is what works with the given person I’m with, and what is far less important is my trying to follow a given theoretical paradigm that I was taught years ago .

Hot Sex/Warm Relationships: Discover Your Unique Balance

Brian Lathrop

The medical model of ‘pathologized’ sexual feelings and behavior is rife with judgmental attitudes and self-hatred that can often keep someone far from coming into a fulfilling sense of sexuality.

Working within a psychodynamic model focused on the renewal of the human ‘spirit’, I have spent the last 25 years of my life working with people who deep down have not accepted themselves or their impulses and who are caught in behavioral loops of impulsivity and self-disgust. My working approach is an analytically based behavioral approach focused on learning to tell one’s self the truth and truly becoming conscious of the repercussions of one’s actions. I am a firm believer in the power of group therapy as a format for learning how to relate to others as a fully sexual human being and offer this within the scope of my practice as well.

Sexual behaviors, beliefs and feelings can ‘feel’ fixed and self defining…….but they can change and they can grow ! This is the shocking truth many clients have come to reflect back to me with their hard work. Sex is more then you believe or you currently know….it’s life’s real adventure !

Who I am

Juliane Maxwald-Schrey

My approach to treating OCSB (out of control sexual behavior) or “sex addiction” is through an integration of psychoanalysis and addiction treatment. Addiction treatment helps to develop strategies to address and manage problematic sexual behavior. Psychoanalysis offers an opportunity to explore thoughts and feelings as they relate to present day stressors, as well as look back to childhood family relationships and experiences to better understand any underlying patterns or connections.

I treat a variety of difficulties, including anxiety, depression, addiction, relationship problems, traumatic experiences and more.

One area of specialization is addiction – this include problems with alcohol and other substances, as well as sex addictions, gambling and other compulsive behaviors.

I also specialize in relationship problems, both for individuals and couples. This can include chronic fighting, problems with communication, issues around commitment, intimacy, infidelity and a wide variety of sexual concerns and problems.

I work with both heterosexual couples and the LGBTQ community. I’m also comfortable working with non-traditional relationships, including consensual non-monogamy, polyamory, as well as individuals and couples active in the kink community.

I provide individual psychotherapy, addiction treatment, couples and marriage counseling, family therapy and sex therapy.

I believe that each person’s therapy is a unique process and is best implemented through an individualized approach. My goal is to establish an accepting and comfortable space for you to talk about and explore your concerns. We will work toward developing strategies to help you cope and better manage your symptoms, as well as focus on underlying issues to help resolve deeper problems.

How I Understand Out of Control Behaviors

Michael Crocker

Crocker

According to affect and attachment theorists, psychotherapy is essentially teaching self-observation while keeping self-loathing at bay and instead, helping the client to develop a liberated sense of free floating awareness and consciousness. In many ways psychotherapeutic work is to help our clients to trust their minds by fine-tuning the connection between affect, feelings, moods, thoughts, bodily responses and behaviors. When feelings are experienced in the body without a conscious awareness and labeling of the feeling, individuals will turn to bodily means to address the unknown feeling. This is when behaviors can get out of control.

As a certified individual and group psychotherapist I work with individuals who struggle with behaviors that they feel have gotten out of control. These behaviors can include sex, eating, substance use as well as gambling and other money-related difficulties. I believe that behaviors that feel out of control are related to feelings that are often unidentified and then turned into actions, often outside of our awareness. I believe that the affect of shame is highly related to many out of control behaviors. Shame can be conscious and/or unconscious. I help my clients to develop an awareness of their shame, as well as other feelings, in order for them to use the feeling states in the service of directing their actions consciously and purposefully.

Many feeling states that are turned into action are blends of feelings such as shame mixed with fear and/or anger. I help my clients to understand the complexity of these emotional states. I purposely collaborate with my clients to study their behaviors and decode what underlies these actions. In doing so, we are able to create the opportunity for choice and volition. This in turn enhances self-esteem and allows my clients to find for the first time or, in some cases, re-find, their connection to creativity, play and relational connectivity.

Do you have a “sex addiction”? Let’s talk about it.

Andrew Erdman

Sexual behavior is deeply rooted in the human experience. Few other forces in our lives are so closely tied to our biology, our emotions, our needs, our thoughts, and our learning history. Thus, it is not surprising that when something goes wrong in this area it can feel as if our whole world is out of control. People may find themselves engaging in abundant use of commercial sex (prostitutes, massage parlors, strip clubs, etc.), having numerous affairs or sexual liaisons, viewing pornography and/or masturbating in an excessive way, or some combination thereof. Very often, men and women find themselves lying to cover up various of these activities, or wishing they could stop or cut down but having little idea how that might happen. Sometimes, people are involved in patterns of sexual behavior that others find hurtful or problematic: They may be told, “You have an addiction,” or “That’s not normal—normal people don’t do that,” and so on. Typically, assertions such as these only add to the deep well of shame in which many find themselves. After all, what is “normal”? And what is a “problem” if a person believes what they are doing is not harmful? (Also, as of the end of 2018, “sexual addiction” was not a diagnosis officially recognized by the American Psychiatric Association.)

