Sexual Health & Intimacy Therapy

Sexual concerns tend to live at the intersection of everything else: the body, the nervous system, relationships, identity, health, past experiences, expectations, shame, pleasure, connection, and the meanings we were taught about sex. That's why this work is bigger than diagnosing a problem and issuing a fix. It's understanding what sexuality means to you, what it has carried, and what you actually want it to feel like.

There's no single definition of a healthy sex life here. I won't assume that everyone wants sex, wants more sex, is partnered, is monogamous, or shares the same goals. And I won't assume that your body or your desire is broken because it looks different from someone else's.

For some people, the concern is behavior: pornography, masturbation, fantasy, or other sexual patterns that feel difficult to control, are being used repeatedly to regulate distress or escape, conflict with personal values or relationships, create secrecy, or continue despite unwanted consequences. This is a real area of my clinical focus, and it has its own space here.

The question isn't simply “How often?” Frequency alone doesn't tell us whether a sexual behavior is healthy, compulsive, or harmful. I want to know what the behavior is doing in your life.

• Are you doing it when you don't want to?
• Are you losing hours to it, or hiding and lying about it?
• Are relationships, sleep, work, or hobbies shrinking around it?
• Do you feel unable to stop, even after deciding you want to?
• Are you crossing agreements or boundaries in your relationship?
• Is the behavior becoming your primary way of managing distress?

I also want to know what is not happening. Someone can feel intense guilt about consensual sexual behavior because of personal, cultural, or religious values without actually having a compulsive behavior problem. Pornography and masturbation are not inherently unhealthy, and distress alone isn't a diagnosis.

Distress matters. So does understanding where the distress is coming from.

What happens before the behavior? What does it give you for a moment? What does it cost you afterward? And what happens when you try not to do it? Treatment may include work with compulsive behavior patterns, shame, attachment, emotional regulation, trauma when genuinely relevant, obsessive doubt when OCD is present, relationship repair, and the ways sexuality has become connected to coping or escape.

Depending on the clinical picture, I may draw from I-CBT, ERP when OCD is present, EMDR, ART, Brainspotting, Deep Brain Reorienting, IFS-informed/Ego States work, attachment-focused, somatic, and relational approaches.

The treatment follows the problem, not the label.

When a relationship has been hurt, you can take responsibility, become more honest, and learn to relate differently. That doesn't guarantee another person will forgive you or stay. Repair means creating enough safety that secure connection becomes possible where it's wanted, and sometimes the most honest outcome is accepting that the other person gets to decide what they need, too.

And stopping harmful behavior is only half the work. The other half is building something in its place:

• recognizing urges and patterns earlier, with more options when distress shows up
• becoming more honest with yourself and others, and reducing secrecy
• developing sexuality that is more intentional and aligned with your values
• tolerating difficult emotions without immediately escaping into sexual behavior
• building relationships with more honesty, consent, and mutuality

Change isn't proved by how ashamed you feel. It's reflected in what you do differently.

A consultation is where we begin to understand the concern and decide together whether an intensive or another pathway makes sense for you.

Therapy intensives are the signature offering here, giving us more uninterrupted time to understand what is happening and work with it carefully.

The format follows the work. If an intensive isn’t the right recommendation, I’ll tell you that and help you think about what might, including referral options when possible.

If your concerns are closely tied to pregnancy, postpartum, or reproductive loss, or to military or first responder experiences and transitions, more context lives on the perinatal and postpartum and veterans and first responders specialty pages.