Our sex therapy services provide support for sexual, intimate, and erotic health concerns. We view sex and erotic health as a fundamental, beneficial, and critical aspect of human life.
Sex is not just about performance. Though sex therapists readily work with concerns related to desire, arousal, orgasm, and other performance issues, sex therapy embraces a view of sex as part of human nature, a mixture of pleasure and connection.
We provide services for a variety of concerns, including:
Sex addiction/compulsive or impulsive sexual behavior/hypersexuality
KInk/BDSM sexual and relationship health
Relationship and sexual health in polyamorous relationships
Relationship and sexual health in swing and open relationships
Performance concerns such as premature ejaculation/fast orgasm, inability to orgasm, delayed orgasms, arousal (keeping an erection or sustaining arousal)
Concerns related to sexual orientation and gender identity - LGBTQIAP
Support for transition for transgender individuals, partners, and families
Deepening intimacy and connection during sexual and erotic encounters
Deepening pleasure during sexual encounters
Finding sexual health in recovery from substance abuse concerns
Finding sexual health and erotic intimacy with mental or physical health concerns
Exploring, understanding, and finding healthy ways to work with one's erotic map
Recovering from trauma, neglect, or abuse (physical, sexual, emotional)
Impulsive or compulsive masturbation
Developing skills to have satisfying sexual relationships
Assisting couples in talking about sex and improving their sexual lives
Recovering intimacy after an affair
Sex after cancer
Sex for differently able-bodied
Examining values and choices in one's sexual life
Working through avoidance concerns
Challenging "turn-ons" that interfere with life (being attracted to someone or something that interferes with one's relationships)
Increasing sexual empathy for increased pleasure and connection
We welcome all gender and sexual minorities - including lesbian, gay, transgender, genderqueer, asexual, demisexual, pansexual, intersex, polyamorous, BDSM and kink orientations, and others.
Both the American Association of Sex Educators, Counselors, and Therapists and the American Board of Sexology have set rigorous standards for national board certification. Dr. Minten has been certified by both boards, and she has remained a board certified sex therapist since 2006.
Sex therapy utilizes many disciplines to assist with sexual health concerns - medical, anthropological/sociological/cultural, psychological, spiritual, and historical. Thus board certification, which includes coursework and supervision along with continuing education requirements, allows clinicians to assist with sexual and erotic health concerns from a broad base of knowledge and experience. Avoiding typical advice and our culture's deeply ingrained myths and beliefs about sex is critical to health.
What is Sex Therapy?
Comprehensive Treatment for Sexual Health
A Word about Out of Control Sexual Behavior, Hypersexuality or "Sex Addiction"
One would expect that millions of years of evolution produced a very reliable human reproductive system with build-in redundancies, resulting in a robust sex drive, unfailing physiological mechanisms, and simple, consistent patterns of reproductive behavior and responsiveness...
In reality, however, humans exhibit an enormous variety of sexual behaviors and preferences, while population studies reveal a surprisingly high prevalence of sexual problems and dysfunctions. Clearly, human sexuality appears to be characterized by diversity and fragility rather than by evolutionary conformity and sturdiness.
(Verhulst & Reynolds, 2009, p. 320)
It’s no longer enough to grab a bite then go home and do a little shagging. Today, we have to understand why we do this, why our partner does this, how we can do it longer, more artfully, and more frequently, and why we are not doing it in with someone in a higher income bracket. As a result we mostly wind up doing it with ourselves.
We’ve been entered against our will in some sort of sexual Olympics, when all we ever wanted was a three-legged race at the company picnic.
from Women are from Manhattan Men are from Brooklyn
Hypersexuality or "sex addiction" is not actually a clinical diagnosis in the DSM (the U.S.'s clinical diagnostic manual for mental health, emotional health, and addiction concerns). However, it's an idea that has gained popularity. It is also know as sexual compulsivity, sexual impulsivity, and out of control sexual behavior, among other phrases and other ideas.
Research shows the etiology (underlying cause) of concerns related to high sex drive and "out of control" behavior is quite variable. Hypersexuality is actually better seen as a symptom not a syndrome.
Sexual desire, appetite, and behavior - low or high - relate to many disorders. Sex is considered one of five basic fundamental symptoms of mental health concerns. These five fundamental symptoms include: Sleep, Appetite (regarding food), Energy, Mood, and Sex. The acronym SEAMS is used by clinicians when tracking the symptoms. When any one or combination of these five symptoms change, a number of clinical disorders could be at play.
Evaluating each person who expresses concerns with sex addiction or hypersexuality for the potential underlying concern leads to a proper diagnosis and then to individualized and effective treatment. Potential "causes" include:
Depression and other mood concerns (mania, hypomania, dysthymia, and depression episodes)
Anxiety and related concerns (social phobia, social anxiety, post traumatic stress disorder, obsessive compulsive disorder, generalized anxiety disorder, and others)
Alexithymia (inability to identify emotions, a symptom which underlies other clinical disorders)
Personality concerns (low flexibility in personality style, low problem-solving ability, struggles with insight)
Cognitive concerns (trouble processing, problem solving and other concerns related to thinking)
Impulsivity issues (such as ADHD)
Compulsivity concerns (such as obsessive compulsive disorder)
Shame - an unpleasant emotion that can drive unwanted behaviors
Dissociation (disconnecting from oneself and one's experience, often a symptom related to trauma, anxiety, or depression)
Naturally high appetite for sexual activity combined with cultural sanctions that increase shame (this combination can increase one's experience of loss of choice or control, given the intensity of the emotions involved)
Trouble regulating emotions
Trouble regulating emotions related to sexual excitement - what sexologist call the "dual control model" of sexual regulation. This model focuses on excitation and inhibition processes. Often sexual behavior that seems "addictive" is trouble with the inhibition process or the "brakes." (Of note, sexology looks at low desire as a flip side of this process. Low desire is often a concern with the excitation process or the "gas" in the sexual desire system.)
An unidentified, hidden, avoided, undesired, or suppressed unconventional turn-on that drives behavior (being attracted to a different body-type, turn-ons related to risk, danger, or breaking taboos for example).
Existential concerns (facing loss, aging, death, loneliness, taking responsibility for our life choices (especially the mistakes), coming to terms with unsatisfying relationships, resolving boredom, finding new dreams when old dreams may not come to fruition, and more)
Relationship concerns: desire mismatch, unsatisfying partner sex, unhappiness in the relationship
Proper treatment for sexual addiction requires first and foremost proper diagnosis. Treatment then is individualized. Someone who's underlying concern is obsessive compulsive disorder will have a different course of treatment than a person who's underlying concern is major depressive disorder.
Dr. Minten is trained in both mental health, clinical sexology, and addiction treatment. In her treatment process you will receive an assessment to determine underlying concerns. Individual treatment plans, depending on your needs and preferences, may be a mix of interventions such as motivational interviewing, DBT, EMDR, existential, insight-oriented, family/relationship therapy, and interpersonal therapy. When relevant, a referral to a psychiatrist for medication could be adjunct therapy. A strong focus on emotions, which drive behavior, will be a core aspect of treatment. Often additional sexual health concerns co-exist with hypersexuality, and these additional sexual health concerns will be treated as well.