In the last 35 years, a great deal of thinking has gone into the assessment and treatment of compulsive and out-of-control sexual behaviors. There are various treatment models which conceive of these behaviors as addictions and thus apply a recovery/sobriety approach. Other modalities seek to discover what purpose a behavior may be serving for a person—psychologically, emotionally, etc.—so that an individual can begin to understand her or his patterns and thus let go of those patterns if they choose. There is no single approach that has been determined to be of greater efficacy than any other; what seems to be most helpful in my experience is a good and trusting fit between patient and therapist—a therapist who wants to, and sincerely believes he or she can, help because he or she has done so before.

Although I have worked with many clients struggling with sexual behaviors that are troubling them, including those who seem to have one relationship after another with “toxic” partners and those on the opposite end of the spectrum who yearn for sexual and emotional intimacy but feel paralyzed as to how to find it, I don’t believe that there is one “right” recipe for all. We are all human, with our thoughts, feelings, needs, and biological drives. I consider my job to be that of a compassionate and curious tour guide who helps a person get to know her or his mind at conscious and unconscious levels. My hope is that my office is a place where people feel safe and willing to understand themselves; to see why and how they have arrived where they are; and to begin to know a more authentic and liberated way of living that comes from within with the assistance of a beneficial client/therapist relationship.

Working with addictions and compulsions

Carol A. Butler

It is challenging to modify compulsive or addictive behavior on your own or even with the help of a therapist or a program, and it may be useful to think about the differences between compulsive and addictive behavior in order to work towards change.  

People who engage in compulsive behavior usually recognize it as absurd and irrational, and they feel bad about it before, during, and after engaging in the behavior. Examples of compulsive behavior are feeling you must repeatedly check to see if you locked the door or turned off the stove or wash your hands, or identifying as a “neat freak”.  They are aware they are out of control in this aspect of their life.

Active addictive behavior, in contrast, usually occurs in an altered, less-than-rational state (sometimes described as a trance state or a delusional state), where a person feels they aren’t out of control, they can handle it, won’t overdo it, are just trying to get relief or escape discomfort. Once the addictive behavior is triggered the person is on a slippery slope, and turning back is unlikely without the tools of recovery. After a binge there may be feelings of remorse, shame, guilt, and anxiety, but those feelings fade when the person is triggered again.

Recovery from addiction begins with learning to recognize your triggers and having ways to help yourself avoid that slippery slope.  Compulsive behavior can be modified but addictive behavior usually needs to stop. Harm reduction programs try to modify addictive behavior but in my experience they are usually not effective after the initial excitement about the notion of being able to keep your addition but not letting it get out of control.  

There is a reason the 12-step programs’ focus on sobriety and community has proved to be effective for many people.  My goal is to be part of the community around the addict who is trying to live a healthy life.

My job as a therapist

I am always learning from people who come to me for help.  I feel my job as a therapist has two components. I want to help people analyze and understand the reasons they feel and act the way they do, but I also want to work with them to change behaviors that they cannot modify by insight alone. Patients sometimes remark that I am “practical”, and I feel OK about that; I understand they aren’t expecting it from a psychodynamic therapist.  

I realized early on that my psychoanalytic psychotherapy training had not addressed sexual issues other than the Oedipal complex, and I felt frustrated and unprepared when patients expected me to help them overcome their inability to have an orgasm or to sustain an erection. When I heard about the groundbreaking work Masters and Johnson were doing in understanding and treating people with erectile and orgasmic dysfunctions I arranged to join them in St. Louis for advanced training. Similarly, I realized I didn’t know how to help people overcome addictions, and that led to advanced training and work in rehabs, teaching, and clinical supervision with a focus on sex addiction and survivors of sexual abuse.  

I am committed to helping people make changes and learn to feel good about themselves so they can enjoy life and make every effort to attain their goals.

Addiction

Josh Wolf-Powers

I find it helpful to think of addiction as a symptom, not just a problem. The problems that cause addiction are what I seek to treat.

I find it helpful to think of addictive behavior as compulsive, behavior in which we engage to relieve intolerable discomfort.

If you are engaged in compulsive, out-of-control, addictive behavior, I am eager to understand not just how you act out, but why – what it is in the moment that triggers the irresistible impulse, and what it is in your past that left you unable to tolerate your feelings without acting out.

Together, we will work to understand not just why you can’t stop, but also, what it is that you get out of your addiction.

No one wants to be an addict. Our challenge, together, is to understand your addiction as a coping strategy, and to develop alternative, less destructive coping strategies.